The Stereotypical Rupture

About 4 months ago when I first found this blog, I had put 118 days to recovery…figuring going the aggresive route should hopefully have me there.  I read/heard a number of stories both on this blog about the incredibly long recovery time, etc.–and that could get downright depressing…so I made conscious decision to do my best to not be one of those statistics.

From a physical standpoint, I am doing great.  When I first get up in the morning the AT is still stiff, and if I run right away I need to stretch it and do some exercises to get it warmed up before hitting the treadmill.  However, if I run later in the day it just plain feels great–in fact it’s the rest of my body that complains, as it had gotten used to couch potato mode.  My calf is still smaller by about 2 cm or so, and strengthening that seems to be the last piece of the puzzle.  I can flex the ankle on my repaired AT to 20 degrees, compared to 22 for my good ankle.  I was at 17 degrees about 2-3 weeks ago, which is considered in the normal range.  My last doctor appointment was also 2-3 weeks ago–and Dr. Askew pretty much said have at it, and that I didn’t need to see him again.  This past Saturday I ran 3 miles at about a 9.5 min pace, which is slow for an “”in shape” me but I was happy with it, all couch potato habits developed in the last 4 months considered.  I can do squats, do leg curls/extensions and lunges just fine.  Toe raises are my biggest focus right now, and I can do those with one foot–I can’t get as high as I would like but that is coming along too.

With spring and a new baby coming soon my posting might be coming to an end, but I may occasionally check the status of people who are at similar stages.  Good luck to all–the new “hello worlds” we see every week, the vets that are almost a year in or past, and especially to those who suffered the ill-fated rerupture.

So, in regards to being “recovered”?   I would say I am about 90-95%, but that depends on your viewpoint, as everyone needs to run their own race.  To quote Kurt Vonnegut: “Sometimes you’re ahead, sometimes you’re behind. The race is long and, in the end, it’s only with yourself.”  I am happy with where I am, and while my journey may not be 100% yet I feel damn good being where I am at.

This morning my regular therapist, DaRinda, was gone so I had another woman who works with her, Jenny, as my PT today.  Jenny had me do some different stretching/exercises (holy cow I have no flexibility in my hamstrings) and they felt great…the hurt-so-good type of stuff.  One was flat on my back with legs straight up–just doing to raises pushing up on a bar that was held down with springs.  The hammies got pinged as I had to keep my legs as straight as possible and head back.  Great though!

However, the most important thing was the use of a little laser device to try to break up scar tissue (it took literally just seconds to do).  I told Jenny that about an inch above my incision there was a 2 inch X 2 inch patch directly on top of my AT that was hard and stiff–and I did bug me a little as I have been doing strength training/running.  So first Jenny rubbed the crap out of it and then said she was a fan of the laser tool and it was worth a shot.  She also told me to pay attention to how long it feels good after I finish PT (it always feels great as it is all warmed up).  It has been 5 hours, including a lot of desk time, and I have never walked so easily or effortlessly since before the ATR!!  Jenny said she could talk to DaRinda and let her know whether or not it helps and continue the process if it does.  Lastly she told me what should have been obvious to me–she said scar tissue gets no blood flow naturally and to encourage the healing process we need to harass it a little–like rub it vigorously (OK, that was funny to type) multiple times a day.  I have definitely added that to my daily repertoire.

God bless DaRinda as she has been fantastic; it was just useful to have a second set of eyes/different experiences to try different things.  To all you fellow ATR’s in similar situations:  inquire about the laser, and at minimum massage the hell out of any scar tissue!!

Twelve weeks and 6 days ago I suffered a complete rupture of my right Achilles, with a repair done 2 days later.  Such a strange experience…never being seriously hurt before it was quite an event in my life.  I was very active–running, playing basketball, lifting weights, walking/running dogs, and playing with a toddler.  I found this site in a drug induced stupor 2 days after my surgery, and it has been both a good friend and reassuring presence as I worked through each step of recovery.

Today was a big day.  For the first time in over 3 months, I laced up my running shoes (a new pair to celebrate the event ) and hit an indoor track.  (I was supposed to have a brand spanking new treadmill by now, don’t get me started on my dissatisfaction with Scheels All Sports!)  I stretched a little and then just started a slow jog and just did a mile with a couple of laps warmdown.  A far cry from 21 minute 5K’s or a sub-2 hour half marathon, but I’ll take it!!!!  Much like when I had to learn how to walk normal again, I also had to learn how to run normal…the natural roll of the foot and just relaxing and letting it happen.  By the end of the run my Achilles felt great and it was coming back to me.  I look forward to adding distance and then speeding up as well.  I can’t tell you all how great it is do something that a few months back was so simple.  One added benefit of the run was once again how great the AT feels…the run really loosened it up and walking after the run felt 100% normal, just as it did pre-ATR.  Some things I learned:

• A lot of the recovery is in your head.  Getting your mind off the AT and relaxing does wonders to returning to normality.
• I am very glad my surgeon was aggressive in my recovery and ecouraged early movement.  I just ran!!  When I first did this I thought it would be another 1-2 months before I was capable of that.
• PT can do wonders.  Even if you cannot afford PT or a lot of it, research stretching, balance, and strength training post-ATR surgery and do it at home and start them when you hit the tendon recovery “safe zone” of 8-12 weeks.

I had a personal goal of 118 days to full recovery.  Based on the marathon tracker this gives me another 30 days to be “back to normal”, or very close to it.  I have every intention of being there.

Since taking out the last heel lift and going sans any walking/heel aids, the recovery has really taken off.  The repaired AT still feels tight if I try to stretch it, but not in a painful way.  Just 2 days ago I started walking our 2 gold retrievers again–a nice break for my pregnant wife and the dogs are happy too!  (Good to have the old man back, I walk farther.)  The walks have gone well and I end up walking faster and more naturally…the dogs like a quicker pace and with the damn North Dakota cold I do too, and actually mostly forgot about the AT.  Nice feeling.

I have weights in my downstairs and while lifting this week I tried legit toe raises on a small device I have…it also felt good and I’ll try to continue to build up some calf strength and flexibility.  So tonight my 2 year old wanted to chase me as we were playing downstairs.  I started my little half limp/run, and much to my surprise I could actually jog!!  With newfound excitement I did a few short jogs back and forth and it feel tight and a teeny bit of pain at the repair point, but much better than I would have expected.  Maybe running in 2-3 weeks isn’t so far after all!

Just a quick message as I had another post op with Dr. Askew yesterday.  Tomorrow is 9 weeks, and he said it looked incredible–he had a med student in with him, and pointed out to her he went with early movement, etc. with me, to point out the benefits.  I am down to just plain 2 shoes (no heel lifts), which is awesome…I still stick to my running shoes for a little bit yet because of the comfort factor.  I still have a little limp as I don’t have the “push” of my toes when I walk yet…hopefully that is around the corner.   My heel gets sore, and I think it is because I still rely on it more that my forefoot–I haven’t gotten that natural roll all the way back.  I still wear my compression sleeve (I remember someone posting a question about those), and it does seem to help a lot with swelling, so I might keep that for awhile before moving to a thinner, white one.

Dr. Askew also asked if I was a runner, to which I replied yes, I was.  He then gave me a peek at the light at the end of the tunnel, and said I could start running in 4 weeks!!!  That will be 13 weeks post op, and that is kind of my own stretch goal anyway.  I am still thinking wow, I have some work to do to get there.  So I love shoes…hence me commenting on Maestro’s new kicks in his video!  So no heel lifts opens up the shoe world again soon!!  Being able to run puts the plan in place for some new running shoes as well!!

I can’t believe 8 weeks have passed since the fateful night my Achilles decided it had enough.  It has actually gone pretty fast, yet slow at the same time.  Fast because 8 weeks have zipped by, but slow in the fact that I hate being so damn…unathletic?   I shouldn’t complain as I can do a lot, but not being able to run or play basketball pretty much sucks.  I can walk pretty well, still having one heel lift.  Any time a shoe/slipper isn’t around with a heel lift I can walk OK with nothing, so I might just give it a go with no heel lift and see how it feels.  I actually wanted to try it by now but tweaked my neck and reaggravated an injury form a year ago when the Maui surf made an example out of me.  That being the case I have been taking ibuprofin the last few days so I think it might skew how good my Achilles really feels.

All in all it feels pretty good, unless I am chasing my son Charlie or playing with our dogs, at which point I halfway jog and cut etc.  Surprisingly that isn’t all bad.  DaRinda has me still biking and doing leg presses, and she has added the little disc with the half ball on the bottom for ankle movement…rotating the edge of the disc on the ground with my foot to get flexibility back in my ankle.  I also do light toe raises, still favoring my repaired AT but still trying to build some strength…it feels just fine to do that.  Every once in awhile it will just be sore at the repair site, which comes as no surprise to me and I don’t think much of it.  I try to walk as normal as possible…try not to limp or favor the repaired AT.  Man, that is a challenge and good PT in itself.

Next week is my next doc appointment and will be 9 weeks. Based on my last appointment I don’t think I would get the green light to go nuts on rehab for another few weeks (based on his comments that it fully heals in 8-12 weeks) but it’s hard to say.  Scar tissue is still nonexistent, and as long as I wear my compression sock no swelling really occurs either.  I wonder how long I’ll have to wear that?

What is crazy is all the new “Hello world” links every week…makes me appreciate how common this injury is and for every new “hello world” I cringe a little as someone will be undertaking this same event.

So with the holidays I wasn’t able to give an update after my 5 week post op last Tuesday.  I first had some PT with DaRinda and then my appointment with Dr. Askew.  PT went really well, and my foot can get to neutral!  90 degrees is a great thing!  :)  My appointment with Dr. Askew also went well–he said it is looking perfect and as good as possible 5 weeks after surgery and there was no scar tissue build up (awesome!).  He also commented that is why he likes early movement in such surgeries as scar buildup is less likely.  I told him DaRinda said I was neutral, which he said was good but said I shouldn’t try to go any further quite yet.  He said DaRinda might try some light strengthening this coming week, too.  I asked how long before the tendon is actually healed, and he said anywhere from 8 to 12 weeks, with 12 weeks when you are usually pretty good to go (aside from gaining flexibility, mobility and strength back).  So 1/2 done with being very careful, and then who knows how long of being just plain careful!

I also asked about my crutches, as I had been cheating a little at home and not using them often.  He said “oh sure, you don’t have to use them anymore unless you want to” which was also pretty cool.  That being said, I have been crutch free since last Wednesday–sometimes the AT gets a little tender and ankle sore from moving more than it has in a month, but overall it is not too bad.  I still have 2 heel lifts for the time being, but may go to one this week.  I still walk slowly and with an obvious hitch in my gait.  Funny, what actually hurts is the bottom of my heel because of the heel lifts–the things are like standing on little mini cinder blocks!!

Happy holidays to all and I hope all ATR recoveries are moving along nicely.

So it has been one month yesterday since my surgery, and a week and change on 2 feet.  So far so good, and I am still not trying to get too crazy.  However, since this IS North Dakota, winter strikes with a vengeance.  This week brought 18 hours of 54 MPH winds while dumping 10 inches of snow…wonderful.  Thankfully I have great neighbors who had my whole driveway cleaned up, mutlitple times!  I think there are some gift cards coming their way in the near future. 

On Monday night though I did some shoveling, as our front door steps and a few feet out had banks about 3 feet high…and given the -10 degrees F temp there was no way I was letting  5.5 month pregant Kasey out there.  She was still able to finger wag me with a sterm look on her face from the window, though–”WHAT ARE YOU DOING” was mouthed to me I think…I just pretended I couldn’t hear her.  It actually wasn’t bad, I just kind of stayed in one spot until some was done, then moved forward, etc.  My back was not a big fan since I didn’t use my legs much, but my guess is my Achilles was thankful.

My incision finally looks great, but I still wear my compression sleeve as it is supposed to really help with scar tissue and assisting the incision to heal flat.  I find that I can walk almost as well with no cruthes now, but still keep one around to assist.  With 2 crutches I can really control how much weight is on it, so I use one or two depending on how long I have been on my feet or if the AT is tender or not.

At PT yesterday I got to ride a recumbent bike!  Wow, that kind of feels weird but no pain.  I wonder if I just sort of “get ready” for pain?  In any case after DaRinda massaged the leg and the AT today it felt great…walking on it after getting it all warmed up from the massage was much better.  I have also been lifting upper body now too and it feels good to not be such a couch tater anymore.  Anyhoo back to work and healing.

First off I hope I’m not offending anyone or rubbing it in any faces that I am on 2 feet so soon…I consider myself pretty damn lucky!  So I am on day #5 with wearing two shoes, 2 heel lifts on my bum foot.  I am actually amazed at how good it feels to get some blood flowing to that area!  I have to be really disciplined not to want to skip the crutch(es) completely…Kasey let me have it last night as I was scooting around the kitchen sans any walking aids.  Truthfully though I feel pretty luck to be at this point.

At PT yesterday I asked about no CAM boot, and DaRinda (my PT) and crew just laughed and said, “Sorry, you’re kind of in uncharted territory for us!”  I take that as a good thing, and asked to measure my range of motion again–I am 6 degrees from 90 when I push my foot up, so that was cool.  The other ATR patient they have right now is a woman who is at 6 mos post op and still having trouble walking, has built up scar tissue, etc.–I feel for her and really hope things turn around.  As for PT for the next 3 weeks or so it will just be massaging the foot, calf and tendon to try to prevent scar tissue, and then I can start some light strength training on it.  (Not sure if DaRinda meant 6 wks post op, or 6 wks from now…in any case I’m chilling out for a few weeks.)

As far as walking it turns out when I was using one crutch I was using the wrong arm (d’oh!)!  Yeah, Andy is S-M-R-T smart smart smart.  It’s funny though–I move slowly with my one crutch and people still give all the sympathy looks and stuff, but I think to myself “you have no idea how nice this is compared to where I was 2 weeks ago”!  Actually though people are great and do their best to get out of my way–except for the Menonite/Huderite lady at Wal-Mart last night who about took me out just outside the door in her mad dash to meet her party.  I just about whacked her with my crutch!  (OK just kidding, it was nice to be totally ignored for once.  )

Anyway, I still go pretty slow and am still pretty paranoid about doing too much right now but love the 2 feet stage. 

So I just go back from a PT appointment this morning, and was anticipating whether or not I would be in a boot yet or have to wait another week.  Needless to say I was shocked when, after speaking with my surgeon, DaRinda came out with 2 heel lifts.  I was instructed to use one or two crutches as necessary and focus on the proper walking gate–use more crutch to ensure I walk smoothly rather than hop or skip to compensate for my bum foot.  Dr. Askew said he was going to be aggressive with me, but wow I had no idea THIS aggressive.

So far so good, I can walk slowly with one or two crutches and it feels OK.  I am a little nervous to say the least, based on people far further along than I am who have suffered a rerupture.  I’m not sure how long this goes on, and was so surprised by this course of action that I never did ask “where’s the CAM boot??” 

Anyone who has any comments, suggestions, or similar rehab please post a comment, and I will keep updating moving foward.