6 Month Update

March 10, 2015

At almost 6 months, my range of motion (ROM) is 100% recovered and daily activities are no longer a huge chore. But, I still have strengthening to do.

Daily Activities
Daily activities have gotten much easier. I no longer think about my achilles on each and every step. Sometimes I struggle a little on uneven surfaces. Also, my body wants to limp and I sometimes have to force myself to walk with a normal gait. I have occasional pain on the bottom of my heel. Like many others, the heel pain was intense in earlier stages, but is much better now. I still do not have feeling on one side of my foot because of damage to nerves during surgery. As the feeling comes back, I get weird electrical shock types of feelings - but nothing unbearable.

Therapy
I have continued going to PT twice per week. I do home exercises two or three times per day. My ROM is strangely a bit better than my healthy leg.

For the new members of this unfortunate club, here is the general progression of my therapy:
1. Flexibility. The initial focus was all on flexibility and ROM (basically, the exercises here: http://achillesblog.com/files/2008/03/achilles_tendon_rupture_mass_gen.pdf).

2. Balance: Once flexibility started to improve, the PT added exercises for balance (e.g., balance on one leg; balance on injured leg and tap my good foot in front, side and back of me; squats)

3. Strength: The last set of exercises has been strength. For example, seated heel raises -> standing, double leg heel raises -> single leg heel raises.

I also ride the stationary bike, use an elliptical machine, and walk on the treadmill. My PT wants me to be able to do a single leg heel raise before he clears me for running. A true single leg heel raise is taking some time to do. I have to put my hands on a table and push as hard as I can.

Lessons Learned
For the new posters, here are a few lessons as I reflect over the past 6 months. I also posted some reflections a few posts back if you are in a cast / NWB for a long time.

1. Be systematic: With whatever protocol you choose (or is chosen for you), be disciplined and systematic. Otherwise, you run the risk of a set back. If you need to be off your feet the first two weeks after surgery with your leg elevated, do it. If you are supposed to wear your boot, do it. If you have exercises to do, do them faithfully.

2. Be patient: This is a long term recovery and you need to be patient and look forward to incremental milestones.

3. Dealing with surgeons. This was my first surgery. In my experience, my surgeon was just focused on repairing the tendon and making sure everything was structurally sound. He was always in a hurry and had little to say about my ability to be functional on my leg. But, my PT was very focused on my functionality and quality of life. Once I realized this, I stopped fretting about the surgeon and it helped me stay sane.

Happy healing to all.

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.