17 Weeks. Moving along ok and physio to take a new leap
Nothing much has changed for me since I started physio a few weeks back.
I am now doing lunges with weight, squats with weight, and balancing a lot longer on the ‘bad’ leg - both on a balance cushion and a mini trampoline.
Can manage to hold myself in a single leg slight squat on either for around 15 seconds. Might not seem a lot, but 3 weeks ago I managed 3 seconds !
Single leg heel lift is sme way off, but I can nearly walk on tiptoes.
Have been given the ok to use my bike on the road lightly with flat pedals, but the PT is more keen to have me use the indoor trainer with my spd cycling shoes. This will give my tendon more work to do, whilst keeping the potential for mishaps to a minimum - not a lot is going to cause an unplanned stop in my garage .. haha.
As for general feelings, in the morning as I wake there are no pains or swellings. It is a little stiff but not that much more than pre accident. However, irrespective of what I do during the day, come around 8PM and both legs feel very tired, delicate and tight. It eases up as I move around but on the whole the strength is returning and my ROM is increasing.
I’m told by the PT that I am more or less out of the woods with regards to a re-rupture providing I don’t do anything stupid.
Not too sure about that, but I can half imagine how it could be re-ruptured as right now I feel as though I am stronger than I probably am.
Will be sorting a bike on my turbo trainer over the Christmas period and then giving it a try as soon as.
The stepper that I was using managed 3 days of 30 minutes a day before it exploded, so that was a waste of time.. lol.
That’s interesting that they want you in your shoes on a trainer. I assume you mean clip in shoes? I have been wondering about that when the time comes that I can get back on my bike. Right now clip in pedals on my road bike make me pretty nervous. I will probably switch pedals to start with and then move back to those.
Hi Millie, I was slightly taken aback too when he said I should use the SPD’s (yes clip in mtb shoes).
The theory is that I can place direct stress on the tendon and ankle area in doing so, but in a controlled fashion that the stationary trainer gives.
Using a bike on the road with flat pedals (as I thought would be good at first) is not as predictable and therefore more dangerous at this stage.
Everybody is different though and my PT has seen my progress over 4 weeks so far so hopefully has an understanding of what I am capable of.
I’ll be buying a trainer specific tyre for my spare mtb over the weekend and will post up when I’ve had a go.
Hopefully then it wil lead up to 30 minutes cycling a day on it, with road riding coming early 2012.
I’ll chime in: When you first start out- especially if you’re trying to pedal normally (pedal axle under the ball of your foot), you’ll find yourself putting very little pressure on the pedals. So much so, that if I wasn’t clipped in, my foot moved around too much on the pedal, leading to unintended changes in how much force the pedal put into my Achilles. I felt much more stable and secure locked into my road (clip in) pedals- from day 1 on the spin bike. The clip-ins also let you start to use the leg in parts of the stroke (pulling through the bottom, and up the back) which don’t engage the Achilles injury at all.
The *only* reason I see to go to a flat pedal would be if you want to ride much sooner, say to get a cardio workout by putting your foot way forward and pushing down with your heel. Some folks even ride with a boot on. I think both of you are beyond that point though.
Both my road (Speedplay X) and mountain (Crank Brothers Egg-beaters) use a pure twisting motion to release… I had no troubles/issues twisting my injured foot out. Clipping “in” was a little diffcult (especially my road pedals)- took a little practice and perseverance. Going through my mental list of pedals, the easiest to clip into - because it’s a forward, not “down” motion - might be a Speedplay Frog.
Adam,
At 17 weeks are you walking normally or do you still limp?
Hia. I would say I am still not walking 100%, but most people think i am back to normal.
At 12 weeks I was walking through with my steps but with a pronounced limp and quite slow.
Now I am at normal walking pace and whilst I still feel the pull in my lower heel, I am pushing off with the toes quite well.
Still can’t do a single leg heel lift and I do suffer late at night walking, with pain in both lower legs, but on the whole I get better day on day.
Physio is working wonders and my strength is coming back.
Today the PT saw me doing squats with weight and said the were now too easy. I am now doing them one legged and can feel it but it isn’t difficult.
Hardest thing is lunges, as I can certainly feel it in the heel and calf when I push up through the toes on the bad leg.
Slowly is still the way, but it is suprising how quickly the leg comes back when trained in isolation and in a correct and strict form.
Thank you for the update Adam!
I am four weeks behind you, and trying to figure out what to expect over the next couple of months.
How’s the atrophy on the left leg? Do you notice a substantial difference in size?
If you have swelling in the foot / ankle / leg, I’d expect it to drop considerably in the coming weeks.
My ankle and lower leg still swell through the day but nowhere near as much as they used to. (Typical, just after spent £80 on cold compress things)
The calf muscle has more or less gone completely. I had no deffinition in it and could not tense anything when trying.
Now it is coming back. I can just about feel it when tensing my leg but there is still no deffinition or real muscle mass. I am to start 30 mins a day clipped in on my indoor turbo trainer soon so will hopefully start to recover.
By the end of an evening, both of my legs are shot and it is a strain to walk up 3 flights of steps to bed. Not painful just weak feeling (in both lower legs)
The main pain for me when doing exercises at physio is in my ankle and heel in particular. The calf / achilles area don’t suffer at all, so I assume the ankle is the weakest and when that builds back up the others will ache in turn.
If I was you, i’d expect a lot of atrophy. Don’t worry though as time and exercise is what is needed. Perhaps exercise over time is more appropriate as there are no quick fixes nor should you push it to regain strength too quickly.
Hope this helps a bit.
> … trying to figure out what to expect over the next couple of months.
I’m coming up on 17 weeks here too…
For quite a few weeks now, I’ve been able to walk without a limp. Put the right shoes on, slow down, concentrate on perfect form, and I could do it. There were other times, when I limped bad- say first thing in the morning (before I had spun the bike), barefoot. I guess what I’m trying to say is: limping is very inconsistent. As time goes on, I find myself having to concentrate less on walking correctly. I’m not as dependent on specific shoes. More and more often, I’ll walk correctly without really trying… conversely, I catch myself limping less often.
However, even now, I will still catch myself occasionally limping. I won’t be surprised if that still true several months from now. But, it’s happening less and less frequently, and when it does, it’s less severe.
I do still get swelling sometimes- the big difference is that it seems to be much more localized (my whole lower leg/foot doesn’t swell). And, it subsides more quickly. Hard, sustained activity triggers it.
I still have some issues with pain/tenderness on the bottom of my heel.
As for atrophy; I think there was a time when my injured calf might have measured bigger… just because of all the inflammation
The calf was just a sack of goo though. I did everything I possibly could to prevent atrophy; but still have some muscle rebuilding to do- both in terms of size & shape… but most especially in strength.
For me, 12-16 weeks saw some big improvements; but things moved more slowly. In retrospect, the progressions through casts, splints, boots, crutches, PWB, FWB, etc., all happened much faster. The trick, I think, is to keep up your motivation and consistency with the rehab, even though the pace of improvement will probably slow down.
Thank you so much Adam and Ryan for this thorough report!
As I look into the weeks ahead, your insight will help me manage my expectations.
Ryan, I am only allowed to wear tennis shoes/running shoes with a half inch lift. I am going to take your suggestion to walk slowly with focus on the form. For me, the pain is exactly at the point where the achilles was stitched. On the bright side, I have no issues with pain at the bottom of my heel or feet. The swelling comes and goes but I have been working a lot, and not adhering to the ice and elevation suggested by my PT.
I’ve been very anxious because I committed to a long trip that could be uncomfortable. Unfortunately I will have to spend two weeks working in Europe; trip is scheduled for March 1st - five and half month post surgery. I’m afraid of the long flights, plus all the commuting by train/taxi, not to mention walking on irregular street surfaces. I feel as if I have reached a plateau and I am not improving. I do notice some gains as far as flexibility and strength, but as you both say, it is a very slow process.
Best wishes for your continued healing!
Claudia