6 months post surgical ATR repair

I’m at 27 weeks, just over the 6 month mark.  When I ripped it the OS told me 6-12 months before you’re back at sports … He was right on the money.  I’ve been really lucky because nothing has gone wrong during my recovery, so I’ve managed to hit 6 months able to participate in most of my prior activities.

Here’s a progress report on the items that feel relevant to me in terms of my achilles recovery:

Scar tissue
Earlier I posted that I was trying to do the Graston Technique on myself to see how it went.  The jury is now in … you cannot do this to yourself effectively.  4 weeks ago I started seeing an Osteopath who has specifically studied adhesion release.  He does Active Release Technique and Graston on me.  These are 30min sessions of which 20min of them I spend sweating and biting my knuckles - it is really really REALLY sore!  He has no empathy, when I gasp (trying not to scream) he just chuckles!  When he does the Graston it feels like he is carving up my ankle, I feel like I’m a prime roast!  I expect to look and see blood.  There is no way I could ever inflict so much pain on myself.

The good news and the reason I’ve actually been back 6 times in 4 weeks … it works.  What used to be a massive very hard lump that felt like a large golf ball around the achilles at the join to the calf is now soft squishy normal feeling tissue.  The whole area has thinned out a bit, it’s still thick, but it looks and feels more like an ankle should.  We have also made headway with flexibility during each session.  So everyone, if you have lots of scar tissue then I highly recommend Graston.

Flexibility
Week by week I’m managing to eke out small increases in my flexibility.  This has definitely slowed down and is something I have to persevere at daily otherwise it starts to regress.  I am unfortunately extremely flexible.  My good ankle does a knee to wall measure of 18-19cm.  At 6 months I’m getting my injured ankle to 14cm when I’m warm.  That’s still only 78%, so although 14cm is more than most people get, it’s putting me off quite a bit in some of my movements and I find it very noticeable.  The ankle feels really stuck and in back squats I’m compensating much more than I used to leaning over which is not good for my knees or my back. 

It feels like something that I just have to work on daily and it will slowly improve.  Part of the problem is extremely tight toes, so my physio has me using yogatoes to try stretch them out and I use them when I do stretching, balancing and squating at home.  I also roll out the bottom of my foot and concentrate hard on rolling my ankle in, lengthening the toes and trying to flatten my arch to the floor when I stretch and squat.

Calf Strength
This is a slow process just like flexibility, but I think that it’s going well.  I can do the 180 eccentric lowers with 8kg in the backpack now.  I’m doing the "burns" routine I posted about earlier but only 2xboth legs and 1xinjured leg per week so far.  It BURNS!!! 

My injured calf is 1cm smaller which currently equates to 97% - so it’s really almost there.  It is actually 0.5cm bigger than what I measured the good side to be 9 weeks post ATR - poor thing can’t catch up because with all the calf exercises I’m doing my other calf just keeps expanding!

Diameter / size isn’t really a good measure because different parts of the calf muscles do different things.  So my biggest deficit in strength is still at the very top section of a raise.  The only way for me to measure this it to try take equal level photos of single straight leg raises on each foot and measure the height difference.  The last time I did this I was getting 12cm on the injured side and 18cm on the good side.  So that’s 67% difference.  Not great but it’s getting there.  I can do sets of 20+ single heel raises but the height deteriorates as I go.  Endurance should be another section to my post, but there’s no way for me to measure that, so let me just say that the injured side’s endurance needs work!

Plyometrics
The most terrifying of all the exercises I do! :)

I can now hop 30+ times in a row and I have been jumping onto my bosu ball which is about 9" high with a nice soft landing.  I (stupidly?) entered the crossfit games open last week and when the first workout was announced I went into a cold sweat … 20 minutes of 25 foot lunges holding 65lbs (30kg) overhead (knee must touch the floor and feet must alternate), bar-facing burpees (that require you to jump over the bar with two feet and land on two feet) and chest to bar pull-ups.  At first my fear was mostly for jumping over the bar, but then when I started warming up and lunged with my injured foot behind me carrying my weight + 30kg right through the toe and with the heel off the ground … I almost bailed!  It felt really scary - I don’t want to go through this ATR again. 

That’s the problem with this injury.  I’m pretty sure I could be running full pace already, but I’m terrified … and I feel rightly so - who wants this to happen again just because you wanted to do some exercise?  But living in fear is a bad thing!  So … I went ahead with the workout and although that injured leg was weak and I struggled to stand up when it was at the back, I managed a total of 225 feet of those lunges and 32 of those jumps over the bar.

This has given me quite a lot of confidence which is good since I know that with 4 more workouts to come we are bound to get box jumps and/or skipping and I need to get comfortable with jumping a bit more.  So yesterday I did some broad jumps along the pavement, and today I stacked some plates on the floor and did some (very scary) 15" jumps.  The box is 20" … so I’ll build it up slowly but I think I’ll be doing box jumps by next week!  Woohoo!

Jogging
This is probably the easiest of the exercises at the moment.  I’m sticking to a max time of 30min and I still jog-walk just to make sure I’m not overloading anything.  We are going away mid-March and I plan to jog every day and start to keep them continuous (no walking) and then add a bit of pace.

Squats
My squats as measured for about 3-6 reps are at about 65-70% of what they were prior to injury.  Front squat is the easiest.  Back squat is actually the hardest.  This is because of the flexibility issue - when the bar is in front the weight forces my foot down but when it’s behind my ankle is stiff and if I hold good form then I fall backwards.  Overhead squats are mid-way between the two.  To be honest I’m not pushing the weight with the squats yet, I just want to do them at a decent weight to build strength and improve flexibility.

That’s it for the 6 month summary.  I’m hoping to keep moving forward with the strength and flexibility during this next month and to lose some of my plyometric fear!

Happy healing everyone!

19 Responses to “6 months post surgical ATR repair”

  1. Wooo hooo, beanie! You are definitely top of class! :-D
    It is impressive how far along you are at six months! And all the ways you are facing the fear of reinjury, by diligently training and strengthening the tendon is really impressive.
    My fear, terror actually, kicked in just reading over the different exercises and activities you do, and the picture of you raising weights that even Popeye would respect (yeah.. I used to be a Popey fan and ate lots of spinach)!. Those weights actually look bigger than you are! LOL (or is it my fear comparing the two?).

    Well, Congratulations on your progress! i certainly hope that at six month I am able to do regular couch potato squats and heel rises (to get stuff on the top shelf, of course)… LOL.

    Take care! And thanks for sharing! ……. Manny

  2. Thank you Manny! I’m still so gutted to find out that your tear was caused by antibiotics :( But you are such a positive person and you’re doing so well in your recovery, I’m sure you’ll be rising up to reach the stuff on the top shelf in no time!

  3. Way to go beanie. I haven’t been able to do any of that stuff for years. But you are truly inspiring. I’ve put all kinds of surgeries off over the years and just slowly let myself decline. If it hurt, I quit doing it. Now I realize how much living I’ve let pass me by. Granted there isn’t much you can do about arthritis except keep moving which I’ve done. Just less and less.

    Maybe my surgery was my wakeup call to get back in the game of life.

  4. Awesome beanie - We have a lot of the same interests with regard to physical fitness, flexibility, etc., so I am going to use your (well documented) progress as a guide in my recovery. I am a little over three weeks post-op and was put in after two weeks, so I have been doing the ROM exercises several times a day and I am putting weight on the injured (right) leg. It doesn’t hurt to walk slowly without my crutches, but I do not want to push it.

    I do not do cross-fit, but I do play competitive beach volleyball and, before my injury, hit the gym and the beach regularly to train. Leg work , including plyos were a huge part of my routine and I’m looking forward to getting my strength and flexibility back.

    I did want to ask - sometimes I feel more of a tightness/pain in my calf. I haven’t really had any pain (except, of course, for the few days right after surgery) in the AT itself - but I do feel it in my calf.. almost like a mild strain. I’m guessing that its normal since there was a lot of trauma and a lot of work being done back there, but I don’t see it mentioned too much in the blogs.

    Keep up the good work - I’ll go through your blog more carefully to see what you were doing in the beginning stages of your PT.

    Kevin

  5. That’s supposed to say “put in a boot after two weeks”..

  6. kpeters - with regards to your calf soreness, I would encourage you to have the dr. look at this and do an ultrasound. I am 2 weeks post op and went in to have my splint taken off, etc. dr thought everything looked fine but I told him about the pain in my calf (injured leg) muscle. To me I thought I just stretched it maybe during the night and felt like a muscle pull. Dr wanted to be safe and requested an ultrasound. Sure enough they found a clot in lower leg and put me on blood thinners. Not trying to scare you but better safe than sorry….

  7. ckoutny - thanks for the heads-up. My Dr. has been very vigilant with regards to blood clots - I had to give myself a blood-thinner shot for the first 10 days and have been taking 325mg Aspirin every day. It is not a persistent pain - I usually feel it when I wake up or after doing some weight-bearing on my injured leg. I agree, though, it is a real risk and I will follow up.

    Was yours a constant/persistent pain? Were there any other symptoms?

    Kevin

  8. Hi Kevin, I agree with ckoutny and think that you should check with your doctor and probably get an ultrasound to make sure that it’s not a blood clot - better safe than sorry when it comes to those! I never had any calf pain and although some people write about calf spasms, not many mention calf pain, so I think it’s worth checking out. Hopefully it’s nothing, I’ll be holding thumbs for you.

    In the early weeks there aren’t many rehab exercises you can do, just gentle ROM and walking in the boot slowly adding more weight. At 3.5 weeks I was also doing small amounts of crutchless walking and I gradually extended the amount as time went on.

    In my 13 week post I listed all the exercises I was doing for rehab by that stage. Some of those started at 6 weeks, then I added more once in two shoes and by 11 weeks I was doing most of those exercises. But everyone follows different protocols, so allow your physio and dr to guide you. If there’s an exercise they don’t mention that you want to try then just ask - I did that a lot.

    I wish you all the best with your recovery! Take care and let us know how you go!

  9. Kevin - the pain in my calf didn’t start out right away after surgery. It was probably 5 days after. I’ve been very active since the surgery so was very surprised to found out there was a clot. Mine was worse after I elevated for quite a while and then brought the leg down. So morning was the worst just trying to ‘loosen’ it up. I really thought it was nothing and that I just strained my muscle somehow. Even the gal that did my ultrasound said usually the leg is swollen and cold and that wasn’t the case with me. This all happened on Tuesday of this week. It’s still pretty tight trying to stretch it out. Hope this helps. Sounds like we’re pretty close in our recovery timeline.

  10. Congrats. I have had 2 sessions of Graston with one of my therapists, and it is great. It really makes the skin smooth. I am contemplating going back just to have it done again.

    That weight looks impressive. Are you a power lifter? One time lift? How much weight is that?

    Congrats on getting your calf back to its original size. That is proof that it can be done within a year if you work hard at it.

  11. Thanks s40love. I’m not a power lifter, but crossfit workouts include power lifts like cleans, jerks and snatches. My competitive sport is actually triathlons but this needs to be supplemented with some strength training. I don’t enjoy doing weight sessions in the gym, so I started crossfit and fell in love with it, it’s so much fun. That pic is of the scary lunges I had to do, it’s 30kg overhead.

    Everyone heals differently and I feel that I have been lucky with being in a position to start training up the calf. Your posts show that you are walking on tip-toes and starting to do single heel raises at 13 weeks, so it sounds like you are also going to be lucky with this. So yes, I think that with hard work you will definitely be able to get full calf strength back in a year.

    Good luck and keep up the excellent progress!

  12. I called my Dr.’s office yesterday - my ortho doesn’t have an ultrasound machine.. They asked me if I had a fever, chills, shortness of breath, and if my leg was painful to the touch and cold - the answer to all of that is no. She said if I do get these symptoms go to the ER.

    The nurse said that now that I’m doing my ROM exercises and putting increasingly more weight on my leg that it is normal to feel some tightness in the calf. I don’t feel any tightness today, so I’m hoping she’s right. I continue to take my 325mg aspirin every day and move around as much as possible.

  13. Kevin that’s good to hear and I’m glad you don’t feel any tightness today. I’ll keep holding thumbs for you that everything is ok. All the best and take care!

  14. awesome stuff to hear! I know your only going to get stronger and better than you’ve ever been. I’m now 13 weeks post op and on a very good track as well. Good Luck, keep sharing!

  15. Thank you Frankie88! I’m glad to hear things are going well for you at 13 weeks and I’m sure everything will just get better and better for you from now on. Take care and happy healing!

  16. Beanie fantastic achievement, great inspiration
    and thank you so much for keeping us posted and sharing your journey
    Only seems like yesterday now, when we started on this road to recovery
    The positives have been many

    Kind regards Robyn

  17. Thanks Robyn, it’s so good to hear from you! It does seem like yesterday when this all began, and you were the person who pushed me into actually writing a blog since at that time I was only commenting, then you specifically asked me where my blog was which made me feel like I better write one! Thanks for that push because as it turned out, I’ve really enjoyed writing!

  18. Thank you for posting all this great information! Your journey gives me hope for when I hit the six month mark. I will have to look into Graston as I do not have physical therapy and have some large areas of scar tissue built up. I look forward to catching up on the rest of your blog!

  19. long - time runned I had / have haglunds deformity for many years; about 3 summers ago something ruptured and i hit the floor; didnt have health insurance , never saw a doctor, assumed it was the achilles about 6 cm up fro insertion. I kept walking on it, had to, self-treated. Anyway been back to running but this site has been very informative. My affected calf is still smaller and can only manage one heel raise. I jhave been lazy about rehab but with the use of a heel insert (3/8″ ) in sneaker have kept the heel bump pain at bay and am doing pretty well with running getting better little by little. Thanks

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