22 weeks but first blog post

Hi all,

I’m a little late getting started on my blog…. I have logged on to this site almost everyday since my ATR and have to say that it’s a great little community.  So much information and support!

A little info about me.  My achilles problems started around the fall of 2010.  I’m a recreational athlete and have competed in various races for about the last eleven years (tri’s, running races and cycling tours).  At the time I was entered in various races 1/2 marathons in Sept. and Oct., NYC marathon in Nov. and Boston marathon in Apr.  Needless to say that I as I upped the training and got great results, I also started on the tendinitis roller coaster.  After Boston (2011) I shut down the running and starting seeking medical advise.  Was told I had tendonopathy and went through various treatments such as:  eccentric heel dips, ESWT (Extracorporeal Shockwave Therapy, Nitro glycerin patches, corizone (into the heel bursa), I think that just about covers it!  During this time I was still able to cycle and stay fit but eventually even walking became a painful limp.  My rupture occurred as I was walking up stairs to go to bed one night (Oct 21/12) and I had surgery Oct. 23/12.

So here I am at 22 weeks.  I often think I am behind in my recovery as I read of people walking w/o a limp or pain at this stage.  After using the search feature on this blog, I am reassured that I am not alone.  My PT’s mantra is that ‘it’s still early in your recovery’ and my mantra is ‘have patience and appreciate all you can do!’.

Have a great day to all reading this and happy recovery!

18 Responses to “22 weeks but first blog post”

  1. I’m just a few weeks ahead of you, and even though I have gained strength and endurance, I still have some pain (especially in the evening, weakness, and sometimes a limp). All of this is noticeably less since I started 2-shoes around 12 weeks, but my leg still lets me know how much I messed it up :)

    My PT sounds much like yours (its early in your recovery), but also pushes my strengthening and endurance training also. I still haven’t started running or plyometrics per the doctor’s orders, but I feel close to physically being able to introduce some. I wish you luck in your recovery and happy healing DEBVN.

  2. kkirk,

    Nice to hear from you and good to know that we have similar restrictions at this point. My PT just introduced eccentric heel drops off a step. I’m no where near running or plyometrics either although I ‘cheat’ and do them anyway in the pool. I’m very lucky that there is a 20 yd salt water pool in the hotel accross the street from my office. The health club membership is expensive but worth it. It’s not the workout that I would like to be doing but you take what you can get with this injury!

    I’ll be following your progress and wish you all the best too!

  3. Today its been 15 weeks since surgery day and i feel pretty nice..i went on a 40km ride on my road bike and my leg was holding pretty good.. i almost walk without a limp and i continue with my balancing/strengthening exercises together with stretching stretching and….stretching…today’s ride was just epic…i was so happy on the bike…still have quite some time ahead of me but I’m very optimistic…Doc says that after a year i won’t even remember the injury…I have to work hard and be patient cause in 2 months windsurfing season starts on the island and hopefully I’ll make it..looking back at these 15 weeks I’ll never forget the time after surgery, the boot, the crutches, everything…i just want to wish everyone a good and safe recovery…this blog has been amazing in terms of psychological support for me and we all know in here what everyone is going through…patience is bitter, but its fruit is sweet!!! I wish the best for everyone!!

  4. lefkas81,

    Sounds like an awesome bike ride! I’m just waiting for the snow to melt on our trail system and then start bike commuting to/from work. That gives me about 44 km a day, throw in a long ride on the weekend and the mileage really adds up. I’ve never tried wind surfing but it looks like a great sport. If you’re already on the road bike at 15 wks, I’m sure you’ll be out surfing this summer. It would be amazing if in a year we could forget this injury ever happened!

  5. debvn

    cycling really helps all kinds of injuries..try and get shoes with cleats and spd pedals if you dont already have any…they really make a difference…as for windsurfing…what can i say…its a truly great sport…you’ll see that in a years time we wont even remember this nasty injury!! take care and have a great recovery!!! :-)

  6. Your story — of a gradually deteriorating AT that finally ruptures under “normal” strain — is very rare hereabouts, Deb. Only a minority of ATR folks even have AT discomfort or pain pre-ATR (though maybe a higher % of runners), and even those folks mostly push harder than stairs when it goes. I’ve heard that steroids (and NSAIDs too) are bad for tendons, though I haven’t seen any definitive studies on it. Most of the few folks here who tore their AT “effortlessly” had taken Cipro or another fluoroquinolone antibiotic. (Recently, those finally got a “black box warning” about tendon tears in the US.) Ever taken one of those?

  7. Deb

    I cheat in the hydrotherapy pool also, Eccentric heel drops starting about 2-3 weeks ago and getting easier, but as I get tired towards the end of my workouts and /or the day I’m not very successful with the heel drops. :)

    BTW that salt water pool sounds very nice!

  8. hey norm,

    Interesting that you mention steroids and NSAIDs, I have had both. I think my injury was caused by a ‘perfect storm’ of repetitive strain injury, a tendon perhaps weakened by NSAIDs and a change in footware (to a lower ramp running shoe). As they say, hindsight is 20/20 but I’ll never know for sure.

    I have never taken fluoroquinolone antibiotics but thanks for the warning.

    Nice to know I’m in the minority around here (lol)!!!

  9. Fellow Achilles rehab-ers. I have beed reading through many blogs on rehab and have found little about how the repaired area actually feels. I had a full tear on right Achilles and I am now at 22 weeks post surgery and all seemed to be going well until last week. I was well through balance and strength training, riding stationary bike and even jogging. Then I began to have some interesting sensations:
    1. Numbness in outside of the ball of foot and toes
    2. Needle like brief pains through length of scare area (mostly high on scar)
    3. Reduction in flexibiltiy
    My strength has not changed but the above symptoms and my issues with patience in recovery have made me concerned about possible re-tear.
    Has anyone experienced such symptoms at some point during recovery process?

  10. Deb, as you noted sometime back our injuries are amazingly similar except that mine never fully ruptured. Given time I think this would have happened. I tried to do a single leg lift back in October and couldn’t even then. My surgery was Nov. 27th. I think the compensating I had been doing for the last couple years gave me a big head start on calf weakness, long before the cast and boot. Surprisingly though I was still able to bike ride up until late October. Right now I can only push down about 70 or 80 pounds right now and am currently at 60 lbs doing eccentric heel drops. Any more than that causes excessive AT pain and swelling for 2 or 3 days. I am disappointed with my pace of recovery also so we have that in common too, probably not just coincidence.

  11. dfoss,

    I remember our conversation very well. I agree that you were probably looking at a total rupture sooner than later. Looking back, I wouldn’t be surprised if I had a partial rupture long before it completely let go. The other strange thing was that I didn’t have any ‘popping’ sound that most people describe.

    I was also able to cycle up until the day of the rupture even completing a 4 day tour from Ottawa to Kennebunkport (very hilly) with a coach bus for the return trip. It was awesome and definitely something I would like to tackle again in the future.

    I’m hoping to get back outside on the bike in a few weeks although my strength for cycling is not good. I’ve been on my bike on a trainer for the last 3 months but just on a light gear and working on keeping my RPMs around 90. As I add gear, I feel strain so I back off. I’ve also backed off from going up to two hours back to just an hour at a time. I think I was too impatient and have a hard time accpeting the loss of fitness and strength.

    You make an excellent point about compensation prior to the surgery. It makes sense that we would be behind some of the other surgical patients who had relatively healthy tendons going into this.

    Sorry my post is long but it’s great to compare notes since we have a lot in common.

    I was also wondering how you know how much weight you are able to push down and during your eccentric heel drops? Are you planning on outdoor cycling soon?

    Keep us posted!

  12. sundance,

    I find it hard to describe how things feel. I usually use words like tightness, tugging or pulling and sometimes burning sensations. I’ve read on here that due to scar tissue, blood cannot circulate properly through the ankle and that causes swelling. That may explain why things feel tight and less flexible. Things also feel different when scar tissue eventually breaks down.

    I have not experienced the feelings that you are describing in your post. It sounds like you are ahead of me functionally at this time. Perhaps you are experiencing a set back and need to RICE and consult your PT or physician.

    Perhaps someone else will chime in with their experience.

    Good luck and keep us posted!

  13. Deb, I do heel drops with my bad foot standing on an analog bathroom scale and my good foot on a phone book. I am also holding on to a chin up bar for more control. My high dollar digital scale wouldn’t work for this, feedback is too slow, had to get a cheap analog one at Walmart.

    At my last Ortho visit I found out that my doctor is very conservative. He told me no long walks until June - a mile or more - and no biking or running until September. The protocol he gave me is metric based, “progress to walk/jog program if appropriate strength and function (15-20 single leg toe raise)”. This is from the Carolinas Physical therapy Network protocol. At the rate I’m going his calender my apply to me. I am concentrating on heel drops right now. I have a stationary bike but just use it now for 10 minute warm ups. I hope to log more time on it eventually before going outside.

  14. Deb,
    Thanks for the reply and wordy response to follow - just a warning.

    Seems rehab protocals and PT advice vary greatly. Typically leaning to the conservative approach (as noted by dfoss), which of course is smart - but to and extent. My program up to week 17 post surgery was a bit too conservative based upon the research I had done.

    I worked into my program more aggressive training, mostly balance training, while still progressing on heel drops with assisted calve raises (single leg using pull up bar), stationary bike at increasing resistance and massage therapy. I recognized good results. Strength recovery still much slower in returning than flexibility.

    But by week 19 was walking without a limp, noticable fatigue and some swelling at night - but felt good. By week 20 I was working in light tredmill work, 2-3″ heel drops with assistance still on raise just focus on repititions.

    The tightness, pulling (like the tendon is slipping through a sleave - especially at height of toe raise), and stiffness is normal based upon all I have ready and felt.

    Which brings me to week 22 and the numbness and needle like pains. These seems to be very unique - even to my PT. The search continues.

  15. Deb, dross

    I think we are all at similar stage of recovery and frustration with slowness of it. As one of you said, could be linked to fact we all had long struggles with Achilles issues. I am just trying to be patient, and not push too much.

  16. sundance,

    Has your PT done the Thompson Test on you? This will confirm if your tendon is intact.

    Numbness and pins and needles sounds like it involves nerves, perhaps an impingement. Do these feelings come and go, do they happen when doing certain things? You say you are stationary cycling at a high resistance. How is your form? Are you turning your knee in/out, likewise check your foot, are you pronating or supinating? I have had to back off on cycling because I realized I was compensating with my good leg and not applying even pressure through the ball of my foot. My PT has also noticed that while doing calf raises, I’m scrunching my toes and turning my ankle out ever so slightly (compensating) and here I thought I was doing them ‘perfectly’.

    I’m just throwing ideas out there but if I were you, I would seek medical advise. There could be something in the kinetic chain that is ‘weak’. Also, as we age, we are susceptible to degenerative disk disease. This could cause symptoms that are mistaken for sciatica etc.

    Finally you could try using a foam roller (or the stick) to massage all the muscles in your legs.

    As hard as it is, this injury will take 6 months to a year to resolve. We are all prone to compensation injuries and set backs.

    I hope you find out the cause of these new sensations in your foot and achilles. Please keep us posted!

  17. Deb,
    Post testing and all is well…according to the docs. . Prognosis is that the Sural Nerve (nerve that runs down outside of ankle and foot) is aggrivated. This is likely caused by normal swelling and scar tissue + increased activity of rehad. Something I was not aware of before is that most surgerys enter from the inside of the leg to avoid damage to this nerve. But, nothing can prevent impingement from the healing process. So - hopefully numbness is temporary and as swelling and scar tissue decline, so will these feelings.

    Sharp pains - suggestion from docs and PT is that this is signes of stress on the tendon. Result of over working the tendon is best guess. Just a couple days of low activity and light stretching have improved situation greatly.

    For workouts - bike is still in (note I wasn’t at high resistance but was pushing the rate of increased resiatance while trying to maintain high cadence) and little has changed with work out plan other than intensity and….

    To your comments, you are spot on about form. I felt I too was doing very well but after asking PT to pay closer attention to my form I am definitely compensating. No bueno. New focus has begun on makiing every movement even more controlled and even. Painfully slow in terms of where I want to be, but patience is king right!

    Back when I first started increasing walking and even jogging activities - In terms of warm up - I watched a youtube video demonstrating the use of a baseball bat to massgae calf and tendon. Using various diameters of barrell and handle to work the lower leg. Great stuff, use it all the time even at home at night followed by ice fro 20minutes. Not something PT told me to do, just something I have found to help stiffness and recovery.

    The journey continues.

  18. hi sundance,

    Great news that all is well. Very interesting explanation about entering the leg from the inside to avoid the Sural Nerve. I’m glad that they were able to diagnose and explain all of your systems as they were not ones that we’ve read about on this forum before. I’ve had impingement also (a shoulder injury) and it resolved after doing PT so I’m sure you are correct in assuming your symptoms will improve once swelling and scar tissue decline.

    I’m with you on slowing things down and paying close attention to form. I saw a my PT today and she remarked that my calf raises are better now. I feel I’m targeting the calf more now (I used to feel I could do them all day) but I also feel stress in the peroneal tendon so she warned me not to over do them. She also watched me walk and said that I’m not picking up my foot (extending my hip) as much as on the good side. So, I now have to ‘practice’ walking. On the bright side, I’ve re-activated my gym membership starting today. I’m off to do a yoga class at lunch and swim later after work. This job is getting in the way of my rehab!!!

    I appreciate that you took the time to update us on your progress. I’m sure someone down the line will also experience numbness, pins and needles and sharp pains and your explanation will be of big help!

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