baezlyons’s AchillesBlog

Thanks for the comments, looking forward to spin class soon.

I plan on hitting spin class in a couple of weeks. I just tested out my foot yesterday on the bike and it can definitely handle more than I thought!

Try it out and see how you feel. But standing is something to definitely watch for. I tried to stand yesterday, but with as slow as I had to go, it’s better to just turn up the resistance.

Happy riding all!

baezlyons– I’m a Spinning instrutor. I started back to teaching my classes while still in the boot with “bad” foot resting in a chair. At 13 weeks (that is when I was fully off the crutches) I was able to pedal with both feet clipped in. At 16-18 weeks I added a little 2nd position and gentle hills–gradually moving into 3rd position with more resistance (I also felt confident to ride outside by that point) At 20 weeks I was teaching pretty much as usual (although I was still pretty careful in the “up” positions), and riding hills outside. I’m at 6 months now and doing my classes the same as I had before AT surgery (I didn’t have ATR but debridement and repair…similar recovery). Last week my class commented that I am “more evil” now than I was before the surgery!

I think class would be fine as long as you don’t stand suddenly. I have been riding my trainer with pedals clipped in since week 14 and went 20 miles this past weekend outdoors. I am 18 weeks post op and loving the bike - having some music in class would be great! Go for it!

I skied a week at Whistler at 17 wks post-non-op following bit.ly/UWOProtocol. No probs except getting thinner ski socks to fit the fatter AT/ankle into the boot. Ski boots are pretty AT-protective; I was at more risk walking around in 2 shoes.

I intend to work on the conditioning of the whole of both legs for the rest of my life (both are injured), so whilst I may have had problems with the achilles, I have a vain hope that if the overall leg is better, maybe I will board again. I guess I have to be serious about my boots and orthotics. For some reason what scares me the most is having the board hanging off a ski lift with the full weight just dangling from my operated side!

Can I get my legs into better condition than they were previously!? I guess only time will tell, odds are against, but people overcome bigger odds everyday!

I started (easy) boarding again last January- about 5 months post surgery. Boarding is a lot tougher on the ATR than skiing.

Oh I was told I could go back to work after Christmas as long as my progress continues. No Jumping or moguls for the first week! Until I get my ski legs back. I’m 12 weeks that will put me at 6mos. Also I am 60 years old. Like everything we do with this injury it’s try and gear back if it hurts or feels wrong!
Listen to your body!

I’m a ski instructor in New Hampshire. My son is a freestyle board coach. One of his friends had an ATR from a landing,and was told to wait at least 6mos and have the PT include exercises that would strengthen his boarding muscles as well as his AT. As long as you board and not take on any air and your PT okays it you should be fine.
I had an impact rupture (landed on the floor after a chair tipped over- landed on two feet)so be careful and listen to your PT.

10 weeks! I’m a boarder and was told to give it 2 years if at all!!!!

I’m nearly 16 weeks and still on crutches.

Good luck with the skiing. would be good to hear how it goes, and if anyone has boarded.

Lot’s of ski info/video on my old blog posts. I first hit the slopes - last season - at 10weeks (day 72) post surgery.

Hi,

I live just a few blocks from the beach and I love the beach.However, although I am in two shoes now and at 10 weeks have yet to attempt to walk on the beach without my boot. Soft sand, unpredictable waves etc will keep me off for a while yet. I stick to the board walk or as jenniferanderson mentioned take the boot off once sitting down. I know this is not want you want to hear ! Take care if you do do it!

I don’t have any experience with going to the beach at this stage in the game, but I did go to the beach for a week prior to my surgery with my Achilles at a complete rupture. I ended up walking on the side of my foot just so I didn’t re-injure or aggravate the injury. It was difficult to walk.

I am only 3 weeks post-op and I know now how dangerous it was for me to go prior to the surgery but I only get one vacation a year an I didn’t want this injury to dictate my summer. The issue with the beach is sand. Sand has no support- it gives when you place each step and you will need to use your Achilles tendon when you walk on sand. (Most of us don’t even think about the importance of our Achilles when walking on sand - we just do it). We need this tendon to walk. If you feel like your Achilles tendon is strong and you don’t have to baby it, you might be okay, but I would definitely be careful this early in the game. I hope this helps! Blessings!

I went to the beach at 14 weeks. I had read about a girl on this blog who had reruptured at week 14 running from a wave that snuck up on her. I was very worried about it so I wore my boot to hike through the dunes to our spot. Once there I took the boot off and buried my feet in the sand. Heaven! I steered clear of the water. I think I was around week 17 or 18 before I felt strong enough to walk bootless on the sand and go into the water. I may have been too cautious, but I would rather err on the side of caution than start all over. It just depends on how strong you feel I guess.

starshep,

Good to hear. I guess I’m progressing about the same as you did thus far. I’m not the most patient person in the world. But, I suppose if it’s one thing that ATR will teach you it is patience. Thanks for the feedback.

californiaguy,
Don’t worry about the dorsiflexion for now. Your physical therapist will give you exercises and guidance on that. You will start with active ROM exercises and progress to passive ROM exercises. The last thing you want to do is put too much strain on your tendon before it’s ready and risk re-rupture. Your therapist will have a better handle on the timing. I went from -10 degrees when I started PT at 7 weeks to +18 (considered normal) somewhere around week 17.

hi starshep,

I have not started any physical therapy yet. I’m on my last wedge in my boot, which is very comfortable. I hope to have no wedge in a week or so.

So I guess that is not out of the ordinary for me. It would feel great just to be able to have 0 degrees of dorsiflexion with no tightness.

Thank you for the feedback.

califoringuy,
ROM advances at different rates for everybody. At 7 weeks I was still below neutral (0 degrees dorsiflexion). Are you doing any formal physical therapy yet?

I’m 6 weeks out non-op and my achilles tendon feels very tight right at neutral (90 degrees). There is no way I could put my foot past this point. Is there a schedule for how your ROM should be at each week? I feel like it’s too tight.

Is this normal and will it loosen up over time?

thanks for the feedback, i still feel like i need mine at 13 weeks.

This is one of the most varied aspectr of ATR rehab. Protocols are split ~50:50 whether a patient who’s already been walking in neutral position should go back to a PF angle (with a heel wedge) when going to 2 shoes. I’m a UWO guy, they got great results and did not, so I don’t “see” it myself.

BTW, my biggest beef with the UWO protocol is their cold-turkey removal of all 2cm of heel wedges (in the boot) at 6 weeks. That’s a very big and sudden change in ankle angle, even if you do it at bedtime and “sleep on it”. I’d do it more gradually — & I DID, because the sudden change bothered my leg.

I’m still wearing one heel lift in each shoe at 15 weeks as I still get a tendon pull when walking any distance. I asked my physio and she said they are usually removed once you can walk without crutches.

I currently am wearing one at 10 weeks post op and 2 weeks in 2 shoes.. My pt took a layer off one but my doc said keep it in for another 2 weeks. (my protocol says keep it in untill week 14 but I think doc will allow me to take it out when I see him next) Im still getting pain in my achilles area when walking, like a sore, when i try to push off with my foot, especially after PT. Does anyone have that problem?

I never had heel lifts in my shoes. I did have them in my boot for a couple weeks, tho. Let’s see. I think I had a cast for 4 weeks, and the boot for another 3-4 weeks (can’t recall that far back - getting too old!). I would say I ditched the heel lifts at about week 6 after surgery. That seems about right.

Normofthe north. Thank you it worked!

There’s a simple trick to let both of you (& everybody else) walk down stairs normally, either with a stiff ankle or with limited heel-raising strength. I’ve outlined it elsewhere incl on my own blog not long ago. Works in a boot, 2 shoes, barefoot.

Instead of planting your injureyud foot as far back on the step as possible, you plant it quite far forward, with around half of it sticking out over the air. Then, as you step over that foot with your UNinjured foot, you let the injured foot roll over the edge of the step. With a few steps’ practice, you’ll look completely recovered on stairs!

I started this FWB in a boot, so when I got to 2 shoes it was already natural for me. Try it!

Hi. Thanks for the comments. yes, in two shoes and for pt doing rom plantar/dorsiflexion, inversion/eversion, ankle circles, ankle alphabet and stretching with a karate belt. I also do pt in a pool two times a week with a wide variety of exercises. when i go to the gym i ride the recumbent bike. I do feel the best after pt but then i tighten back up. I guess I just have to keep at it. My rom is not in normal parameters but showing improvement (not exactly sure of the numbers at my last pt). I have more range with plantar than with dorsiflexion.

I’m at 11 weeks post-op also.
My ROM was in the normal parameters at week 7 (second week of PT). That is according to the measurements that the PT took.
In the real world, my ROM isn’t perfect. I also go one step at a time descending stairs because pointing my toe downward to get to the next stair is difficult and unnatural feeling (even though the ROM measurements are exactly the same in both my ankles now).
I think that this feeling comes from the weakness that I feel when I put my weight on my toes to support myself going down the stairs. I also have a lot stiffness in the inside of my ankle.
Before I leave the house for work in the morning, I feel the need to go through about 15 minutes of stretching and PT drills. I do ankle stretches constantly during the day to loosen it up, especially if I am about to embark on a bit of a walk.
Does it loosen up after stretching and use? The times that I have the best movement and feel normal are after a particularly intense PT session.
Joan

Hi

What exercises are you doing? In 2 shoes? What range do you have, pfº and dfº? i.e. down and up. It doesn’t all happen at once and it does need work from you.

Looking forward to hearing more.

Thanks Kim. Mine feels a little better today.

I’ve got the same thing at 13 weeks - PT said to stretch it and do all the same exercises I do on the other foot. Doesn’t seem to help much - but hasn’t gotten any worse either.

Ya, what they all said. The vast majority occur before 12 weeks post-whatever, but by no means all of them. Super-slow rehabs probably extend the at-risk period, especially for the non-op crowd.

You are still vulnerable. Watch your step, and give it another month. On the bright side, once the tendon is healed it is unlikely to rupture.

Baezlyons:
For most people it seems that the risk or re-rupture greatly decreases after the 16 week point. My doctor told me that by that time, the only way I was going to re-rupture was if I fell or did a strong cutting motion. The repaired tendon comes to maximum strength at the 6-12 month period.

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