9 1/2 weeks. (Sorry. Nothing like the movie.)
I don’t know why I even have to show up at the clinic for my monthly check-in with my surgeon. He has a formula and he is not deviating from it. He phones it in. Twelve weeks, that’s when he decrees it’s time to put shoes on. As he demonstrated the danger move for my tendon, the “push-off” that your back foot does while walking, I decided against telling him that I’ve been wearing shoes around the house for more than a week, and though I’m very cautious, my push-off is feeling pretty good. I left feeling irritated (again). I waited an hour for that. This time he didn’t write a note for the PT. So I’ll just tell her that weight-bearing is allowed now, and I am to take “the next steps” in my therapy, and just see where that gets me. Don’t get me wrong. I have great respect for him and for his training and skill. I do understand that the tendon is still fragile and requires A LOT of strengthening before walking in shoes (to be honest, some of you five- and six-weekers just out of a cast are totally freaking me out) but I’m at 10 weeks this Friday, I have been working with my ROM exercises, elastics, towels, then standing/shifting weight for SEVEN weeks now. I wish he would tailor his approach depending on the patient and their progress, but I guess he prefers to wait until the magic 12 weeks, when the risk for re-rupture starts to drop.
On a happier note, I met a winemaker from New Zealand recently who had an ATR four years ago. He told me that it didn’t REALLY improve — get stronger and more flexible — until he got back to his yoga practice about one year after his surgery. Now it is as good as the other one. He said in hindsight, he thinks he should have added it in much sooner, like around six months post-op. I’m ecstatic. In March I did a 30-day yoga challenge and felt stronger, fitter, more toned (not to mention calmer) than I had in years. I was a total convert, and was crushed to think I wouldn’t be able to get back to it for a long while. I even emailed my studio and asked what class would be suitable once I’m ready to return. (They said start with Restorative Yoga, followed by Yin, Pilates and Hot. None of them do too many series/poses that stress the Achilles. Vinyasa will have to wait until later.) I hope to start in about six weeks.
The best news of all is that my four-month long regimen of probiotics and vitamins may be paying off. The past couple of years had been one long blur of infection/antibiotic cycles: sinusitis, bronchitis, Strep, repeat. It may or may not have contributed to the ATR (see Cipro/Levaquin debate), but even before my injury I was looking for ways to strengthen my immune system and had started working with a naturopath. I was disappointed when I got Strep throat on Thursday, and then wondered if my self-diagnosis might possibly be wrong when it started to improve on Saturday. On Sunday at the clinic, my doctor said she thought it was strep throat, but since I appeared to be on the mend, no antibiotics needed. Still waiting for the result of the throat culture, but if that’s the case, I feel a bit like I won the lottery!
Oh my. Yoga and naturopathic medicine. What’s happened to me?
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A PT friend of mine sings really high praises for incorporatin Pilates into rehab for the ATR. I think a lot of us forget that the injury affects our entire right leg from foot to hip and all of it should be strengthened.
Yoga is awesome and I have decided I am going to try it once I hit 12 weeks or so (if I am in shoes by then– I hope to be.) I have never done Yoga (I know! pathetic) but I really need the stretching/flexibility and I get board with regular gym stuff. While you seem to be frustrated with your surgeon, I am 100% certain that no shoes till 12 weeks cannot hurt. From what I’ve read, most people get into trouble when they push too early/too hard. Seriously, what is 12 weeks when compared to the rest of your life, being active and fit? nothing. Good luck !
Thanks for your comments UoP and Polly. I am going to work in some Pilates for certain, I might even look into some training on a reformer, which is the crazy looking torture machine they use in some studios. Polly, at first, be sure you find a class that is easy on the achilles, so no “downward facing dog” pose, which is one of the first that you would usually learn. I wish I was going back at 12 weeks, but that seems unlikely at this point. I will have to be leaving the house in my shoes and walking with a smooth gait before I can shoot for that!
I know you’re right about my doctor’s protocol — it certainly won’t hurt, and rushing things could. I think I am more frustrated by his 2-minute check-in and one-size-fits all treatment. But I have decided to be patient, not my strong suit (breathe Deana, breathe). Especially when I read of people here just a few weeks from surgery, walking in bare feet, which seems incredibly risky. I worry that I might be complicit in their risky behavior because I’ve been complaining about not moving faster. So I will zip it from now on. I hit 10 weeks yesterday, I am walking slowly in shoes in the house and at the office (no stairs, no going outside), and I am faithfully doing my PT several times a day. It feels like a plateau, but in less than 2 weeks I get to start working with my PT on walking and I hope things will improve quickly after that.
I also think walking in bare feet a couple of weeks out of surgery is a bit risky (I will constrain my real thoughts) but I don’t think anything you have said has contributed to that. Some people will risk regardless and I think those posts may encourage others with a similar natural to do the same. Concerning you, I think you have done remarkabley well. I predict the next few weeks will have some encourging developments and your confidence will grow. Funny how we have to learn to walk again but I feel you are doing everything right and that should translate to a good result. I also think walking in bare feet a couple of weeks out of surgery is a bit risky (I will constrain my real thoughts) but I don’t think anything you have said has contributed to that. Some people will risk regardless and I think those posts may encourage others with a similar natural to do the same. Concerning you, I think you have done remarkably well. I predict the next few weeks will have some encouraging developments and your confidence will grow. Funny how we have to learn to walk again but I feel you are doing everything right and that should translate to a good result.
Thanks Stuart, I appreciate your comments more than you know, and I think it’s a good thing for all of us that you are here advising caution. Norm once compared AT repair to tonsillectomy for surgeons . . . it doesn’t seem to be the most exciting injury for them to treat. It’s easy to feel a bit neglected by our doctors and to turn here for advice. But rushing to get better fast is not worth the downside if we overdo it and rerupture. Far better to practice caution and take a few weeks longer, but end up with a strong, solid tendon. I went searching for your blog to find out the history of your own injury and think I missed it. Or … are you a doctor, or a PT? You seem exceptionally well-versed on the subject. And, it was me who got the advice from my PT to put a shoe insert in my boot. I am happily wearing it now — it certainly helps with the heel pain when I am on my feet for any length of time.
Deana, Thank you for the comments and support. I have been thinking about cutting back some comment of late. I don’t have a blog and there are reasons that don’t need to be shared at the moment. I am not a Doctor or PT but I know at times it would seem I am touting business. I grew up with parents that trusted the doctor without question and ended up questioning everything. Mostly it was a search for knowledge. I have a science background and have studied anatomy, histology and physiology (many years ago) then I changed careers. I am fascinated with the human body and how it works and through my work have attended and assisted in numerous autopsies. I have also been fortunate to have good physios and a GP doctor that was also a marathon runner. Over the last 30 years of seeing them we have shared much. I am no expert though and would be uncomfortable for anyone here to think of me that way. The other thing you would realise reading my comments is that I am probably more concerned with how people are getting their heads in the right place. From experience, most challenges we face require the head to be right in order for the body to do it. That is why marathon runners tend to be a bit older. This is a marathon and requires the discipline a marathon runner has. You need a keen sense of when to push and when to back off. I read a comment from you to a new runner this morning and was pleased to see that empathetic support. Most of us seem to settle after the first few weeks and helping others through this is important. On my second (and final) visit to my surgeon I said I had hoped there was one more marathon in me and he said he saw no reason why not but for the moment I have promised my partner there will be no talk of it until the new house is finished.