FHL Tendon Transfer - Rehab 3

Well, I forgot to log my last visit to the doctor on February 6 at 10 weeks post-op.  The doctor spent about 10 minutes testing the strength of my new Achilles.  Then he had to confirm my surgery date because he couldn’t believe I was only at 11 weeks.  In summary he said I was months ahead of schedule and that I didn’t need any further follow ups.  His comment was “Don’t do anything crazy.” We scheduled a visit with his office’s PT staff to do an evaluation.

On Sunday, February 7 I did my first hike, 7 miles round trip, 2,200 ft vertical gain, with no problems, but it is mostly just a dirt road.

During my visit to PT they had me walk to check my gate and couldn’t figure out which foot had been operated on… so no problem there.  I received a combination of massage and electro-stym therapy in order to reduce the remaining swelling, which was due to hematoma related to the surgery which had hardened in place.

I continued my twice a day home physical therapy, with some balance work suggested by the PT’s, and visited the PT’s office three times a week for a two week period while they helped to resolve the residual swelling.  I added twice a week hikes.

On Sunday, February 27, at 13 weeks post-op, I climbed Strawberry Peak, an 11 mile round trip with 2 short class 3 rock sections and about 3,500 feet of vertical.

On Sunday, March 20, at 16 weeks post-op, I did my first trip back to the Sierras, a snow climb up the Tuttle Creek drainage just west of Lone Pine, CA.  We turned around at the 6 hour mark as I was experiencing some tingling and mild pain. The snow started to get soft and post holing with my left foot really sucked.  Following the “Don’t do anything stupid” rule.  I wore a full height boot with a lace up brace to guard against rolling the ankle or a rapid flexion, the typical result from post holing.

So, where am I?

My left calf is about 1 inch smaller than the right calf.  I can elevate onto my toes with both feet. I can’t elevate using just my left foot, but I can support my weight on the ball of my left foot, which makes climbing possible.  The process of getting my left calf back to full strength is going to take quite a while.  As I ruptured my AT in March of 2015, and only began using my left calf normally 10 months later, the general rule of thumb is that it takes as long to get it back as it did to lose it.  Which means 10 months.  But I can rehab it by climbing, and that works for me.

As far as advise I can offer, here’s a list of what worked for me.

  1. Get in the pool.  I did 3-4 days a week. Half and half, swimming and kicking with a kick board. Circulation is good for healing.
  2. Do the rehab yourself, every fucking day, assuming you see a PT get a protocol from them. When you have your ass parked on the couch watching TV, that is a good time to do the boring elastic band work.
  3. Have your PT teach you how to massage it yourself.  It reduces swelling, which is something you want.
  4. Ice is fucking magic.  I got 3 large blue gel packs and iced my Achilles before and after any exercise, at least 4 times a day. If it starts to hurt, ice it.
  5. When you are out of the boot and ready to walk, then WALK.  Get some high top boots, a set of walking poles and take up hiking.
  6. To strengthen your calf muscle don’t rely on just the rehab exercises, do your hiking with a backpack and gradually, over time, add weight.  I use bags of cat litter.
  7. Accept the reality that it is going to hurt.
  8. DO NOT USE OPIATE pain killers.  I got my doctor to prescribe Celebrex. It is way easier on the gut than alieve or ibuprofren.

9 Responses to “FHL Tendon Transfer - Rehab 3”

  1. hi Mark,

    thanks for this update, it sounds absolutely fantastic! very well done on the progress.

    i came out of the boot two days ago and walked 1.5 miles that day, it felt weird but liberating.

    i can’t lift myself on toes with neither one nor two feet yet, only in the water. i had a wee stint at dancing the day i went to shoes, and it feels surprisingly good! i know i have to take it easy for the first 4 weeks so i go over the magic 12 weeks of high risk of re-rupture but i can see the light at the end of the tunnel now.

    keep the good work up


  2. This is great news, Amountainclimber! (or Mark, if you prefer)
    I’m glad you are back to challenging the heights, and that your orthopedist couldn’t believe your progress! LOL
    Let me verify though: You are one year past the achilles tendon rupture, AND 17 weeks past FHL tendon surgery? On the same leg? Wow….
    Well, thanks for all the tips and suggestions. I definitely have to do more of what you are doing.
    Take care! and happy healing!………. Manny

  3. Pozaicer, just a side comment: congrats on the dancing in two shoes! waiting for the video! But to get to the stage Mark is at, we are going to have to do some serious work! LOL
    Mark will climb the heights while we dance up the slope!


  4. Amountainclimber I became out of breath just reading your post lol

    Wow, that’s all I can say… just… wow

  5. Pozaicer, now that I’m past my medication almost killing me, the pool is getting easier. I’m optimistic I will get back to my “pre-surgery” pool state soon.

    The land exercises are not progressing as fast as I would like but that’s just my impatience to be better after declining for such a long time.

  6. I see a direct connection between climbing a mountain and the rehab process. If I look up at the summit, far off in the distance my reaction is, “Wow, that is a long way, how can I make it?”

    The answer is, I don’t have to make it.

    All I need to do is take one step.

    And then then another step.

    By finding the value in each step, I forget about the summit, until the moment arrives where I realize that I am standing on it saying, “How did that happen?”

    So, my suggestion would be, forget about progression, just take one step (the exercises plus ice), then do it again, then do it again.

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  7. Metonia, Take your time and you won’t get out of breath. The next choice, is always, just one step. How hard can one step be?

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  8. Manny, It is all dancing.

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  9. Pozaicer, Dancing is great (my daughter dances for a company), there is no better thing than finding the beauty in movement. How bad can rehab be if you dance it?

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