Chip’s Achilles Recovery

I am excited that I really do not notice any problem any more under normal conditions…walking around or walking fast on the treadmill about 4.5 speed. My calf is still only about 50% of the good leg and strength has a long way to go for real explosive power.  I am continuing to do the toe raises but can still not do a full toe raise on the bad leg. I am going to go back to doing the resistance band daily.

I am walking 95% normal - strength is coming back. I have been reluctant to really test it so far. I am doing the rehab and exercises daily and PT once a week. Just a reminder to the new folks - I reruptured after doing very well at 3 months the first time around. Do not push it too quick.

I need to keep reminding myself to go slow and take it easy. I sent the knee walker back to quickly. I had a trip to SF last week and over did the walking. After the flight home the swelling was up, especially around the incision. I leave today and am going to wear the boot on the advice of my PT. Patience is key right now and I can not rush it. Doing PT 2x a week - massage and exercises. Met a girl, Chrisse - 22 - a year off of her rupture while tumbling - doing well. She told of a person she met who reruptured with a PT doing calf raises - Let’s be careful out there! (Hill Street Blues reference for you fans.)

I am encouraged and cocerned at the same time. I am FWB with out support around the house. The knee walker/roller was a big plus on vacation last week through the airports/going to the park etc. The incision looks the same and you can not tell I had a second surgery. I am doing my exercises consistently - using my cell phone to set alarms daily at different times. Just started with the resistance band going slowly. I have an appt. with PT who is reported to be the local Guru on foot and leg injuries.

My conern is the strange feeling in the pad of my foot - numb like. I also had surgery on the same foot to screw my 5th metatarusal together and also fractured the toe next to in - both in the last 2 years. I have continued pain in my heel like the last time. I know I should not wear flip flops, but the Croc ones have the best padding in the heel. I have been walking around the house without my boot some, being very careful.

I want to start riding the bike soon. Even chipping and putting a little bit. Hitting drivers off my knee has been a good drill without putting any pressure on my leg. I have it mastered almost now - almost always straight - about 225. Hope I can hit it that straight when I can go standing up.

Virutally no directions from my doc. I have an appt on the 29th. I am sure he will say, looks great - keep it up. That’s what he said last time and then I entered the 2x club that afternoon.

A potential warning - two days before my re-rupture I had the worst cramp of my life in that calf. It is very possible it was a contributing factor. The muscles are very close and my new rupture was high above the original repair. Be very careful if you are getting any cramps. I purchased some OTC Leg Cramp pills by Hylands. That same cramp has been simmering in that calf again.

Got the cast off today. The scar looks great. You can not really tell another surgery has been done. I am using the same boot as before and being very careful today and a few weeks. PWB with crutches. My foot feels very strange, worse than last time. I am having my kids taking turns rubbing Daddy’s foot.  I have a long way to go - more atrophy than last time it seems. Hopefully the first tear had extra time to heal at the same time. Feels great to be out of the cast as you all know. The heal if very tender and more pain in my ankle than I remember the first time. No real clear direction on protocol from the doc. I will begin the basic ROM exercises and slowly build back.

If anyone has any advice on rehab that has worked for you please share. I want to start riding a bike with the boot in a few weeks and get back to PT.

It has been a month since the second surgery. I am getting out the the cast of on July 8th and going into the boot. The last time I made the transition I mentioned doing a lift/wedge in the boot and my doc said it was not necessary.

Does anyone have advice on lifts/wedges? The boot I have from the last time is not adjustable.

I have been doing many more isometric exercises this time around - toe spreads and toe curls. I hope that will help. I really have no pain and have had none from the incision. I wish I had tried it earlier, but I ordered a knee walker for monthly rental fee of $140 - free shipping both ways - I have a vaction coming up in mid July and wanted to be more mobile. The company is KneeWalkerRental.com. - save $20 with save20 code at check out. I searched everywhere for a used one and they do not exist. They are crazy expensive to buy - $300 - $500 for what seems like a simple unit. You can buy a great bike for that much.  

Here a two links to good article on rehab/PT for achilles I wanted to share. I thought they gave some good details - especially part 2.
http://ezinearticles.com/?Active-Rehabilitation-Of-An-Achilles-Tendon-Injury&id=887530

http://ezinearticles.com/?Achilles-Tendon-Rehabilitation—Part-2&id=887536

Also - does anyone have input on riding a bike outside? How much have others done safely in the boot or post boot with success?

I apprecaite your feedback and encouragement. The first month has gone by quickly.

I had been progressing very nicely since my surgery - about 11 weeks out - walking almost normal - 4 pt sessions - doing my exercises and felt very good. Walking up the stairs (on the phone) walking slowly I slipped a little - don’t remember what happened really and POW. I knew what happened this time without a doubt. The shocking thing was that it ruptured above where he had repaired it- very high in the incision. I was pissed to say the least - total shock. I called my doc, went in the next am, had surgery that afternoon. I am now a week after surgery and feel good.

Had a unique “nerve block” on my leg this time. Last time I was so sick after the surgery I mentioned it to the Anest. doc and he mentioned the block. Went behind my knee and found the nerve that controls the leg and injected the blocking agent. The upside is I felt great after the surgery, no morphine drip needed this time, but it was there. Had a nice meal and went to bed. He said the block would last 12 - 18 hours. Did not say much more than that. After 24 hours I could literally not even move my toes. The leg is asleep - just like you slept on your arm - same feeling. I was a little concerned but reality is it can last much longer. It slowly wore off over the next 5 days…..upside was virtually no pain in the incision. I have to fly on Sunday and am a little concerned. I have bulkhead locked in and can get it up on the 2 short hour flights.

Lessons??? What can I share?

First timers - consider the nerve block.

Stay out of flip flops - I am going to wear shoes - I think it would have made a difference. Hard to say if I had stayed in the boot a lot longer. I do not think it would have happened if I was in it, but Dave was doing well and was in the boot when it happened to him. I was doing well and had been out of it for a month.

Oh - stay off the phone when walking on the stairs and take it a little slower than you think you should.

I have to say I am very excited about my progress after six weeks. I am way ahead of where I thought I would be. I am swing my weighted Momentus golf club with no problem at all. I have not played yet, but I really believe it is possible. I will wait another week.

 I had my first day today without the boot all day. Just walking around in tennis shoes. I am doing my ROM exercises 3 x a day and using the elastic strap as often as I can. When I go out to do anything physical I will wear the boot to keep me from doing something stupid - like at baseball practice with my son, playing catch etc.

I know I have a long way to go. It is still very tight in the am and takes awhile to warm up, but now pain. I had my visit with my doc a week ago and he really did not have much to say. It looks great - excellent progress - wear the boot for a couple more weeks. Keep doing what I am doing. He did not think a PT  would be able to help me a lot. I thought that was interesting.

Getting in the boot after 20 days or so was great. I used the crutches for the first 10 and have rarely used them the last ten days. Walking FWB was been excellent PT. I have been doing the basic ROM exercises and just added a new one. I have the exercise bands (surgical tubing with a handle basically). I put the handle over the pad of my foot and pull back to create tension and then do foot extensions back and forth. No soreness from anything except for my heel. After walking awhile my heel feels bruised almost. It is tempting to try a tennis shoe. I have my next appt with my doc on the 21st. I am very excited about where I am one month post op. I would recommend to others who read this and are facing surgery to do your homework. I put info in a previous post about Dr. Myerson who had his patients in a boot 10 days post op. I look forward to starting a formal PT program. My goal was to be able to play a golf tourney with my Dad starting June 9 - I am confident I will be able to now.