7 Month Update

I am making incremental progress on single leg heel raises on my way to running again. PT and rehab is getting monotonous - but, I am still doing the work.

Daily Activities, Flexibility, Pain
As I mentioned in my prior post, my flexibility is all the way back and I am not experiencing pain. I can do everyday activities without a problem. I have been out with my children doing a lot of city walking (in DC and NYC) and enjoying the spring weather. Swelling is under control and I certainly have a larger achilles heel area now where the repair was done.

Running and Athletic Capability
I am still not running yet. I am focusing on maintaining a good attitude in this stage as the rehab is very much in the monotonous stage. I assumed I would be all the way back at 6 months. But, it is not in the cards for me to be on the shorter end of the recovery guidelines. So, I will keep posting for the benefit of others who have a similar timeline.

I am still going to PT (once per week now) and doing exercises every day. The next goal is to do a full and stable one-leg heel raise before running again. Right now, I can only do a partial one leg heel raise. I tried 30 seconds of a very slow jog on a treadmill - I could do it, but I want to have a stronger push off before doing that again.

Current Exercise Focus
My exercises now are focused on strengthening the calf muscle. Here are the highlights. (Remember that these exercises are for the later recovery stages. If you are in the first several weeks, the focus is on range of motion and balance).

1. Electro-stim calf raises: The PT puts the electro-stimulation pads on my calf muscle. He cranks it up until the stimulation makes my muscles contract. Then, I do heel raises for 7 or 8 minutes.
2. Squats while standing on one of those blue Bosu balls (the ball is flipped over onto the soft blue portion)
3. Windmills: balance on the injured leg with two cones in front of me. Pick up the left cone with my right hand and stand up with arm raised (repeat with opposite side of body).
4. Get a hand weight (on the same side as injured leg). Balance on injured leg. Put hand straight up in the air. Do a squat and cross hand to opposite foot.
5. Wall sits: sit on the wall (with back against wall). Do heel raises.
6. Toe walks: get up on toes. Walk a short distance while doing my best to stay on my toes with injured leg.
7. Use leg press machine and do heel raises
8. Bike, elliptical, and treadmill walking. I have been cranking up the incline on the treadmill.

Here is my milestone update
• Injured: 9/13/14
• Surgery: 9/26/14
• Week 1 - 2: NWB (splint - foot at 25% angle
• Week 2 - 8: NWB (fiberglass cast - foot at 5% angle)
• Week 8 - 10: PWB (fiberglass cast - foot neutral). Added about 30 pounds of pressure every 4 days
• Week 10 - 14: FWB (fiberglass cast - foot neutral)
• Week 14 - 16: FWB (boot - one heel wedge)
• Week 15: Started PT
• Week 16: Started wearing 2 shoes indoors in safe environments
• Week 18: Reasonably comfortable with 2 shoes outside; can do a decent seated heel raise
• Week 20: Getting stronger. Able to perform double leg heel raises well; flexibility coming back - can do squats (body weight)
• Week 23: Range of motion is 100%; Working on single leg heel raise; Daily activities are not difficult anymore.
• Week 28: Can do a partial single leg heel raise; working on doing a fully stable one leg heel raise before trying to run again

Happy healing to all

6 Responses to “7 Month Update”

  1. It’s so nice to hear from you, especially since we are so close in time, I’m 22 weeks now. Even though you’re milestones look way different than mine (for example you were in a long cast period and I wasn’t and you started PT way after I did) we are pretty much at the same place doing the same exercises now…Everything you said regarding Daily Activities, Flexibility, Pain, Running and Athletic Capability, as well as Current Exercise Focus rings true for me also! YAY that…I make the point so people can see that in the end things do even out in the hopes they won’t worry so much about their protocols being different.

    About heel raises, I read lots of blogs here and many people report never getting to them even after a year and I personally don’t know why but suspect heeling alittle long or not having proper rehab. I thought they were a silly measurement when so many people in these blogs seem to put so much weight on them and I was way more concerned with proper rehab via eccentric heel drops for proper tendon remodeling not concentric heel raises which are secondary in my point of view and come after a good eccentric program…so anyway I was watching this YouTube a woman was posting of her rehab at 6 months and she was demonstrating the early pre-movements she was using to get to full unassisted heel raises, she had just start her heel raise program. At over 5 months at the time I thought the technique sound and gave it a try and was surprised at what I could do with the early movements. A few days later my PT had me do “funny walks”…this reminds me of Monty Python…and one was what I call a skip-up where you just are skipping but go up on the balls of your feet…not the tip toe you described but more of a walk with a skip - up on your balls while in motion and I stopped and just started doing unassisted single leg heel raises at a pretty good height, not as high as the uninjured side but very clearly heel raises…anyway that walk and the pre-movements I tried really helped. So without a goal of single leg calf raises I can now do them. HA HA..so much for our plans…it just happened.

    I think the method you described, “1. Electro-stim calf raises: The PT puts the electro-stimulation pads on my calf muscle. He cranks it up until the stimulation makes my muscles contract. Then, I do heel raises for 7 or 8 minutes.” is sound…I’ve seen it elsewhere and though my PT isn’t using that method, it just goes to show how many doorways there are to reach our goals!

    thanks for the update…big smile for you!

  2. Hi Donna,

    Yes, it is good to see that I am doing similar exercises as you. I forgot to mention that I am also doing eccentric heel drop exercises. I have found that getting on the stairs and doing heel drops and heel raises has lots of benefit. Hearing your experience, I think I will add more of those to my routine and see how it goes.

    Keep it up and thank you for all the encouragement you give everyone on this site.

  3. You are most welcome. I like to gather and disseminate information…and I really like the nice people in this community.

    Great that you’re doing the heel drops too, I assumed you were. Your PT sounds great.
    I started doing them on the stairs but because I had insertional Achilles tendonitis many years ago that movement was aggravating the back of the heel and that old injury was coming back so I’ve been doing them the last 4 weeks on a flat surface, I get the same benefit for the gastroc part of the calf…so if anyone does the full heel drops on the stairs (the gold standard) but has back of heel pain their is a way to do them on a flat surface. I also can’t do the bent knee version to get to the solues muscle so am building that part of the calf using the theraband. You can do the heel drops twice a day, 3 sets of 15 each time and you can do them two ways…one way with straight leg for the gastroc and one way with bent knee for the soleus. You can ask your PT if your interested.

    Two weeks ago I started focusing on walking up steps with the ball of my foot instead of my whole foot as I had been. I think that really helps build the calf muscle in a dynamic way. Previous to two weeks ago I could not walk up steps like I had preinjury on the ball of my foot really engaging the calf muscle…nope, just wasn’t ready…have you tried that yet?

  4. donna
    can you send us a link to - I was watching this YouTube a woman was posting of her rehab at 6 months and she was demonstrating the early pre-movements she was using to get to full unassisted heel raises, she had just start her heel raise program - please! I am struggling with rememebering to do heel raises at 6 months, although I try when I can!

  5. Sure…go to YouTube and search Shelly Prosko - she has a lot of great videos. As a yoga instructor when she ruptured her achilles she made it part of her yoga series. The video I was referring to was “Achilles Rehab 6 months non-op”. Best o fluck to you.

  6. LOL…my new language…put a space between the o and f and get best o fluck to you…ha ha.

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