bikin’ soon

I know that one of the last things to come back in the recovery process can be full weight heel raises.  However, I have not spent any time doing anything to speed the process  until this week.  I have read that in the pool or other partial weight-bearing approaches work well. I just haven’t been interested enough to start.

I was talking with a friend last week and the idea of using a weight-assisted dip machine might do the trick.  This is the lower yourself from two bars kind of dip, not the chip and dip kind.  I gave it a shot and it works pretty well.  I can spend a few minutes everyother day on the machine (in the gym at my workplace) and I am doing a lot more than I was before.

Today was my fourth “workout” (5 minutes or less) and I did 2 sets of 20 with 60 pounds of assist each  time.  I think the progress will come quick enough.

I have been icing less and less just due to being tired of messing with it…even though the Cryo Cuff does make it easy!  I still feel the tightness and mild pain when I walk, but this continues to fade as the weeks go by.  I have not been back to PT.  The value for the time and money just wasn’t there.  I am satisfied with my progress, so I imagine I will just keep up the current routine until I can’t do something I want to be able to do.

I did bike another 150 miles this week…this seems to be my norm distance lately.  I did made a transition to more MTB miles, with 45 this week after last week’s inaugural of 8 miles.  Also, the off-road mileage included 2,200 feet of climbing.  That is more climbing than I have done in any other whole week of road riding since I have been back on two wheels.

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My recovery has continued to be uneventful and encouraging.  However, the reminders that I am not 100% are regular and important.  Especially when I walk, I am cognizant that I have a ways to go.  This is not true on the bike, where I feel virtually no effects of my limitations.  Maybe I need to mix in more walking with all of  my biking?  Many people have noticed, though, that I seem to be walking normally.  From my perspective, it does feel kind of normal, but deliberate and not fast.

As my recovery has been progressing, I have been slacking on some of the basics, such as wearing my pressure socks and icing my ankle.  The consequence was I began having more pain when I walked.  I believe this is just because I have been working it quite a bit and I was not doing much to keep the swelling in-check.  Since I got this simple reminder again, I have felt like an addict when hooked to my Cryo Cuff.  If you don’t know what this is and you need to ice your ankle, I would strongly recommend this system.  I have come to crave the feeling of the icy water as it slithers around and suffocates my ankle in a watery embrace.  Frankly, it just feels good and seems to be good for me.

Since I am commuting to work on my bike this week, I cannot take my Cryo Cuff with me.  So, I took a special bag designed to be filled with ice and strapped to whatever body part you need to  ice.  While this thing seems like it should work pretty well, it does not.  It cooled things down some, but only did about 20% of the job the Cuff does.

On the biking side I had a great week.  On Wednesday I rode a moderate 40 miles after work.  Then, I did my normal weekend of group rides with 50 on Saturday and 30 on Sunday.  Surprisingly, as I totaled my mileage for August, I discovered the 614 miles is the most I have ridden on my road bike in a month for the past 4 years, other the year I biked across Iowa in July 2007 for the RAGBRAI ride.

Although I have not been on my mountain bike yet, I will be participating in a 4-man team doing a 24-hour race 3 weeks from now.  This race format is a lot of fun.  It is a relay structure, where the first rider takes a lap, 13 miles in this case, then the next rider takes a lap and so on.  The goal is to be the team with the most laps when the 24 hours is done.  I am confident of doing this since I will ride less than 1 1/2 hours, then rest for 4 1/2 hours or so before riding again.  It feels good to be making plans to compete again…not to win, just to be in the game.

I have post-poned getting on single-track trails on the mountain bike just to lessen the risk of re-rupture due to a crash.  I rarely go down, but I do believe my chances are higher on the trail with so many more obstacles.  My first time out will likely be this coming weekend.

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I got engaged on a Friday the 13th and married on the 13th the following April…24 years ago!

I had my first visit with the physical therapist today.  He only provided encouragement, suggesting that while the tendon is thick, as expected, the motion I have is very good for this stage of recovery.  He measured the dorsiflexion as 10 degrees on the recovering leg and 15 degrees on the normal one.  My walking gait is virtually normal.

He massaged the leg for a bit.  I spent a few minutes on the Biomechanical Ankle Platform System (BAPS) with the smallest hemisphere.  I stood for awhile on one leg.  Al l-in-all I didn’t learn or do much.  No judgement yet, just a pretty slow start. 

The only exercises I was given to do at home: 

1.  balance on one leg until fatigue, several times a day

2.  sitting with dumbell or other weight on my knee/thigh and do toe raises (I did this a couple of weeks ago with about 20 pounds …probably move up to 30-40 pounds now)

3.  Stretch the hamstring, calf and Achilles with a towel or similar thing while sitting on the floor.

I only did my weekend rides, with the boot, this week.  I rode fifty miles on Saturday, even contesting the sprint at the halfway point.  My fitness is still a work  in progress, because I was pretty wiped at the end.   I rode 30 on Sunday at a good pace with a group, although still carrying some muscle fatigue from the day before.

Another indicator of my fitness is my heart rate on these moderate rides.  I compared the 50 mile Saturday ride to the same ride early in the season last year:  the last two weeks I am about 20 beats per minute higher as an average for the whole ride.  This week I spent over 10 minutes of each ride at the heart rate I average during 1 1/2 hour mountain bike races (160 bpm), compared to none to 2 minutes last year.  This may not be the best training regimen since I should be rebuilding my base fitness, but it has been fun. 

The big question now:  to boot or not to boot while riding?  The therapist was not really convicted one way or the other…finally opting for the conservative, “let’s wait a little.”  I think I will be putting SPD pedals on my bike and doing solo rides since they are a bit safer.  I will be using SPD pedals since they have adjustable release tension and I can make the left one feather light.

I have continued using the Cryo cuff to ice my ankle.  It always feels great after  spending an hour or two in it, so I will certainly continue this, along with the recommended therapy.

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Without this blog I don’t think I would recall how quickly I have progressed over the last three weeks since the cast was removed.  Midway through this week I dropped the aircast for everything except biking.  While I am still very careful, I have been comfortable everywhere I have been.  I am especially cautious on stairs and other uneven surfaces.

The big revelations for me this week are self-massage and orthopedic pressure socks.    I have a friend who is an occupational therapist.  I should have talked with her two weeks earlier, as she explained some of the whys and wherefors of things I should be doing.   I don’t start real physical thereapy for another week, so  I might have learned the same things then, but I am quite grateful to have gotten a jump on them.  By massaging the tendon surgery site and the whole calf I am gaining flexibility.  I expect at least one of the reasons for this is loosening the fascia layers on the muscles and tendons so they will slide on one another better.

I have also progressed from just wearing pressure socks while I sleep to wearing them just about 24/7.   Even though I reported my swelling had gone down some last week, as I have become even more active with my ankle the swelling returned.   By wearing these socks all the time, my cankle has disappeared again.  I am not sure how much this makes it feel better, but normalcy is a good thing too.

Over the last couple of days (espeically since starting massage) my walking has improved considerably.  My stride length is about 80% of normal, with a minor limp, as I continue to refrain from pushing off with my left foot. 

Biking remains good as I commuted to work a couple of times and rode a total of 50 miles over the weekend.  The new addition is riding on a spin bike without the boot.  I did half an hour yesterday at about 80 watts, then added another half an hour today during spin class at something more like 100-120 watts (no meter on the 2nd bike).   While I could have done those workouts and power levels with one leg, I was putting pressure on with my left leg too.  I am experimenting with the pressure, cadence and flexure to see if there are any issues. ..none yet after these two efforts.  I could bike without the boot, but I believe the risk of injury due to a fall is too high.  The doc originally said four months from surgery until I’d be on the bike, so I expect another five weeks or so of riding outside with the boot.

Next Monday I see the doc and learn how he thinks I am doing.

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At home I have been wearing running shoes most of the time.  Since my ankle is still kind of big, I have been using an old pair of my sons shoes that are one size larger than my normal size.  Although it is slow getting around since I cannot bend my joint past 90 degrees, it feels great to be out of the boot for a few hours each day.

The doctor cleared me to ride an indoor bike, provided I don’t bend the ankle joint or put much force on the tendon.  I was relieved to hear this since I bike a lot.  However, about mid-week I got this crazy idea that I could ride my road bike with the boot on.  I would just take the clipless pedal off and put a platform pedal on.  I wouldn’t be breaking the doc’s guidance because I wouldn’t be bending the joint…it will be protected in the boot.  Likewise, if I was to crash for some reason, I think the boot would provide pretty good protection for the tendon.

I gave it a provisional try on Thursday night for a couple hundred yards and all seemed well.  Yesterday I went on a leisurely 15 mile ride and again, all seemed fine.  There was a little heel pain after awhile, but it didn’t seem like an issue.  After taking off the boot and sleeping on it, still, all seemed okay.  Today I pushed a good bit more, going on a 40 mile ride and averaging about 17 mph.  I am pushing some with the left leg, but the right leg is doing the lion’s share of the work.  At the end of 40, it was pretty tired.

Does anybody have experience to suggest I shouldn’t be doing this riding with my boot on?

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