Week Five!

Week 5 post surgery started this week. I’m weight bearing at 50%, and getting more used to it every day. I managed to walk a pretty long block yesterday, and took the knee scooter the rest of the way. The limiting factor isn’t my leg, but my arms - I hate crutches and I’m definitely lower body dominant!

My achilles is a bit throbby today. I’m not sure if it was all the walking yesterday, or the fact that my calf twitched when I was tending to my scar out of the boot. My foot dorsiflexed a bit, but I didn’t notice how far as I was focused on something else. Based on what I’ve read here, I think it would be very unlikely that I reruptured on a calf twinge, so hoping it’s just sore from the unexpected stretch or walking. I’m of course paranoid though.

I see my ortho on Tuesday, and want to talk to him about my big toe. It’s pretty stiff. I’ve got a virtual physio appt on Friday with my old physio who has started his own clinic in another city. He’s awesome and hoping he will be super helpful. My chiropractor/athletic therapist has been working on my other muscles - hips, quads, etc, to keep them pliable. He says I look good and pretty balanced, all things considering.

I have a lump in my leg and some swelling along where my Greater Saphenous Vein is, and so I am concerned that I may have a superficial blood clot. Seeing my doctor today, who will likely refer me for a doppler. I’m 99% sure it’s not a muscle strain, and if it is a thrombosis, I may have to go on anti-coagulants which would be a real bummer. I’m crossing my fingers but the pessimist in me is not happy.

I’m supposed to move my vacocast to 30-15 hinge, but am going to work up to that over the next week - I’m at 30/25, then 30-20 tomorrow, then 30-15 by next Monday. And then, over the following two-weeks, get to 30-0! Scary but exciting all at the same time. Dying not to sleep in this boot but know it is good for me.

Hello world! Three weeks post surgery.

Hi all!

I’m deejayzed. Unfortunately I am now a member of this super cool club.

41F, tore my achilles while playing tennis. I wasn’t even going to go - it was a Friday night doubles social, but I thought, “Why not? Let’s meet some new people!”. I rode my bike there (25 mins), warmed up, played 40 mins of casual doubles, and then on the third rotation, shuffled backwards to get a ball. Heard the gunshot sound, and knew exactly what I had done. I’m not a weekend warrior, but had returned to tennis in April after being off of activity for a while because of a concussion. I’d been doing indoor biking in the winter, and had been playing tennis 3x a week for most of May and June. That week I was feeling great and had played an hour of tennis every day. The tear was especially frustrating as I had begun to really improve (I only took up tennis last year), figure out my serve, and had just won my latest match 6-0, 3-0, against someone I used to be evenly matched with. I also had a major concussion in January, and was finally feeling like myself again, so that was doubly frustrating.

I had a full rupture, 1.5cm of separation on plantar flexion, high up. I’m a former national level athlete player and former Team Canada member (in ultimate frisbee), and have a lot of sporting left in me. I got two opinions - one surgeon (#14 Ortho in my city) said surgery, given my history and goals (I want to play master tennis at the provincial level by the time I’m 45), the other said I was in the grey zone with a 1.5cm gap. I ended up going with surgery, since I wanted maximal push off power. I was terrified to go under the knife during covid, but had several doctor pals vouch for my surgeon. A few friends work at the same hospital and made sure I had good tunes and good vibes for my surgery - my surgeon knew that if he messed up he’d have to answer to my pals, and he knew my sports history and goals of being a tennis boss.

Had surgery 3.5 weeks ago, open repair. Repair was strong, plantaris tendon intact, which was helpful for approximating tendon edges at the right distance. Took the opioids once the day after surgery and said ‘nope, I don’t like this’, so was on extra strength Tylenol for 4 days, and then was fine with nothing. Day 2 was the worst, had to supplement with some Advil, but then on day 3 things started to settle. Watched the olympics and was amazed at how many athletes had come back from achilles injuries, including the two double gold medallists of the men’s high jump, and a Russian gymnast who had only torn his achilles in April. I had to turn off his performances because I was certain I was going to see him rerupture on live TV. But he did great, 6th in the all around and helped Russia win the gold in the team event. 3 months after surgery! Incredible.

I was on top of many things thanks to all of you - I was casted for a week, which was then removed to check stitches, and am in a Vacocast. Initially set at 30 degrees PF, I’m now at 30-25. I’ve got an iWalk from a friend, and have a knee rover for longer distances. I’ve been using a pneumatic compression icing device (the Game Ready), as early research shows that it increases the number of Type 1 collagen fibres that are laid down, and have that for two more weeks - it’s expensive to rent! I’ve got silicone strips for scarring, bio oil for scarring and scar mobilization. Upped my protein intake, taking collagen and cucurmin, trying to eat lots of fruit and veggies. I planted a vegetable garden this year during the pandemmy, so that has been great!

The hospital has free Physio, but their protocol seems very dated (equinus for 4 weeks, didn’t want me to use any therabands for my quad/hamstring exercises after I complained that a leg lift wasn’t doing much for me when I’m used to squatting). I brought 3 different early mobilization/early ROM protocols to my surgeon, he took a look and said I was fine to follow any of them, so I’m following the Banff protocol (similar to the UWO protocol), doing inversion and eversion exercises and light dorsiflexion. I’ve started partial weight bearing, 25% - I’m part of a trial for this cool device/footpad inside my brace that measures how much weight I’m bearing, and buzzes if I go over 27%. I’m still a little scared to put a lot of weight on it, even though 25% doesn’t really hurt. Plan is to be gentle at 25% this week, and then progress to 50% next week. I saw my sports therapist today, he did work on my hips and quads, and a bit on my calf to get it ready for dorsiflexion. Acupuncture too!
There is a lump of scar tissue on my achilles, and I live in fear of rerupture, but am trying to work on that mental fear. I know the 8-12 week period is the danger zone, so will be very vigilant then.

I was able to push my work start date to October, so I have lots of time to rehab, and plans to figure out how to do handstand pushups - I’m used to being all legs, because of my former sport, but time to get that upper body to match. I’m going to try to post weekly as well, hopefully my journey will help someone else, plus, it’s very cathartic.