Feb 28

Thought I would write a bit of an update as its been a while…

Im now into week 22 (to the day!) of my recovery and (*touches wood) everything is progressing well. I started driving around the 13/14 week mark and have now been driving long distances comfortably enough. My FULL range of motion is back 100% and having seen the physio this weekend, he confirmed that its even better than my other foot!! I think thats because I’ve been putting most of the emphasis of strecthing the injured foot.Having a sports therapist who understands my desire to get back to football helps greatly.

I am walking without a limp most of the time, unless the footwear in question is completely flat!! Even then it isn’t noticable. Gym work has increased significantly, good 45 minutes of mixed cardio. Walking upto the speed just before jogging and at a steep incline (stretches out the foot nicely), bike work and cross trainer. Resistance constantly increased and can pretty much go full pelt. I tried a steady jog in the gym which was manageble but didn’t want to try anything before consulting the physio.

The physio (this is the one who works with the professional footballers) has said the I could “probabaly get away with it but its that 10-20 percent risk”. As such he is happy that I am way ahead of schedule and has given me exercises that concentrate on the explosiveness and strength required to get back to running in approx 4 weeks. These excercises are things like jumping!! Jumping would you believe!! More specifically jumping from a squat position and landing on your toes back into the squat position. Also single calf raises from a squat position amonst other more advance stuff which I can’t describe very well!! Calf muscle is still smaller obviously but not far off and not massively noticeable. Oh I’ve been swimming once a week to mix it up too.

So, hopefully in a month I will be running (although I can jog now but am listening to the physio) which will feel fantastic Im sure. I think the most “pain” I get is when Im sat at my desk all day and don’t have the opportunity to walk and stretch as much much as I could. Also, days are better when Ive had my workout at the gym, always feels more comfortable (even normal) subsequent to a workout. Stiffness is at a minimum in the mornings now, just a few stretches and walking around making breakfast sorts it out!

I wanted to make another point here and that is regarding physio. The physio Ive had from the NHS has been not been hands on AT ALL. No massage, nothing. Just a check up every week to check progress and new excercises. Pretty useless to be honest. Private physio has been the same better as he measures, pushes, prods and really tests the tendon and I only see him between programme steps (the last one being 6 weeks and I wont see him for another 4). My lovely mother massaged my foot (with some homemade special oils!) every day in the early stages but now every few days. For me the physio has been a checkpoint for progress and to obtain advice and new excercises to keep pushing progress.

I really am starting to feel normal now, the only thing missing is the running which I will work hard to achieve. I now often stop and feel massive relief for being over the earlier days where I was so down. Guys, keep positive, it gets better every day. I will update once I start the next stage of my programme……..jogging/running….

Take care and good luck.

P.s. In prep for running Ive ordered a pair of Nike Free 5.0. Went to Nike store in London and tried them on and they are VERY comfortable!!

11 comments so far

  1. 1 normofthenorth
    12:50 am - 3-1-2010

    It’s so interesting to see the approaches in different regions, Chana! I’m in Canada (Toronto), where surgery was totally standard for us athletic folk (I’m old, but very serious about my sports!) until about halfway through last year, when most of the best Sports Medicine Clinics stopped recommending it, in favour of immobilization (all boot, no cast) with rapid physio and weight bearing (both starting at 2 wks in). The sudden change was because of the results of a new study of surgery vs. none, linked from my first blog post, at http://www.achillesblog.com/normofthenorth/2010/01/19/second-atr-first-non-surgical-cure/ . Unlike your local docs, the local ones here are planning to use the non-surgical cure for their top athletes, varsity and professional! (My doc is the chief surgeon of the local pro football team — that’s Canadian football, not what we call soccer here.)

    I’m 11 weeks in (started in the boot 2 days after the ATR, on Dec. 10), been in 2 shoes now for almost 3 weeks, after a short transition in a HINGED boot. Details at http://www.achillesblog.com/normofthenorth . I was clomping around without crutch or cane from 5-ish weeks in. (All following the protocol used in a study of surgery vs. none, linked from my first blog post.)

    My ankle now feels remarkably normal and comfy and stable, except that my calf is still weak. I can do perfectly straight 2-legged heel raises, but 1-legged ones — and “pushing off” properly at the end of a walking stride — are out of the question. Everything (stability, balance, comfort. . .) has been progressing quickly and steadily, although my actual calf strength doesn’t seem to have improved much in the last week or so.

    My ROM seems identical to my other ankle — though it lost a bit of dorsiflexion ROM 8 years ago as the result of tearing the AT on THAT side and having it surgically repaired! Going to the dorsiflexion limit feels more natural and discomfort-free every day, unless I’m loading it up a lot, like hanging over the edge of a stairwell step.

    Based on the results of the study I’m mimicking, I’d say your NHS folks could push you all through the steps several weeks more quickly without any harm, and probably with some health benefits — not to mention the psychological and lifestyle benefits!

    Keep improving, and good luck with the return to athletics!

    FWIW, as I’ve posted a dozen times here already, I love my old surgeon’s guideline on when we’re ready to go back to the kind of sports that tore your AT: He said it was OK for me when I could do a bunch of 1-legged heel raises without grunting or sweating. That’s going to be my guide this time for returning to competitive volleyball, as it was last time. (I returned to aggressive downhill skiing and racing small sailboats long before then, BTW, as I plan to do again this time.)

  2. 2 2ndtimer
    10:10 am - 3-1-2010

    Sounds fantastic!
    These are interesting exercises, can you tell me how exactly you do the single calf raise from squatting position?

  3. 3 chana7
    2:03 pm - 3-1-2010

    You stand on the injured leg and bend the knee so the knee is over the toes (like a squat) and push up until your onyour toes and repeat! Its just an advanced calf raise!

  4. 4 normofthenorth
    2:23 pm - 3-1-2010

    FWIW, I’m crusading to stamp out the use of “conservative” to mean “non-surgical”. To be sure, avoiding surgery avoids all the risks and complications of surgery, so it’s “safer” in that regard. But traditionally, the non-surgical approach has been done with WAY LONG and SLOW schedules of immobilization and restrictions on WB — but that association is a historical accident (and should be stamped out!), as the recent studies in NZ and the Univ. of W. Ontario have proven.

    For my first ATR, 8 yrs ago, I had surgery, but my surgeon was (and called himself) “conservative”, so I got wrapped in THREE casts in a row, then finally into a hinged boot. I didn’t get into shoes for 17 weeks! THAT was CONSERVATIVE!

    By contrast, with this ATR, and NO SURGERY, I’m on a much faster schedule. From a fixed boot to a hinged one at 7 weeks, then mostly 2 shoes around 8 weeks. That’s more than twice as fast to 2 shoes, yet some conventional language calls it “conservative”. It is not conservative, it’s just non-surgical! (Work with me here!)

  5. 5 chana7
    2:51 pm - 3-1-2010

    Norm - Just for you mate, the title has changed :)

  6. 6 normofthenorth
    12:53 am - 3-2-2010

    Thanks! :-D

    So far, your blog is the only place where I’ve really “let loose” with that rant — though I’ve THOUGHT it a few times! Chocolata got a polite little diluted version. . .

  7. 7 lotte Vestergaard
    3:00 am - 3-2-2010

    hello from denmark.
    This site has been very helpfull to me and now I feel for sharing my atr history.
    I rupture mine at the day before new year 2009 in a badminton match. Today 8 weeks and 5 days. Here in Denmark there also is different opinions whether go for surgery or conservative. I went to the hospital 1 hour after the injury and the regime iheer is 4 weeks in a walkabout in 30 degrees eguinus. And then 4 more weeks in a 0 degrees position. I was told not to remove the walkabout at any time the first 4 weeks. I went on with 2 crutches, but the 2 first weeks i was lying with the leg high most of the time. After the first 2 weeks i did some small isometric contractions af my calf every day, and I started to put my foot in the floor to support my balance when I was standing, just partiel weightbearing. 4,5 week I´ve got my foot in 0 degrees. There was a big atrophy of my calf. After 1-or 2 days i was fully weigtbearing without any pain. It was quite a releive to go around carring things. But I must admit that my life has been inddoor for this period. I I have been sitting or lying a lot. Today I shall go to the hospital to remove my bout. I have been taking the boot off the last week and done some range og movement exercises lying/sitting. For the last 4 days I havent got the bout on at all inddoor. And I ám cykling 2 x 15 min a day and my calf have been 2 cm bigger already. I can feel that the tendon is tight but i dont push it. I walk with a limb, but as I walk slowly it isn´t so much. I can feel the tendon is heeled with an increase but it seems ok. The Thomsen test is negative. It is all positive. Iám longing to get my life back.
    Thats my history. Good luck for your all. I feel good being in the conservative regime so far. If the body can heel itself, I think that is the best.

  8. 8 Mary Margaret McEachern
    12:24 pm - 3-2-2010

    Best of luck with the running! You give me hope; I’ve been a serious runner all my life and I’m only in week 4 (to the day…I’m 4 weeks out of surgery). I have run for 30 years. I will tell you that you’re making a great choice in shoes; that is the one I have worn (I wasn’t wearing it when I ruptured–I wore a racing flat) the past several months and it’s just perfect for high-arched, fore-foot striking faster runners. Keep us posted and best of luck!! I hope to at least be jogging sometime over the summer :-) Take care, MM

  9. 9 Kevin H
    7:43 am - 3-3-2010

    Well done, pal!

  10. 10 normofthenorth
    3:06 pm - 3-3-2010

    Lotte, you should start your own blog here. And make sure you’re listed in the roll call with your dates and status in your profile. Your protocol sounds fairly similar to mine (see my blog), except that I was in equinus longer (6 wks) and Weight Bearing sooner (PWB 2 wks, FWB “as tolerated” 6 wks). I’m almost 12 weeks in, and still working at eliminating the little limp at the end of every stride over my “bad” (left) foot.

    So far, the non-surgical approach has been better in every way than the surgical approach I had 8 yrs ago when I tore the right AT.

  11. 11 normofthenorth
    3:10 pm - 3-3-2010

    Chana, I actually JOGGED a few steps on Monday night! I was crossing a busy street, and the light was changing, so it seemed like a good time to hurry up! I’ve skipped a few times, in boot and in shoes, but this was the first time I actually (more or less) ran, though only very briefly.
    I’m still lacking enough calf strength to push off normally on the left side, but my physio and I are working on it!

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