Craig’s achilles blog - one day at a time

Had the best kind of doctor visit this morning: quick and to the point.  I was cleared to begin light jogging.  Hooray!  4-5 minutes every 3rd day, gradually building up to longer runs as my strength builds and I feel more comfortable.  My doctor was happy with the progress in my calf strength, and said that if all continues to progress that my next appointment, scheduled for 5 weeks, will be my last.  He expects to clear me for full impact at that time including cutting and jumping.  I’m fairly certain I’ll visit my regular basketball game at that point, but haven’t quite decided when or if I’ll play again.

Not much else new to report since my last post.  Other than some initial tightness in the morning, my tendon feels pretty good.  Once I’ve stretched, I feel like I’m walking without a limp.  My stride feels the same on both legs, and I’m comfortably wearing dress shoes again.  Funny, though, I was thinking this morning that I rather enjoyed being able to wear shorts and running shoes to the office everyday.  The grass is always greener.

Best of luck to everyone.

I think I posted last time that I’m spending less and less time thinking about my injury.  Well, I’ve noticed over the past few weeks that I haven’t spent much time on the blog site either.  On that note, hi to everybody!

It’s funny, I don’t feel like there is much to say as I’m in the slooooow progression stages.  However, the last few times I’ve started a post it seems that I end up writing a small novel.  Tonight is no exception.

The family and I concluded a successful Hawaii trip last week.  What a great time.  One of the best parts of vacation is the feeling of sleeping in your own bed when you get home, but Hawaii is one of the few places that I really dread leaving.  Mahalo to the island and the people there for helping me remember how to relax and enjoy all that life has to offer.  Of course, now that I’m back home, it’s been back to the rat race as I’ve struggled to get out from under the mountains of email and miscellaneous tasks that piled up while I was away.

Anyway, on to the topic of my Achilles.  I had been a little nervous about our Hawaii trip since that fateful day in April when I joined the land of ATRs.  I’m happy to report no problems what-so-ever.  Walking on sand was fine, though I was a bit slow when both sand and an incline were involved.  I went snorkeling a couple of times, and didn’t have any problems just enjoyed all of the beautiful fish.  One of the reasons we decided to visit the big island was because the kids wanted to check out the volcano.  We visited it on August 16, which happens to be the 4 month anniversary since my ATR surgery.  Hiking around the volcano itself was relatively easy.  The ground is mostly flat with a lot of trails.  When we were done at the volcano, we decided to drive down to the ocean to see where the lava enters the ocean.  There is a viewing point about 100 yards from the ocean and about ¼ mile away from where the lava enters the ocean.  Unfortunately, you can’t see the lava flowing (I didn’t feel like forking out the $1,000 for the family to take a 45 minute helicopter ride over the lava), but we could see large flumes of steam that were created.  The challenge of getting to the viewing point was a ~ ½ mile walk on old lava rock.  It is very undulating and looks like a rolled ankle waiting to happen.  Needless to say I was very cautious in walking out, but what a cool place to be for that very special 4 month anniversary (LOL).  Of course, I had to wear my achillesblog T-shirt that day for the pictures.  Check out the picture below!

One of the bad things about vacation was that I not only missed my PT appointments, but I wasn’t very good about doing my exercises.  Yesterday I had my first session since coming back.  I have felt the strength in my calf increasing over the past few weeks, and have felt especially strong the past few days.  When I go to PT, I usually do most of my exercises before I see my therapist.  Before I left on vacation, I had been doing 25 lbs with my bad leg on seated heel raises.  However, yesterday, I could only find 15 lbs of the smaller weights, so I said what the heck, I’ll give a full 45 lb plate a try.  I’m happy to report that I was able to do 3 set of between 12 and 15 reps, though it was a good workout.  Shortly after I finished this exercise, my therapist was ready to see me and called me over.  After some gentle massage during which I told her I was feeling a lot stronger, she asked me to stand up and do some squats.  I told her they were relatively easy, so she instructed me to stand on my tip-toes.  “Ok, now balance on your right leg, and do a heel raise.”  What do you know, my heel actually came off the ground!  I couldn’t hold the position for long, and while it seemed like there was a mile between the floor and my heel, I’m sure it was barely enough to slide a piece of paper in.  Regardless, I had successfully completed my first heel raise.  The milestone we all shoot for!

Everything continues to be getting better.  Here’s a picture taken today.  I’m very happy with the scar, but wish the achilles wasn’t so thick.  That will get better in time.  I’m scheduled to see my doctor next Tuesday.  I’m really hoping to get clearance for some light jogging.  It’s been hard driving to work or taking the kids to school and seeing all of the runners out at the park I pass each morning.  I can’t wait to join them!

Best of luck to everybody, and I’ll do my best to stay caught up on everybody’s entries and comments.

This past week marked 100 days from my surgery.  It’s amazing how much my life is different today.  Not only from 6 months ago, but from 1 & 2 months ago as well.  I try to keep up with the site daily, but I haven’t been able to nearly as much as the first 2-3 months after surgery.  Shoot, I had intended on posting this entry on the 100th day after surgery.  Unfortunately, it is now day 102.

I’ve been really busy at work lately, but I think the real reason I haven’t been as active on the site is that I’m no longer thinking of my injury every 5-10 minutes of every day, rather it’s more like once or twice an hour of every day.  Part of me feels bad that I haven’t put the time into reading everyone’s blogs, especially some of the newer people, but part of me is glad that I’m getting to the point where my life isn’t completely obsessed with the achilles tendon.  Eww, does that sound as bad as I think it does?

I feel like I’m gradually getting back to my old lifestyle.  I’ve been driving for about a month now, and feel completely safe and comfortable behind the wheel.  While my pace isn’t nearly the same as it used to be, I’m back to making my regular weekend walk to the coffe shop and back.  I’m not able to do a single leg calf raise yet, but I feel the strength slowly coming back.  Hopefully, the calf raise can happen within the next month or two.  I’m even getting some wind back as I’m able to ride the stationary bike at a good pace for 30 minutes or more.

Though the recovery milestones aren’t nearly as exciting as they were for the first few months, they are still coming.  This was a particularly good week:

• I started walking around the house barefoot with only a minimal limp last weekend.  Up until then I had to either put my shoes on, limp badly with no shoes, or use the crutches.  I spent a lot of time last weekend just moving my ankle, lots of circles one direction and then the other.  This seemed to greatly loosen up my joint, which in-turn has helped my dorsiflexion.
• My achillesblog.com shirt arrived on Tuesday.  Woohoo!
• On Wednesday, I took my kids to an all-star football game for last year’s high-school seniors.  My neighbor was coaching and scored me free tickets.  The big deal here was that I had to walk a good distance in the parking lot, and up and down many stairs into and out of San Jose State’s stadium.  No problem here what-so-ever.
• I removed 2/3 of the heel lift from my shoe on Thursday.  At first it felt a little odd, but I’m pretty comfortable now.  I’ll, likely remove the lift completely this week.

Our family vacation to Hawaii is a little over 2 weeks away.  I’m feeling very confident that I’ll be ready to hike the lava flows when we get there, something the kids have been looking forward to all summer.  I’ll have to wear my achilles.blog t-shirt on the hike and post a picture afterwards.

In the meantime, best of luck to everybody.  Keep healing and chugging forward in the marathon of recovery.

I went back to PT for the first time in 2 weeks yesterday.  The pain I was having has pretty much subsided now, so I was anxious to get back to strength training and working on my joint stiffness.

Had a good, though uneventful, session at PT.  Rode ~4 miles on the bike, did some leg presses, some toe raises on the leg press machine, worked the orthotron, and a few other miscellaneous stretches.  I’ve felt like my ROM has improved a bit over the past two weeks, and my therapist noted the same.  After some joint work, I was able to get my dorsiflexion slightly past neutral.  I even did some barefoot walking (hadn’t really tried that yet).  This weekend, I’m going to start daily walks.  I’m hoping to increase the distance in ~1/4 mile increments with the goal of hitting 3-5 miles ahead of the family Hawaii trip in mid August.

I certainly feel like I’ve hit the slow point of the recovery process.  Progress is tracked in weeks and months instead of days.  Another reason why the marathon analogy is so appropriate when describing the recovery process.  At the same time, I can walk with only a slight limp, so life is getting closer to “normal” again.

Much luck to all in your healing.

Thought I’d put up some overdue pictures.

Seems like a long time ago… 19 days after surgery.  Right after stiches were removed

Today, 74 days after surgery

I’m real happy with my scar.  I couldn’t, however, get a picture that did a good job showing the bruising.  That is, there is more bruising than this picture indicates.  You can notice a small scab at the bottom of my scar.  This is new, and I’m sure is related to my latest issue.  I should point out that I didn’t completely lose my scab until Monday of this past week, so I hadn’t been “scabless” for long.

As I mentioned in a comment earlier today, I’ve resorted back to crutches while I’m at home trying to minimize the stress on my wound, and hopefully, get over this latest issue.

Anybody who has spent much time on this site has read at one time or another that recovering from an ATR is a long, slow journey.  This journey has many great milestones, but also, a fair share of setbacks.  I feel very fortunate that my setbacks have been few and far between.  Slow and steady, the progress has come.  However, today was a bit of a hiccup for me on that road.

The morning started just like every other for the past few weeks.  Wake up, spend 1/2 hour or so doing stretches, then get ready for the day.  I’ve noticed an increased ROM over the past few days.  My oh so tight ankle joint has been slowly getting looser and looser.  I finished getting dressed and was ready for the day.  My wife wanted to go into work early, so with my new found driving freedom I volunteered to take my younger son to school.  His preschool is only a block away, so I figured, what the heck, let’s walk to school.  My walk has been getting better and better.  I’m no longer being confused with Lurch from the Addam’s family dragging my bad foot.  Anyway, not more than 50 feet into the walk I was suddenly struggling with a burning pain on my achilles.  Time to go back home and drive Alex to school.

After dropping Alex off at school, I shrugged off the pain, went home, and got ready for my PT appointment later in the morning.  The pain was still there when I walked, but it wasn’t too bad.  I arrived 45 minutes early for PT, so I warmed up by starting my regular exercise routine.  Everything went fine, but it burnt a good amount when I tried some more aggressive stretches.  When it was time for my massage and soft tissue work, I made a point of telling my therapist about the burning in my achilles.  We talked about possibilites as she worked my leg and foot: inflamation from walking more than normal, extra stretching or strength work, or maybe irritation from my shoe.

To make a long story longer…  I put my shoe back on and started doing some walking.  My therapist watched me and was analyzing my walk.  Then it happened.  I was talking about how I felt like my strides were getting longer, more “normal”, and all of a sudden riiiiiiiiiip.  I felt something on the bottom of my achilles tear.  It was a sharp pain, very different than my ATR, but I was freaked.  My therapist had me sit down and take off my shoe.  She performed the Thompson test and miscellaneous strength tests.  Everything seemed ok, so she had me “gently” finish my exercises and take it easy.  “It’s probably just scar tissue.”  The top of my shoe seems to irritate my scar some, so I’m really hoping that is what the problem is.

Well, I spent much of the rest of the day worrying about what was really going on with my tendon?  It still burns when I walk with my shoes on.  What was it that tore?  Was it just scar tissue or something else?  And should I be walking and stretching my tendon with this burning inflamation or scaling back and taking it easy?  Darn this whole listening to your body process can be hard.

Anyway, I already had a doctor appointment scheduled for tomorrow, so I figured things could wait another half day or so.  I hope to get some resolution as to what the problem is, what I can do to help it, and is it really something to be concerned about.  Of couse, the real goal is to continue progressing down the road of recovery.  So as I write this, I’ve taken a couple of advil, iced for the night, and am hoping when I wake up tomorrow everything will be a little better…

Decided to try something this morning that we right leg ATRs have dreamt about for a while, driving.  We needed to get a couple of things for my son’s birthday party, so I volunteered to drive to the store and get the items.  My wife hemmed and hawed for a second, but I think it was just for show as she has to be tired of doing all of the driving…

It was a pretty un-eventful trip.  About 3 or 4 miles round-trip with about 5 stoplights each direction and a max speed of ~30mph.  Accelerating was a bit difficult, don’t expect to see me winning any drag races anytime soon, as the fine muscle control just isn’t there.  I considered this a good thing as not going too fast means no chance of braking too fast/hard.  The difficult part was the drive back.  I walked around in the store for a good 1/2 hour, so when it was time to leave, I was already getting fatigued.  I used my left foot for initial braking on the way home, and switched over to my right foot for the fine part (I hate the jerk stops that I get when braking completely with my left foot.)

Clearly, it’s going to be a while before I’m ready for a major road trip, but hopefully, with a little more practice and continuing to do my exercises and PT, I’ll be able to make the 10 mile morning commute to work and allow my co-workers to turn in their taxi badges.

6th PT appointment today.  It’s funny, within a few days of my ATR, my neighbor was telling me how bad PT was, “They are Physical Terrorists” based on his experience with a knee rehab.  I’m not sure if it is because my recovery process is different than his was, or if it is the masochistic athlete side in me that enjoys being pushed, but I really enjoy and look forward to PT.  I know deep inside that I believe you can’t progress without being challenged.  And compared to running seemingly endless suicides in basketball when I was a kid or pushing through the boot-camp and kick-boxing classes as an adult, PT just doesn’t seem that hard.

Outside of PT, I’m continuing to have limited dorsiflexion as I can only get to -2 degrees.  I continue to walk with a heavy limp.  This is the case even though I’ve been good at stretching regularly during the day, doing my prescribed exercises, and icing and elevating at night, though I could probably stand to elevate more during the day.  It is amazing though, when I go to PT how much extra ROM I get through the massage and stretching.  A few times after some stretching tonight I felt like I was actually walking without a limp.  That felt great.  I think I’m going to try and push myself a little harder these next few days during my stretching exercises.  Of course, the thought of rerupture (daveleft, I really feel for you) always seems to be nagging in the back of my mind, and probably makes me a bit timid.

I also got to ride the bike today for the first time.  With minimal resistance (set to 5), I had to convince myself to keep my cadence at a reasonable pace, as I had the urge to go for the gusto and hit a sprinter’s pace.  It felt great to get blood pumping and my heart rate up.  I was allowed 10 minutes today, but it was hard stopping at the beep.  I would have loved to stay on for a while longer, but with the massaging, stretching, and other exercises, my legs are pooped tonight, so I’m glad I stopped when I did.  I will definitely be hitting the bike at the gym outside of PT now, so I can get that feeling back.

On a completely different note, we have an exciting, and busy weekend ahead of us.  Our 12th wedding anniversary is Sunday.  I have to work overtime as I was a bit of an ATR newbie during Mother’s Day and wasn’t able to step up for the occasion.  Sunday also happens to be my oldest son’s 8th birthday.  Drew has a birthday party on Saturday, and we’re all going to a baseball game on Sunday.  I’m sure I will be ready for ice and elevation by the end of each day.

All-in-all, I feel that the amount of progress I’ve made over the last few weeks has been amazing.  Very good for the soul.  I looked at my bad leg this morning, and even thought that the atrophy wasn’t that bad any more.  (I’m sure I was still half asleep at the time though)  I think back on how slow the time went for the first 2-3 weeks of recovery, and how quickly the past 2-3 weeks have flown by.  I also look forward to the joy of driving again (may try a little this weekend if time permits), being able to swim (still have a bit of a scab, so my PT says not yet), and jogging/running/simply going out and having fun with the family.  I know those days aren’t too far ahead, and will be here before I know it.  I also look forward to crossing the NYC marathon finish line, and am thankful for all you other bloggers out there who have helped with the journey, and will be crossing that line too!

I had PT scheduled for 3:30 this afternoon.  It turns out that the PT center is about a mile from my house.  I was running a bit early, so I asked my friend driving me if he could swing by my house real quick.  When I got home, I dropped off some work stuff and hobbled into my room to grab my right shoe.  I remember reading somebody’s blog 6-8 weeks ago when they said, “my doctor said if I had brought my shoe, I could have walked out in it.”  I was determined to be prepared even if I wasn’t ready to go into 2 shoes.

Well, as soon as my physical therapist saw me walk in, he said that gauging my walk it was time to try a shoe.  So, yes, sure enough, I’m now out of the boot and into two shoes!  (I have to say, as much as I hated being in a cast and enjoyed being able to take my boot off, I think I actually was less comfortable in that darn boot than I was in the cast.  Good riddance!)

Just as I was when I first went to FWB, I’m a bit nervous/tentative while walking in 2 shoes.  At the same time, I’m excited to take another step (literally and figuratively) in my recovery towards “normal” life.  Unfortunately, I’m still 1-2 weeks away from being able to drive.  I don’t have the strength for breaking hard, and drive in just enough traffic that I figure it isn’t worth taking the chance.

I went through a pretty good workout today at PT including leg presses (work on my weakend quad), toe presses, 1 minute timed stands on my bad leg while balancing on the nearby table as necessary, and a series of other exercises.  Needless to say, the ice and “stim” at the end of my session felt great.  I think me and my achilles will rest well tonight.

I plan on following up with my PT / ortho, but in the meantime I’m looking for some advice with regards to the angled setting on my boot.

I had my third PT appointment today, and there was a marked improvement in my dorsiflexion vs my last appointment last week (7 degrees vs 15 degress pre massage, 3 degrees vs 8 degrees post massage).  The real encouraging part is that it appears to be joint stiffness that is preventing me from reaching the goal of 0 degrees, and I’ve been able to get a lot of strength back quickly (blue colored thermaband and #3 setting on the Orthotron if these mean anything).  So really, it seems I just need to work on a long of stretching drills for my ankle joint.

My boot has settings in 7.5 degree increments.  Since I’ve started FWB, I’ve stayed at 7.5 degrees.  My PT today suggested that I try to go to 0 since I’m getting close in my sessions, and I won’t progress with it set at 7.5 degrees.  I tried 0 degrees tonight, and while I’m still able to walk on it, my foot really starts to hurt after a few minutes.  So I decided to drop it back to 7.5 degrees.  When I was putting it back to 7.5 degrees, it occured to me that I could set the front setting at 0 and the back setting at 7.5 degrees to allow the boot to flex between the two.  (Does that make any sense at all?)

My question is, does anybody have any thoughts on whether or not it is a good idea (safe?) to allow for flexing in the boot?