Ups and Downs-11 weeks postop
I’m really feeling the weight of a long recovery–the ups and downs, and the plateaus. At 11 weeks I have now been in 2 shoes for 3 weeks. The first week was part-time 2-shoes and then full time 2 shoes and walking more and better as time goes by. A few days ago, after a rigorous PT session my leg was especially sore and swollen and I thought I was never going to get better and I will always walk with a limp. Today was a little better, walking a little better, leg a little less swollen, with a little less pain. Okay, already I get it. This recovery is SLOW compared to what I WANT it to be. I guess that is how most endeavors of any significance go, development of mastery takes time. In this case the mastery is simply to walk and then run again. So I’m back to being patient and slowing down. Just to make myself feel a bit better I took both of my bikes to the shop last week and tonight I picked them up all tuned up and ready to ride–one a commuter bike that I hope to ride to and from work this summer to get back in shape and the other my off road, full suspension Gary Fisher HiFi Pro, with newly slimed tubeless tires is ready for action some time later this summer when I am up for it-hopefully sooner rather than later. Just having them “ready” to ride gives me hope. Tomorrow I visit my Dr. again for a checkup to see how my progress is going. For all those just starting out, remember to pace yourself and stay the course and don’t worry when you have bad days as they are likely to show up. Just know that you also will have many good days on the journey. Best of luck to all!
April 17th, 2009 at 5:21 am
Hi Bode,
I’ve been doing some thinking about limping, (haven’t we all?), and I think I may understand this frustrating plateau issue.
Early on, the issue is regaining flexibility. We reach a point relatively early on when we can walk almost normally, because we are flexible enough to stride our good foot reasonably far in front of our bad foot. If we walk slowly and concentrate, it looks pretty normal. So we get to a “slight limp” pretty quickly. It’s great, because the crutches and the boot are gone, and we can live relatively normally. We get to this nearly-normal point pretty quickly, so it’s only natural to think that completely normal can’t be very far away.
The problem at this point is that the calf is still weak, so we can’t get our bad foot’s heel off the ground until our good heel hits the ground up front and takes some of our body weight.
When we walk normally, as one leg swings forward, the our body weight rolls forward on the other foot and that heel comes off the ground. Briefly, our entire body weight is supported by that one calf muscle. This happens with every step people take, and is more important the faster we walk. That’s why our “slight limp” gets more obvious when we try to walk faster. You can also demonstrate that things aren’t quite normal by looking at the length of each step while walking across a tile floor, (the tiles make it easy so see how long your steps are). When your bad foot goes forward, your good leg’s calf can do its job, and that step is of normal length. When your good foot goes forward, that step will be a little shorter because that back heel is stuck on the ground longer.
So that transition from “slight limp” to no limp depends on that calf being strong enough to hold our entire body weight for step after step after step. That takes a lot of time, and that is what’s so frustrating for most of us, I think, that we got to that almost normal “slight limp” relatively quickly, but getting the rest of the way to normal takes so long. Depending on how much your calf atrophied, it can be a long haul to get past this plateau. Even while the calf is getting stronger, that slight limp remains until it is strong enough to hold your entire weight on every step. You *are* making progress, but it isn’t as *visible* as it was early on when flexibility was the thing holding you back.
The ups and downs, I suspect, have to do with how hard we are working that calf. A hard day’s work means a tired calf, and the next day you walk (and therefore feel) worse. But that means you are working your calf hard enough to make progress! So being patient and slowing down may not be the answer. The way I see it, those “bad days” are a sign that I’m working the calf harder, and will therefore get to my goal sooner.
Does this sound right?
Doug
April 17th, 2009 at 1:37 pm
Bode,
Keep hanging in there, it is improving a little every day. I agree with Doug53 and am having to force myself to try to walk heel to toe with every steup instead of just shuffling around. I just completed my first two week in shoes and first PT session. When I look back I see how swollen and achy I was after the first full day. Much better now, but still a long way to go. Catch my latest blog on massage tips to reduce swelling.
Keep up the good work!!
IowaJim
April 17th, 2009 at 8:54 pm
Hello Doug53 and IowaJim–Thanks for the tips and encouragement! Yes, Doug your explanation makes sense. I am seeing some progress even in the last two days as the limp gets a little less pronounced. I will get back to building the calf muscle and enduring the pain. I think I just needed a couple if easy days to recover. It’s great to have you all helping me along the journey!
April 17th, 2009 at 9:01 pm
Hi Bode,
When it comes to the heavy exercise, I’ve been doing what the weightlifters have traditionally done, alternating hard exercise days with rest days. It shouldn’t be *too* painful, though, just enough to let you know you’re really working it.
Good luck! Us Minnesotans have to stick together, especially if we are fellow cyclists, too.
Doug
April 17th, 2009 at 9:15 pm
Hey Doug-Great to know you are here in MN! Yes, I know the weightlifting drill of alternating muscle groups, rest/recovery days, etc. and need to get on a more disciplined schedule so I don’t over do the exercise and don’t slack off either. Hoping to get a bike ride in this weekend–with my flat pedals for now, not ready for the clip-ins yet. When do you think you will be riding again?
April 17th, 2009 at 11:13 pm
Hi Bode,
I started riding again about a month ago, but with my mid-foot on a flat pedal at first, to lessen tendon stress, and my shin/foot splint on, just in case I had an awkward stop. I even put a soccer shin guard on backwards, to protect my tendon in case I slipped off the pedal and it tried to spin around and whack the back of my leg. I started clipping in, without the splint or the shin guard, (and the seat back up to its normal height), just last week. I was out on the bike today, and it was a lovely evening here in the Salem Corners Metro area. I’m looking forward to getting out of the saddle on the hills soon, as my calf is just beginning to hold my weight.
Like you, I stayed with the basketball with the young folks a little too long. I’m going to hang that up. Hard to believe, after all these years, but I don’t want to go through this again. Biking, skijoring, and the kayak are enough to keep me happy in my old age.
Enjoy that ride! I hope the rain doesn’t get in the way.
Best wishes,
Doug