coolkiwi’s AchillesBlog

16 responses so far ↓

• mari // Apr 16th 2010 at 6:27 pm

  Powerful stuff to have 2 feet!

• normofthenorth // Apr 16th 2010 at 7:01 pm

  Congrats!

• coolkiwi // Apr 28th 2010 at 7:00 pm

  Got into shoes again about 10 days ago - have been mega busy, so first real chance to post! Had 15 round for a BBQ last week and just delighted in being able to scoot round, do the shopping and prep all the food, rather than having to shop online and trust a deli. By the end of the day my foot was aching, so I reverted to moon boot for the dinner part, and that really helped. Am finding walking gets easier by the day, though I am limping and go downstairs very carefully - am not keen on stretching it out yet. But to all the ‘newbies’, there is light at the end of the tunnel, hang in there and it will get better! And thanks guys for all the support, it made a huge difference and the advice and knowledge in those early days was invaluable (coz the hospital tells you next to nothing!)

• normofthenorth // Apr 28th 2010 at 7:40 pm

  One of the more interesting transitions I’ve made in the past ~month (I’m at 19-ish wks now) is in the way I walk down stairs.

  For a while, I was fanatic about always placing my bad foot near the edge of the step, so I could “roll” my foot over the step, without any risk of dorsiflexion under my weight. (I was, as you say, “not keen on stretching it out yet.”)

  Now I’m concentrating on using stairs as exercise — putting as much weight as possible on my “bad” toe (or ball of my foot), and using that calf-and-AT to lower my weight as slowly as possible. At the end of the step onto my “good” foot, I’m dorsiflexing normally over the “bad” one.

  So I’m still concentrating on doing it “right” — but “right” used to mean “as safely as possible”, and now it means “so my still-wimpy calf muscle gets some exercise out of it”!

• doug53 // Apr 29th 2010 at 4:55 pm

  Hi Norm,

  It’s funny that you bring up going down stairs as an exercise opportunity. I’m 14 + months out now, and the one old exercise I still do out of habit is to bounce my weight back up as I hit each step going down, keeping my heel as high as possible. The extra force of the descent gives the calf a bigger eccentric load to handle.

  Great to hear about your successful ski trip,

  Doug

• normofthenorth // Apr 30th 2010 at 6:08 pm

  Good to “hear” your “voice” again, Doug, we all missed you!

• coolkiwi // May 31st 2010 at 2:49 pm

  Hi all - update on progress. Have found a great physio - two visits later I am walking without a limp (in heels) and only very slight limp in flat shoes. Physio says it has healed really well - it is slightly ‘tight’ (short?) which is apparently better than being stretched. I do stretching exercises every morning before getting out of bed and that really helps. Have also done some pilates with the physio and plan on continuing that even when physio sessions have stopped. Can’t believe that it is 14 weeks - doesn’t seem that long ago (strangely) that I was on crutches - boy do I regard people on crutches with new sense of admiration and respect now!

• normofthenorth // May 31st 2010 at 8:56 pm

  Sounds great, CK! My first ATR was repaired a bit short (8+ yrs ago), and it never bothered me or my sports activities a bit. In fact I generally became more active and aggressive and effective at volleyball (e.g., switching from 6’s to a mix of 4’s and 2’s) after the AT healed — which was a good trick considering that I had a 60th birthday somewhere in the middle of that span!

  Now, even without surgery, my “new” ATR seems to have healed up more like the first one than like the pre-ATR ones. I have a tiny bit more ROM than on the old post-op side, but it’s very close. I’m not going out of my way to stretch hard to try to get it any longer, based on my happy experience with the other one.

• coolkiwi // Jul 19th 2010 at 7:47 pm

  Hi everyone

  Am at 21 weeks now. Doing physio twice a week, and she is delighted with my progress. Am doing lunges, single calf raises, but also really focusing on posture. She said I wasn’t using my core to support my limbs - over reliance on joints. Possibility of that leading to injury, and boy, wouldn’t we all try anything to prevent recurrence! Have just been away with the kids (winter hols over here) did lots of walking in ‘flat’ shoes and also some with 2″ heels. No adverse effects. Tennis here I come (soon-ish)

• Coolkiwi2? // Aug 29th 2010 at 12:12 am

  Hi Cool Kiwi,
  I hope my recovery goes as smooth as yours. Just one quick question: I too live in Welly… how’d you handle all of the stairs? I live in a 2 story house on the side of a hill which requires me to get up 30-40 stairs to get to roadside - like so many welly houses! So not outside at all - just up and down the inside stairs. But I have to brave the stairs soon…

  Sounds like your routine is same as my routine, however due to being unable to get an Ortho booking at 2 weeks, I’m in at 3 weeks. I’m going to try convince Dr. to put me straight into a moon boot then. At 9 days post injury I’m already getting quite a bit of movement (naughty I know to try but my cast has a little bit of movement after the swelling subsided).

• normofthenorth // Aug 29th 2010 at 9:36 am

  Coolkiwi2, lots of good modern protocols use removable boots instead of casts, and start movement “exercises” and even PT as early as 2 weeks, so I’m not sure you’re being more naughty than nice! Fight for the boot! And check out a good modern protocol (from a study with good results) at bit.ly/UWOProtocol .

  30-40 stairs sounds like a lot, especially if they’re outdoors without a good strong banister (or do you say hand-rail?). I’ve survived TWO ATRs (both sides) in the same 3-story house (though I really live on only 2, plus a few stairs outside). The first one was tough and scary, because I was NWB on casts for a LONG time, and the banister was on my “good” side on the way down, which didn’t help. Unless I wanted to slide down on my behind (and I did NOT), I had to crutch-walk down the stairs with my cast in the air, or resting gently NWB on the step. It reminded me of skiing a steep scary run, kind of a “leap of faith”. I only lost my balance or slipped 2 or 3 times, and didn’t injure anything when I did — phew!
  This last time, my NWB was only 2 weeks, thanks to that protocol, and I was FWB soon after 4 weeks, which was WAY better for stairs. In addition, I had switched sides, so even when I was NWB, it was quite easy to pop down the stairs by putting both crutches in my “good-side” hand and putting my weight on the banister, on my “bad” side.
  Once you get FWB, you should be able to do that “roll-over” described above and elsewhere, to use the boot to walk down stairs pretty quickly and pretty normally (at least when seen from a distance!).

• Coolkiwi2? // Aug 29th 2010 at 12:38 pm

  Thanks Norm.

  Down for me is ok… its going up where I loose stability, as you are having to lift your body weight so often, and being a girl I don’t have that upper body strength that guys naturally have.
  After loosing balance on the 15 steps inside a couple of times I’m just a bit nervous about tackling the outside steps. But as they say… you’ve just gotta do it! (and yes the stairs here have no handrail so its 100% use of Crutches. Oh well!

  Hint to the novice crutch users out there, don’t try to hop up a stair backwards… ends in a hilarious butt-crushing self realisation you are not superwoman and the laundry basket you are trying to drag can just wait!

• coolKiwi // Aug 29th 2010 at 1:16 pm

  Hi CoolKiwi2 and Norm

  Well, I have one of those Wellington homes with a drive on section and internal access to garage. Two storey yes, but access from front is to upper storey and the kids live downstairs. So until I was weight bearing I decided not to do stairs thank you, as I found kerbs daunting enough. I was on my own with the kids for a couple of weeks and was scared stiff of falling over.

  Re NWB protocols etc….seems to be ‘one size fits all’ when it comes to treatment in NZ. I found some movement inside my cast, and the moon boot was great, although for the first two weeks of that you are supposed to be NWB, which makes six weeks NWB in total. But I talked to the ortho, (Btw you will see a different one each time!!) and he said that it was fine to ‘walk on eggshells’ with bad leg in moon boot for the first two weeks (ie weeks 4-6) At weeks 6-8 you start to walk properly, and it happens really quickly.

  I am now six months down the track….walking heaps (physio says lots of uphill work) starting to jog up and down our long corridor at home (bit like the Silver Ferns when they warm up pre match) and am on course to start playing tennis in four weeks when we are on hols in Aus. Oh and lots of calf raises (the most enjoyable bit - not)
  My personal advice would be don’t rush it, be patient and get someone else to handle the laundry. Btw if you live in northern suburbs then I can recommend great physio (ex Silver Fern)

• normofthenorth // Aug 29th 2010 at 6:28 pm

  There is one trick that I found helped a lot while crutch-walking on stairs. It’s maybe sort of obvious, but I found it helpful to accentuate it, kind of “overdo” it: When you’re (say) going up, just before you step up one step with your “good” foot, do everything you can to make yourself taller, to raise your center-of-gravity (COG) as high as possible, while you’re still balanced on the lower step. Then, when you actually shift your foot to the higher step, don’t raise your COG right away — keep that as a separate, second, move.

  So the sequence is like this:
  1. Stand on a step (2 crutch-tips and a “good” foot) normally.
  2. Stand on that step (2 crutch-tips and a “good” foot) way up high, both by standing tall and maybe also going up on tip-toe. (I sometimes shifted my “bad” foot up to the next step at this point, but YMMV.)
  3. Quickly step the “good” foot onto the higher step, with NO change in your COG. So you’re in a kind of semi-crouch at first, on that next step.
  4. Once you’re balanced on that foot on that new step, stand up tall. Then shift your crutches up and stand up even taller, and do it all again.

  The trip down is a similar sequence of steps, with the “step” and the “COG up-or-down” separated a bit.

  At least for me, making the actual shift of the height of my COG (up or down) totally separate from the “leap of faith” (lifting my “good” foot in the air and stepping with it) seemed to make everything more solid and less OMG scary.

  As one of my fave TV ski instructors always used to say “I hope that works for you!”

• Coolkiwi2? // Aug 29th 2010 at 11:46 pm

  Thanks for all lessons and words of wisdom.

  Makes me laugh at how its the silly little things you do everyday that are the hardest to do when impaired. I give full credit to those who are impaired long term… man they must be strong in ways I can’t even think of.

  CoolKiwi - thanks for the advice, very glad to hear the ortho’s here are approachable and agreeable to modified progress plans. I’ve got a physio just down the road, he seems to have held some great sports physio roles here and in Aussie. I’ll try him out first.

  Norm - great idea to accentuate the movements, I will try it out tomorrow.

  thanks again, Coolkiwi2?

• coolKiwi // Aug 30th 2010 at 12:10 pm

  Been back to the physio this morning - am now on weekly appointments (good if you do twice a week to start off). Lots more calf r.aises on the menu plus side stepping/jumping. She made a couple of interesting points:

  The big hurdle (which I got over in the last month) was to engage my ankle (on injured leg) fully, therefore no more limping. It is easy to get into the habit of limping

  I am now probably walking better, with better posture than before the injury….standing ‘further back’ in my stance and longer strides.

  I’ve also found that following the injury I’ve had time to review my approach to body and health generally, and have made some really positive changes. So maybe there is a silver lining….

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