May 01 2010
8 months along
Progress continues, though more slowly than hoped for, now eight months post injury. On one leg, I can raise my heel off the ground about an inch at best. The injured calf is still smaller than the other. Running feels a bit awkward, though my general sense of balance is clearly improving. My calf swells slightly by the end of the day. The surgical repair site is mildly sore upon waking, or after sitting or standing for a prolonged period, but the soreness dissipates within a few minutes. I’ve been out shooting baskets a couple of times, but not willing to get into an actual game yet.
At my six month visit, my orthopedist was mildly concerned that the tendon might be healing long. My ankles have always been fairly flexible, and I can’t detect any obvious difference in the range of motion (dorsiflexion) one side to the other. In any event, I would do anything to avoid surgery again. For now, we are taking a wait-and-see attitude. I’ll see him again in another month.
Doctor J,
If you want to speed up your progress, the key thing is to work on your calf strength. When I was at the stage you are at now, I approached calf strength like a weightlifter might, working on strength hard every other day, hard enough to make it a little tired and sore that next “off” day.
One easy exercise that might be appropriate for you at your stage is to simply walk around high up on your toes as much as you can. If that’s too easy, “bounce” a little as you walk like that.
Did your doctor say why he/she thought your tendon might be long? Was it just slow strength progress, or was it something more specific, like loss of all strength when your ankle nears full dorsiflexion?
Good luck,
Doug
Doug, I think you meant “plantarflexion” for your last word, right?
At 8 months, Dr J, I’d think that your dorsiflexion ROM should be a pretty good measure of your healed AT length. The most precise measure of that is probably how far you can place your heel from a wall (in front of you), foot flat on the floor, while touching your knee to the wall.
If you can get your healed foot any farther from the wall than your uninjured foot, then I’d say that AT healed a bit long. After my first ATR was surgically repaired and healed, I had lost a bit of dorsiflexion ROM, which my surgeon said was where he was “aiming”. Now — after my second ATR has had 20 weeks to heal without surgery — my two dorsiflexions match virtually exactly. (Don’t ask me how the gap in my torn AT got closed up without surgery! It’s a complete mystery to me, though the latest FOUR randomized-trial studies all say that’s exactly what happens!)
About a month ago, when I was working on calf strength more aggressively and religiously than I am now (close to Doug’s approach), I developed a sore spot where that other dorsiflexing tendon (Anterior Tibial Tendon) attaches to the bone, maybe an inch or so in front (”toe-wards”) from my inside (medial?) ankle bone. I backed off for a couple of days, until the pain went away, though my PT thought it was nothing scary, and nothing he couldn’t control with his strong thumbs. (He did not use the word “wimp”, but he was clearly THINKING it!!)
You’re right, Norm, I meant plantar flexion. You have “medial” right, too, meaning closer to the middle of the body, as opposed to further left or right.
The body is amazing, how it can heal things back to the proper shape. The example I see the most is when newborn babies sometimes break their collarbones during birth. The initial healing is a big round lump of bone to hold the ends together, but over time it slims down nicely into normally-shaped collarbone. It knows, somehow.
Doug
Somehow it seems even more amazing that my 65-y-o body remembers how to make body parts, compared to a newborn infant, whose cells have just done the whole thing from scratch. (I’m lucky if I remember where I parked the car!)
Doug, I think one of our first exchanges here — back when I still had the crutches leaning on the table beside the computer — was after I said “dorsi” or “plantar” backwards, and you pointed it out. So we’re even!