*WK 10-11: Learning how to walk again at 40! (Aug 16-31st, 2016)
September 2, 2016 by agnesatr
2016-09-22 UPDATE:
VIDEO REVIEW OF WEEK 10 and 11:
The last 2 weeks have been the most exciting so far! Sorry for the long post, but a lot happened. It was definitely a period full of changes.
DOCTOR’S 2 MONTH FOLLOW UP:
I saw my orthopedic doctor at the end of week 9. My progress was good, achilles tendon looked well and I was cleared to start weaning out of the boot. This transition was estimated to last about a month. I was given a new boot since the straps of my old boot were completely worn out and the new boot was much lighter and was making walking easier. It’s Aircast boot and I wish I got this one much earlier! I really like this one better than my black boot.
At the appointment my husband and I asked the doctor a lot of questions, since we have not seen him for a month and my condition changed quite a bit since then. TIP for everyone going for a doctor’s appointment: keep compiling a list of questions for your doctor and bring that list to the appointment. Then at the doctor’s office refer to that list and make sure that all your questions get answered. It is so easy to forget things we wanted to ask. I almost felt bad asking so many questions, but hey, I am injured and my doc is an expert, so I got to use him as the resource. He was really good and patient answering everything. I feel bad for the next patient, who probably needed to wait longer that day! Sorry…
STANDING ON 2 LEGS WITH NO BOOT
The day after my doctor’s visit in my physical therapy (PT) I was told to stand up for the first time with no shoes on. That happened with my heels on half foam roller and toes on the ground not to put too much pressure on the injured achilles. I learnt to really trust my physical therapist, as he is really good/experienced at what he does and seems very logical in his approach of therapy. So, I just got up without thinking and followed his instructions only seconds later to realize what happened - I AM STANDING on 2 legs with no boot on for the first time AFTER 2 months and 1 week. I sort of freaked out inside with happiness. It was really exciting moment for me. My injured leg did not pop again, it did not hurt and it seemed to hold me in whatever limited capacity it could! Major moment!
STANDING FOR THE FIRST TIME WITH BOTH FEET
LEARNING TO WALK AGAIN
I was given few calf exercises to be performed at home (see below for details). My physical therapist told me to always have something under my heels to not over stretch the tendon. I was told to go home and try to walk in the house in 2 shoes and do my PT exercises daily. I was to wear inserts under my heels in order to have a bit of plantar flexion position and provide some relief for the tendon. After my second PT that week I was told to get more adventurous in the house out of the boot. That day and over the weekend with everything I did I was thinking: am I adventurous enough? At the same time I was really cautious not to step weirdly on my foot as re-rupture was on my mind constantly.
So, I started with simple tasks at home in 2 shoes, like slowly walking around the counter for 5 minutes, then I would put the boot back on. Emptying dishwasher in 2 shoes, or doing light cleaning then putting the boot back on. I was not able to do any serious tasks outside of the boot yet, so whenever there was something easy on the horizon I would take my boot off and try to do it in the shoe. When working at the computer, I would keep the boot off and just move my foot around in plantar flexion position.
The boot was still main part of my routine. That week I was putting tile floors in one of the rooms as well as putting cabinets together. Needles to say I needed to wear boot for these tasks and was forced to take breaks to walk around in the shoes only. These breaks were needed anyways, as my heel still was hurting when walking in the boot for a while. Somehow, getting out of the boot and walking (read: limping) in the shoes was providing relief for the heel.
BOOT IS STILL VERY MUCH NEEDED
At the end of week 10 I ventured outside in 2 shoes. It was slow and cautious. The trips were short at the beginning and to safe destinations. At the end of week 12 I am now trying to go to most places in 2 shoes only. On straight road I try to walk normally. Uphill, however, I walk sideways, or avoid it if possible. Stairs are easy, but I am very cautious on them and use railing.
BRAVING OUT THE WORLD IN 2 SHOES
I started my walking out of the boot in a robotic way. I was basically walking in a shoe, like I was walking in a boot. That meant big limp. I thought I was not supposed to bring my foot in dorsi flexion position. That was basically looking like a robot walk. At the beginning on week 11 I went to physio with both shoes on and got schooled about walking in 2 shoes. Apparently, I was supposed to start with the heel, roll through the foot, end up at the heel, get on toes and lift the heel. I was asking if this will not make me heal long and was told that walking alone will not do that, especially that my heel is raised in the shoes. Running, stretching and dorsi flexion exercises at this point could cause it. Well then, now I am trying to walk like a human being! It is going well. I just feel little weakness in the injured leg, which causes slight limp. When I really concentrate there is no limp, when I am tired or talking while walking, limp is back. It is going to be a loooong way to normal walking with no thinking.
My physical therapist took a video of my walk and we analyzed it in slow motion. That was great as I saw what to improve on. It was good to see the motion of my healthy and injured leg and compare these. I realized, I use my knee too soon in the injured leg. I was able to improve on that already. The video of the walk from the side and its analysis is something worth doing for everyone starting to walk again!
Now I use boot for physical things I am afraid to do in shoes and also outside when going on soft surfaces, or to unpredictable place, or when I need to walk faster.
SLEEP WITH NO BOOT
I decided during that week that I would sleep with no boot on on the weekend. I was scared of tightness in the morning, hence I was postponing booting the boot at night. My doc told me to get night splint if I get tightness after sleeping with no boot. So, I decided to put my compression sock on and sleep in it, just so that I have some kind of reminder that this leg is still very fragile. My night went well for the foot, but I kept waking up many times checking if the leg was fine. In the morning, however, I was very surprised that I had no tightness and that I could put my boot on with no problem and walk in it. That was very encouraging. I slept another night in compression sock, that went well as well. The following few nights I slept in fuzzy sock only on the injured foot to serve as a reminder. A week after my first bootless night I slept with 2 naked feet and I was totally fine. Today, at the end of week 11 I am completely comfortable sleeping with no boot. It took me longer to be fine with sleeping with no boot, but I got there in my time and am now minimally thinking about it at night. Just being slightly more cautious with the covers.
SHOWER WITH NO BOOT
The same weekend I also took my first shower with no boot. That event was not overly exciting, as I have been washing my foot in the shower while sitting on a chair and showers generally were not challenging with the boot cover and the seat. But I did that and I was more cautious on wet surfaces and when getting in and out of the shower. The PT exercise of balancing while standing on the injured foot definitely helped with that. I was not supposed to walk bare feet, so I was wearing my sneakers or a boot with heel inserts right up to the shower and putting them back right after. Have not showered in the boot since. Shower still is a place I am very careful at and try not to relax too much. Wet floor plus weak achilles tendon combo can become disastrous pretty quickly!
PT PROGRESS IN LAST 2 WEEKS:
1) Seated heel raises: Started them with 0 lbs and am now doing them with 35 lbs dumbbell on my knee (towels needed for cushion). I started with 3 sets of 20 reps each held for 10 seconds. Now I am doing 3x day 3 sets of 20 reps each held for 10 seconds while adding some pulsating to engage calf more.
2) Laying down prone plantar flexion: we retired it as it became too easy after 2 weeks even with pressure applied by PT while doing the exercises
LAYING DOWN PRONE FLEXION
3) Weight shifts with raised heels - these were retired after week one, as I was able to stand on one leg with raised heel pretty quickly. I can now stand at least 2 minutes on the injured leg while unassisted balancing. I do it at least 2 times a day. Started doing yoga tree pose as well, but with raised heel.
4) Standing on one bent leg with raised heel — we started this in week 11 and this one is still hard. I manage doing it for a minute, but end up sweating while doing it. This is something I currently am working on improving.
5) Squats with raised heels: These are pretty easy, as they mostly work upper legs and I have been working them out daily throughout the injury. It’s just fun doing them out of the boot now. Working on equal weight distribution as the body naturally moves to the good side to compensate for the weak side. Started doing sumo squats too making sure injured foot is in plantar flexion. Inner thighs are appreciating it.
6) Calf raises: Started them with 75% good leg / 25% bad leg weight distribution and with something under my heels. Am now working on equal weight distribution. I am now 50/50, but the injured leg is weak and need to concentrate on it’s engagement. Doing 1 set of 20 3 times a day, each rep held of 10 seconds. My raise is equal in both legs, but the injured leg needs lot of work to be comfortable before going into single calf raises.
7) Calf raises - pulses: This week my physio therapist made me do calf raises pulses. Doing 20 of them 2-3 times a day. Working on equal weight distribution.
8 ) Stationary bike: I was cleared to bike with no boot on in week 10. Have been doing 30-40 minute rides every other day gradually increasing resistance. Shorter, warm up rides on the other days. Injured foot does not go past neutral while biking (toes pointing down).
CLEARED FOR STATIONARY BIKE WITH NO BOOT
9) Pool: Ventured out to the swimming pool as was encouraged by my physical therapist. Walking in the pool was so much easier than outside. That was fun. Then I swam with a pull buoy, thus not using legs, but upper body only. My upper body really enjoyed variation in the workout and it was so relaxing. The most challenging part was walking bare feet to get to the pool and taking shower. The floors were so uneven and wet! I brought my boot all the way to the edge of the pool, but we walked between the pools and I needed help with that. It was a fun experience and I cannot wait to go back again.
10) Stability ball bridge with leg curls: Have been doing 3 sets of 20 daily. This is great workout for hamstrings and glutes, but also activates some calf muscles that wrap around the knee. I keep my feet in plantar flexion position doing them.
11) Side plank with clam shell: These work outer thighs, core. I do 3 sets of 20 on each side a day. I need to add resistance bands to these, as I gained confidence with my injured leg outside of the boot
12) Regular workouts: doing more weight bearing workouts as long as they do not stretch my injured calf and my foot does not go past neutral.
And now the good part: I gained 0.5 inch in my injured calf over the last 2.5 weeks! Now I am up to a whooping 12 inches. I lost total of 2 inches. The good news was that my right (injured) calf was always bigger than my left calf, so I have 0.5 inch of gain left to match my healthy calf. 
The calf does not feel like hanging meat anymore and when I squeeze it nothing loose moves around anymore when pushed from the side. Yay! Progress!
KT TAPE
I asked my doc and physical therapist about KT tape. They both said that this will not protect my leg from going too far into dorsi flexion position and will not prevent re-rupture, BUT it can serve as a reminder if I bend too far while walking, or moving around. We got some tape on amazon and my physio therapist showed us how to apply it. We recorded it, so I will include it in my video update. I will update in the next blog how well it worked out for me. Btw, I got really bright color, so that people see it clearly when I walk slowly when I do not wear my compression sock. Not having a boot on my leg makes me feel vulnerable especially that there is no longer any indication for strangers that I am injured. I still wear compression sock daily. I got second pair of MOJO socks as I really like them. See more on it on my ATR EQUIPMENT page.
That’s it for my long update. It was a lot of firsts and a lot of work over the last 2.5 weeks. Because of the extensive PT, constant practicing of walking and concentrating on/analyzing the leg, time passes by really quickly at this stage. If you are reading it and are at earlier stage in your healing, there is something to look forward. This is a fun stage, but also stage you really get to work hard. If you put effort into it, you will love it!
Happy healing all!
Wow! It looks like you’re making excellent progress.
With that level of dedication, you should be back to 100% in no time. Keep up the great work!
I wish I had your discipline…makes me ashamed of how lazy I’ve been in my own rehab.
Simon
Hi there, Agnes. I had achilles tendon surgery on June 28, 2016. So, right behind you in the healing process. I’m grateful that I was allowed to work from home until I heal. I pretty much stayed in bed with my leg elevated for the first 4 weeks (which I think is the key). I absolutely hated the crutches and boot, so happy to get rid of those. Started PWB at 7 weeks and FWB at 8 weeks (without crutches); transitioned from boot to shoes that same week. Walking very slow with a pronounced limp, but getting stronger. I started physical therapy last week–my PT gave me some great exercises to do on my own (good job on your video!). Although it has only been a couple days, I can tell the exercises are helping with my flexibilty. Frustrated that my achilles tendon is still tight, but not gonna rush it. I’m told the magic starts between weeks 8 and 12.
Hello Agnes:
Good to see you are doing well….. I am sure you may have been elated to ware two shoes again….what was like to ware a shoe on your injured foot? I hope you had a good relaxing Labor Day holiday.
With regards to my wife’s injury things have been pretty crazy over the last several weeks. As you may remember my wife’s injury happened on July 16th, and we decided to go the non-surgical route just like you. She was first casted on July 21 and we were instructed to comeback on August 4th for a cast removal and evaluation. On the morning of August 4th we received a call in the morning that our orthopedic doctor had emergency surgery and that she is rescheduling all her appointments. This was such a disappointment. Anyway, we asked if we could come and see someone else and get the cast changed. There was a PA who was available and we scheduled an appointment with him for that same day. At the appointment my wife’s cast was sawed off and examined by the PA. After two weeks in the cast her leg looked very thing…..that she almost wanted to cry…. After the PA examined he said that there did not seem to be any connection between the two separated tendons. He mentioned that she should be casted again and to come back and show are regular orthopedic doctor. We pleaded with him to place her in a CAM boot and he had none of it….and said without the doctors instructions he did not want to make things worse. So she was casted again and she hobbled out of the doctors office pretty depressed. Anyway we made another appointment with our regular doctor on August 11th. At the August 11th appointment the cast was removed and the doctor examined her ankle and also did a ultrasound. At which point she said that it has not healed to her satisfaction. She recommend that we go the surgical route since it will be better and the chances of re-rupture will be very slim. This was such devastating news for my wife and me. It was almost five weeks since her injury and there was no healing in sight. So anyway, we decided to go the surgical route and until sugary day she was placed in a CAM boot with heal raises and a plantar flex position. Surgery was scheduled for the morning of August 17th and since this was her first major surgery she was pretty scared and nervous. The nurses at the hospital were pretty nice and calmed her a lot. They assisted her change to a surgical gown, and doctor came in and marked the correct leg and asked her to sign her initials with a marker. After I kissed her she was wheeled to the theater. After the surgery we were in the recovery room for a couple of hours until she was out of the anesthesia. With the help of two nursed she changed back into conformable cloths and wheeled out…..They had a placed a very large temp bandage on her leg…..the nerve block was very effective….and she took her pain pills just as it was waring off…..she was in considerable pain and hard time navigating to the bathroom etc…. here is a pic after surgery resting at home http://tinyurl.com/zmemhom
On August 29th we had our first post surgical appointment. Her bulky bandage was removed and the staples were removed. The doctor said it looked good and she was once again placed in a cast. Here is a pic of her cast http://tinyurl.com/jmnc7ox Our next appointment will be on September 12th and we are hoping that she will be back in the boot and will be on the road to recovery. Agnes, this whole injury has been such a drain on us all….especially for my wife. We are hoping she will be able to walk again in two shoes at least by Thanksgiving without any serious limping etc.,
Thanks for listening and your continued support…your page has been a great resource and motivator during these most challenging times for my wife.
Simon,
Whatever you did/are doing is definitely working, so keep at it and do update on your progress.
Haha, you are recovering so well that I doubt you were lazy with your rehab!
Russell,
Glad to see your recovery is going well! I definitely feel that after getting out of the boot into shoes and starting calf PT things suddenly progressed so fast in comparison to the previous weeks! For me the stiffness just started recently and it goes away when I do few exercises. So, I definitely do some sets of calf raises and seated heel raises to warm up the muscles first thing in the morning and whenever I feel tight. Keep at your PT and that will help with the tightness for sure. The massages given by PTs help too. Ask for Graston tool massage, if your PT has not tried that already on you. That helps massage scar tissue and helps with tightness. I was told tightness will be there for some time, so we got to fight through this stage… All the best on your recovery!
Tommy,
Oh no! I was really wondering about your wife! So sorry to hear about her tendon not connecting. Our bodies are mysterious beasts and you just never know how things will or will not heal for each of us…
I am glad your wife’s surgery went well and I hope her recovery will go as smooth as possible from now on. There are ups and downs for everyone at some stage, so it’s always important to keep your eyes on the bigger picture. Hopefully the worst is behind you guys. I am crossing my fingers that all looks good at the Sept 12th check up!
Btw, at least your wife has some cool cast colors and matching toe nails again! And the calf atrophy is normal. Mine looked tiny after 2 weeks. The important thing is for the tendon to heal and the muscles will follow later when the PT starts. I would not worry about aesthetics now.
Walking in the shoes is challenging, but very exciting at the same time. It’s a process and lots of hard work to re-train the brain to use the muscles correctly again. One step at the time, though.
You guys hang in there. Maybe you guys should also start a blog to record your experiences. It might help your wife to journal her journey and share her story with others. It also gives one perspective of how far they got through the weeks.
Thank you for the update and hopefully things will go well now that the tendon is attached! Hang in there and happy healing on this second round for your wife!
Hi Agnesatr - just reading your blog from week 10-11. I am almost at week 10 and starting some more aggressive strength training. Can you tell me what calf “pulses” are?
Hi Kevin,
Calf pulses are just calf raises done quickly up and down without holding at the top. These are different from doing them slowly and holding them at the top for couple of seconds or doing them eccentrically. The pulses were something I was started on at the beginning of my calf PT. Now I use them as a warm up for more strenuous calf workouts or before running. Hope that helps and that you are recovering well.
Hi, love your blog. Thanks for being so detailed it really is so motivational. Im at week 6.5 and just started fwb in my boot. That feels like huge progress. Im always looking ahead and enjoyed seeing your progress at 10 weeks. Im so sxcited to get to shoes but so nevous also. I had no op but am a bit itchy in the achillies. Did you get this? Weird. Also since fwb im swelli g a little. Did u get that? Againm thankyou x
Hi Heidi,
Glad you are enjoying reading. I know reading others’ blogs helped me out and still is. Hope your FWB is going well. Getting into 2 shoes will scary, but going slowly and thinking about it with every step will help out. Being cautious is the key at that stage as well as making sure you do not develop limp - so working on proper walking technique is important from beginning. It won’t be pretty initially, but it will be exciting.
As far as itch, nope, I did not have any itching sensation in my achilles. I wonder if it is scar tissue. What does your PT/doc say about it?
Yes, the swelling will worsen with FWB. I wore compression sock the whole day when I started FWB. That helped a lot in controlling the swelling. If you are planning on getting one, make sure it is the knee high, so no fluid gets down to any of the calf area.
Good luck with your FWB and then 2 shoes walking! Being nervous is ok, that what makes us more careful!
“Your journey of relearning to walk at 40 is incredibly inspiring. Your determination and resilience shine through step. This is testament to the human spirit capacity and adaptation.