19.5 weeks post-op: in search of the single calf raise

I guess I’ve been plugging along normally for some time now, but since I can’t do a single calf raise (I’m not counting the 1 mm raise for 1 ms), I cannot go for a run and I am missing the endorphins and the ability to eat with impunity.  The single calf raise is really the thing and if you are reading this Dennis you should consider adding this as a data point, in my humble opinion every bit as important as the other data points.    At 4.5 months I am nowhere near being able to do this despite 50 double calf raises a day and putting more weight on the bad leg on the way down.   This inability really precludes participation in all sports, except golf and tiddly winks, and I know many people who claim golf is not even a sport.  My buddies all make fun of my scrawny little calf, with winter coming at least I can cover it up.  Hopefully I won’t see a picture of it on one of the very useful and informative public shaming sites on twitter.

To others reading this in an earlier stage of recovery this post may all seem rather frivolous; don’t get discouraged, you will soon be in this place and if it is all you have to complain about life will really be pretty good.

Anyone farther down the recovery path than me, how long did it take you to go all the way up on the weak side and hold it for a few seconds?

13.5 weeks post-op: becoming almost normal

It’s been 3.5 weeks since my last post, it seems that once we begin to return to normal and are not obsessing over our tendons we forget about this wonderful institution, achillesblog.com.  I have a new PT who is a heck of a nice guy, he used to be a trainer for a professional football team.  This guy has treated hundreds of achilles injuries over the years and gotten the boys back on the field.   He’s hooked me up with the ERP machine a couple of times which makes my atrophied calf contract rather severely for a few seconds, then a few seconds of rest, then the cycle repeats for 10 minutes or so. Wow this thing really makes my calf contract!   Whether doing this once every 10 days to 2 weeks is better than old-fashioned calf raises I’m not sure, and will probably never know.   I do my calf raises every day, up on two, then slowly lower myself on my injured calf, which still has a very long way to go.   I’ve got an elastic and 4 ankle exercises sitting down every night until it is fatigued.   No running allowed until I can do a single calf raise on my injured leg, or asymmetry will be introduced in my running stride leading to hip issues, etc.  The PT thought I might be able to do my one-legged calf raise as early as 16 weeks, but I just can’t imagine it with my current progress, we’ll see.   He has me walking slowly backwards up a 10 degree incline on a treadmill for 5 minutes.  Very long strides simultaneously help with stretching and strength building of the calf.   Then I drop the treadmill to zero degrees and walk forwards for 10 minutes at a faster pace, focusing on heel-to and symmetry.  He feels this technique will help get rid of my limp and speed recovery.

I started golfing at 12 weeks, and the key I believe is to be extra careful in the rough replenishing one’s supply of golf balls.  The doctor and PT have no concerns that I can re-rupture by swinging a golf club in a relatively normal fashion.   If I were Happy Gilmore I think I’d still be on the bench.  I seem to have lost 10 yards on most of my clubs from last year, not sure if this is due to my weak leg pushing off in the downswing or that I’m a year older.  It’s been great to get out to the links, the course I play is a great walking course so I don’s need a power cart, the 12,000 steps per round are great physiotherapy.

All in all things are going very well, I’m off to the gym to do my 15 minutes of arm cycle and 35 minutes of stationary bike, then my treadmill exercises, golfing in the afternoon and I should be ready for a cold beer for dinner.

I’ve also run into more and more people who have had this injury, some operated, but most non-op.   The non-op guys have turned out just fine that haven’t suffered the re-rupture, it amazes me that the tendon can grow back together, nature is a wonderful thing.

Good luck to all in your recoveries, the first weeks are not fun but do what you can in a safe manner.  Try and do things you haven’t had time for in the past.  The early weeks will soon become a distant memory.

10 weeks post-op with the $64,000 question(s)

I’m just back from my doc and got a “keep doing what you’re doing” recommendation. He gave me clearance to start FULL activities in 2 more weeks, keeping in mind my calf will still be weak. He wants to see me a final time in 5 weeks at week 15 where he will bid me adieu.

I have a little bump on my achilles which is just above the top of my running shoe so it isn’t a rubbing problem, I haven’t tried my hiking boots yet. He thought the bump was some swelling due to the sutures and it would go away, I hope he’s right. Otherwise when I poke around the area it feels a little numb, like the effect of freezing which is not quite worn off.

I’m feeling a bit philosophical today, trying to understand answers to these questions:
1) op vs. non-op:
I asked my doc about this, and he’s seen good and bad results with each. I asked him what to do if I ruptured the other one, and he suggested I could try non-op and send him a report once it healed comparing the two recoveries, funny guy. I think it can be summed up fairly simply, “if you can make it through 1 year without a re-rupture, they are comparable, the chance of re-rupture with non-op is higher so be extra careful”. Both techniques require vigilance on the part of the injured party, do your physio religiously, and I’m not talking about sitting on your butt hooked up to the placebo machine, it is about hard work on a daily basis, as your body permits of course.
2) why do some people heal faster than others:
Going over these many blogs there is quite a variance in recovery time which is confusing. All that the doctor could tell me is that smokers and diabetics are at a disadvantage when they go the surgery route. If anyone knows of a study on this (different recovery rates) please post a reference to it on my blog.

I’m walking 1.5 hours every second day as fast as I can (still limping), and walking about 45 minutes plus 40 minutes low tension cycling the other days.

I can do an assisted calf raise using my fingers on a counter, and can hold it in the up position but notice I am cheating a bit (leaning over on the good side).  I have a long way to go in this department.

If you’re early on, 0 - 4 weeks, you’re healing and take it easy. Enjoy that first shower when the cast is off and tell your partner that you love her/him. Your caregiver is key to your existence on this earth!  4-6 weeks with partial weight bearing is a big improvement as hands are so handy for doing things other than holding onto crutches, ditching the boot at night at 6 weeks requires a celebration, and weaning from the boot at 8 weeks is wonderful.

Keep up the great work everyone!

9 weeks post-op: walking and stationary bike

I’m just back from my 3rd physio visit, she was happy that my dorsiflextion stretch had not increased, and wants me to continue to ‘not stretch’ for another two weeks until my next visit. Apparently I am unusually pliable and she doesn’t want me to overstretch things. I had the obligatory 15 minutes on the placebo machine. She introduced inversion/eversion exercises with an elastic band. I’ve been on a stationary bike for the last week every two days, working up to 2 sets of 14 minutes on fairly low tension, burning about 170 Watts or so. I checked the gauge of a buddy of mine and he was burning about 270 Watts, so think I’m doing OK for now. I’m working towards 2 sets of 20 minutes by next week with the same tension. I have also been walking 1.5 hours per day at a good pace. I’m doing some assisted toe raises in a corner in the kitchen, the calf is still very weak but making progress. I noticed on another blog someone standing on one foot (the injured one), it was very tricky for more than a few seconds but this is also improving with practice. Who has time for a job? Next week I see my OS for my 10-week appt, who predicted he would give me the go-ahead for golf at 12 weeks. Fingers crossed, keep walking, cycling, etc, the prize is in site. Good luck to everyone out there, keep at it!

8 weeks post-op: two shoes, heel, toe, push

I had visit #2 with my PT yesterday. My dorsiflexion stretch had gone from zero to 2/3 of the stretch of the good leg in one week, apparently this has happened too fast and I am not to stretch for the next little while. I am to start strengthening my calf muscle instead. This runs contrary to my instructions last week, but I’ll just go with the flow, I think PT is more of an art than a science. I also had a good 15 minutes with the placebo machine, the thing they hook you up to that zaps your leg with electricity so the PT can handle multiple patients in parallel, a marvel of modern capitalism.

The PT told me I had to start pushing off with my toe on my injured foot when I walk, and I have been doing that the last two days with some success.   I have to consciously think ‘heel, toe, push’ to myself as I retrain my brain to use my injured foot properly. The strength of my calf is very poor, which makes the ‘push’ part a bit of a challenge, but will hopefully improve quickly with walking based on the many blogs I have read on this website.  When I add the two weeks between my injury and surgery to the 8 weeks post-op I realize I haven’t used my calf at all for 10 weeks, so I probably shouldn’t be surprised at its minimal strength.

My leg was still a bit too swollen for my PT’s liking so she sent me off to the store to purchase a compression sock, just the minimal 8-15 pounds rating. It felt really good when I first slipped it on, I was a bit skeptical but am now a convert. The PT told me to wear it all day, and remove it overnight. The sock has really helped reduce swelling.  My wife insists that as long as I am wearing only one compression sock when my shorts are on I don’t look like a total goofball.

I’ve only put on the boot a couple of times in the last few days, once to finally get the winter tires off of my vehicle and once to fertilize the grass, otherwise I’d say I’m officially ‘two shoes’ at 8 weeks.
I had a short 15 minute session on a stationary bike yesterday after PT with low resistance, I’m not much of a cyclist but I’m determined to get this into a routine, it is time to switch the arm cycle to a spin bike. Other acceptable options at this stage of my rehab for cardio are deep water running, swimming, and the elliptical.  I have yet to see anyone sweat on an elliptical machine, can anyone out there dispute my observation?  I sink like a stone in the swimming pool and as a rule don’t like to get wet unless I’m in the shower.  I think the bike and lots of walking is the way to go in my case, until that coveted day when I get the clearance to go for my first jog.  :-)

7 weeks post-op and meet the PT

I was told today that I’ll first be working on increased ROM (range of motion), and when I can bend my right knee within 2 cm of how far my left knee now bends when my foot is flat on the ground, I will begin strengthening.  I have no idea how long this will take.   She told me I would not tear it by stretching, and no calf raises right now as this is a strengthening exercise.

I am to:

- raise my injured foot high in the air twice a day for 20 minutes to reduce swelling.  Swelling apparently slows down the healing process.
- two different achilles/calf stretches she showed me at least 5 times a day to increase range of motion
- walking with boot off to build strength, short steps with both feet with emphasis on symmetry and heal-toe. I am noticing that my injured heel stays on the ground when I walk but my good heel lifts off the ground, oscillot’s post weighs heavily on my mind and I will keep it that way for now, as the raised heel is really a mini calf raise.

I’m wandering around in bare feet in the house and strapping on the boot when I go outside for now.  I’ll probably venture outside with some runners on for a 10 minute shuffle up and down the street tomorrow.

One other interesting comment she made was the unlikelihood of tearing the Achilles in the same place, as it is about twice as thick there and always will be it is stronger after it knits.  Another tear would be above or below the existing one.

I hope everyone’s recovery is going well, there are a lot of great stories to read!

the best laid plans of mice and men

A quick note after getting a bit enthusiastic after my last post, I’m at 6.5 weeks post-op. I don’t think that my plan of working up to walking a couple of hours in the boot every day is going to work out. After my successful 20-minute walk the first day of no crutches and AirCast I decided to walk home from downtown, normally doable in about 45 minutes. At 30 minutes my right groin was starting to get pretty sore so I sent out the SOS call to “she who looks after me”, who arrived shortly thereafter and only gave me a minor blast before letting me into the car and driving me the rest of the way home. At least I still have the bus ticket. In the house I am shuffling around sans boot, and feel like the creature from the Black Lagoon as I slide my bad foot down the hallway. Patience grasshopper.

At night my injured leg is quite a bit more swollen than it was pre-FWB.  In the morning the swelling has gone down a lot, this seems to be a common theme from the blogs I have read.  I haven’t tried a compression stocking.

I meet my PT tomorrow, after reading oscillot’s latest post I think if she asks me to attempt a calf raise I will suggest that she kiss my ……


I’m just back from my 6 weeks (plus a couple days) post-op visit with my orthopedic surgeon. He performed the Thompson test and was very pleased with the result. He suggested I should start PT, his prescription says “assess and treat”. He doesn’t want me to use the crutches at all, I had been using a single crutch this week when I was out and about. He suggested I start walking, so when I got back home I took a 20 minute stroll through the neighborhood, boot on of course. It felt great! One small miscue, I took a step off of a curb and landed with my right knee locked (hyperextended) when by boot hit the pavement, no harm done luckily, I have to stay focused and keep that knee bent a bit.
He wants me to slowly wean myself from the boot over the next two weeks, I was quite surprised by this. I asked about swimming, deep water running and cycling and he said start that at 8 weeks, and to go easy, cycle on the flats or gentle hills in a low gear.
I tried several short steps in my two bare feet across the kitchen floor later at home, toe pointed outwards as he suggested which reduces the stretching on the Achilles. It worked!
He said I should wake up in the morning and be ready to get back at it, if I don’t feel good I have overdone it the previous day. I’m hoping I can work myself up to a 2-hour walk around 9 holes this Sunday afternoon, although that may be a bit ambitious.
I wanted to take a 3-day trip in a car, and he said maybe in another four weeks. If I went today he would want me to stop the car at every 30 minutes to walk around. This is to avoid problems with blood clotting apparently, so I will be good and stay home.
I can finally lose the boot at night, sweet.
I am to see him in 4 weeks, at the end of week 10. He expects to see me with a big smile then, getting pumped up for week 12. He also cautioned that my next 2 weeks have the greatest chance of re-rupture, so BE CAREFUL!
No golfing with the boot on, but he said I could start golfing at 12 weeks when the boot is off. Another pleasant surprise. I still may sneak in a few half wedge shots in the interim, boot on, but mum’s the word. :-)

6 weeks post-op

I’m 6 weeks post-op and have been reading these blogs from time to time, they certainly have been very helpful in dealing with my mental anguish. Thanks to Dennis for setting this up and to everyone who has told their stories.
On April 6, 2015 I tore my right Achilles tendon while starting to move forward to retrieve a drop shot in badminton, something I’ve done a thousand times. The next thing I knew I was on the ground wondering why I had done a face plant after hearing a low frequency noise in my shoe, had my orthotic broken? Knowing that many badminton players had suffered this fate I felt above my heel and there was my Achilles so I thought I was OK. I had no pain at all. I suppose this is why people like me do not make good doctors.
There was a physiotherapist nearby who squeezed my calf, the Thompson test apparently, then told me to go to emergency.
A buddy took me there and when I arrived they put me in a wheelchair and I waited around for a while. A young boy brought in by his parents who was making a hell of a racket jumped the queue in front of me, and eventually left with a band aide on his arm. I considered suggesting to the parents they take their kid to the children’s hospital down the way where they are quite adept at dealing with these issues, but thought better of it. Then a slobbering and violent drug attic was dragged in by EMS and he jumped the queue in front of me too. I wondered if that guy had paid any taxes or Health Care premiums for the last couple of decades, then assured myself he had been, he probably was just having a bad day. Man did he ever stink.
When nobody else was left in the waiting area the emergency doctor saw me, a very nice guy. It was 2 in the morning and he was more tired than I was. He told me that I had fully ruptured my Achilles tendon. He went on to say that if I was a professional athlete I would get surgery, otherwise I would get the non-operative or conservative approach. This felt somewhat unsatisfying. My only choice was the colour of my cast, hot pink seemed to be appropriate, they casted me, booked me for a meet and greet with an orthopedic surgeon in two weeks, and sent me home in a taxi.
The next couple of weeks were spent researching this so-called conservative approach, I had never heard of it. I spoke with a very experienced athletic trainer who seemed not particularly impressed, a good friend physiotherapist of mine who tracked down the latest research and said it would be fine, and a bunch of other friends who knew nothing at all about medicine but of course had the strongest opinions on the subject, they were all incredulous.
At 56 I’m no spring chicken, but very fit for my age. I do not consider myself a weekend warrior, being semi-retired and able to exercise every day. I do a lot of running and stretching, weigh the same 150 pounds as I did in University (perhaps with some minor redistributions toward my centre of gravity), and can usually break 45 minutes in a 10K. Three sets of 30 jumping squats per week have kept my running knees happy and given me strong legs for my age, and there is no way that this should have happened to me. I think denial is a common problem with many people. I am done with badminton.
I went to meet my orthopedic surgeon at two weeks post tear. My research had given me the opinion that if I made it through a year without re-rupturing, the results of operative vs non-operative would be the same. Unfortunately, of the 3 non-op people I had met in those two weeks, two of the three had re-ruptured, one at 6 weeks and one at 6 months. Now any of you statisticians out there may want to remind me that a group of 3 does not constitute a statistical population, but hey, it’s hard to be objective about my own Achilles.
I had been a bit miserable those first two weeks about this non-op approach, but was resigned to it and all I wanted to hear from the orthopod was that it was “going to be OK”. However I was presented with options to continue with the non-operative approach, or get surgery the next day. You’re kidding me right? So at day 15 post Achilles tear I re-set my recovery clock to day zero, had a spinal, and a scalpel cut through my skin and a very skilled orthopedic surgeon, also a very nice guy, stitched up my Achilles tendon on April 21. He then put me in a splint with a tensor wrapped around it, and said “see you in two weeks”.
Up to that day I had not had a single ibuprofen or acetaminophen since the tear. Enter Percocet. As the spinal wore off these pills became increasingly more important. My first night at home I was completely stoned on Percocet’s, I remember waking up every 5 minutes or so, looking at the clock, and thinking, “5 minutes have gone by, I feel pretty good right now”, over and over again. The following evening I took my 9th and final Percocet, it was time to kick. There were 3 left in the bottle and I thought I should take them to the Pharmacy for disposal, or not. The first week post-op were really quite unpleasant, my body was not working particularly well in a number of areas that I won’t go into, suffice to say the first few days of week 1 sucked, but things got better near the end of week 1.
By the way, if you suffer this injury and do not have an outstanding relationship with your spouse or roommate, you are screwed. My wife has been simply amazing.
At the end of week two post-op I saw my orthopod, the splint was disposed of, and I got an Aircast with 3 x 1.5 cm wedges stacked on top of each other in the heel. My earlier research found some hinged ones available in the U.S., perhaps these are better. Some have a removable piece on the bottom that can be removed if it gets dirty from wandering around outside, a nice option I do not have. I am subjected to a scrub scrub scrub every time I come inside, a small price to pay for the cooking, cleaning, smiles, encouragement washing sheets, etc. that I am the recipient of. A hard man may be good to find for some, but I’d much rather have a good wife, and I’m not referring to that creature on the TV show.
When I got the Aircast at the end of week 2, I was allowed 25% weight, which is “just a little bit”. But a bit is better than none. Press your injured foot on a scale to figure out how 25% feels. The cast could come off at home, I could wiggle my toes and do the dorsiflexion thing that is mentioned on many of these blogs. The Aircast was hotter than hell in bed and I called the nurse the next day to ask if I could take it off at night. No way. So I remove the front part of the Aircast every night before bed and replaced it with a folded socks under the straps, then cinched the straps, this is a compromise that is cooler allows me to sleep. Be careful during those 56-year old nightly bathroom breaks, don’t forget to turn on the light. One crash with a half-cast and you and your new friend the orthopod will have an Achilles reconstruction to deal with.
At 4 weeks I took out 1 wedge, and increased to 50% weight, another incremental improvement that was greatly appreciated.
After 5 weeks post-op the 2nd wedge came out, now 75% weight. I noticed one of our contributors spoke about using 1 crutch on your good side. A great tip, you will move along a lot smoother using this technique, but you probably shouldn’t do it until 75% weight bearing. This also frees up a hand. Going from zero free hands to one hand is a wonderful experience.
As I mentioned at the start, I’m 6 weeks post-op, and will visit my doctor in a couple days. My last wedge came out today and theoretically I can lose the crutches, we’ll see what the doc says. I walked across the kitchen today with baby steps in my boot and no crutches, two free hands, piece of cake. Then up and down the stairs sans crutches, unbelievable! Two free hands are much better than one.
I’m a right-handed golfer with a right Achilles issue. Last night I swung a couple of wedges on the driving range, with my Aircast of course, I’m hitting a straight draw and need to weaken my grip a bit I think, this is exciting stuff, back to my comfort zone of paralysis from analysis on the golf course. I have ordered my Achilles blog t-shirt and am looking forward to sanctioned FWB. Still no PT for the foot other than my simple exercises when I got the Aircast, PT starts at 6 weeks after doctor clearance. No I have not asked the doctor about swinging a pitching wedge.
In retrospect these 6 weeks post-op (8 weeks since the rupture) have not been all bad. I’ve been playing a lot of piano (a bit of a challenge early on with the swelling), and can now play some pieces that I’ve been dabbling with for years pretty well. I’ve also been reading some classics on my kindle, improving my English with the likes of Charles Dickens and Emily Brontë . I have been working my upper body at a gym nearby every two days without fail, a nasty little arms-only machine like bicycle pedals that go round and round, attempting to give my cardiovascular system a workout with my scrawny arms. My upper body is stronger than it has been for many years. I have experienced the kindness of strangers who have opened doors, fetched chairs, offered words of encouragement, and of course told me their stories. I have realized why there are bars and removable hand shower heads in some showers, larger toilet stalls for handicapped individuals, and buttons beside doors to open them up. I have been horrified after surgery touching various parts of my anatomy and feeling nothing, and incredibly thankful when the freezing came out. I really think that I am a better person.
Now onwards with PT!
I’ll report back soon. Good luck to all!

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