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.

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.