*WK 8-9: Heel pain, flying, toega and dancing … (Jul 30th - Aug 15th, 2016)
August 16, 2016 by agnesatr
The last 2 weeks were pretty much all about walking in the boot full weight bearing (FWB), doing physical therapy (PT) for ankle/toes/little bit of calf and trying to manage heel pain.
HEEL PAIN MANAGEMENT
As mentioned in previous post, I started FWB in the boot with one wedge at the end of week 6. The Evenup platform made that pretty easy for me. In week 7 (week 6 in my protocol) I was to remove the wedge and go to 0 degrees (neutral). Couple of days after I did that my heel started to hurt after being on my feet for 2-3 hours. It was hurting right under the heel. No other pain anywhere else, but this annoying strong pain that pretty much stopped me from walking. Resting, elevating and icing were the only remedies when I got to that point. I was forced to take the crutches wherever I went and use them when the pain got bad. In the evenings I pretty much needed them.
I started researching heel pain and I read everywhere that that’s normal at this stage and that this would pass. I bought gel inserts. That seemed to let me avoid the pain for a bit longer, but not stop it. I also had some old gel pads for the heel, so I added them on top of the gel insert. That felt even better, but the pain was still coming back in the evenings. My PT mentioned that it might be good to put the wedge back in. I tried that, placed the gel insert on top of it and the heel gel insert on top of that. That was like walking in a wedge shoe. That combination was the most successful, but the end of the day always brought heel pain with it. I iced and elevated a lot in the last 2 weeks.
I posted the gels I used on my ATR EQUIPMENT page.
THERE WAS A LOT OF RIDING AT THE BACK OF THE CAR WITH FOOT UP TO REST HEEL PAIN AFTER WALKING
I am grateful, however, that this is the only pain I am having. Frankly speaking I did not feel any pain since day 3 or 4 from the rupture, so in spite of this onset of the heel pain after walking in week 7, I feel pretty happy with my recovery so far. Cannot complain.
AIR TRAVEL
We had a family function to attend that was out of town. I was cleared by my doctor for it since it was not too long of a flight. I called the airlines in advance and reserved a wheelchair. I knew I need my crutches as well, since I had no idea how my foot would react to flying. At the check-ins I asked for seats with more leg room and we were moved to the front of the cabin both times. I think the wheelchair really helped out. I felt funny to be pushed around the airport, but at the same time I did not want to use my leg before the flight. At both airports it was my husband pushing me. At our airport they had these cool wheelchairs, where you can place your hand baggage under the seat. At our destination airport they had the traditional wheelchairs, but we were shown how to load the bag on one of the foot rests. It worked out well. We also had priority boarding, which was helpful. On one flight the attendants stored my crutches in the coat closet and on our way back we stored them in the overhead compartment.
I took aspirin the day before the flights and on the day of flights as a precaution against blood clots. I also took a ice bag with me to the cabin to ice my leg. One tip is to actually load your ice bag at one of the cafes close to the gate before boarding as they can run short on ice on the flight. I was also told by my doctor to remove my boot on the flight and do my range of motion exercises. I did that once in every 45 minutes or so.
After the flights the foot was definitely swollen, but I had no pain, just tightness from swelling. When we came back, the swelling was more significant, but I had my PT the next day and my physio used massages and tight tape with which he pumped the liquid up. That was pretty cool actually. He also told me to definitely ice above my heart that week to reduce the swelling from the flights.
As a side note, ladies are at advantage as far as wearing heels on the good foot while wearing the boot. I managed wearing my formal footwear on my good leg to the family function and even dance a little in the boot (that was a new one for me for sure 
).
At least the shoe color matches. 
COMPRESSION SOCK
My PT also recommended knee high compression sock. I wish I was told about that before I flew, lol. I ordered MOJO compression socks and so far am pretty happy with them. I will be ordering another pair of them as I can see myself using them for a while. I wear the sock throughout the day taking it off for my daily PT exercises. I take it off during the night and replace it with my fluffy sock. And yep, I still sleep in my boot. I am chicken and even though my protocol allows me to sleep without the boot, my doc said that it is fine to keep it on at night. My problem is that when I keep the boot off for a while and keep my foot in plantar flexion position my achilles area gets really stiff and it takes some time before I am comfortable in neutral again. I just cannot imagine how stiff I would be after 7 hours of sleep in plantar flexion…
I posted the compression socks I used on my ATR EQUIPMENT page.
PHYSICAL THERAPY, TOEGA, ROM, EXERCISES
I got couple of new moves for my daily PT in addition to the exercises from last post. I have also been doing something called toega: yoga for toes. After my PT in week 6 I noticed how stiff my toes were and I was just researching for something to help me with it. I came across TOEGA. I laughed at first, but once I tried it, I saw how hard it was to do these things with my injured foot and how easy with the healthy foot. I asked my PTs and they all knew about it and said that is a good idea. I do these exercises when I wake up and before going to sleep. I think they really helped my toes a lot since. The injured foot toes flexibility is starting to look similar to my healthy foot flexibility. My toes and muscles around them do get sore though when doing these exercises. One important point, I was doing all these in sitting position and in plantar flexion to make sure my leg does not go and stretch past neutral.
I am still doing my range of motion (ROM) exercises 5-6 times a day. All in plantar flexion position. I also still work out while wearing the boot almost daily. I always start with stationary bike or rowing machine and then do my strength training with body weight and weights.
8 WEEK DOCTOR CHECK UP
On Monday, August 15th, I had my 8 week protocol doctor’s check up (9 weeks since rupture). I was told that the tendon looks really good and it is healing well. It is little thicker around rupture site, which I was told was good. The swelling level apparently was looking goos as well. I was cleared to start weaning out of the boot into regular shoes, asked the doctor, what it seemed like, 100 questions and was told that right now it is time to concentrate on my PT and calf. I am to come back for another doctor’s visit in 4 weeks. Hearing good news from the doctor is always re-assuring and pumps you up for the next stage of healing.
So, overall the last 2 weeks were definitely new experiences for the leg. There was more PT, more walking in the boot and more brainstorming on how to manage my heel pain. One thing I can say is that I am more comfortable with my leg, I can keep it out of the boot longer while sitting and am not as finicky about it. With that said, I am very cautious with it as the re-rupture is very much on my mind. I still shower in the boot with the cover on it, sleep with the boot on, but am definitely feeling that the leg is stronger and healing. A final pic of some of my boot adventures:
Happy healing everyone - in whichever stage you are in now. Looks like every stage has its challenges, but we can get through it one day at the time!
Agnes:
Your videos and the above blog have truly helped me through my ordeal. I broke my right ankle and was shocked by the length of time it took to heal. After surgery, I found that I was getting depressed and feeling very alone and vulnerable. I found your story line and have been following it through as I’m going through this healing process. Although different situations, they are very similar. With the help of your videos, I see progress and have been able to keep depression at bay as both my ankle and body heal and the trauma is becoming history. Your positive and informative approach is so helpful. It is what it is and I feel like we are getting through it together. Thanks for you well thought out videos!
As mentioned in previous post, I started FWB in the boot with one wedge at the end of week 6.
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The most common causes of heel pain are plantar fasciitis (bottom of the heel) and Achilles tendinitis (back of the heel). Causes of heel pain also include: Achilles tendinitis. Achilles tendon rupture.
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