Today was my third visit with my surgeon, quick in an out. They took my half cast off and threw it out, wish I could had kept the cast since I have the other half at home. So anyway they removed my stiches, with a little bit of bleeding, but I was told this is [...]
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Simple ankle flexes come in 2 directions. Dorsi… means toes up, closer to your face. Plantar… means toes down, away from your face. Dorsi stretches your calf and AT, flexing the calf pulls on the AT to make Plantar (though some smaller muscles and tendons can do it without load in an ATR.
Google knows lots of things, faster than us.
oh man do i have strange sensasions . like really weird sht goin down.
if you could please what is dorkiflexsion?
Let us know how you get on. Stay positive. So many little pains n sensations to get used to along the way that come and go.
Well I have been reading up on it. It doesn’t stay only comes after I walk over a mile. And read that it may be a blood clot. But I don’t have the bruising or swelling or pain. The only thing that matches is that I can’t walk as far as I had been previously walked around 2 miles, but cut back to half that since pain the the bottom of my feet. My surgeon last time I saw him said everything is healing right and dismissed me. I get more info out of my physical therapist. Which sad as it seems I will have to do this Thursday and then maybe get another foot specialist.
Surgeon irrigated with Club Soda?? I got nothing.
Walking up and down real stairs is one thing, but some big “steps” - like getting off a bus - can be extra tall. Not a big deal for a sound body, but an injured leg is different. You should be able to discuss this with somebody on the phone, like a nurse/practitioner in your OS’s office, or your GP.
Some of these “reinjuries” break up adhesions (especially post-op) and bring benefits after the initial pain and scare. Others cause painful rehab setbacks. (I report on one of those on my blog, and elsewhere. A MONTH of pain from doing too much too soon under my PT’s insistence!)
There’s probably a third category that contribute to Healing Long or other chronic problems whose causes are poorly understood.
If you haven’t learned my trick for going down stairs quickly and safely, check it out, on my blog and a dozen or 2 other places. Good for leaving buses, too!
I have an appointment october 7th. Yeah I have stopped trying to walk up the steps or down them. Want to go to the emergency room, but I don’t have persistent pain or anything. Just paying too much attention to my legs in a long time.
No magic insight here, but (1) if it hurts when you do X, don’t do X, and (2) if something worries you and we don’t have a simple answer here, ask your Doc.
You’re not alone feeling paranoid, we all get that at this point I think.. Sound advice from ‘the man’ I think. Good luck n keep going.
David You are the man. I worried when I felt a tearing feeling since I felt it on the good leg as the bad leg. I went slow and once I got up movement was way better. I had heel on the floor body slanted and slowly bent my knees. I Never had My pt do any stretch that helped with this. They either do a forced dorsiflexion which doesn’t really help with the stiffness. I would do this exercise everyday, but I don’t want to push it. Strangely enough my walk speed even increased twice over.
The stretch you describe (heel on floor, knee bent, lean forward) will stretch your Achilles and soleus muscle. Doing the same thing, but with knee locked straight will stretch your Achilles and gastrocnemius muscle. Both are good to do, as tolerated (i.e. discomfort, ok, but no pain). The result of stretching is to loosen the tendons and muscles, so what you’re experiencing afterwards sounds appropriate. The particular sensation you feel could be adhesions from surgery breaking down, also good, or just the tendon-muscle stretching. If you’re doing these stretches slow and controlled, they would be very unlikely to cause a re-rupture. -David
12-13 weeks in is probably a good time to get more aggressive with DF stretching. Hard to say if it’s locked joints or scar tissue or something else, but retaining DF ROM is important, though it can presumably do serious harm if done too much too soon.
Chris I have been having that pinching issue too. It really reared it’s ugly head at PT yesterday. My PT was trying to stretch the achilles and calf, but could not move my foot to dorsiflex enough. She did some manual manipulation by pulling my foot and moving it around in the socket. After a small crack I had full range of motion. She said there are a ton of little joints that can basically freeze up because you haven’t used it and it can cause pinching. Literally immediately after I felt that little crack my foot freed right up. I was able to stand on one leg and actually get my heel off the ground, and she was able to stretch the heck out of my calf. It felt so good. I am now able to do some light wall stretches with no pain. I could not do that on Sunday.
Idk, I have problems when I do the towel stretch. But the wall has made it like night and day with how my foot feels. No painful tension when i simply dorsiflexion allows me to walk more and at a longer stride.
Yeah, I still stretch this a lot I still stretch with a towel and do the calf stretch like you pictured. I have a little pain but realized some of it had to do with my she’s. I’m a at 17 weeks by the way
Well I was having an intense pain when I dorsiflexion my foot, but after this stretch the entire day I had no problem or pain. Have you ever had a pinch nerve react when you dorsiflexion or had that issue.
I wouldn’t call this a miracle cure, but it is a very good stretching exercise for your Achilles’ tendon. At 6 months, I still do this daily, for both legs–and with the knee straight and bent. With knee straight, this stretches your gastrocnemius (along with your Achilles) and with your knee bent, this stretches your soleus muscle (along with your Achilles). Additionally, I’ve been directed by my PTs to also do these stretches with my foot straight ahead, and pointing left and right (so, 6 different stretches in all). Over time, these help to improve your ROM in the dorsiflexion position. BTW, this is also called the runner’s stretch. -David
Is hard not to think of every twinge as the beginning of rerupture. I do it too. Part of the recovery road I suppose, doubting and worrying. Glad all is ok.take care.
I agree, with mags11, that hopefully it is just your scar tissue.. but I would have it checked just in case… to all of you: please be careful also with your PT… I was told that my Achilles was overstretched the first time… take it slow and easy!!
If it occurred doing nothing it seems like it would just be scar tissue breaking up, seems weird that your tendon would be weak enough to just tear on its own (and not have had something else tear it). The pt will be able to tell how things are. Best of luck!
Good luck to you on this. Hopefully we’ll hear tomorrow that all is well and you’ll continue on the road to recovery. Wishing you the best results.
Hi Chris 89. Wishing you good luck and hopefully the crack noises turn out to be nothing. Your PT should be able to help you decide what you should do. Best of luck! 
Well the pain is only after doing a lot of walking or doing heel raises and basically after I put a lot of workout into the foot. The pain is there but gone once I flex it. I was told that is just because my tendon is a lot thicker and hard to flex, but we will see. I started fwb a little later than you, so that may or may not have something to do with it.
I have tightness all around my ankle after (and really during) my pt exercises which I think is to be expected. I figure it is due to swelling and just being in a boot for awhile.
I’ve never had pain when I’ve pointed my foot down which I do a fair amount. But you are a few weeks ahead of me so that could be the reason.
I see, trust me. I push myself, but when I feel like I can no longer do it I stop. I have had a couple things in therapy I would not do for the requested time. Weighted squats being one of them and standing on a slanted slope stretching the tendon for 20 mins I did for 5 mins that was a little to rough for my tendon at this point. And assisted toe raises were asked to do and I gladly declined. I am not trying to push myself and I even bring my crutches when I go out for a walk. I will be cautious though I am not trying to be set back again.
Chris, my blog remembers better than I! It was during my first ATR rehab, a long time ago. First day I could walk perfectly barefoot, my young PT literally paraded me barefoot the length and breadth of the university sports-med clinic! The geezer was the star of the show, recovering from his ATR faster than the undergrads on the varsity teams!
Then we retired to her station to do the work. Near the end of the session, she told me to do 1-leg heel raises. I refused (because I couldn’t do 8 reps, my rule of thumb for OK intensity) and she insisted. “Just do as many as you can.” (Nobody should EVER tell me that, even UNinjured!)
I wasn’t smart enough to refuse again, so I grunted out a few. The pain didn’t start for a few hours, but it lasted a month, back in the boot, before I could walk perfectly barefoot again. Don’t Go There!
Norm, what was the month long painful setback. I mean my doctor and pt are along the same line they both say that pain is good if its temporary. When I do almost anything there is a tiny bit of pain, but again I am not in the business of overdoing it. I want to get better, well enough to pass a physical either by December or February . Whichever date is safer. Thanks
In general, I recommend avoiding anything that causes pain. Obviously short-term transient pain is probably less serious than chronic pain, but I think I’d back off enough to avoid all pain. You want to keep advancing at a good rate (comparable to the most successful protocols/studies), but keeping everything incremental.
Pretty soon, your main overdoing risk will be a serious setback but not rerupture. Still worth avoiding. I had a month-long painful setback, too late for a rerupture but still a major PITAnkle!
8 months of it though. I cringe after finishing an exercise with my legs because it hurts to move it around after that. So I shun to think where I will be at by the end of the year.
I had loads of pain in my tendon for ages. Took about 8 months to go. I think being too aggressive with the stretching did not help.
I did have a month off all PT at about 6 months as it was so sore. Just active walking only. Never thought it would improve but all good now at just over a year. Thinking about going back to squash!
I would assume as much, but the tendon is sensitive to the touch for a while after and it stays throughout the day. I elevate, but don’t ice. I guess I might have to add ice, and I was doing the front part of my foot not my heel. Yeah the tendon feels intact, but tenderness persists and is only relieved when I touch it. I will try icing it now and practicing range of motion. If I can work something out on the bike I would enjoy that, since I don’t like going outside with this injury. Too many stares wondering why I am walking so slow. Hahha thanks Norm and Dk I guess I will update if anything changes between now and tomorrow.
I am experiencing a bit of the same thing while using the stationary bike. It’s just swelling in the foot and around the tendon. You would know if you did damage to the tendon. As soon as you are done exercising, ice and elevate. The swelling will go subside very quickly, and you will gain back your ROM. Think about the bike riding motion. Your are basically pumping blood into your feet. My PT told me once I am done on the bike elevate above the heart and ice. Then do ROM exercises after icing while keeping the foot above the heart. This will allow you to do full ROM without the swelling. Then ice again after completing ROM. Stay positive Chris you are doing well. I like reading your posts, because it seems we are at about the same place in recovery.
I don’t know.
But the easiest way to control the AT-challenge level from bicycling is to control your foot position on the pedal. Heel on the pedal =~ 0 challenge. Toe on the pedal +~ maximum challenge. In-between = in-between. In the spirit of INCREMENTALISM, start with your heel on the pedal, and only gradually shift away from there.
ATR2014, we can get you HALFway back to normal walking speed while your strength & ROM are still lacking: Just walk asymmetrically, with one long stride and one short one. Unfortunately (and unlike the downstairs trick), there’s no way to make this look normal. But if you make sure that everything else about your stride IS normal, you’ll be taking good care of your legs and body, and getting around at a HALF-decent speed. (I don’t have to tell you which stride to shorten, because your body has already told you! )
I just spent a week on a cruise ship to Bermuda and got a lot of practice walking! I still have a limp but if I walk slowly, it’s barely noticeable (can walk barefoot now too but I don’t like it). However, it is very inconvenient to walk at such an incredibly slow pace.
For me, going up the stairs isn’t a problem at all - never even had an issue with it. However, going down is very scary. I do what Norm has repeatedly posted on this blog (thank you so much for posting the tip over and over, Norm) and that is walking down with my bad leg over the edge of the step and roll over it. No pressure or stretch on my Achilles and I don’t look like a total invalid going down one step at a time.
Nice work! Loosing that limp is a big milestone- onwards and upwards (especially stairs!)
Congrats on no limp Chris!! That is awesome. I walked today for about a mile without the boot. I was most definitely limping. Especially toward the end.
Norm,
Great advice on the whole stair issue. It really helped me out.
-Dan
Chris, both seated and standing heel raises are good exercises and go after 2 different calf muscles. Seated heel raises engage the soleus muscle, while standing ones charge the gastrocnemius. If you’re struggling with single-leg heel raises now, try doing double-leg heel raises and, while at the top, shift your weight over to your injured leg for a controlled eccentric contraction (lowering your body and heel back to the floor). Try doing these standing next to a counter with just a couple of fingers helping you balance. -David
Thanks for the comments. I figured that I would need more calf strength, which I have very little of at the moment. I am thinking of practicing seated calf raises with a ten pound weight to get started, at physical therapy they make me do heel raises while grabbing something. And it is kind of scary when I heard of people rupturing by doing such. I will do what I need, because right now I can’t even walk to the corner store unless I bring my crutches to go up and down my steps outside my house. I would love to be able to just go. Again thanks.
The main variable that controls the AT-friendliness of stairs is how much of your foot is on the step and how much is hanging off. Ironically, that variable works differently when going up and going down: Going up, you can take the load off the AT by putting your whole foot on the step. Going down, you can avoid overloading your AT by letting the front of your foot hang out over air, and letting it roll around the step as you step onto the other foot one step lower.
That latter technique can avoid the most common work-around on steps, going downstairs asymmetrically, always leading with the injured foot. With this “trick”, you can walk down symmetrically, at normal speed, without stressing your weak and inflexible leg.
Chris, I think I understand what you’re alluding to regarding walking up steps because I experienced the same issue during my recovery. Walking well on flat ground came much earlier than doing the same on stairs. It’s also one thing to take steps flat-footed, but it’s another to step on your toes first. The key here is building-up your calf strength enough so that you can control the eccentric contraction of your Achilles (single-leg) as you step toes first and lift your body up using one leg. Building-up calf strength just takes time, but as your muscles get stronger I think you’ll find that walking up steps will get easier, too. Keep working on those single-leg heel raises and taking the stairs will get easier over time. -David
Good news on working out the limp. I’m behind you a bit so I don’t have answers for getting up stairs yet. I hope to practice at my mom’s this weekend as she lives in a split level so there’s always a few stairs to navigate. Just keep up the good work and before you know it you’ll have the strength you’re looking for. Though I am sure someone else will have better advice.
No advice I’m afraid, just sympathy and wishes for speedy recovery from your set back. Sounds painful. Hope someone can give some feedback on their experience. Good luck and take care.
Hey Chris89,
My big toe was stiff and jammed up for a while after I went into two shoes, too. There was pain when I tried to curl it and it felt like the knuckle/joint needed to “pop.” It eventually worked itself out after a week or two without any kind of PT or stretching, so I wouldn’t worry about it.
I pick up marbles with my foot, I didn’t get a toe graft, Just very hard to flex my big toe. When i flex it with my hand it hurts. Yeah, when I see my pt this Monday I will ask about it, but I am scared hahaha that they will go overboard on the pt.
