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Had surgery for ruptured Achilles tendon, popping during jumps. Should I have been in a walking boot immediately after the cast came off?

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Internal Medicine Specialist
Practicing since : 1998
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I ruptured my right Achilles tendon and had surgery 12/2/11. Wore a cast for 5 weeks and was instructed to start walking asap, no walking boot. Was doing PT twice a week and was making great progress. This is my 11th week post op, about 80% walking stride back. This Tuesday (2/14/12) the assistant physical therapist was aggressive with my training and had me doing jumping exercises for the first time, not assisted. While doing 4 corner square jumps, i felt a pop that was similar to when I ruptured it. The incision started to bleed on the bottom. My Ortho looked at it immediately and said it felt like the Achilles was still attached. I'm now in a walking boot and have to use a cane when I walk. Had an MRI today but won't know results until Monday. Should i have been in a walking boot immediately after the cast came off? Should I not have been doing full blown jumps at 11 weeks post op? I fear I may have ruptured or have a tear and may need surgery again. Frustrating!
Posted Sun, 6 May 2012 in Bones, Muscles and Joints
Answered by Dr. Jasvinder Singh 2 hours later

Thanks for posting your query.

I can understand your concern for these symptoms. Mostly walker boot is recommended in week 3-6 after Achilles tendon repair depending on the pain that the person has. This is extended till 7-10 weeks by which time wedges if placed are gone. Calf presses and leg presses are allowed by this time and hopping, skipping and advance dynamic drills are started at 14+weeks. Running is started at 16+ weeks and active sports after week 26.

There is a risk re-rupture if jumping down from a height by this time is done. However some clinics mention that exercises like jogging/running, jumping, eccentric loading exercises and noncompetitive sporting activities should be started only after 6 months. This varies from clinic to clinic based on individual patient presentation, which is assessed throughout the treatment process.

In your case, only an MRI (Magnetic Resonant Imaging) can tell whether there has been a re-rupture of the tendon or not. A walker boot could have been preferred.

Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries.

Please accept my answer in case you have no follow up query.

Wishing you good health.
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