Achilles tendon blog: D+43

Achilles tendon rupture…43 days later. Yesterday I finally tried half-walking without crutches. By half-walking, what I really mean is shuffling on the CAM boot with the bad foot forward. I can also hop and use the CAM boot as a skateboard, but I doubt my orthopedist would appreciate that.

I found this article [Ruptured Achilles Tendon] discussing what is worse: a torn Achilles tendon (AT), a torn anterior cruciate ligament (ACL)/medial collateral ligament MCL, or a broken leg bone (tibia or fibula). I tend to agree with the article that the Achilles tendon rupture is the worst injury a person can have. Muscles and bones have nutrient-rich blood flowing through them to aid in recovery. Ligaments and tendons lack blood circulation, so there are limited methods of accelerating the healing process through the body’s natural healing processes even with artificial augmentation. This puts ACL, MCL, and AT injuries in a separate category from bone injuries.

What separates ligament injuries from tendon injuries? The answer is “biomechanics” or “physics”. Ligaments join bones to other bones; tendons join muscles to bones. In the case of an injured ligament, the surrounding muscles can compensate for the torn ligament. In the case of an injured tendon, the entire joint becomes immobilized and there are no muscles that can compensate. Granted, in the case of a torn ligament the surrounding muscles must work twice as hard, but they are working. In the case of the torn AT, everything below the knee is completely immobilized. With both injuries, hopping is one way to compensate, but with the torn AT the option to hobble is out of the question for about a month. Within a few weeks of a broken tibia or fibula, some weight bearing (up to 50 pounds on a 150-pound person, or 33% of body mass) is permissible. With a torn ACL and a graft, the patient can apply up to 75 pounds (50% of body mass) within a week. With the Achilles tendon, the patient can begin applying 50 pounds of pressure (33% of body mass) at 6-12 weeks out!

I am just now entering the hobbling phase. I can shuffle short distances, but I should be able to hobble around the house in a couple weeks, albeit painfully.

anterior cruciate ligament (ACL) and  medial collateral ligament (MCL)

anterior cruciate ligament (ACL) and medial collateral ligament (MCL)

calcaneal (Achilles) tendon

calcaneal (Achilles) tendon

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2 thoughts on “Achilles tendon blog: D+43

  1. Pingback: Week 64 of 213: “He divines remedies against injuries; he knows how to turn serious accidents to his own advantage; whatever does not kill him makes him stronger” | Aerospace Cubicle Engineer (ACE)

  2. The new recovery protocols for all types of Achilles tears and treatments have partial weight bearing beginning in weeks 2-4, not 6-12 for optimal strength and range of motion at full recovery. I had a high, almost complete tear and was able to partial weight bear at 2 weeks in the boot with crutches, do the push off zombie hop to get around the room and stand on it enough to do upper body free weight workouts. Not sure about the exact weight percentage, but that puts it about even with the other injury types. I’d rather have this than the ACL/MCL which requires surgery and has a longer rehab timeline. But I most definitely would rather have broken any other bone in my body than either of those.

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