PT visit

I saw my PT today for my shoulder problems and we discussed my foot.  He checked the MRI results and said the marrow and the bursa area of the bone are both inflamed.  He emphasized, again, that if things are hurting BACK OFF!!!  So I’m taking his advice to heart and won’t be going to the gym today.  I went yesterday and didn’t do anything that I would call high impact but the foot is aching today so something I did made it unhappy.  I really have to be patient and let my foot get to the point where it has no pain.  That is incredibly hard to do when I’m at the 11 month mark and want to be out playing soccer and going to my exercise classes.  I also spent over a decade doing things despite my foot pain so it is hard for me to get in the mindset that I shouldn’t feel any foot pain anymore.  My PT also reminded me that if I don’t back off I could end up with a stress fracture and then I would REALLY be hating life.

So I’m going to try real hard to be easy on my foot.  I’ll hit the pool this week and hopefully that will be exercise that doesn’t bug my foot.  My next doc visit is on the 25th and I would love to go in there and tell him there is no pain … only time will tell!

In France for the Women’s World Cup

After 10 days in France we’re heading back home.  We were there to watch 5 World Cup games - 3 from the group stage and the semifinals.  We saw the US play France and England.  Those were great games.  The semifinal between Sweden and the Netherlands was pretty boring.  I averaged about 6 miles a day.  Some days much further, some days shorter.  At the end of every day my foot was swollen.  I was able to ice sometimes, but not always.  The bone is still sore and I know running on it isn’t a good idea since I had to do that once to get on the metro that was about to leave.  Needless to say my foot was unhappy about that.  I did wear my boot part of the time but if I did a lot of walking in it then it started to cause a sore and bruise on my calf bone.  I’m bootless today for the plane rides.  Once I get home I’ll see how I do with some of the early stage exercises - heel lifts and heel drops.

I see my doc at the end of July so we’ll see if all that walking annoyed things even more.  He did tell me to minimize walking but he also knew that would be difficult in France.

Ettie (World Cup mascot) and me in my boot

Back in a boot at 44 weeks after surgery

The pain I got at my first soccer game had my doc a bit worried so he had me come in.  When I described that the pain was more along the outside of my foot he did an xray to make sure I hadn’t fractured something.  The xray did show that my bone density was not back to the pre-surgery level so he was concerned I was getting microfractures that won’t show in an xray.  He squeezed my heel and that caused a shooting pain up the back of my foot and the fact that I was still getting swelling and my foot was still sore most of the time concerned him.  So he told me to wear the boot again until I can get an MRI.  An MRI can verify whether there are microfractures.  Hopefully I can get it scheduled before we leave for France next week.  So no more soccer or HIIT classes this week.  I’ll also eat more calcium rich foods for the next several weeks just in case :)

It was a good thing I did get in to see him since I had a soccer game tonight, a HIIT class tomorrow night, soccer training on Friday and then soccer games on Saturday and Sunday scheduled.  Any of those might have resulted in a full blown fracture if the bone is still weak right now.  I’ll bring my boot with me to France so I can wear it if my foot is bugging me.

This is definitely a setback but I’m glad I went in to see him.  A few extra weeks in the boot is much better than months of recovery due to a fracture.

2nd soccer game was better

On Sunday I had an hour training with my soccer coach and then played 70 minutes of soccer.  I warned the team I might have to bow out early if things started paining me but my only limitation was I couldn’t (and wouldn’t) sprint real hard.  I warned them about that too - LOL!  I did make some good plays so I haven’t forgotten everything I knew last August.  I did hope to sub out but we didn’t have enough players for subs.  The achilles is still sore today but I think the KT tape has helped.  I definitely was more cautious as I played to make sure I didn’t push off hard to accelerate again.

No more games until next week so the achilles will get some rest.  I do have another training session scheduled tomorrow and I’ll make sure to do more of my strengthening exercises in the interim.

First soccer game lasted 10 minutes

Well I tried playing soccer last night.  My time on the field was about 10 minutes - tops.  I warmed up before the game (not something I always do :) ) and things were going well initially.  Then a teammate sent a fast pass my way.  I cut right with some force to accelerate quickly, since it was moving fast and about to go out of bounds, and felt a sharp pain on the outside of my surgery foot.  I did manage to get the pass and send it down field but from that point on I was limping.  I walked and tried to jog to see if it was just a temporary pain and it wasn’t.  So off the field I went.  Quite a bummer since we were short 2 players!

I happened to have a PT session scheduled for a shoulder problem today so I had him check out my foot as well.  He saw the same swelling I did and said that was the bursa.  I did some checks to make sure the tendons/ligaments on the outside of the foot weren’t the problem. They weren’t.  So I’m back to icing/advil and I put on some KT tape to see if that will help with the pain and maybe relieve the inflammation faster.  KT tape helped a lot when I pulled my IT band.  I’m trying the tendinitis method of applying it and if that doesn’t do much by tomorrow I’ll try some alternate patterns for applying it.

Needless to say I am NOT a happy camper!  10+ months and this dang foot is still causing me issues.  It’s painful to do heel raises right now so I know something is pissed.  I also emailed my doc to complain - LOL!  I don’t see him again until the 1 year point but I asked him if seeing him any earlier might provide some insight as to what is taking so long.  I had games a soccer training session scheduled today (I have had NO problems from all the moves/work I’ve done in my training classes) and then a game on Saturday and another on Sunday.  I have serious doubts I’ll be able to play in either game.

On the plus side my PT gave me some exercises to use for my shoulder/arm issues.  I was doing about 15 exercises initially and I cut that down to about 5.  He gave me 4 more focused exercises based on where I’m still having issues.

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.