This information and expert perspective is highly useful.

thank you. I have seen your video, it's a great advice on the shoulders, for the first time in my life I have this problem for any reason. my right side collar it pops when I lift my right arm.

Hes talking about degenerative menicus people being 50 and 60 years old but this is happening to early 40 year olds, i had a degenerative menicus at 41 years old , 2 and a half years getting fobbed of by the nhs had to give up my job after a year because i couldn't walk no more than 5 minutes on it limping all day. Worked all my life never been out of work. My advice to anyone would be dont waste your time with the nhs. Had a surgery 2 and 1/2 years on nhs thay trimmed some skin that should not be in the knee did not trim menicus. Still cant walk on my knee after 5 years now 45 probably can only walk about 1 mile with pain the next day. Need another knee surgery nhs wont do nothing as iv been back there. Thinking about getting knee done privately but not sure what it costs.

What a great video. Very informative. Thank you.

Giving blood thinners does not help prevent thrombosis in patients who have their lower leg in a cast or who have undergone keyhole surgery on the knee. This is evident from a study by the Leiden University Medical Center (LUMC). The researchers therefore advise doctors against routinely prescribing preventive anticoagulation to these patients. Doctors can only consider this in patients with a high risk of thrombosis. The results of the study were published in The New England Journal of Medicine. This study was designed to weigh the pros and cons of anticoagulation treatment. A total of 3,000 patients participated: 1,500 patients with lower leg casts and 1,500 patients who underwent keyhole surgery on the knee. By fate, half of all patients received blood thinners and the other half received no medications. Approximately the same number of patients in both groups developed a thrombosed leg or a pulmonary embolism. The results showed convincingly that there is no point in giving every patient anticoagulation, the researchers said. They do not recommend prescribing preventive anticoagulation for everyone. Doctors can only consider doing this in high-risk patients.

I have only watched the first few minutes but I just want to thank you for this information. I have been told I may have this after I had an x-ray, but the pain is intermittent and when it is triggered it's incredibly painful. I can't walk on it as the pain is so sharp, so I favour that part of my foot with a limp.

I rer ruptured my Achilles after 4 months of treating it the first time. The first rupture was complete and took the non surgical approach. Wearing boot for 3 months with wedges and PT for a month. After 4 weeks of PT I ruptured it again at the same spot. It did not get out into a boot for days. I am now in a boot with wedges for the last 4 weeks. Do I did to go through the same protocol as before and what are my long term prognosis after the delayed boot after the 2nd rupture? Will it ever heal? I don't have a calf anymore and will this affect the leg for strength in the future?

Excellent video. You covered every situation. Thanks for sharing.

@completephysio these have been so helpful. I’m wondering if you can recommend a physio in Sydney, Australia by any chance?

A very informative video, my wife is suffering with very painful arthritic ankles and has also bone growth and deformity ! she has been offered fusion but no mention of ankle replacement ! She has already had both her hips replaced and also suffers with arthritic wrists.. she's worried how she will cope wth the long recovery period (6 months) and the impact on her other joints !!

For the attention of Mr Sam Singh you operated on my Haglunds Deformity at Guys Hospital 2021 the surgery was a complete success and you saved my running career. When I returned to Guys to personally thank you they informed me you no longer work there. I only discovered this podcast today and recognised you straight away. I will always be grateful to you kind regards Scott

So what if it's the short bicept tendon, no other pain, no repetitive strain, no overhead mouvements, no tennis elbow. Pain from gripping phone and mouse.

This video is amazing thank you so much for sharing your wisdom.

It is not painful? I almost lost consiousness 3 times because of the pain... Full rupture... 6 weeks ago almost... Shivers still go through my spine when I think about it! But yeah.. Before covid I was always active... with covid I quit sports.. after covid I started kickboxing again this spring! After 5 weeks it happened when I went all in... I guess because of the pain I felt I am very serious despite non-op! I am very careful! I am confused about all the different protocols though.. In many hospitals here you get a 2 weeks cast in 30% pointing down.. and after 2 weeks you get an achillotrain.. and thats it.. I got a cast for 6 weeks and should have been at neutral position according to my hospitals protocol.. But I am still at 15%. Still got the achillotrain.. and now I have to figure out life.. Luckily there is the internet... Bought myself a vacoped...

this is a wonderful discussion and is extremely helpful. Thank you for sharing this information. I am currently on physio and I will monitor my situation 3 months later to decide if I should have PRP. Thank you so much ! From Singapore

Excellent explanation, thank you 🙏.. Obviously I’m here in the early days of a miniscus tear and was trawling KZfaq for answers, this was brilliant and very informative. Thank you again

Thanks

Just ruptured mine on 7/4/24. 1.5cm gap. Had surgery 2 weeks later. Currently in a cast. My surgeon said I’ll be in a boot next week.

I was just diagnosed with this in my gluteus medius. This is so painful.

I’m 48 now and ruptured my Achilles 2 years ago. I was told that surgery wasn’t an option for me on the NHS and that they only offer to elite athletes so my only option was conservative treatment. No I’m not an elite athlete but I consider myself quite athletic, especially for my age. I’ve skateboarded at a good level for 30+ years and I actually ruptured my Achilles skateboarding. In addition, I’m also a keen runner and have been running as long as I’ve been skating. The point I want to make to those now worried about taking the conservative option is that I have fully recovered and am skating and running as well as I could before my injury. The only thing I will say is that it took over a year for me to get back to this level and I followed a strict rehab and physio plan. The hardest part I found was getting my calf muscle bulk back and that to this day, it is still not quite there yet.

How do you take boot off

The video is useful. The physiotherapist needs to stop talking over the surgeon and listen to what he's saying. That was annoying. It's ok to listen, you don't have to be constantly talking to get through the video. Otherwise, useful information.

Recently ruptured mine, within 2wks I was cast straight away, vacoped boot and ultrasound scan. There is a 4.7cm gap at neutral and at 30 degree of plantar it closes to 4cm...im not convinced this will heal and ive not been offered surgery on NHS...i need this to be right...what do i do?

Hi Love this video. Somewhere I saw a report (or you said it) for something like TARVE a report about ankle replacements etc. Now trying to find it. Can you help. I'm ini this position right now but the UK NHS hospital has kept me waiting since 2019 and now say after all that and all discussions about replacement they now won't give it to me! So I've moved hospitals ! Found this really helpful. Off to a forum clinic today and I still think they want to give me a fusion too... but they've said they will give me the replacement if I want. :D This helps encourage me that this is the right decision. Thank you.

Can physiotherapy graduates give injections for their treatment??

My knees vibrate a bit when i move it up and down with clicking noise and every time i squat or just bend they hurt like crazy i need help please

Great video thank you

At what stage (how many weeks after being fitted with the boot) did she transition to 1 crutch?

Very vague

I have midfoot osteo and sporatic arthritis as well as collapsed arch and bunion my consultant says it would be a very difficult operation as its so bad I'm 65

Thank you for filming and loading this up. Gives me hope. Is there anywhere I can purchase the ‘ossa offloader knee brace’ ? of a decent quality

Redo the video so we can see what and where.

Thank you. So helpful. I'll try these because my shoulder really hurts

This is really helpful, thanks!

this info is 10x better than what my orthopaedic surgeon told me, thank you guys

Excellent video. Might be a good idea to make this compulsory viewing for Consultants and Physiotherapists. They are somewhat blasé in their approach to patients.

Very informative, complete - thank you

What we can we do

3 weeks post surgery and had my first adjustment yesterday to the vacoped…today back to some pain and discomfort when putting weight through the leg…hopefully this doesn’t last long and settles. Is it normal to be in discomfort when making the adjustments?

My opinion?! SURGERY Anytime!

Excellent content. Thank you.

Great video. I am 61 years old fit and have had an ankle fusion. I was not informed of ankle replacements. My bad for not researching.

Thanks I was worried

21:55 For those with late diagnosis

Thanks for the video. My symptom is a “dull” or radiating ache/pain from the front of the foot to the upper side of the joint. Not a searing pain. Could that be osteoarthritis?

Chris, Thank you , very informative and good to understand you can cycle in the boot too..

33:33 - 39:13 is good information for late diagnosis patients

I wish I would have seen this video earlier. ER doc said I only had a muscle contusion after snowboarding accident. Left ER with an ankle brace at 90 degree angle followed by a 5hr manual shift drive home. I then got an MRI showing partial Achilles tear with complete calf muscle tear. (Skeptical of the partial tear after this video) Ortho doc said to go surgical route which I will do now since I went two weeks without plantar flexion knowledge. Hopefully it heals up and too much blood/fat hasn't accumulated.

Excellent informative podcast👏

Ruptured mine a few weeks back on holiday! got myself into a same day cast equinus (thankfully had holiday insurance) and saw Sam as soon as I got back, he looked at my ultrasounds and I basically said I’m not leaving until you agree to operate haha…I’m 51 and extremely active. To be fair he did discuss the option of non operative treatment but that was never an option for me. Post surgery Sam agreed it was the right choice as my tendon ends were a mess and it would never have healed together as well non surgically. I had open surgery and I believe the failure rates are lower than keyhole, although the recovery is longer (and of course there is infection risk as with any surgery). Open surgery also allows for a stronger suture as it’s easier to work on fully exposed. Sam used the Krackow suture technique which is a proven choice for strength. I am now nearly 3 weeks post op and one week in the Vacoped boot @20 degrees. I’m being religious in my rehab stretching from plantar flexing to neutral and toe crunches plus a little side isometrics. Nothing past neutral however. Non op Vs op depends on two factors, will the tendon ends realistically join? and secondly how much do you need FULL and maximum functionality restoring. Do not leave it to chance, get an ultrasound asap and a cast as a minimum within the first 24hrs as the longer you wait the less options you have. Sam’s been great, this is bread and butter for him and if you have the opportunity to see him for treatment, do it! Cheers!