February 15, 2016 - 9 Month Progress

February 15, 2016

So it is mid-February and I ruptured on May 10, had surgery on May 20, 2015, that puts me 40 weeks and one day post injury, and 38 weeks and 5 days post surgery. I just round it off to 9 months.

My last update was around Thanksgiving, when I did a turkey trot at a fast walking pace. I have made very steady progress since then. I work out on a treadmill 5-7 days a week. My main focus has been on progressing from a “walk” (one foot down at all times) to a jog (periods with both feet off the ground). During December we were out in California for a couple of weeks and I took advantage of the nice weather to take daily 4 mile walks in my Skecher’s Shape-up Comfort Walker shoes. Back here in Northern Virginia, I have been hitting the gym daily. My basic workout has been 40 minutes on the treadmill - the first 10 at a fast walk - 3.5 mph - then the second ten minutes also at 3.5 but increasing to a 10 percent grade by adding one percent per minute - the third ten minutes lowering from 10 percent to zero grade, then the last ten minutes at my fast walk 3.5 mph. In mid-January I had to go for a treadmill stress test ordered by my cardiologist and I did fine, all the way through the fourth stage, which is 4.2 mph at a 17 percent grade!

In the past week I have incorporated jogging into my workouts. My jogging speed is 4.2 mph, a very light jog, but a jog. Today I did 10 minutes fast walk (3.5) then 15 minutes jog (4.2) and the last 5 minutes at 3.5. I hope to get up to 20-30 minutes of jogging within the next week or two, and to then get out on the road and properly jog a 5K in the early spring. My jogging is sure to help my Achilles heal (hey - double entendre!) as the jogging action adds a plyometric push-off aspect to the motion.

In addition to the walking and jogging, I have continued with the strength and balance exercises I learned in physical therapy. About 3-4 times a week I do 100 heel raises of different types. I can just barely do a one legged heel raise on the healing leg - I am a little disappointed because it is so easy to do on my good leg, but I am trying to remain patient. I also do toe presses on a leg press machine, and I walk on my toes using a Theraband for resistance. I also use an “Indo-Board” for eccentric strength and balance training, and do one legged floor toe touches.

My walking is absolutely fine - I am a little sore sometimes but I have completely lost any trace of a limp. I force myself to use a full range of motion when I go up and down stairs, and I work through morning stiffness when I wake up.

I am not taking any type of medicine since I don’t have any pain. I am very careful about my footwear now. I wear Skechers Shape-ups as much as I can. For gym shoes I am wearing Asics Gel-Kayano 22’s with the insole removed and replaced with blue ‘Superfeet” orthotics. I have a pair of low Gore-tex Under Armour boots for bad weather and I have a gray merino wool Superfeet orthotic in them. I am also back in my favorite daily shoes, a pair of low cut Vibram-soled Timberland shoes, and I got low profile carbon fiber Superfeet liners for them. My dress shoes are Allen Edmonds Park Avenue shoes - I don’t have to wear them every day, and I can’t get even the lowest profile black Superfeet into them, but I do okay when wearing them.

My scar has healed very well - I continue to use Bio-Oil once or twice a day, and a couple of days a week I use a silicon sheet over the scar.

So I am hoping that the last three months of my healing - taking me up to my one year anniversary on May 10 - will continue to go smoothly and I will continue to progress. My goals in the next three months are to be able to run a 5K in 45 minutes or less, and to be able to do one legged calf raises evenly on both legs.

Best of luck to everyone in your healing.


November 18, 2015 - 26 Weeks Post-Op (Six Months!)

November 18, 2015

Not a lot to report except for a major milestone - six months post-op today!

Everything is going well and I pretty much have forgotten about the injury.  I wear regular shoes with Superfeet insoles and I walk without a limp. I am in the gym 6-7 days a week. The only thing I still can’t do is run, ie, have both feet off the ground at the same time.  I can walk fast (1 hour 5 kilometer pace) at a high incline.  Truth be told, I am pretty sure I could jog right now, but I am holding off until I build up more strength.

I am doing calf raises, resisted duck-walking using Therabands, eccentric strengthening on the leg press machine, one-legged balance exercises, and a few other  exercises every other day.  My daily cardio is a 40-60 minute fast walk on the treadmill or a 30 minute bike ride or elliptical machine workout.

The last resisted exercise I cannot do is a one-legged calf raise on the bad leg.  I am working towards it, but just don’t quite have the strength. I have gained full symmetry back in both calves, but I notice that on the repaired leg, the development in my calf muscle is "shorter" than in my uninjured leg - I think as I continue to exercise it, more of the calf muscles will regain strength and tone.

My scar looks good. A couple of nights a week I apply a silicone patch to lighten it up a bit, and when I don’t have the silicone on I rub some Bio-Oil into it.

So that’s it, I am pleased with the progress. Also very happy that I went surgical and got into an early weight-bearing protocol and in to PT early.


October 7, 2015 - 20 Weeks Post-Op

October 7, 2015

Hard to believe it but I got out the calendar (as I do every Wednesday) and ticked off the number of weeks since my surgery on Wednesday, May 20, and today marks 20 weeks!  At this point, I really don’t remember that I ruptured my Achilles unless I think about it. My gait is completely normal, but I feel a very slight “hitch” in my right ankle when walking in flat shoes. I am wearing either well-supported shoes with “Superfeet” arch supports or specialty shoes like Skechers Shape-Ups on a daily basis.

What I CAN do: I can walk normally up and down stairs, as I have a full range of motion.  I am unlimited in terms of cardio work on a bicycle, elliptical trainer, or Stairmaster. 3-4 times a week I do specific strength and balance exercises in the gym, these include leg presses focused on eccentric strength, stability pad work, one-legged yoga poses on my “bad” leg, two legged calf raises, and plyometric hopping exercises. On the treadmill I walk at a 5km per hour (3.1 mph) pace for 30-60 minutes.  I have absolutely no fear of rerupturing at this point and I work hard to put stress on my calf muscles as I seek to rebuild them.

What I cannot do is run - and I define running as leaving both feet at the same time in a forward motion.  I feel like I could if I wanted to, but I am waiting at least another month while I continue to strengthen myself.  I feel like I could probably do a one legged calf raise on my “bad” leg, but I am going to wait on that as well - in the mean time, I do about 100 2-legged calf raises a day and focus more and more of my weight on the “bad” foot.  My biggest issue is eccentric strength.  For example, when walking down stairs, I put the ball of my ATR foot down first and it is still very hard to prevent the heel from just plonking down - I just don’t have that eccentric strength (strength as the calf muscles lengthen) yet, but I recognize it and I am working on it every day.

The scar looks okay - I rub Bio-Oil on it a couple of times a day. It is small and even, the surgeon did a great job on it.  I have lost 15 pounds of the 20 that I gained since the injury, and I am going to try to keep the momentum up and lose a little more.

That’s it!  Very pleased with going the surgical route, with my early weight-bearing protocol and with getting in to physical therapy early (3-weeks post-op.)  I am going to “walk” a couple of 5K’s this Fall - whereas my pre-injury 5K time was around half an hour, I just want to do the distance in an hour (I have been doing this on my own, but It will be fun to join an organized 5K event.)

Best of luck to you all in your continued recoveries.


September 16, 2015 - Week 17 Post-Op Update

September 16, 2015

Every Wednesday since the day of my surgery on May 20, I think about how another week has passed.  I am really doing great and can honestly say that I am better than I was before the rupture (bearing in mind that I had a diagnosed moderate tear for a few months before the rupture.)  In the past two weeks I traveled on business from my home outside Washington DC to New Delhi, India and back again and I am happy to report that I experienced no swelling or discomfort in the repaired ankle at all.  I have not been icing or elevating just because I don’t need to.

What I have been doing is exercising.  I am back on the elliptical trainer for 30 minute pain-free cardio workouts and when I have time I follow that with a 30 minute walk at 3.1 mph on the treadmill.  I pick 3.1 mph because that is the distance of a 5K run.  Before my injury my standard 5K time was around 30 minutes, so I feel that now I could easily complete (although not RUN) a 5K with an hour or greater limit, so I am starting to look for one here in the area.  I have also been keeping up with the strength and balance training that I learned before I was discharged from PT.  For example, I just got back from the gym where I did 50 2-leg calf raises, 3 sets of 15 balance exercises where I stand on the bad leg and bend down and touch a yoga block with my opposite hand, plus the most important exercise for me now - eccentric strengthening.  Eccentric strength is strength in your muscle as you are extending it, so if you imagine yourself standing on your forefoot - you use eccentric strength when you lower yourself on to your heel.  As recently as 2 weeks ago all I could manage was to drop my heel, but with continued work I am finally getting some control over the process.  Besides walking, I use a leg press machine with 90 pounds (the amount is not important as long as you have some resistance) - then I do basically a 2-legged toe raise on the machine, and I just use my bad ankle to lower myself back to a little past neutral - then back up on two toes, down on one as before.  This eccentric strengthening has really been helping me and I have noticed that my heel soreness has almost disappeared, since I am no longer dropping my heel when I walk.  Going down stairs, I also practice eccentric strengthening by going down to the next step on my toe and lowering the heel.

I have completely normal range of motion, very little pain, and my gait is almost back to normal.  I don’t think I have a limp but my wife tells me I still have a little bit of one.  Oh well - keep doing strength and balance exercises!

For workouts I am using my old running shoes - Asics Gel-Kayano 20’s, with green Superfeet insoles.  I am mostly using the Skechers Shape-up Comfort Walkers for everyday use and have even taken my dogs on a couple of 2-3 mile weekend walks on fairly smooth terrain.  I would like to get back to hiking the trails around my house more regularly now that the weather is nice, which I should be able to do.

My scar looks fine - I rub Bio-Oil on it several times a day mostly because I like how the Bio-Oil smells.

That’s it for now - my advice to everyone starting out with the injury is that the time actually passes quickly - get in to PT as soon as you can and start to reclaim your life from his nasty injury.  I am very pleased I went the surgical route - but of course my perspective is that I did not have any surgical complications, so I guess that is easy for me to say.  It gets better - hang in there!


August 10, 2015 - 3 Month Follow-up - Discharged! Shoe Guidance.

August 10, 2015

My ATR surgery was on May 20, 2015, so technically I will be at 12 weeks post-op this Wednesday (it is Monday, so that is two days from now). Today was the first follow-up with my Orthopedic Surgeon in about a month, due to both of our vacation schedules.

As I mentioned in the last post, I am doing great, walking in two shoes and driving. When I saw my OS today he did the Thompson Test, checked my strength, and said that while he was there for me if I needed anything else, he is done with me, I am discharged! I told him that I have dropped down to one PT session a week and they are scheduled out for about the next month and he told me that should suffice as well, if I continue to work on the exercises I learn in PT on my own, which I have been doing all along.

In PT I have progressed to two footed calf raises with no support (30 a day), eccentric strengthening on a leg press machine, resisted toe walking back and forth. heel walking, calf stretches against the wall, heel to toe balance walking, stability work on a blue Theraband stability trainer, and practice stepping over a step, as opposed to just step-ups for strengthening.

My gait is getting better by the day. The slower I walk, the easier it is to have a normal gait. I concentrate on working my repaired leg through the entire normal range of motion from heel strike to toe push off. I still have just a little pain walking down stairs but I am doing my best to concentrate and work through that and come down stairs the "normal" way rather than one foot at a time.

The OS gave me an instruction sheet which is very helpful. I told him I was starting to develop a little heel pain from the asymmetry of having a heel lift in one shoe and not the other, and he told me to go to "Superfeet" or custom insoles for both feet so that the pressure will be equal. He gave me the following instruction sheet for shoes which I think is extremely helpful:

1. Arch Supports: Custom or over-the-counter "Superfeet"
2. Motion Control Shoes: For example Brooks Beast, New Balance 1012 (and I add Asics Gel-Kayano to that list)
3. Danskos
4. Birkenstocks
5. Skechers Shape-Ups
6. NO barefoot, flip flops, slippers, high-heeled shoes, Uggs or Crocs!
7. To ensure proper support make sure that your shoes DO NOT "bend or fold" excessively.

So I consider it a great day. Still taking things one day at a time, but steadily improving with every passing day :)