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Achilles Tendon Rupture

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 EarlyBird 22 Nov 2016
Anyone got any experience of returning to climbing after an Achilles Tendon rupture?
In reply to EarlyBird:

No, but had a friend who did his playing football. Six months in plaster then 2 weeks afterwards he did it again running up some stairs and had another 6 months in plaster. So, take it easy whatever you do and perhaps avoid anything dynamic or powerful moves off that leg.
OP EarlyBird 22 Nov 2016
In reply to Hugh J:

Thanks. The Consultant hasn't been quite so gloomy regarding timescales for immobilising the leg (I'm in a boot rather than plaster), or the chances of re-rupturing the tendon. I should be able to return to some form of perambulatory activity in a few weeks, and with a bit more intensity from about three to four months. However, he's said no climbing for a year (a year!).
 keith hal 22 Nov 2016
In reply to EarlyBird:

Hi mate

I did mine in a fall last August( broke my ankle at the same time) Totally detached tendon so I had to have surgery. 12 weeks on crutches and boot. Walking by nov ,back at wall in late December early Jan mucking about on 4+/5s etc. Got a couple of easy winter routes done in March plus more indoor stuff. Physio discharged me on April 21st saying to do as much stuff as I could running/climbing / walking etc....so I did!

Hope this helps and best wishes for your recovery.

Keith
OP EarlyBird 22 Nov 2016
In reply to keith hal:

Thanks for the response, Keith. Was that August 2015? It's encouraging that you were able to return to climbing within six months. Perhaps my Consultant is being cautious.

Alan
 Dr.S at work 22 Nov 2016
In reply to EarlyBird:

Did mine playing thugby, there are a number of options depending on the nature of the tear including non-surgical management.

I think a year before returning to climbing is very pessimistic, key for me was physio - I got given exercises to do from a physio in the recovery ward just after my GA (just range of motion stuff) and then started weekly physio sessions within a week or so of surgery. It appeared that there was not a lot of evidence around time to return to function and the physio I saw was keen to see how quickly they could get me back to my desired level of functionality.

Obviously physio wise you need to put the effort in!

good luck!
OP EarlyBird 22 Nov 2016
In reply to Dr.S at work:

Thanks. I have a partial tear and will not be having surgery. I think physio wise getting back to climbing sooner rather than later will provide the motivation to put the effort in

Alan
 keith hal 22 Nov 2016
In reply to EarlyBird:

Hi Alan
Yes it was 2015. I think NHS are v cautious regarding re ruptures but my physio( a v good private sports physio) told me most occur within first 8 weeks of op....I think if you have a tear and it is healing without surgery it may take a bit longer to get back ...extra month or so but everyone has a slightly different experience.

 keith hal 22 Nov 2016
In reply to EarlyBird:

Def agree that getting a good physio is vital. The first NHS pysio I saw( after about six weeks!) was really pessimistic and not particularly helpful at all...if you can afford it get a good sports physio.
Best of luck.










OP EarlyBird 22 Nov 2016
In reply to keith hal:

Cheers, Keith. I'm sure I can find a climbing sympathetic physio in the High Peak.
 Mark Kemball 22 Nov 2016
In reply to EarlyBird:

A partial rupture, I guess it depends on just how bad it is, and how well you stick to your physio exercises, but, checking my logbook, I ruptured mine on 1st October 2014 (climbing fall), my first route back on rock was 29th December, so that's 3 months. The whole ankle still doesn't feel quite right and I doubt it ever will... However, looking at your profile pic, I suspect I'm quite a bit older than you, so, theoretically, you should heal more quickly.

Good luck with the recovery.
OP EarlyBird 23 Nov 2016
In reply to Mark Kemball:

Cheers, Mark. I'm older than I look!
 Ray Sharples 24 Nov 2016
In reply to EarlyBird:

Similar to the above. I had a partial rupture (football), no surgery but quite a lot of physio. Its a few years ago now, but I think I was back on the wall in 3-4 months, although it was probably a year before it fully recovered. I did find I needed to go up 1/2 a size in Anasazis after that (on one foot anyway), although I have gone back down again and can't really tell it happened now. Best tip would be not to rush it; I had a few backward steps early on in the recovery process. Good luck!
 Dr.S at work 24 Nov 2016
In reply to keith hal:

All my physio was via the NHS, and was really good - so do see what you are offered, no doubt it varies a lot regionally.
OP EarlyBird 24 Nov 2016
In reply to Ray Sharples:

Thanks, Ray. I'll be careful not to rush it - although I 'd like to think I can get back on the rock before the beginning of next winter. What kind of backward steps did you experience?
OP EarlyBird 24 Nov 2016
In reply to Dr.S at work:

I'll save my pennies until I've sampled NHS physio - although a friend of mine locally had a poor experience with the NHS following an ankle injury.
 Ray Sharples 25 Nov 2016
In reply to EarlyBird:
Just overdoing it a bit and realising that I had gone back a week or two in how sore it felt on the wall. Progression was generally positive though! I went to a private physio (who also used to climb).
Post edited at 20:37
 Timmd 26 Nov 2016
In reply to EarlyBird:
I'm finding myself thinking that a lot of a hill walking mightn't be a bad idea?
Post edited at 01:00
 webbo 26 Nov 2016
In reply to EarlyBird:
I ruptured mine on January 16th this year bouldering. The NHS wanted to treat in conservatively I.e. Put it in a cast and leave, however the research suggests if you are active a repair has a better outcome in avoiding re rupturing. So via my missus' health insurance I got to see a Consultant privately and had the operation on January 27th. I was in an airboot and non weight bearing for about 2 weeks the allowed to gradually put weight on my leg. Boot came off on March 8th, started physio on the 15th. I was going 3 or 4 times a week following an established protocol for Achilles rehab, which started with massage, stretching, theraband and cycling on the static bike. I got the OK to use my turbo trainer at home but had to keep to a pain threshold of 3 to 4. Physio gradually increased over over next 6 weeks to where I was doing bounding exs on the step aerobics step. I was allowed to increase my use of the turbo and started cycling outside on April 2nd.
I was discharged by the Consultant on May 10th and the physio later that week.
I started climbing again on my home board on May 2nd, I had been doing upper body weights and finger boarding all the time I was injured.
I was training on my board as normal by the beginning of July and I rode a 100 mile sportive on May 22nd in gold standard time.
I would want a physio who follows the protocol for rehab( just google Achilles' tendon rehab to find it) and as long as you stick with the program, you should get back to fitness pretty quickly.
Having said that I found the bounding stuff quite intense but if you have done step aerobics I guess it might be ok
 Offwidth 26 Nov 2016
In reply to webbo:

At last some detailed advice I would like to see. Conservative treatment is bad for climbers; keyhole repair best... specialist physio a major benefit. There was a specialist in Sheffield who did repairs this way with some very fast recovery. I've also seen someone re-rupture trying to push the physio aided recovery too fast... take care.
OP EarlyBird 26 Nov 2016
In reply to Timmd:

For you or for me?
OP EarlyBird 26 Nov 2016
In reply to Offwidth:

Thanks, Offwidth. Have you had personal experience of ATR? I have a partial tear and the consultant has not recommended surgery - I asked having read up on the injury. He explained that recovery times, and the chance of re-rupture, with the conservative recovery route are not substantially different to the surgical route; this is based on recent research, apparently.
 webbo 26 Nov 2016
In reply to EarlyBird:
My Consultant Neil Budgeon at the Nuffield in York said there was a 20% higher chance of rerupture going down the conservative route. He operates on most of Rugbys Super League players. I initially went to the NHS fracture clinic and the medic there said we only operate on people who are very active I explained I was but he still said to treat conservatively.
Also conservative treatment is Physio led and in my case when they contacted me they asked me to attend a hospital 20 miles away. I asked if I could be seen in a unit 9 miles away as due to the cast on my leg driving would not be recommended. They wouldn't move on this, which another reason why I went private.
 Offwidth 26 Nov 2016
In reply to EarlyBird:

My wife and various friends had fully blown tendons. What is said to be best ranges from consultant to consultant but best advice for sport remains repair (keyhole best).
OP EarlyBird 26 Nov 2016
In reply to webbo:

Thanks, Webbo. This concerns me - what rates as "very active"? I climb a couple of times a week, road cycle for 1 and half hours + four times a week, plus dog walking every day. I reckon, conservatively, that's 15 hours of exercise a week. In comparison to most of the people I know that is very active.
 webbo 26 Nov 2016
In reply to EarlyBird:
Neil Budgeons take on it was, if you think you are athletic then you are athletic and therefore very active. Age didn't come to it either in his opinion I was 60 when I ruptured mine.
My exercise is usually climbing 3 or 4 times a week, one of those would be outside if possible. Then cycling 3 or 4 times a week one of those being 70 plus miles.
That's a good week, this week been on the board twice and two rides 41 and 72 miles.
Post edited at 16:17
OP EarlyBird 26 Nov 2016
In reply to webbo:

Thanks, Webbo. Really helpful info. I have an appointment with the Consultant a week on Monday. I will be asking some very direct questions. Might be checking the state of my piggy bank as well.
OP EarlyBird 26 Nov 2016
In reply to Offwidth:

I can't help having a suspicion that the surgery option might have been deliberately downplayed.
 webbo 26 Nov 2016
In reply to EarlyBird:
I would be mentioning all the bouldering you do and how that involves a lot of impacting on your feet/ Achilles
OP EarlyBird 26 Nov 2016
In reply to webbo:

Top tip! Cheers, Webbo.
 mhughes 29 Nov 2016
In reply to EarlyBird:

I'm an orthopaedic surgeon and an active climber, I'm active in MR/SAR etc. I would definitely not get mine fixed if it ruptured!
Mike
OP EarlyBird 30 Nov 2016
In reply to mhughes:

Hi Mr/Ms Hughes, do you mean you would not have a surgical repair for a partially ruptured tendon?
 mhughes 30 Nov 2016
In reply to EarlyBird:
I personally wouldn't have it repaired if it was completely ruptured, I think the only scenario I personally would have surgery on it would be if it was neglected and had a large gap. Modern aggressive rehab regimes with equinus boots and targeted physio are so good it makes it hard to justify the risk of surgery IMHO, it used to be a fairly common operation but I think I've seen 4 or 5 in the last 4 years, none of which were for straightforward tears
Mike
OP EarlyBird 01 Dec 2016
In reply to mhughes:

Thanks, Mike. That's interesting. Now I feel a bit better in my ski boot.

Alan
 Denni 01 Dec 2016
In reply to EarlyBird:

I've snapped both of my achilles tendons!

First time back in 2006, I was stuck in a cryo cuff, give loads of lager and then after 3 days casevaced back from the jungle in Brunei. Straight into theatre and operated on. In a cast for 4 weeks on crutches then another cast with it slightly moved for 2 weeks. Then into an air boot for 12 weeks with the foot being slightly raised every 2 weeks until it was at 90 degrees.

After that, mild physio for about a month and then into proper rehab sessions (I was miltary at the time and it was proper hands on rehab once a day for at least 90 minutes, agony!) My rehab went on for 4 months and it took me at least that to then go for a very short run. Back to running/climbing etc properly a year near enough to the date of the accident. (14 months after op did the Marathon des Sables without any tendon problems)

Second time, 2013, no surgery as the guidelines had changed but with exactly near enough the same treatment as above. Didn't go back to running as wasn't in the military but managed to again after about a year get properly back into climbing, skiing etc.

All this time past now and I still get flare ups with tendonitis and in my case, if I decided to take up running again then according to the Consultant, I'd have a high chance of one of them snapping again. Maybe this is just because I'm a big old unit at 6ft 3 with a big upper body either way, patience is the key and if you rush it, you're going to be buggered.

Personal opinion from someone who is very active and has had conservative treatment and an operation, I'd go for the operation any time. My achilles has a fairly big amount of scar tissue but it is definately stronger than the non operated one.

Good luck and don't rush it.
Den
OP EarlyBird 01 Dec 2016
In reply to Denni:

Thanks, Denni. Twice! How depressing. I don't know if build and weight makes any difference to healing rates - I'm short and light so I'm hoping that is an advantage. I'm interested that you say the repaired tendon is stronger than the naturally healed tendon: what evidence do you have for that? Is the tendonitis in both tendons?

Alan




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