11 Month Update

At 11 months, I am making good progress with getting back into athletic shape and only have a few annoyances in everyday life.

I have been able to run 4 miles on a treadmill at about a 12 minute per mile pace. After being released from PT, I continued the exercises on my own until they got easy. I still do a lot of stretching, heel raises, and squats. When I started running, I was very cautious and followed this pattern:
* Alternated walking and running for 30 seconds at a time - for a total of 5 minutes. I did this until I felt strong.
* Ran for five minutes straight and continued until I felt confident.
* Ran for half a mile and continued until confident
* Ran a mile and worked on getting my time down to under 11 minutes (pre-injury I was around a 8.5 minute single mile)
* After that, I started adding distance instead of speed (speed still makes me nervous)
My next hurdle will be running outside.

For everyday activities, all is well. Sometimes I limp out of habit, when I get tired, or if I am around someone else limping. It is strange. I have to stop and tell myself to walk normally. The bottom of my foot also gets sore at times.

I would be interested if anyone else can share what they did to get themselves back into running shape at my stage.

For everyone in the early stages, I will state the oft-repeated advice of patience. Also, be systematic and diligent in following whatever protocol or doctor’s orders that you have. As you see in my list below, my doctor’s orders were pretty difficult to follow. But, eventually, you will be out of the woods.

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
• Week 32: Stopped going to PT after he said there were no more exercises he could show me. Continued the work on my own
• Week 36: Jogging on treadmill at about 4 miles per hour; 30 to 40 seconds at a time.
Week 45: Can run a single mile in about 10.5 minutes. Ran 4 miles at a 12 minute per mile pace

7 Responses to “11 Month Update”

  1. Running seems so far off for me at present! Looking at your protocol it seems really conservative. Were there any reasons for the slow, deliberate recovery or the Docs just thought it was best?

    I am 6 weeks after injury (Non surgical) and I am walking around without the boot at home and will be wearing 2 shoes in the next few weeks.

    My timeline was as follows:-
    26/6/15 - Ruptured Achilles (48mm gap)

    1/7/15 - Had appointment with Surgeon and decided non operative and fitted with Cam walker boot at 30°

    15/7/15 - Saw Surgeon again and tendon had joined already so said I was able to go to neutral from 30° but Physio said that was too soon so went down to 22° and slowly go to neutral over a few weeks

    22/7/15 - Went back to Physio and went down to 7°
    In between these 2 appointments I go from partial weight bearing.

    29/7/15 - Went back to surgeon who advised was happy with the healing and said I should try and go back to 2 shoes and at the same day my cam boot was put to neutral.
    In between these appointments I went to full weight bearing (Started only FWB indoors but when I was more confident I then stopped using crutches at all)

    5/8/15 Surgeon makes me walk bare foot back and forth and advises that I should have no issue with 2 shoes but myself and the Physio think it is too soon. I am given strengthening exercises to do in a pool including double heel lifts and balancing on my bad ankle for 4 reps of 20 seconds.

    After this appointment I took to not wearing my cam walker at home and only use it when I am outdoors. I am 6 weeks after the injury and am sleeping without the boot and about to travel to the US on Saturday (I am in Australia)

    I have had weekly physio appointments and am doing 4 in the 2 weeks before going overseas. I also have started accupuncture and have had 2 sessions and will have a 3rd on the 15/8 before I fly out that evening.

    I will wear 2 shoes when in the hotel while overseas but will wear my boot when I am out and about just to make sure it is protected.

    its funny how different peoples protocols are and I have done as much as my body would allow and never had any pain whilst doing it. (I do get aches now I am exercising the actual tendon) but I feel I am still along way off being right, but I can get around now quite well so its not as painful a wait.

    I also was able to climb stairs yesterday for the first time, but unable to go down stairs yet but that will come and I am hoping to be able to do single leg calf raises too but that is also a no go at present.

    My “walk” is still zombie like but it is hard to get back into it and the longer it takes the more you’re trained to the new way.

  2. Yes, my protocol was slow! The doctor said it was based on the severity of my rupture and his past success. I believe the overriding factor was his personal history performing these surgeries. He probably does well over 40 achilles surgeries per year and is a professor at a medical school. So, he was very rigid in his protocol and just wanted to get me past the 12 week high risk zone with the tendon structurally in tact. After that, he released me and never saw me again. Now, all seems fine since it is in my past and I did not have any set backs. At the time, it was a bit rough. Also, PT was starting from ground zero because of the significant atrophy and stiffness. Overall though, I am glad I chose to just stick to my doctor’s plan and keep the stress level down through it.

  3. ctc - I seems to me the only problems you need to address is push off strength and gait training. Have a read of Skelona’s last post and see the program there. Also read my comment so I do not have to repeat it. Strength building needs to be complete and take in more than just your calf (gastroc and soleous). If you over do one muscle then it has a corressponding affect on other areas. Likewise if one area is weak. I have always found stairs most helpful for strength building and going down is as important as going up. Stairs force you to use both legs evenly. They also provide good stretch and cardio with a bit less impact. A sensible warm up and cool down on flat ground is important. Work within your limits so you may start walking stairs before running them. Do not overdo stairs either. Your body needs long strides as well so stairs are used as a component of your training.

  4. I agree Stuart and stairs are my nemesis at the moment! I am not yet 7 weeks after rupture so I am not too worried about it.
    My calf is almost the same size it used to be so that is going well and I actually went out yesterday with 2 shoes on for the first time. I took slow calculated steps in a place I am very familiar with that is not too busy.
    When I am in Disneyland next week I will not be wearing 2 shoes and will take the extra protection of the boot just to be on the safe side. (I am also much quicker in the boot too)

    I was able to do a single heel raise in the pool yesterday too for the first time, but I had to be in almost neck high water to be able to do it, if I was in waist high water it was still too hard to do.

  5. Matt - go easy on those heel raises even in water. You are doing so well but there is no need to push things at your stage. It will come but when we try to find out how much we CAN do then we can put ourselves back. Finding that balance is tricky. I am sure my words are not necessary but others may read this without the full picture.

  6. Thanks for the detailed update ctc! Great attitude and great to see your progression.

  7. Big smile for you, it’s always so nice to hear from you and I am glad you are happy with your progress! If I were a runner I’d share to answer your question, but I a walker! My running days were over way before this injury.

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