*Month 8 and 9: Agility is back. Still need more strength and flexibility. Hamstring/Sciatica. (Jan 17-Mar 8, 2017)
March 9, 2017 by agnesatr
Here is my vlog from month 8 and 9:
9 MONTH DOCTOR’S VISIT
I just came back from 9 month doctor check up. Actually, today exactly is my 9 month rupture anniversary, btw.
The doctor said that the achilles looks good and that I healed ahead of the usual surgical estimates. Thompson test returned almost same movement in my injured leg as in my non-injured leg. Ultrasound of the achilles showed much more organized tissue than last time, so that’s good to see. It was interesting to see the site of the rupture, which had more unorganized collagen than the surrounding areas. My doc mentioned before that it might take couple of years for the collagen to be organized. It would be interesting to see the ultrasound of the rupture site in couple of years to compare. So, as far as the achilles goes, I am discharged from the doctor! Most of the appointment was dedicated to my hamstring, which might now be actually sciatica pain. More about it below.
AGILITY: p90×3 and JUMPING ROPE
And here is my return to my pre-injury workouts.
Before this injury I worked out about 6 times a week doing P90x and Insanity programs. Some of them require quite a lot of agility. I was wondering at the beginning of this injury how long would it take me to get back to doing it again. I have been working out regularly from day 7 after rupture, but I started doing some of the workouts from my programs in month 5. Initially only the ones that did not require jumping, so things like yoga, upper body, lower body static strength, etc. At the end of month 7, however, I was cleared by my PT to do any jumping exercises as well, so I “jumped” right back to more explosive workouts form my programs. During first explosive workout, I remember, after 15 minutes my achilles was letting me know that it was feeling it. I managed full 30 minutes, but could feel my ankles and achilles until the next day. It was not a bad pain, but soreness you have, like you have not used bunch of parts of your ankles and achilles in a very long time. It felt sort of good, lol. Now that I have been at it for over a month, it is much better. Still feel it after the dynamic workouts, but not with the same intensity.
I also started jumping rope, as I mentioned in the last post. That has been great for ankles and calves! Once I forgot to set the timer and just kept going at it happily listening to the music. Well, I could not walk for the next 3 days, my calves were so sore. So, here is the proof, jumping rope really works calves!!! Now I monitor the time I jump though!
Here is a compilation of some explosive moves, just to show that we can get back to agility. My injured leg is still a bit weaker on push off (I do not notice it that much on two legs jumps), but it absorbs the landing pretty well. During single leg jumps I still feel weaker. They are getting better though.
I have been going to PT once a week in the last 2 months. My physical therapist was splitting the time between my achilles and hamstring. For achilles, it was mostly working on regaining flexibility. I get Graston tool work done and some ankle mobilization. We stretch it with added resistance and then utilize the new, stretched out range of motion to do some calf work outs. Rest of the calf work is done by me at home at this point. I still do PT 6 times a week at home. It is pretty much same exercises as in my last post, but modified here and there. Still lots of calf raises, but all on an incline. Still lots of balancing and squats. Rest is taken care of by my regular workouts. On top of that hamstring rehab work…
I still get massage therapy done once a week as well.
Few changes since last time:
1) All soleus and gastroc stretches now done on a platform. DIY platform = styrofoam block + old shelf + wobbly cushion.
2) Added resistance to to stretches. I am using pull up assist that I attached to my bench. This stretch has worked pretty well in returning dorsi flexion thus far.
3) Stretches in lunges on incline with knee over toes. Just doing calf raises in the lunge position, moving whole body up and down. This works dynamically on dorsi flexion and also works nicely on calfs (and quads ).
4) This is really good stretch for arch in the foot. Doing many calf raises, I always felt pain in the arch. This helps a lot with it. Being on the incline sideways and balancing works well in straightening the arch and also the inside part of the achilles. Initially I was getting spasms in my foot after 30 seconds of doing it, it was so bad. Now that’s passed and I do it couple of times 1 minute each time. I recommend this one to everyone. I was really grateful for my PT after he gave me this one!
CALF STRENGHT AND FLEXIBILITY
I hit a true plato in my dorsiflexion at 9cm. For the longest time, every time I came in for my PT, I was at this dreaded 9cm in knee to wall test (toe to wall measurement). With help of my PT and with stretching we were able to get it to 10.5cm-11cm, but it was always going back to 9. Finally, I think it was mid month 8, I was 10cm at the beginning of the session. That was exciting. haha The little things! This one actually is not worrying me anymore, I will get there. Stretching feels good now, so I do not mind doing it few times a day. It does not take much time, so I am ok with it.
Now, as far as strength, that is hard to truly measure. I know that single calf raises are used as one measuring statistics, but so many other muscles are used in calf raises and I think after doing 1000s of calf raises my body learned a bit how to compromise with other muscles, so that measure is not exact. But anyways, in month 6 I was able to do 60 single calf raises on the injured leg. In mid month 8 I did 120 single calf raises with healthy leg and then whipped up 120 with the injured one as well. I could do more with each leg, but decided to stop there. Saying that, they are not as easy in my injured leg as in the healthy leg. They require MUCH more effort. I actually was drenched doing the test on my injured leg.
I now do all (including bent leg) calf raises on incline and they are much harder. Still a lot more weakness raising from below neutral than from neutral. I feel a big difference in incline calf raises in my injured and non-injured leg. My numbers are also fraction of the ones going from neutral, so this is something that is still very much work in progress.
You can see above how puny my injured (right calf) looks in comparison to my uninjured one, lol. Where is my gastroc? I do not really worry about it. I just want the strength back.
WINTER SPORTS UPDATE
I have been doing quite a bit of downhill skiing this winter and the achilles is holding up nicely. It gets sore after couple of hours and I need to massage it during lunch time, but then it is back to normal for the afternoon runs. So, still not 100% back, but it is not slowing me down, which is great! I have the next 2 weekends full of of skiing, so am eager to see how the achilles will do in consecutive days of skiing on longer trails!
Snowshoeing had the same effect as skiing. I feel the achilles after couple of hours, but it is not to the extent that I have to stop.
HAMSTRING UPDATE and RUNNING
I mentioned in few previous posts that I injured my hamstring at the end of November while running. Well, I am still struggling with this thing… I tried a run in month 8 to test it and my hamstring flared up again. I vowed not to run again until I feel absolutely nothing in my hamstring. Lets see how that goes… My PT has been rehabbing my hamstring more than my achilles, it seems, and now I have a separate referral just for hamstring rehab.
On a positive note, during my trial run my achilles did really well. No pain, no after effects, ran with complete flat shoes for the first time and it was ALL GOOD! It was also so good to run, but what to do, got to wait a bit longer… Again, patience, patience…. If there was a pill for patience…
And today at my doctor’s appointment for achilles check up, my doc evaluated my hamstring problem as well and he thinks that it might be sciatica pain, so it will be treated as such in PT at the moment. Doctor has a plan of action for it, so I am hoping to be finally pain free in coming months! Crossing fingers…
LIFE AT MONTH 9
I still think about achilles every day, but that’s because I do PT every day. Because of PT it gets sore, calf gets sore, so it’s hard to forget it completely yet. A lot of time otherwise I do not think about it now. I had a bad slip on our floor in month 8 and I did not even think about the achilles, so I guess that’s a positive mental progress. Now I think about my hamstring instead, since I have to give some feedback to my PT in our weekly sessions, haha. That’s my unfortunate side effect of this achilles injury.
Once more wishing everyone happy healing, lots of patience with this ordeal and as little setbacks as possible!