A very weird difference in the healing between right and left feet

I’m still working to get back to the strength level I had before Christmas. A visit with my doc where he had me do an unassisted heel raise when the foot was NOT ready for it set me back quite a bit. I had done a couple of those in PT about a week earlier - but clearly the stars were not aligned properly when my doc wanted me to do them.

One thing I finally figured out, which is quite different from my right foot recovery, is that I don’t feel the pain while doing heel raises until I take all the weight off the foot. Pretty strange! For my right foot I would feel the pain that told me to stop, as I was doing them, so it was easy to judge when to stop in order to avoid overdoing it. It actually took me a little while to figure this out with my left foot which was one of the reasons I kept over doing things. I would happily do heel lefts all in a row and not feel any pain until I stopped and took the weight off the foot. At that point the pain could be quite intense, but the damage was done.

Weird! So now I do a few heel raises, then shift all my weight to the right foot and wiggle my left foot around to see how it feels. If it still feels OK I do a few more. I emailed my PT to see if he could explain why this is happening. Now that I finally know how NOT to overdue my exercises, I hope I’ll actually make some progress in gaining strength.

Only time will tell!

But one bit of progress I do finally see (and I’m at the 5.5 month mark now … sigh …) is that my foot doesn’t swell when I’m on my feet most of the day.

With the differences I see between how my right and left feet heal I’m not at all surprised out how differently each of us heals as we go through this process.

PT appt #6 - 5 months since surgery

Saw my PT today and told him about the bone bit in my heel. He was pretty amazed - LOL! He was happy that bump was quite a bit smaller now. We discussed my slllooowwwwww progress. He said I’m either over-doing it, not doing enough or something is wrong. He ruled out the last two since my doc says everything looks good and he knows I’m not one who doesn’t do my exercises. So, somehow, I’m overdoing it. Today I just did walking in the pool, swam some laps and did some heel raises in the pool until I could feel the heel starting to get unhappy. At home I’m going to go back to seated heel raises with a weight until that is pain free. I did that last night and it was not pain free. It wasn’t as painful as when I do it standing but it wasn’t a cakewalk. Tomorrow I’ll take a break and see how things feel on Sunday. My PT said if I take a break and things go better after that then I’m overdoing it. Tonight I’m going to put heel lifts in my shoes to see if that helps the achilles relax a bit as well. I don’t feel like I’m doing much since I have fewer exercises that I did with my right foot! I go back again at the end of the month and I’m hoping I’ll have some improvement to report!

Doctors Appt - week 20

After finding the bump on my heel that was quite inflamed I accelerated my 1/8 appt to today. When my doctor emailed me that he thought a suture might have been left in I went ahead and squeezed the bump and this time I got a hard little bit of something out. When I looked at it under my jewelers magnifying lens it looks like a small piece of bone. Today when I went in the inflammation is completely gone and I just have a little knot where it was. My doc wasn’t quite sure if it was bone since he was looking at it without any magnification but he figured it was either bone or suture. He said they flush out the surgery area a LOT after all the grinding is done but it is possible that some little bit gets stuck somewhere and doesn’t flush out.

I complained to him that I was already a month behind my right foot recovery. At week 20 with my right foot I was already doing all kind of jumping exercises and running regularly. I still can’t walk normally with my left foot. He told me my right foot healed REALLY quickly. I was at the top of the scale for speed of healing with my right foot. It could be because my right foot is my dominate and was stronger before I had the surgery. It could be that the inflammation from that little bit of bone slowed things down. He couldn’t say for sure. But he did say I was healing at a more “normal” pace with this foot. LOL! So using my right foot healing time frame as a point of reference is not a good idea.

He said for the next month I should wear shoes that are more rigid (like good quality running shoes) so my achilles doesn’t have to work so hard in that last bit of flexing as I walk, go back to using heel wedges for a while in my shoe if walking continues to be an issue, put heel wedges on the floor as I’m doing my heel raises so my foot isn’t starting from flat ground. He did have me do one unassisted heel lift and I’m still paying for it. I texted him about 2 hours after my appt to let him know my foot still hurt, I was still limping and I was getting pain spasms all because of him - LOL! I just had to give him heck for making me do something my foot isn’t ready for. :) I did try doing a heel raise starting from 9/16″ and 7/16″ stacked heel wedges but it was a no go. My achilles is just too sore from that 1 heel raise I did at my appt.

They did take an xray of my foot from several angles to make sure there were no other bits of bone hanging around. My doc did think that a piece of bone that small would be visible in an xray. I’ll have to see if I can get a picture of my little bone bit through my jewelers magnifying lens.

So in short he said my strength is good, my calf muscle tightens up well as I push and as far as he is concerned I’m doing fine. He was actually quite happy I was able to manage a heel raise - even if it did hurt like heck! I do need to send him an email to remind him that he told me I could start running at the 3 month mark …. so he set my expectations high as well.

PT appt #5 (about 4 months)

I complained to my PT guy that my progress hasn’t been as fast as I think it should be this time around and he said that was to be expected since it kept getting annoyed due to over use …. sigh!!!! However he did have me do an unassisted heel raise while there - actually I did 4 of them. They were hard and did hurt. He said some pain is expected and as long as it doesn’t result in things hurting or aching or being stiff the next day that was OK. All the PT instructions I have say that if the pain only lasts about 10 minutes then things are OK. I guess that applies to earlier in the PT process since those are sheets I got at the 3 month mark. So … I’m going to push things a little more - in some ways. He also said it was OK for me to use the gym machine that improves calf strength (you set a weight and push with your toes) and to do leg presses and switch it up by doing the leg press with my toes. And he reiterated that I need to go sllllooowwww as I lower myself from the heel raise since that is how you gain strength. So I have new things to work on. I did some lunges at PT to try to figure out which one was causing pain previously and didn’t feel any pain. So if my foot still feels good for lunges tonight then I’ll start doing the lunges while holding weights. And my flexibility increased .5cm since my appointment 2 weeks ago. He said I still shouldn’t do any running since I can barely do a heel raise unassisted. Once I can do them unassisted and with not much effort then I can start running. One other tweak he suggested for adding strength is to go up on my toes on 2 feet (unassisted) and then stay on my toes with must my surgery foot and slowly lower down one footed.

So despite my feeling that I wasn’t making much progress over the last 2 weeks I actually did - just smaller increments than I hoped for. And he gave me a plethora of things that I can do which always makes me happy! I LOVE having lots of exercises I can do since the more exercises I can do the quicker I’ll get stronger. I go back again in 3 weeks - right before my next appointment with my doctor.

I hope everyone enjoys the holidays and good luck in the healing process in 2019!

And, since I can’t add a picture into my comments here is the bump on my foot that is still bugging me at 18 weeks. It’s about 1/4″ in size. My doc thinks it might be a suture that got left behind. I’ll see him on 12/31 so he can look at it.

bump on my foot at 18 weeks

bump on my foot at 18 weeks

PT appt #4 (about 3.5 months post-surgery)

Well my hubby was out of town for a week and I had to cook for me and the dog (he has kidney issues and a handmade diet keeps his kidney numbers in the normal range), walk the dogs, go to the store, run all the errands and do some yard work. I have a chair in the kitchen and try to use it but clearly I didn’t use it often enough. My achilles is paining me most of the time and just a little bit of walking will flare up the pain quickly. My PT did some checks and felt a knot in the tendon above the surgery site so he thinks I have tendonitis. So he told me to stop doing the PT exercises, don’t do the elliptical (but I can do the recumbent bike) at the gym and basically give it a break. Sometimes you can’t avoid over doing it - but don’t be surprised if your recovery takes a few steps back when you do. :) On the good side my shoulder/nerve has gotten a bit better. The tingling I felt in my arm and down into my them is less intense. Tilting my head back doesn’t cause the tingling anymore so the nerve may be calmed down and the problem may now come from a trigger point in my shoulder blade area.

So I’ll not go barefoot for a while and will wear my clogs that are essentially a heel lift to take some stress off the achilles for a few days. And hubby will have to run more errands. My PT told me that when it doesn’t hurt to walk I can slowly start up the exercises again. So I continue to laugh at my doctors statement at my appt a few weeks back when he said I can start running now! LOL!

PT Appt #3, week 14

Well I’m having more PT appointments this time around. I think the thought process at Kaiser changed in 1.5 years since I had one PT appt at 10 weeks and then didn’t have another one for a month. Not that that is a bad thing this time around since my PT guy is also helping me with a pinched nerve issue that affects my neck/shoulder/arm along with my foot recovery. He had me doing side planks to help strengthen the hips/core but that was bugging my shoulder so those got changed to sideways monster walks with a band. And I’ll be doing full blown lunges now rather than split squats. I also told him other exercises I added on that he had me doing for my right foot and asked why he has me doing very few exercises this time around. He said most folks stop doing them if they get too many. I’m thinking … what???? I guess some folks just don’t want to work hard to get back to maximum functionality. Anyway I told him I want to do more things rather than fewer so he added a few more. A balance exercise that I did about 15 years ago when I first found out I had the bone spur on my right foot. It’s a bit more challenging than just standing on one foot. But I’ll still do the 1-footed balancing on the bosu ball when I’m at the gym :) And he gave me some additional stretches for my arm/shoulder/neck. I did overdue the heel raises on Saturday and my foot is still not happy so I’ll have to back off some on the exercises until it stops paining me. The heel raises are definitely the most strenous exercise as far as my achilles is concerned so I have to pay more attention to how those feel so I don’t overdue it again. I’m also using too long of a stride when I walk since I can feel a slight limp as I try to go faster by stepping longer. So I’m trying to focus on taking smaller steps with no limp.

So even though I went through this process 1.5 years ago it’s still a learning process this time around :)

Ah - but I am done with heel lifts now! I was wondering if I had progressed much from my last PT appt and I guess I have. I am able to deal heal raises a bit more upright now. I still have to hold some weight in my hands as I lean on a counter, but not as much as last week.

PT Appointment #2 and one step forward, 1 or 2 steps back …

Well let me first start out with my one step forward, 2 steps back story …

My doc gave me the OK to get rid of heel lifts and go barefoot on Monday.  So I’ve been slowly weaning away from the heel lifts.  Adding a few more hours of flat time each day.  Well,  unfortunately, I didn’t listen to what my foot was telling me yesterday.  My foot was warning me at the 5 hour mark (and part of that time I spent standing and cooking in the kitchen) and I ignored it and went another 2 hours without heel lifts.  Well today I’m in lifts, achilles is aching and sending periodic shooting pains and is generally unhappy.  I’m guessing I’ll be in lifts all day today.  So the lesson is - listen to your foot and don’t ignore it when it starts getting unhappy!  I think I’ll be icing it shortly too.  :)

I saw my PT today and told him I overdid it yesterday.  He said overdoing it once in a while is OK since you need to learn the current limits of your foot but if you overdue it too much then you may need to go back a step for a day or two to get back to where you were.

My PT said I was walking pretty well with lifts.  Barefoot I’m not walking quite so well.  I can feel it too - it feels tight when I start rolling forward.  He said the foot/leg doesn’t have the strength for a good push off yet.  He measured my knee-to-wall distance.  I think the right foot was 15 cm and the left (surgery) was 10 cm.  I’m going to measure the same thing differently - bend to get the knee to the wall and then measure how far back my toe is.  He tested out my flexibility and said it was pretty good for where I’m at.  He then gave me exercises focused on building strength - going up on tiptoes, a couple of one footed squat exercises and a hip bridge.   And after doing just a few practices of each my achilles is even more sore!  LOL!  He told me that these will be hard so if I have to take a day or two off from doing them that’s OK.  I’ll see him again on 11/19.  My exercises are:

- lean on bed/table/counter, go up on toes, drop back down to flat foot slowly,  start by going up with both feet and drop down with just the surgery foot and as the surgery leg gets stronger start going up and down on just one foot.  And, as the leg gets stronger move my body to be more vertical until I can do it standing upright

- similar exercise to the above but bend the knee slightly and keep the bend constant as I go up/down on tiptoes, and initially lean on something and let the arms hold some of my weight and as it gets stronger put less and less weight in the arms

- stand on surgery foot, put other foot on a chair and squat down while torso is vertical.  I should feel this in my quads if I’m doing it right

- stand on surgery foot, put other foot on a chair a bit further away, lean forward and squat down.  I should feel this in my butt muscles if I’m doing it right

- lay sideways on my surgery side, do a hip bridge with elbow and foot on ground.  Initially do it with both legs together but as my hips/core get stronger do it with the top leg in the air.  One can do this with the hand on the ground but I have a very unhappy tendon in my wrist so putting that kind of pressure on it is not a good thing right now.

I’m going to continue to do some of the flexibility exercises I was doing as well.  Definitely will keep doing the wall push achilles stretch.

My achilles is definitely not happy right now.  My mantra for the future is …. I will listen to my foot and do what it wants me to do immediately, not 2 hours or more later!  LOL!

3 month doc visit

Saw my doc today for my 3 month visit.  I’m OK to ditch the night splint - YAY!  I can ditch the heel lift - YAY!  I can go barefoot - YAY! And I can start some eccentric exercises - YAY!  I’m OK to jog - YAY! - but since I’m not quite walking normally yet I don’t think I’ll be jogging anytime soon - LOL!  Since I know it took a while to transition from heel lift to flat I will only go barefoot for short walks at this point.  I spent a bit over an hour in a croc as I made my lunch and after that I could feel the achilles complaining so I went back into my clogs which essentially have a heel lift since they are "high" heels.  So over the next week I’ll spend more and more time in shoes with no heel lift until my achilles is comfortable with a flat foot again.  I tried one eccentric heel drop and that was all I could do - LOL!  My doc said go up to my toes using both feet then drop down with just the left foot, holding weight in my arms as I do it.  I think I will hold off on these until I can actually go up on my toes while standing.  I see my PT on Friday so we can discuss the plan based on what he knows I’ve been doing for the last 2 weeks.    I can also use a stationery bike (as opposed to recumbent) and the elliptical machine (in flat mode).  So I’ll start doing the elliptical tomorrow when I visit the gym.  I recall that I also had to work into that slowly for my right foot.

Now the REAL work begins on strengthening and stretching!  Woohoo!

And I see him again in 2 months.

First PT appt at week 10

I went to see my PT guy.  I picked the same guy I had for my right foot since he knows what I want and was very competent.  He checked out the flexibility, … and said it was all looking good.  My docs instructions weren’t all that clear so I had him go through an email the doc sent me where things were laid out more clearly.  He’ll also confirm with my doc as well.  Anyway he said it is still too early to work on strength and flexibility in a more serious fashion so he asked what I’ve been doing for the band exercises and I showed him.  He then brought me a blue band and showed me a different way of doing the same exercises so I isolate just the foot muscles.  It is much harder to do it that way - LOL!  So I at least have a new way of doing the same thing which will focus more on just the foot muscles.   I go back in 2 weeks, at the 3 month mark, which is when I get to start the REAL PT work :)

He did give me another exercise to do for my shoulder though.  I really tweaked my right shoulder during the NWB stage and it still isn’t back to normal.

But one good thing is that I’m done with the boot now!  Yay!  Still have to have lifts, use night splint and no barefoot yet.  But every little thing that gets me towards full recovery helps.

2 shoes!!!

Finally I get to start the transition into shoes (with a heel lift of course)!  Actually I cheated and started the transition 2 days ago - LOL!  I wore my clogs a good portion of the day.  I wore my tennies yesterday (the official start day) and the 5/16" heel lift must be less than what I get with the clogs because by the end of the day my achilles was not too happy.  I might have been in shoes too long too ….  I’m supposed to be 1/2 time in boot, 1/2 time in shoes.  So today I’m staying in the boot longer and we’ll see how the achilles feels tonight.  So glad I’m onto the next big step in the recovery process!!

And now I can retire the knee scooter! Yippee!

2 shoes finally!