bobfv’s AchillesBlog

Well the time really does pass quickly.  We returned on Monday from 2 weeks of vacation out West, and today marks 11 weeks to the day since my ATR surgery.

While we were gone I did not go to PT, but I did go to the gym each day the first week and I progressed through most of my PT exercises.  I did standing balance on each leg, leg raises in four planes of motion, massage and Theraband resistance with the assistance of my wife, toe presses on a leg press machine, and eccentric strengthening on a leg press machine - pressing down with both toes and then back to neutral under resistance with just my repaired leg.  Also, I did at least 3 sets of 10 of two footed calf raises every day.

Most all of my activities were fine.  I wore mid-height hiking boots with a heel lift for extra support.  My gait is pretty normal but I walk pretty slow, some steps feel perfectly fine, others make my repair site feel like someone is squeezing it with pliers.  Range of motion is the same in both ankles, which is great.  The biggest problem I have had is with walking down stairs, but we are starting to work on that specifically in PT.

I went back to PT on Tuesday morning, the morning after my flight home.  I was excited to show my therapist how strong I had gotten and how I could do two legged calf raises with ease.  That was a mistake - never gloat to your physical therapist.  He proceeded to kick my butt for an hour, even having me walk around on my tiptoes with resistance bands, which really hurt a lot.  It helped to have him work with me on my stepping and I think before long I will be fine walking down stairs much better.

I continue to drive with absolutely no problem.  I got another set of boots - side zip lightweight mid-height black boots from Under Armour, they work great!  I added a 1 cm heel lift to my right boot. They are “Men’s UA Valsetz RTS Side-Zip Tactical Boots.” Extremely comfortable, lightweight, and supportive.

My scar is healed and gives me very little trouble.  Around the house I still don’t go barefoot, I use light shoes with a heel lift to remove some of the stress from my Achilles.  I took walks up to about a mile on vacation and plan to continue walking as much as I can.   Being out of the boot, I feel my strength and muscle tone returning.  The hardest thing for me now is my balance, it is taking a while to come back.  I bought a stability pad to help me work on my balance at home, and will be doing some one-legged exercises in my spare time too.

Next appointment with the OS is next week - looking forward to that.  Will concentrate on improving strength and balance before my next OS visit.

I am in the middle of my 7th week post-op and I have progressed in my PT protocol to a new set of exercises designed to get me back in two shoes and regaining my strength and balance. The protocol now includes:

• Normalize gait
• Progress calf strengthening
• Seated heel raise>>>standing heel raise>>>single leg heel raise
• NMES prn  (neuromuscular electrical stimulation as needed)
• Gradually progress dorsiflexion past neutral in stretching and strengthening
• Progress to equal ROM bilaterally
• Eccentric plantarflexion strengthening

I am enjoying these new exercises, for the most part, and continuing to do many of the exercises I learned in the past four weeks of PT.  I have stopped wearing the boot to bed at night and I take very short walks without the boot in the house, very carefully.  In PT I use my street shoes with a heel lift.  I am still doing seated heel raises and have not started the stimulation yet.  My range of motion is very good - I practically have the same ROM in both ankles, but I am not about to push it on dorsiflexion.  I am doing plantarflextion on the Total Gym in shoes which is kind of scary, because I have the balls of my feet on the machine and my heels off of it - the idea is to press down with my toes, but I am scared of slipping and going in to a big, unintended dorsiflexion.  I am also enjoying working on single leg balance - I alternate lifting one foot off the ground and standing on one leg for ten seconds at a time.

I have an appointment with the OS this coming Wednesday, and I am hoping to get his blessing to lose the boot and to start driving.  That will be exactly 8 weeks post-op.  Other than that I feel great, no pain whatsoever.  I bought a pair tactical boots which are lightweight and have a side-zipper entry and I plan to wear these in the first weeks out of my Aircast boot to provide extra support and protection. I have worn them around the house and they don’t seem to put any pressure on my scar, which has healed almost completely.