20 weeks - training again
20 weeks post surgery - 4.5 months!
I’ve had a great week … I’ve started training again! It feels amazing 
So my big milestone of the week is that I have returned to the scene of the crime! Exactly 20 weeks after the day of the injury I went back to my crossfit box and joined a class. I was pretty nervous about a whole bunch of things but once I was there it was just like old times and I can’t even begin to explain how happy it made me feel to train side by side with all my friends and feel capable again - injury? what injury?!
Crossfit forms the strength and high intensity section of my training, but triathlons are my thing. So I’ve also started a sprint distance triathlon training program but I am walking instead of running.
In terms of rehab:
- I am up to 4kg in a backpack while doing the eccentric lowers.
- My knee-to-wall measure is 10cm most days and I can hold it for 30 seconds but if I’m stiff I only get 9cm.
- I’m still walking around on my toes, doing strange lunge walks, walking backwards, walking in a crouch and generally trying as much as possible to engage my calf whenever I’m on my feet.
- The bosu ball at home is just awesome and I am getting better and better at doing balancing and single leg mini squats on this. I have also found that a great exercise is to turn it onto the dome side and then stand in the middle on the injured leg and try to push it forward so that the front edge touches the floor and then back so that the back edge touches. It works my calf like crazy on the push forward and then gives a nice stretch as I go back.
- Squats are improving. Although I still fall backward a lot of the time, I am managing to do some overhead squats with a broomstick. Overhead squats require flexibility and stability in ankles, hips and shoulders so I’m pretty happy that I’m managing to get a few done, but I admit that they aren’t pretty and when I record myself I can see how my uninjured leg is compensating which puts my alignment out, so I have a lot to work on in the squats.
- I’m rolling my foot out on a golf ball and I’d say the discomfort has moved from pure teeth pulling torture to that of a waxing session (sorry boys, some of you won’t get this but I can’t think of a better analogy).
- I did some research on removing the deep scar tissue. One method that pops up quite a bit is the Graston Technique. I’ve tried to find scientific articles with experiment based research results but I haven’t had any success. However it gets favourable responses from lots of people with surgical scar tissue. The reason I locked onto it is that although it uses expensive tools and you’re supposed to be trained in the technique, there are quite a few "self help" videos and articles on it where people do it to themselves with spoons or blunt butter knives. This also led me to Gua Sha which uses a similar technique with ceramic Chinese soup spoons. I couldn’t find any reason how I could hurt myself if I tried it as long as I stay off the actual tendon. So I’ve been giving that a go with a stainless steel teaspoon edge and handle. I’ve been doing it for 5 days now, only on the sections between my achilles and shin on either side. I lubricate heavily and then do just 10 up and 10 down rubs on each side. The first day I did it I couldn’t believe the sounds and feeling I got from the inside (medial) section! It sounded and felt like driving over gravel. Today it still sounded gravelly in sections but nothing near as bad, and I was able to push pretty hard. What happens is a lot of blood floods to the area in those few scrapes and it goes red, so I figure a lot of blood in the area can’t be bad. I’m not hurting myself at all, there’s no pain while I do it. My plan is to try and do this myself for a month. I don’t really have the time or want to spend the cash to go to another therapist, especially if this is something I can do myself. And I also think that doing it once a day must surely outperform once or twice a week? I do it before the eccentrics in the morning because I read that there’s more benefit if you disturb the tissue and then give it direction using stretch and strength - no idea if this is true, but it made some sense. So the jury is still out on this one … I will keep you posted I am also massaging the whole area quite vigorously with my hands twice a day and it seems to be getting more supple generally but first thing in the morning its still hard as a rock.
Here’s a pic of my calf raises with 2 legs, good leg, bad leg side-by-side. Even when I raise on both legs my injured leg is not reaching the same height as the uninjured side yet, but it’s close. The single raise on the bad side is very weak in comparison so there’s a way to go still with strengthening that side. If you look closely you can probably see the lump as well.
Here’s a pic of the broomstick overhead squat, barefoot which made it extra tough, it took me a few tries to get it.
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This looks amazing. Having only just ruptured mine where you are at feels a million miles away.
From your talk about scar tissue i am assuming you had surgery? Are you based in the UK? If so was this done by the NHS? I haven’t been given this option at the moment which i am bit worried about as i teach PE for living and i am very active.
Congratulations, Beanie, and thank you for the details and the pictures. I might not understand all of your details and explanations, since I’m not into gyms, but it sounds like you are a real athlete and are recovering fully.
Manny
jleggett6 at the beginning it is really overwhelming and scary, but it gets better and there is so much rehab that you can do once you move back into shoes that things really start to pick up. You are looking at about 6-8 weeks of pretty boring downtime I’m afraid, but even during that time you can have fun learning how to walk well in the boot and doing other sorts of exercise like swimming, upper body, etc.
I am in Australia. I did have surgery and the scar tissue lumps are probably a direct result of that. If you go the non-op route then you have far less likelihood of getting adhesions.
I agree with everything that Jayli and Stuart posted on your page. There are a number of studies that have shown non-significant differences in both re-rupture rates and strength post ATR between surgical and non-surgical treatment. However, the non-surgical treatment must include functional rehab with early weight bearing and early range of motion otherwise other studies have shown that the re-rupture rates for non-op are higher.
I only read about all this after I’d had surgery. I was offered both treatments but my OS recommended surgery since I was very active, still quite young, non-smoker, etc. This was all on the day of the rupture and all I could really think of was that I wanted to get fixed up and surgery seemed like the only thing that would work. But I have found out since then that this is not the case.
Stuart mentioned some of the names of articles you can read to help you make your decision. Here are some of the links to those articles:
http://www.ncbi.nlm.nih.gov/pubmed/23224384
http://www.ncbi.nlm.nih.gov/pubmed/21037028
http://www.udel.edu/PT/PT%20Clinical%20Services/journalclub/sojc/04_05/apr05/wallace.pdf
http://www.ncbi.nlm.nih.gov/pubmed/17885221
There was a blogger here who did his AT a couple of months before me - Evan Brown (username ejbvmi). He went non-op with early weight bearing and PT and he has had an excellent recovery and was running again at 20 weeks. I know that one case doesn’t show anything, but in a direct comparison of Evan’s non-op to my op recovery timeline and functionality, I would say that we’re pretty much the same. If you choose to continue non-op, then have a look at his blog and his youtube videos because he shows all the exercises he did at the various stages.
achillesblog.com/ejbvmi/
http://www.youtube.com/watch?v=pEJp0UoT7SE&list=PLu1nHtWBBf8YfYz6JCH4z_vrVBF592gHI&index=4
I wish you all the best and good luck with making your decision. The best advice I can offer is to equip yourself with as much information as possible to help guide your choice. Once you’ve decided then stick with it and have faith in it - it will work! You’re young and from reading other blogs it seems that the younger people really recover well and are back in action quickly. Be positive and I’m sure you will make an excellent recovery and be back to teaching PE and resuming your own activities soon, as if it never happened.
Hi beanie, congrats on all your success. I’m new to the site and have surgery planned for beginning of February for a large heel spur under my achilles tendon.. I’ve only started reading everyones pages and must confess I’m getting scared. TMI maybe lol. But I’m glad to have found this site because I also had very unrealistic ideas on what my post-op would entail.
I look forward to reading about our continuing progress
Hi metonia, TMI - I know all about it. I scared myself silly reading all the re-rupture stories, but I think it has been good to get all the information, the good and the bad, because it’s helped me to make choices about my rehab that I wouldn’t have known to make without it. Remember usually a small percent have complications and problems, but they do happen so you need to be aware of them.
There are lots of different injury types on this site, so when you read through the blogs always go to the first entry to find out what the initial injury / problem was for the person. That way you can mostly read blogs that are more relevant to bone spur removal. The rehab protocols seem to be a bit different and I think that usually when the bone is involved people are NWB for longer, but I’m not sure about that. There are a number of active posters at the moment who have had surgery for bone spurs or haglunds deformity. You can also use the search box at the very top right of the main achillesblog.com page, this retrieves all postings and comments that mention whatever you search for and it’s a good way to find relevant information.
Good luck with your preparations for surgery and let us know how everything goes.
Hi Beanie & all
Beanie I just read your progress update and am thrilled that you have been able to start training again. How happy did that make you feel and what a reward for all your hard work and dedication to recovery. Great progress
beanie,
congrats on the great progress!! so glad you are back to training, it seems like yesterday we were discussing about going to two shoes out of our boot!!! I’m learning the exercises from your posts and trying to implement, best wishes
Thanks Robyn & Gutzer, I’m so glad that we’re all gradually getting through this together. All the best and happy healing!