It’s been nearly 11 months since my Achilles surgery, and my recovering Achilles feels pretty good.  In fact, it feels better than my right Achilles, which gets tender after I play basketball.

I now play basketball once or twice a week, and I go to the gym a couple of times a week for strength training and running.  I wear my ankle brace, which I think provides some protection from accidental contact.

I went skiing for a day while I was in Salt Lake City, and it felt great to be out in the mountains.  I had difficulty fitting into my ski boots that I’ve had for several years, and I had to take the bottom insole out of the boot.  My foot either grew after my surgery or my heel now protrudes more than it used to, jamming my toes into the tip of the boots.  Without the insole, I was comfortable in the boots so that was not a problem.

Overall, I am pretty happy with my recovery progress.  I am still hesitant with jumping and pushing off hard with my left leg, but that hasn’t stopped me from doing the things that I love.  I still play basketball, tennis, ski, and run.  My recovering Achilles feels fine after any sort of activity, but my right Achilles gets pretty sore.  I have to really be careful, or I’ll be getting matching surgery scars, and I don’t want any more surgeries.

I exchanged e-mails with John and Brendan who were on this site from the very beginning.  They have moved on from their injury/recovery, and they are not so focused on it as we all once were.  John said that he went skiing a few times this season.  He said that he didn’t have as much control of the skis at first, but he felt fine and was able to cruise at high speeds and carve some good turns.  He also reduced tension on his bindings a bit too.

John mentioned getting some additional Physical Therapy and taking Pilate classes, and I am also going to look into more PT and give Pilates a try too.  It’ll be beneficial for my ailing knees to strengthen my core/legs.

I still feel a bit of stiffness in my Achilles at times, but I’ve gotten used to it.  I wonder if I am feeling the sutures that were used to stitch together the tendon.  It’s the non-dissolvable kind so it’s still there inside me.

Here are some more pictures:

Yeah, the scar doesn’t look pretty, and it hasn’t improved since the last time.. Except that I am able to wear one of the dress shoes that I wasn’t able to wear a few months ago.  There are some shoes that I still can’t wear, and I threw out a pair.   They were old anyway.

It’s more obvious from this picture that my Achilles tendon seems thicker than a normal tendon.

My left calf muscle has recovered to its original size/strength.

Thanks for reading, and if you are in the early stages of recovery, be patient and don’t get discouraged.  It’ll take time, but you’ll get back to doing the things that you love in due time.  Have a happy new year, and lets hope that we’ll be healthier in 2009!

STRAIGHT-LEG MARCH (for the hamstrings and gluteus muscles)Kick one leg straight out in front of you, with your toes flexed toward the sky. Reach your opposite arm to the upturned toes. Drop the leg and repeat with the opposite limbs. Continue the sequence for at least six or seven repetitions.

SCORPION (for the lower back, hip flexors and gluteus muscles) Lie on your stomach, with your arms outstretched and your feet flexed so that only your toes are touching the ground. Kick your right foot toward your left arm, then kick your left foot toward your right arm. Since this is an advanced exercise, begin slowly, and repeat up to 12 times.

HANDWALKS (for the shoulders, core muscles and hamstrings) Stand straight, with your legs together. Bend over until both hands are flat on the ground. ‘‘Walk’’ your hands forward until your back is almost extended. Keeping your legs straight, inch your feet toward your hands, then walk your hands forward again. Repeat five or six times.

Stretching: The Truth

WHEN DUANE KNUDSON, a professor of kinesiology at California State University, Chico, looks around campus at athletes warming up before practice, he sees one dangerous mistake after another. “They’re stretching, touching their toes. . . . ” He sighs. “It’s discouraging.”

If you’re like most of us, you were taught the importance of warm-up exercises back in grade school, and you’ve likely continued with pretty much the same routine ever since. Science, however, has moved on. Researchers now believe that some of the more entrenched elements of many athletes’ warm-up regimens are not only a waste of time but actually bad for you. The old presumption that holding a stretch for 20 to 30 seconds — known as static stretching — primes muscles for a workout is dead wrong. It actually weakens them. In a recent study conducted at the University of Nevada, Las Vegas, athletes generated less force from their leg muscles after static stretching than they did after not stretching at all. Other studies have found that this stretching decreases muscle strength by as much as 30 percent. Also, stretching one leg’s muscles can reduce strength in the other leg as well, probably because the central nervous system rebels against the movements.

“There is a neuromuscular inhibitory response to static stretching,” says Malachy McHugh, the director of research at the Nicholas Institute of Sports Medicine and Athletic Trauma at Lenox Hill Hospital in New York City. The straining muscle becomes less responsive and stays weakened for up to 30 minutes after stretching, which is not how an athlete wants to begin a workout.

THE RIGHT WARM-UP should do two things: loosen muscles and tendons to increase the range of motion of various joints, and literally warm up the body. When you’re at rest, there’s less blood flow to muscles and tendons, and they stiffen. “You need to make tissues and tendons compliant before beginning exercise,” Knudson says.

A well-designed warm-up starts by increasing body heat and blood flow. Warm muscles and dilated blood vessels pull oxygen from the bloodstream more efficiently and use stored muscle fuel more effectively. They also withstand loads better. One significant if gruesome study found that the leg-muscle tissue of laboratory rabbits could be stretched farther before ripping if it had been electronically stimulated — that is, warmed up.

To raise the body’s temperature, a warm-up must begin with aerobic activity, usually light jogging. Most coaches and athletes have known this for years. That’s why tennis players run around the court four or five times before a match and marathoners stride in front of the starting line. But many athletes do this portion of their warm-up too intensely or too early. A 2002 study of collegiate volleyball players found that those who’d warmed up and then sat on the bench for 30 minutes had lower backs that were stiffer than they had been before the warm-up. And a number of recent studies have demonstrated that an overly vigorous aerobic warm-up simply makes you tired. Most experts advise starting your warm-up jog at about 40 percent of your maximum heart rate (a very easy pace) and progressing to about 60 percent. The aerobic warm-up should take only 5 to 10 minutes, with a 5-minute recovery. (Sprinters require longer warm-ups, because the loads exerted on their muscles are so extreme.) Then it’s time for the most important and unorthodox part of a proper warm-up regimen, the Spider-Man and its counterparts.

“TOWARDS THE end of my playing career, in about 2000, I started seeing some of the other guys out on the court doing these strange things before a match and thinking, What in the world is that?” says Mark Merklein, 36, once a highly ranked tennis player and now a national coach for the United States Tennis Association. The players were lunging, kicking and occasionally skittering, spider-like, along the sidelines. They were early adopters of a new approach to stretching.

While static stretching is still almost universally practiced among amateur athletes — watch your child’s soccer team next weekend — it doesn’t improve the muscles’ ability to perform with more power, physiologists now agree. “You may feel as if you’re able to stretch farther after holding a stretch for 30 seconds,” McHugh says, “so you think you’ve increased that muscle’s readiness.” But typically you’ve increased only your mental tolerance for the discomfort of the stretch. The muscle is actually weaker.

Stretching muscles while moving, on the other hand, a technique known as dynamic stretching or dynamic warm-ups, increases power, flexibility and range of motion. Muscles in motion don’t experience that insidious inhibitory response. They instead get what McHugh calls “an excitatory message” to perform.

Dynamic stretching is at its most effective when it’s relatively sports specific. “You need range-of-motion exercises that activate all of the joints and connective tissue that will be needed for the task ahead,” says Terrence Mahon, a coach with Team Running USA, home to the Olympic marathoners Ryan Hall and Deena Kastor. For runners, an ideal warm-up might include squats, lunges and “form drills” like kicking your buttocks with your heels. Athletes who need to move rapidly in different directions, like soccer, tennis or basketball players, should do dynamic stretches that involve many parts of the body. “Spider-Man” is a particularly good drill: drop onto all fours and crawl the width of the court, as if you were climbing a wall. (For other dynamic stretches, see the sidebar below.)

Even golfers, notoriously nonchalant about warming up (a recent survey of 304 recreational golfers found that two-thirds seldom or never bother), would benefit from exerting themselves a bit before teeing off. In one 2004 study, golfers who did dynamic warm- up exercises and practice swings increased their clubhead speed and were projected to have dropped their handicaps by seven strokes over seven weeks.

Controversy remains about the extent to which dynamic warm-ups prevent injury. But studies have been increasingly clear that static stretching alone before exercise does little or nothing to help. The largest study has been done on military recruits; results showed that an almost equal number of subjects developed lower-limb injuries (shin splints, stress fractures, etc.), regardless of whether they had performed static stretches before training sessions. A major study published earlier this year by the Centers for Disease Control, on the other hand, found that knee injuries were cut nearly in half among female collegiate soccer players who followed a warm-up program that included both dynamic warm-up exercises and static stretching. (For a sample routine, visit www.aclprevent.com/pepprogram.htm.) And in golf, new research by Andrea Fradkin, an assistant professor of exercise science at Bloomsburg University of Pennsylvania, suggests that those who warm up are nine times less likely to be injured.

“It was eye-opening,” says Fradkin, formerly a feckless golfer herself. “I used to not really warm up. I do now.”

You’re Getting Warmer: The Best Dynamic Stretches

These exercises- as taught by the United States Tennis Association’s player-development program – are good for many athletes, even golfers. Do them immediately after your aerobic warm-up and as soon as possible before your workout.

STRAIGHT-LEG MARCH

(for the hamstrings and gluteus muscles)

Kick one leg straight out in front of you, with your toes flexed toward the sky. Reach your opposite arm to the upturned toes. Drop the leg and repeat with the opposite limbs. Continue the sequence for at least six or seven repetitions.

SCORPION

(for the lower back, hip flexors and gluteus muscles)

Lie on your stomach, with your arms outstretched and your feet flexed so that only your toes are touching the ground. Kick your right foot toward your left arm, then kick your leftfoot toward your right arm. Since this is an advanced exercise, begin slowly, and repeat up to 12 times.

HANDWALKS

(for the shoulders, core muscles, and hamstrings)

Stand straight, with your legs together. Bend over until both hands are flat on the ground. “Walk” with your hands forward until your back is almost extended. Keeping your legs straight, inch your feet toward your hands, then walk your hands forward again. Repeat five or six times. G.R.

http://www.nytimes.com/interactive/2008/11/02/sports/20081102-MARATHON-PANO.html?ref=sports

http://www.nytimes.com/interactive/2008/10/27/sports/20081027_MARATHON_INTERACTIVE.html?ref=sports

http://www.nytimes.com/slideshow/2008/11/02/sports/1102-MARATHON_index.html

http://topics.nytimes.com/top/reference/timestopics/subjects/n/new_york_city_marathon/index.html

Some of my friends are renting out a court on Wednesday nights, and I’ve started playing basketball again.  I’ve played three times so far, and it’s been great!  However, I’ve been taking it easy on both ends of the court.  I don’t think I can go “all out” yet, so I’ve been happily running back and forth playing team ball and taking set shots when I am wide open.  I used to love slashing to the hoop, and I don’t do that.. yet.  Since I don’t back peddle any more, my defense has suffered too.  And I never cared for rebounding anyway, so not much has changed there.

All things considered, I am more than happy that I am able to do this 8 months into the recovery.

My wind is definitely there, and my achilles is doing fine.  However, my knees are bothering me and I think that is what is keeping me from doing more on the court.  Looks like I have to go see an orthopedist about my knees, but if he/she recommends surgery, I probably will decline and stick to sports that are less taxing on my knees.  My knees felt okay playing tennis, so I might just stick with that.  Well.. we’ll see, I’ll do what’s best for my long term health.

So do I feel like my achilles is 100% by now?  No, and I don’t think it’ll feel 100% for a few more months.  I’ve heard from others that it may even take longer to feel 100%.  It’s almost like nursing a mildly sprained ankle for a long time.  It feels okay to move around, it’s a little sore at times, and I baby it a bit.  But I don’t limp any more, and my knees are more of a concern than than my achilles now.

It was a beautiful day today.  I jogged along the Hudson river about a mile to the gym, worked out for about an hour, and jogged/walked back home.  I am starting to do more leg exercises in hopes of strengthening my knees.

As a side note, it looks like Elton Brand (NBA player who came back from an Achilles rupture last year.) signed a five-year, $79.8 million deal with the Sixers.  Go Elton!  http://www.nydailynews.com/sports/basketball/2008/10/11/2008-10-11_elton_brand_boosts_76ers_character_and_c.html

It’s been a while since my last post, but I’ve been checking the site everyday reading everyone’s posts during my free time here and there.  I am still amazed by how many people are on the site, and we now have close to 200 Achilles Bloggers.  That’s a lot of people healing, recovering, and working hard to get back to normalcy.  When I designed the marathon tracker, I never thought that there would be groups of people at each 1/2 mile marker.

Speaking of the marathon tracker, I’ve finally made it to Manhattan!  When I ran the nyc marathon some years ago, probably the most memorable part of the race was running through the Queensboro Bridge into Manhattan.  I had thought that there were lots of people cheering on the runners in Brooklyn and Queens, but getting off the Queensboro Bridge ramp into the streets of Manhattan and feeling the amplified waves of cheers was definitely something else.  I probably ran about a minute faster that mile with adrenaline pumping through my system.

It has been 32 weeks, almost 8 months since my injury, and I am pretty happy about the progress I have made in my recovery so far.  I’ve been playing tennis fairly regularily, and I’ve been enjoying the cool fall weather.   I signed up for a group tennis clinic that takes place every Thursday night for 1 hour at an indoor tennis court near where I live, and I am looking forward to playing regularily.

I probably played more tennis this year than the past few years put together, and that’s probably because I now appreciate being able to run around more than I did before the injury.  I am still fairly careful out on the court, and I don’t bother chasing down really difficult shots.  I’ve learned to ‘let go’, and I am okay with it. 

I’ve been going to the gym to work out two-three times a week, but I don’t do any calf specific exercises.  I run about 15 minutes to warm up and then I do upper-body workouts as well as squats with light weights.

As far as my recovering achilles is concerned, it’s in pretty good shape.  I can do several single leg calf raises, but I do have a bit of slight, dull soreness that comes and goes if I put too much strain on my achilles.  Yes, it’s not 100% yet, but I don’t expect it to be.  I don’t limp anymore, but I still can’t wear some dress shoes.  Oh, here are some pictures of my scar.  It really hasn’t changed much since my last post.  Unfortunately, I haven’t been good about applying lotion, mederma, etc.

Well, maybe there has been a slight improvement in appearance, but I don’t care too much about how my scar looks, really.  I think it’s a cool scar.

Here’s the close-up:

My achilles tendon on my recovering leg is definitely thicker, and it’ll probably stay that way.

It’s holding up pretty well.

It still makes me cringe when I see images of single leg calf raises, but it doesn’t feel/seem that bad when I am actually doing them.

\

Just a word of encouragement to all the new bloggers:  Take it slow and be patient.   The first few weeks are the hardest, but it gets better, and you’ll eventually get back to doing things that you love.  Happy healing!

I’ve hit the 6-month recovery mark!
I hadn’t played tennis in over a year, and I ventured out to play this past weekend on a dry, warm summer day.

A good college friend of mine happened to be in the city, and he brought his tennis racquet with him. I got to the courts first, so I took some tentative practice serves. It felt a little strange, and I could “feel” my achilles. So much for putting my legs into my serves, but I slowly warmed up enough to feel comfortable with taking practice serves with decent power. I don’t have the most consistent serve, so I wasn’t serving any worse than I did before the injury.
It really felt great to have the racquet in my hands, going through the serving motion, hitting the ball, and jogging to the opposite end of the court to pick up the balls.

By the time my friend showed up, I had warmed up enough to break into a light sweat. I carefully stretched my achilles on both legs, and we started to hit the ball back and forth. I made sure to not stress my achilles by making any sudden stops or abruptly changing direction. I didn’t chase down any really difficult shots, but I was fairly quick on my feet enough to get to most of them.

Another good thing about playing tennis with my friend is that we usually just focus on being consistent and keeping the ball in play within reason. So that allowed me to ease into getting back to where I was before the injury.

My friend was surprised by my mobility as he’s gotten used to seeing me limping around these past few months. I could tell that he was really glad, as he’s got his tennis buddy back.

I do feel a slight soreness in my achilles today, but I suppose that’s to be expected. I’ll take it easy for the next few days and see how I feel.

One step closer to full recovery!

Update: We have 61 votes! Please sign up and send in some more votes!. The most popular proposal has 2698 votes.  I think we need around 900 votes to be in top 25. Thanks everyone!

I have an American Express Card, and I received an e-mail from them about the Members Project that they are sponsoring. I am not sure how well known this is, but I checked it out and found it to be interesting.

Here is the snippet of the e-mail that I received:

It’s never been so easy to make a difference.

Whether you want to protect the environment, save our schools, or fund the arts, Members Project® is your chance to help choose which projects will share $2.5 million in funding from American Express. Last year, Members Project brought clean drinking water to over 3.9 million children across Africa. What happens this year is up to you.

Here’s how you can get involved:

1) Join the discussion. Find a project you’re passionate about, discuss it with other supporters, and help campaign on its behalf. 2) Share your idea for a project. Do you have a project that could make a difference? Share your projects until August 19. 3) Cast your vote. Beginning September 9, vote on your favorite project and help decide which ones will get $2.5 million in funding from American Express.

So, thinking about AchillesBlog.com and seeing first hand the benefit of online social network (community support) when it’s centered around our personal experiences with the recovery, I drew up a proposal.

If you are curious, here it is: Online Community Proposal for the Members Project

If you are interested in voting for this project, all you need is an e-mail address to register.
(You don’t need to be an American Express card holder .)

The project proposal can be modified until Aug 19th, 2008 so I am open to suggestions.

The deadline for the voting is September 1, 2008, but the sooner you vote, the more attention it’ll get, and the more attention it gets, the more vote the project proposal will receive.. you get the idea.

Thanks!

The AchillesBlog.com T-shirts have been a great success! I am delighted that everyone liked the T-shirts, and I am glad that I’ve been able to make them available at-cost. Thanks to your support, especially Kathy (kkdub), I’ve been able to give out T-shirts to some of you.
(If you haven’t ordered a T-shirt yet, and want a free T-shirt, please let me know.)

Here’s what the inventory looks like now:

I ordered 4 T-shirts total. One for myself, one for my brother, one for my sister, and one for my friend Jah who’s been really fantastic. (He is in the Picture Gallery.)

It was silly of me to not order one for a close friend of mine who helped me through some rough times during my recovery.. so since he wears the same size T-shirt as I do, I gave him mine. I’ll order a few more for the second print so that I can have an AchillesBlog T-shirt too!

I hope your AchillesBlog T-shirt becomes your favorite tee, and as Daveleft suggested, if you want to be included in the T-shirt gallery, please let me know.

I am curious if anyone knows how bad/good coffee is for your body.

If diet had no consequences on my health, I’d get up in the morning, have an icecream bar, chocolate, and a large cup of coffee with lots of creme. And then I’d wash it all down with another large cup of coffee with lots of creme.

I’ve cut back on my coffee consumption, as I was having trouble sleeping.  I just don’t fall into deep sleep, although I have no problems sleeping 6-7 hours straight.

Also, does caffeine effect your tendon recovery?

I’ll do some research and post some info here as I find out more about coffee and caffeine.  Please feel free to comment here if you happen to know a lot about this and know of some interesting references on the web.

Update:
Here’s a good article form NYTimes:
http://www.nytimes.com/2008/08/05/health/05brod.html?em

So coffee isn’t bad for you after all. I drink 2 cups every day, with cream, no sugar, and no guilt!
I’ll use how well I sleep as an indicator to monitor my coffee consumption.

This past Saturday, I drove into the city and went for a jog in Central Park. Now that I am living in NJ, I really miss running in the park. I used to live a couple of blocks from the park for several years, and I loved eating a small breakfast in the morning on a sunny Saturday, lace up my running shoes and go for a nice long jog around the park.

I wanted to run the full loop, which is little over 6 miles. My goal was to see how long I can run until my recovering leg started to complain. I ran about 5 miles, until my leg started to feel uncomfortable.
I could have pushed myself to run the last mile, but when I started to notice the soreness in my achilles, I knew that it was time to stop.

I also stopped a couple of times during the run. Once to ask why there were all these people lined up (Bon Jovi concert), another time to talk to a scalper to see how much he was selling the “free” tickets for. ($40) I went back to running.

I think 5 miles is more than what I have ran in quite some time. Even just before the injury, I wasn’t regularly running 5 miles, so I feel good that I am getting in a decent shape, and my leg is steadily improving. I have to say that I wasn’t breaking any world-records. I was running pretty slowly, but steadily. The speed will come with time.. or so I hope.
I now have a great deal more appreciation for my good health, and I am thankful that I am now able to do the things that I am now doing.

I do have some knee pain in the recovering leg, which I think is due to altered biomechanics of my gait. I am going to see a couple of podiatrists in a couple of weeks, so I hope to have some good orthotics to hopefully correct my gait.

My legs have been sore from Saturday’s run, but it’s been the good kind of sore. My achilles is holding up well, and I do have a slight limp sometimes, but I feel more comfortable bearing weight on it.

The recovery is really gradual at this stage.. Steady progress is the operative phrase for the moment.

For those of you following behind us, the old-timers, be patient and keep up the good spirits. It gets better. You’ll get there.