Ruptured Achilles Tendon

[Greybeard]

I ruptured my Achilles tendon in October which necessitated surgery, 7 weeks in casts and now weeks(Months) of rehab excercises. What is the general opinion about getting back on a bike. My healing is going very well, I am walking quite comfortably but my lost calf is still in hiding. I have been told that I should look at 6 months from the date of the surgery. Already suffering major withdrawal symptoms.

[PJP2013]

Hi, I ruptured mine in May and went through the same things you gong through now.

 

Only thing can say is do as much rehab and possible and listen to your physio, they will tell you when it's safe to get back on the bike. Everyone is different and also depends on how disciplined/motivated you are in the rehab. 

 

About that missing calf, it helps to see a biokineticist after you finish the physio, they will help bring it out of hiding.

 

Good luck and wish you a speedy recovery.

[davidtinker]

I did the same about 3 years ago. 10 day wait for swelling to go down, op, 2 weeks in cast, 3 months in space boot with pysio. My pysio said I could ride indoors but no power just spinning for a month to help get rid of scar tissue. I hate the trainer so I went on the road instead but stuck to the "no power" rule e.g. only using my good leg whenever I needed power (robots, little hill up to my house).

 

After a month of that she said I could ride normally. So about 4 1/2 months after the injury. I did 5x 2h rides a week. Couldn't do any more than 2h without leg getting very sore (scar tissue breaking down). My quad came back (was 10cm thinner than good leg) but my calf is still smaller today.

 

You get your strength and fitness back very quickly. I did a 2h53 Argus after only 3 1/2 months of training (approx 8 months post injury). I still couldn't stand because of my weak calf and even now I mostly ride seated. Not sure if thats a good thing or not.

[Rapunzel]

Out of interest sake, were any of you on fluoroquinilone (eg Ciprofloxacin) antibiotics prior to your ruptures?

[davidtinker]

No. I was playing bubble soccer at a company function.

[Greybeard]

I had tendonitis for 2 months before the rupture and was taking Cataflam on and off and Flexadrin. I took some visitors on a hike up the mountain and the condition worsened to the point where I couldn't ride. I was painting at home and slipped on a ladder which then caused the tendon to rupture.I was on anti biotics in september, one month before the rupture for flu.

[PJP2013]

Out of interest sake, were any of you on fluoroquinilone (eg Ciprofloxacin) antibiotics prior to your ruptures?

 

No antibiotics, also ruptured playing football at a company "team building"

[mecheng89]

I ruptured my Achilles tendon in October which necessitated surgery, 7 weeks in casts and now weeks(Months) of rehab exercises. What is the general opinion about getting back on a bike. My healing is going very well, I am walking quite comfortably but my lost calf is still in hiding. I have been told that I should look at 6 months from the date of the surgery. Already suffering major withdrawal symptoms.

I suffered from an injured Achilles tendon (called Achilles tendonopathy, not ruptured like yours). I got shock-wave therapy once (after multiple consultations) and it seemed to have done the trick (not pleasant      ). 

 

Her words to me were "does it hurt before, during OR after your exercise? If so, you are not recovered". I lived by those words and I believe I've made a full recovery. Stopped running completely inbetween, but continued to ride (reduced distance and intensity is compulsory). Rest really works. But after 7 weeks off the bike you're starting from zero essentially. 

 

How did you rupture it? Must have been terrifying. Edit: didn't read your latest post.

Edited January 4, 2019 by mecheng89

[Mudsimus]

I kept running on Achilles tendonopathy during training for Comrades last year. Bad idea, my left Achilles started tearing and I ended up in a moonboot. 2 months of no running. Its fine now, but as soon as you experience any pain around your Achilles you should back off.

[Chingy182]

I ruptured my Achilles tendon in October which necessitated surgery, 7 weeks in casts and now weeks(Months) of rehab excercises. What is the general opinion about getting back on a bike. My healing is going very well, I am walking quite comfortably but my lost calf is still in hiding. I have been told that I should look at 6 months from the date of the surgery. Already suffering major withdrawal symptoms.

I'd agree with some of the comments here and advise some low level indoor cycling to help with mobility and blood circulation. Post-exercise use some ice therapy to assist with the recovery.

 

Also make use of a physio/bio for stretching, strengthening and proprioception exercises.

[V12man]

I had tendonitis for 2 months before the rupture and was taking Cataflam on and off and Flexadrin. I took some visitors on a hike up the mountain and the condition worsened to the point where I couldn't ride. I was painting at home and slipped on a ladder which then caused the tendon to rupture.I was on anti biotics in september, one month before the rupture for flu.

Some specific antibiotics are associated with tendon issues... Quinolones... best avoided unless absolutely necessary - I am curious as to whether you were taking one - can you remember the specific antibiotic?

.

[Me rida my bicycle]

Started reading this and thought hell eina that sounds serious and then all the people it has happened to wow!

Now I would like to know how to avoid something like this being off the bike for so long my wife will kill me.

[CAAD4]

Started reading this and thought hell eina that sounds serious and then all the people it has happened to wow!

Now I would like to know how to avoid something like this being off the bike for so long my wife will kill me.

Avoid running and stupid Company "team building"...

[solty]

A few years ago the doctor gave me medication for suspected pneumonia with the strict warning "No exercise, or you'll snap your Achilles tendon", known side effect of the pills.

The medication cleared up my lungs very quickly but I hardly moved for a month out of fear.

[superga]

there is some research that has been linked to mucoid fibre degenerarion in some tendons to quinolone based antibiotics,  specifically fleuroquinolone. 

this has been associated with antibiotics that could have been taken up to as much as 6 months prior and slowly degraded the fibres within the tendon itself, over time and only show clinical signs and symptoms months later.

mucoid fibre must be confirmed on diagnostic ultrasound and or MRI and once the degree of degeneration has been established then only can the treatment protocol be decided on.  some may require surgical intervention whislt others may need a more prolonged conservative management.

It is vital to determine the correct diagnosis and must not be confused with TA tendonitis or tenovaginitis.  the clinical management of all of these are different and so is the rehab.

 

there are also different types of tears that are managed differently as to time frames as to when and how the muscle tendon complex can and should be loaded. eg diff types of stretching, concentric and eccentric loading, time appropriate balance and propioceptive training etc. 

 

tears within the tendon itself are managed differently to tears within gastroc or soleus muscles  as both muscles fuse into the TA at different points.

 

musculotendinous junction tears are also managed differently from avulsion fracture tears.

 

different types of strapping and bracing can also be used during the rehab phase to facilitate earlier return to certain physical activities 

because the archilles tendon is the most heavily loaded in the lower limb it is more susceptible to undue weightbearing strain.

if you are a mtb'er with cleats very forward you load the TA even more especially on single track downwards due to the repetitive strain when off the saddle.  proper shock settings both dampening and rebound for your weight and riding style is also vital for reducing strain on the quads and the TA's.

 

In short speak to a sports specific physio who knows about road and mtb cycling and regularly sees post op TA surgery patients.  do not treat until you know what is wrong and what the causes were. 

obviously the fitness and activity level of the patient will also greatly influence the rehab protocol

your bike setup might also have to change temporarily during the different stages of your rehab recovery.

 

hope this helps

cheers 

gary

[Greybeard]

Thanks for your excellent advice. I will be following up on issues such as set up and setings. The physio I worked with was very good and the rehab is going well, but at a controlled(  ) pace. I was fortunately quite fit when the problem developed and this has helped. Regards, Graham.

there is some research that has been linked to mucoid fibre degenerarion in some tendons to quinolone based antibiotics,  specifically fleuroquinolone. 

this has been associated with antibiotics that could have been taken up to as much as 6 months prior and slowly degraded the fibres within the tendon itself, over time and only show clinical signs and symptoms months later.

mucoid fibre must be confirmed on diagnostic ultrasound and or MRI and once the degree of degeneration has been established then only can the treatment protocol be decided on.  some may require surgical intervention whislt others may need a more prolonged conservative management.

It is vital to determine the correct diagnosis and must not be confused with TA tendonitis or tenovaginitis.  the clinical management of all of these are different and so is the rehab.

 

there are also different types of tears that are managed differently as to time frames as to when and how the muscle tendon complex can and should be loaded. eg diff types of stretching, concentric and eccentric loading, time appropriate balance and propioceptive training etc. 

 

tears within the tendon itself are managed differently to tears within gastroc or soleus muscles  as both muscles fuse into the TA at different points.

 

musculotendinous junction tears are also managed differently from avulsion fracture tears.

 

different types of strapping and bracing can also be used during the rehab phase to facilitate earlier return to certain physical activities 

because the archilles tendon is the most heavily loaded in the lower limb it is more susceptible to undue weightbearing strain.

if you are a mtb'er with cleats very forward you load the TA even more especially on single track downwards due to the repetitive strain when off the saddle.  proper shock settings both dampening and rebound for your weight and riding style is also vital for reducing strain on the quads and the TA's.

 

In short speak to a sports specific physio who knows about road and mtb cycling and regularly sees post op TA surgery patients.  do not treat until you know what is wrong and what the causes were. 

obviously the fitness and activity level of the patient will also greatly influence the rehab protocol

your bike setup might also have to change temporarily during the different stages of your rehab recovery.

 

hope this helps

cheers 

gary