Soccer training @ 39 weeks since surgery

My old soccer coach (from 3 or so years ago) is still doing 1-on-1 training sessions so I set one up.  It went pretty well.  Before he got there I did some 1 footed jumping tests and I was able to jump the same distance on both feet.  So that’s one more thing to check off on my PT list.  Now I’ll do diagonal jumping for distance and see how the left compares to the right.  We just did basic warmup, some dribbling drills, shooting drills, 1 footed rebound drills, …  I was winded after the warm ups - LOL!  But I already knew aerobic capacity was an issue.  My quads got tired before my feet which made me happy.  I started out in my old, soft backed cleats and after warm ups my coach asked how old they were.  I took that as a subtle hint that they looked pretty worn.  So I switched to some old, but hardly used, hard backed cleats and did the rest of the session in those.  I was happy that for the first time in 13+ years I had no heel pain with a hard backed cleat!!!

My foot still feels good tonight and I didn’t feel the need to ice it.  I see some swelling but it is pretty much the same swelling I’ve seen for many weeks.  I’ll do another training session on Saturday and if that goes well I’ll start playing with the over 57 league.  That is 8 on 8 and on a smaller field and at a slower pace than younger leagues so it will be a good starting point my soccer playing.

Nothing like finally getting some real ball touches to make a gal happy!

I had training session #2 on 5/18.  This time the calves and lungs were the limiting factor this time - LOL!  The feet are fine!  I will definitely start playing in June since my achilles is not having any issues.

Achilles specific exercises log

I figure if I log what I’m able to do here I can see progress over the course of a month.  At least I hope so!  So tonight (4/1) I did:

20 heel raises right and left with 8# weight … my PT said it is more important to do fewer reps with weight now

10 eccentric heel drops right and left with 8# weight

5 jumps on left foot, using the wall for support - not very high and after 5 the foot said stop, so I did

In general I’ll do the exercises on both feet - but I know my right foot jumping is way better than my left so I’ll give my right foot a vacation for a bit until the left foot is stronger.

4/3

10 heel raises right and left with 8# weight ..

5 bent knee heel raises right and left with 8# weight

10 eccentric heel drops right and left with 8# weight

10 jumps on left foot, using the wall for support - not very high

4/4 & 4/5

I tried running on 4/4 and the foot just hurt so I mainly walked.  I’m not sure if it is the shoes, running on the sidewalk and on a gravel trail (previous running has been on a grass field) or ???.  The foot was still unhappy last night (4/5) as well so I could only do:

5 jumps

10 heel raises (no weight - only because the weights were in the bedroom and hubby was asleep already)

I’m going to change shoes and go back to running on grass today to see how things go.

4/6 - run/walking was a bit better but after walking through the kids sand box at the park for a bit I massaged my heel and noticed a major sore spot…  so … I’ll give it a break, ice, take advil.  I’ve come to the conclusion that every time I move to the next level in rehab I plateau a bit while the foot acclimates.  I’m now in the acclimate portion of 1 footed jumping.  So I have to pay close attention to any pain and take a break/ice/advil when it starts up to keep the inflammation under control.

4/9 - gave my foot a few days of rest

12 jumps on left foot, using the wall for support - not very high

15 heel raises right and left with 8# weight ..

15 bent knee heel raises right and left with 8# weight

12 eccentric heel drops right and left with 8# weight

Iced right after the exercises

4/10 - Went to HIIT class.  Felt pretty good!  By the end I couldn’t do the scissor jumps over the line but did everything else.  The initial run to warm up felt good.  I did wear my silicon pad.  I probably should ice today (4/11).  :)

4/11 -

15 jumps on left foot, using the wall for support for 10, 5 done standalone

15 heel raises right and left with 11# weight ..

15 bent knee heel raises right and left with 11# weight

10 eccentric heel drops right and left with 11# weight

Followed this up with icing since I noticed I had some swelling before I started.

4/14

15 jumps on left foot, using the wall for support for 5, 10 done standalone

15 heel raises right and left with 11# weight ..

15 bent knee heel raises right and left with 11# weight

15 eccentric heel drops right and left with 11# weight

4/15

Ran for 15 minutes, run/walk 60 sec each.  Have been slacking on running so I’m starting back at the beginning.  And I really detest running so this is the hardest thing for me to do - LOL!  But the foot feels pretty good tonight so that’s a plus.

4/18

20 jumps on left foot, using the wall for support for 15, 5 done standalone.  Did a distance jump test and left foot is still weaker than the right - LOL!

20 heel raises right and left with 11# weight .. Tried 15# and that was just too heavy at this point.

20 bent knee heel raises right and left with 11# weight

15 eccentric heel drops right and left with 11# weight

Followed this up with icing since my achilles has been paining me basically all day.

4/19 - Did some running on the treadmill.  Could only handle 1min/1min alternating walking/running.  Iced when I got home

4/21 - Tried running and the achilles wasn’t liking it so I stopped.  I’ll do my heel lifts and such tonight and see how it likes it.  If it’s still unhappy I may take a few days off to see if it gets happier.

4/24 - Did my HIIT class last night and did more of the low impact versions of the exercises in hopes of keeping the achilles calm.  At home I was able to do 1 footed jumps without the wall support.  Then I just did 10 calf raises with 8# on both legs and 20 eccentric heel drops with 8#.  I’m still icing and adviling …

4/27 - Went on a 1.5 mile walk and ran a little.  I’ve been icing and adviling.  There is some definite swelling so until that gets under control I won’t be making any forward progress.  :(

4/29 - Still icing and adviling and laying off a lot of the heavy PT work.  Doing heel drops on the stairs still - 15 - unweighted, and unweighted heel raises.   I did do a jump test and I’m getting close to being able to jump the same distance on both feet!  So the rest is doing some good.

5/2 - went jogging, still doing 60/90, heel and lung capacity are limiting - LOL!

5/3 - did 30 unweighted heel lifts, 15 weighted (#11) eccentric heel drops and foot felt good afterwards

5/4 - was able to do 1 footed jumping forward back in all directions unassisted this AM.  Not jumping far, but I’m keeping my balance.  And in the afternoon I ran/walked for the full 20 minutes.  My foot was not the limiting factor - LOL!  I did some 2 foot jumping onto a bosu, forward and backward.  I did another distance check with 1 footed jumping and the surgery foot is about 4 inches short compared to the other foot.

5/6

20 heel raises right and left with 11# weight ..

15 eccentric heel drops right and left with 11# weight

5/13

15 heel raises right and left with 15# weight ..

15 eccentric heel drops right and left with 15# weight

Jumping forward, back, side to side is controlled on both feet.  Now I’ll work on jumping back and forth over a line for distance.

A walk into the canyon

I did my run/walk PT in the neighborhood today. Was back to doing 1 min walk/1 min run since that was what the foot told me to do. Last weekend I was up to about 1 min walk/90 sec run but it wasn’t painless. I really detest just running so as a reward I hiked the trail down into our canyon and back. The trail head is in the park where I was running. I figured it would be a good workout for the achilles with the steep trail, having the foot move in different directions on the rocks, … At another park where I run take my shoes off at the end of the run/walk and walk barefoot in the sand at the kids play area. It’s another way to break up any remaining scar tissue since your foot is moving at different angles in the hills/valleys of the sand.

Anyway I got to see some beautiful flowers, the lovely green growth due to our rain and enjoyed it tremendously! The last time I walked this trail was at least 15 years ago and it was pretty barren. :)

Some of the native flowers …
california native allium sisyrinchium - blue eyed grass

The path through the California oak trees …

path through california native oaks

PT Appt #9 - 32 weeks since surgery - Last one!

Saw my PT today. He checked glute, quad and hamstring strength and all looked good. Left leg wasn’t substantially weaker than the right leg and the hamstring on the left felt stronger than the right - not sure why that is ….

Flexibility has improved for both and now the left is just about the same as the right. I get to start 1 foot jumping now, 2 foot jumping up/down from a platform, adding weight as I do heel raises, continue doing the eccentric heel drops on the stairs, continue to work on the walk/run until I get to where I can just run.

Once I can do a distance 1-footed jump the same on right and left and can just run I can start transitioning into soccer. At the end he said I’m done with PT visits unless I run into a problem. :) So I have my homework to keep me busy. I tried 1 footed jumping last week and it was quite a bit easier this week so I’m still making noticeable progress week to week which makes me very happy!

7 3/4 months doctors appt

Saw my doc today and he said I’m doing well. He again said he had no explanation for why my right foot healed so quickly - LOL! He said my left foot is more normal though the fact that I can already do one legged heal lifts already is actually ahead of schedule. Apparently many cannot do that at this stage. So if you’re at 7+ months and can’t do a heal raise - no worries - that’s normal. He said he didn’t want me playing soccer for another 3 months and I told him I wouldn’t wait that long - LOL! I’ll let my foot be the judge. I can’t yet hop on one foot and I definitely need to be able to do that before I start playing.

He also said that at this point stress fractures can occur if I push too hard and too fast. Your bones can only handle a certain amount of stress - no matter what. Normally your achilles will keep things in check so that the bones aren’t over stressed. Since my achilles isn’t at full strength it can’t control things enough to keep me from getting a stress factor. So he said that I should only add significant new exercises/workouts every 3 weeks. That gives the achilles time to get strong enough to handle the next stage in recovery. I know I need to dial back my HIIT workout a bit. I did too much jumping last night based on the ache in my achilles all day today. And on Sunday I added more to my running (1 minute run/1 minute walk up from 30-45 sec, and 1 more lap around the field), then did the calf rotation machine (only gym machine that strengthens the calf/achilles) and then did a 1/2 hour HIIT class. All of this together caused the achilles to ache the next day as well. Today is my rest day. :) I’ll probably just do heel raises this evening. He did tell me to do eccentric heel raises now. Go up on the toes with both feet on a step, then switch to one leg and slowly lower down below the step. Always go up using both feet at this point. So I’ll do some of those tonight as well if things feel OK.

I also asked about the thickness of the heel from the ankle down. He said that is a combination of swelling and scar tissue. As time progresses more of the scar tissue will remottle and the swelling will continue to decrease. I had to look back at photos of my right foot to see that it, too, was pretty thick as I healed. Right now my right foot looks pretty normal so the thickness is just a part of the healing process.

And he did say I can wear my soccer cleats while running and do some very gentle side to side movements, start doing ladder exercises - gently, … Ladder exercises will definitely stress things since you’re on your toes the entire time. I’ll verify with my PT next week as well before I start up a bunch of new exercises.

Now I think it is time to do some icing to alleviate some of the ache from my HIIT class last night.

So keep at it and remember that it takes a year or more to get completely back to normal in most cases.

PT appt #8 - 7 months since surgery

Saw my PT today. He said my barefoot walking was noticeably better and I demonstrated that I’m doing unassisted, 1 footed heel lifts now. My left foot flexibility is still 1cm less than my right foot so I need to focus more on flexibility. I’ve already begun hanging my heel down from the edge of a step to get a bigger stretch. Once I can easily do heel lifts on flat ground he told me to start doing those on a step as well so I’ll get a stretch on the way down and I’ll have to do more work to lift the heel when it is dropped below the step. He said I could start run/walking. I told him I already started that after talking with my doc. He said to continue doing that and to start doing jumps up/down on 2 feet and when those are easy do jumps side to side.

So … YIPPEEE… I’m finally at the jumping stage. I actually have done a little jumping already - LOL! I’m taking the HIIT classes that I used to take and I just do the low impact modifications most of the time when jumping is involved. When the jumping isn’t too strenuous I do it, but even then if I start feeling it in my achilles I switch to the low impact exercise.

My PT also did soft tissue massage again at this session. Whoooiiieeee that is painful while he’s doing it. No pain afterwards. He asked if it helped the last time. I said - who knows. After that and after taking advil at max dosage for about 3 weeks and I started doing my own daily achilles massage I finally able to make progress in my recovery. It could be a combination of everything. He did still see a little swelling in the bursa area so I’ll be careful to pay attention to how that is feeling. Clearly when it was inflamed recovery progress stopped.

My PT also reminded me to ice when needed and take advil if I think it’s necessary. As much as I used to ice my achilles before surgery I still keep forgetting to ice it now.

Making some definite progress - woohoo!

I’m doing 30 unassisted heel lifts now, I walk almost normal in bare feet, I can walk on my toes (though I can definitely feel that my left achilles is weaker). I have a PT appt on Thursday so I expect to get some jumping exercises this time around!

I started making progress after I took maximum allowed advil for several weeks. My doctors phone assessment of an inflamed bursa must have been correct. Once the inflammation reduced I started making the kind of progress I expected to make 2 months ago.

Needless to say I’m in a better frame of mind. :)

A week of walking and standing in Tucson makes for an unhappy achilles :(

This is the time of year for the gem show in Tucson. I make my annual trek there to stock up on gems and findings needed for my jewelry design business. I have to say my foot definitely got annoyed since I was basically on my feet from about 8AM to 6 or 7PM (except when I was driving from one show to the next). The surfaces I walked on were generally uneven so I’m sure that was a workout for my achilles and added to its unhappiness. By day 4 it was paining me and I finally looked closely and noticed that it was swelling again. I probably should have iced but just elevated a bit and went to bed at night - LOL! In the AM all the swelling was gone, but by the end of the next day it was right back. Now that I’m home I’m elevating it more, icing and giving it a bit of a rest. My foot is much happier today, no swelling and just a bit tight. I’ll do my PT exercises tonight and then I’ll be back at the gym tomorrow.

PT appt #7 - 6 months since surgery

Went to PT today and I’m just about where I was at just after Christmas. Now that I figured out how to tell when I’m overdoing it I can stop doing that. My PT felt around my foot/calf and the only area that feels different and painful is the back of the heel where the bursa is. So he concurs that it may be inflamed and causing some of my problems. Unfortunately I ended up experiencing one of the more serious side effects from meloxicam - swelling and weight gain. So my surgery foot that wasn’t swelling was, all of a sudden, swollen again - as was my other foot. So I stopped taking that and switched to advil. I think it is helping but it was a bit hard to tell until the swelling went back down.

I can do my calf raises more upright now and I did do one unaided heel lift last night, just a smidge off the ground, but being able to do it without bad side effects was a good step forward. I see my PT again in a month and we both hope I’m doing unaided heel lifts by then so I can start jogging/jumping/…

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.