eastcoastrunner’s AchillesBlog

Yesterday my PT told me I cannot use my Boot EVER again. It’s causing too many forefoot/toe/front of ankle problems, and my AT is doing just fine and I don’t need the boot anymore.  I’ve been in 2 shoes about 2.5 weeks now.  I’ve only been using my Boot for road walks longer than a mile and trail hikes of 4-5 miles. I live in New England, so most of our Woods trails are rocky, rooty, wet, and the hills are steep but not too huge.  The boot helps prevent all the scary foot movement and makes my foot feel “safe” and protected. I miss trail running so badly and the hikes have kept me sane. I have the permission of my Ortho to hike with the boot in the woods all I want “within reason”.  But my PT has said that each time I strap that boot on I am setting myself back again with the forefoot stuff. I am supposed to be able to start running next month, but not  if I can’t  push off through my toes and use my whole ROM.

I’ve been singing a twist on an old Beach Boys song: “She’ll have fun, fun, fun, till her PT takes her cam boot away….”

The PT suggested going back to flat trails (here that means Rail Trail) and using Trekking Poles. I’m thinking this sounds like a reasonable compromise.  So, here is my question: have any of you used trekking poles to take some of the pressure off your AT foot? ( in my case the AT feels ok if a little tight, but the front of my foot is stuck and can’t move thru it’s full ROM without nasty pain) If you find the trekking poles useful, do you use 1 pole opposite your AT foot like a cane? Or if both poles, do you prefer to use “opposite arm/opposite leg” like walking/running, or “both poles in front with AT foot/step”  like using crutches @ PWB?

Thanks so much for any suggestions! I know this is not the worst problem to have, and I am thankful!

I just got back from my 13+ week appointment with my Ortho. I wasn’t sure what his reaction was going to be when I walked in carrying my boot instead of wearing it, but he smiled.  He said it’s good to see I’ve made great progress since the last time we met.

My boot is a muddy mess from trail hiking yesterday. Ortho laughed when he saw it and said his looked the same when he was at this point after his AT surgery, too.  He said I can hike any single track hilly trails I want now– within reason– with the boot on. Once I am comfortable walking at least a mile in general without the boot I can start to hike on flat trails and can work up from there. We have a nice Rail Trail nearby.  He said YES to a 2-day hike in the Berkshires (on the AT–Appalachian Trail, seems appropriate!) with my tent/pack near the end of September.  I was pretty surprised he said yes to that, but very excited that he did!

I am cleared to start DRIVING again! Woo-Hoo! Now, I just need to get my car back from my 23 year old son… Driving also means I can go back to teaching several of my fitness classes that I was unable to get to during the day time. Speaking of teaching my classes– he also said YES to carefully going back to teaching my Spinning Classes! YAY! (I can clip in to my pedals but  need to stay seated for now, gradually building back to the standing and  climbs of my  regular classes…but that just makes sense anyway)

Best news of all? He said I can start RUNNING next month!!! Of course it will be a very slow build up, and he wants me to wait until I see him on August 2nd (exactly 4 months post-surgery) before I actually start running. I think I’ll bring along a running plan so he can see I’ll build appropriately.

I asked about doing a race I had registered for before surgery that is at the end of October.  He is worried I will try to build up mileage too soon if he says yes right now. So he said we will leave it as a “possibility” and see how I am doing at my next appointment. (disclosure: the race is a 30 mile trail race, so his concerns are legitimate) I will try not to get my hopes up too high at this point. Perhaps he will let me walk it if not run…

OK…for now my goal is to not get too excited and try to do too much all at once. But I will start by teaching my Spinning class with both feet on the bike tonight!

This has been a really good week! I’ve made a bunch of  progress. And just to top off the niceness of the week, my Running Partner and I “hiked” 3.5 miles in the Woods on mostly singletrack trails this morning–ever so very slowly–and no swelling in my foot after! (hiking in the boot is awkward since stepping on a rock or root with the rocker is unpredictable. I’ve been really careful) Going THAT slow means that you have extra time to see all the cool birds and critters

 I’ve been going to PT twice a week where we’ve been really working on getting my forefoot to loosen up– and my foot to work as a “whole” so that when the Ortho releases me from the boot, I don’t have to go “from nothing to all”.  I had a high degree of stiffness and pain in my big toe joint which we thought at first might be gout. It wasn’t gout, but it was a big hinderance to making progress. (a few weeks ago I described how this stiffness prevented me from being able to get off the crutches and go FWB–after 1 PT session I was able to ditch the crutches and go FWB)

Well, between the PT sessions and my own work at home and in the pool, things have moved well enough that I have been walking barefoot without the boot around the house for the last 2 days! When I showed my PT that I could walk barefoot yesterday, I think he was as excited as I was! He gave me some new mobility exercises to work on this week between our sessions. My big toe joint turns blue when I’ve done too much, but at least my AT area is pretty pain free!

I haven’t yet tried to put 2 shoes on. Barefoot I can really work on gently lifting my heel off the floor and working through the stiffness in the toe joint during the gait. Question: did most of you go from FWB in the Boot to barefoot and then go to 2 Shoes, or did you just go right from FWB in boot to 2 Shoes?

I see my Ortho for my 3 month visit on Thursday, and I hope he clears me to DRIVE and go back to teaching my Spinning classes with “2 legs”. I was supposed to stay in the boot until we met again…but I suspect walking barefoot as tolerated around the house one week early will be considered “OK” by him. (I hope!) I put the boot on for everything else other than walking around in the house. My boot is falling apart from over-use though!

I’m now about 10 1/2 weeks out from Debridement and Repair surgery.  Walking FWB no longer hurts most of the time, and I’m moving along pretty quickly! I  enjoy going to PT. (except for that Graston Massage stuff they do with the metal tool…that is NOT enjoyable!) My ankle ROM is gradually getting better and the stiffness in my forefoot/big toe is slowly getting better, too, although that is still more painful than the heel and AT area.

My Ortho still hasn’t given me the “OK” for pool running/aqua jogging  nor cycling –although I cannot understand why not! My PT suspects it is mostly because of my inability to limit things to reasonable amounts. In other words, when told to listen to my body, my body is more of a whisperer than a shouter!  So I have found a “creative” solution to teach my Spinning classes on the bike instead of from a chair…and a way to aqua jog keeping movement on my right foot to a minimum.  Maybe these solutions might help others stuck in “cardio limbo”.

That chair that I’d been using to sit on  to teach my  Spinning classes while on the crutches just so happens to be the exact right height to place my booted foot on while sitting on the bike! I place the chair slightly forward of the right crank, making sure the pedal clears the chair. I place my booted right foot in the chair. My hips are exactly level! So, my left leg is doing all the pedaling and I know that is not ideal, but it’s so good to feel like I’m participating in my class, and especially to sweat!

For the aqua jogging: I’m allowed to swim with a pull buoy, but I hate lap swimming. I’d been “running” with a flotation belt around my waist and a pull buoy between my knees and just moving my arms. This week I started using the pull buoy one lap down and back, then taking it out and using left leg to ”run” while right leg rests across the thigh of left leg (makes me feel like a sea horse..) down the lane, then both legs back, being very careful to limit ankle motion in the right leg. Repeat over and over for 45 minutes!

This week I have also had Unfounded Fear regarding that screw in my heel. Even though the Ortho showed me the x-ray on my last visit of the heel and screw and how it’s sitting right where it is supposed to, I am scared that the tendon is going to tear off the screw. I know I have no reason to worry, really, but can’t help it! I guess this is my version of what ATR’s worry about re-rupture. (my AT didn’t rupture)  The incision area has been really tender this week, too, so I fear that the screw is working out of my bone or getting infected–unfounded fears. My PT thinks the incision is tender due to nerves reforming and it’s good. I’m not usually a worrier, so I guess I now understand what some of you have mentioned about these injuries “messing with the head”. I’m getting messed with this week!

Just wanted to quickly share… I can put full weight on my foot today and I have started walking FWB!  Yay! I am so excited!

I woke up this morning with very little swelling and much less stiffness and pain in my forefoot. I did my PT exercises and thought, well, that felt pretty good. So I just went for it. I know I am showing my age, but that song that Winter Warlock sings in the 1960’s ”Santa Clause is Coming to Town” special was going through my head: “put one foot in front of the other, and soon you’ll be walking out the door”.  My Husband and sons were clapping and cheering.

Now I’m going to rest and ice it for a bit and try not to do too much all at once

Yesterday was a couple “firsts” for me. I got to sleep w/o the boot for the first time, and I slept GREAT!

 Then I got to go in the pool for the first time since surgery!! I’m a terrible lap swimmer, and my Doc won’t let me do deep water pool running  yet, so I did a sort of “no legged” aquajog with the pull bouy between my knees and the water belt around my waist, using only my arms to propel me back and forth. It was cardio anyway, and today my arms feel it! My foot felt pretty good after. I wore my boot right to the pool, took it off at a bench, used the crutches to get to the edge of the handicap steps that go into the pool (had my friend bring the crutches back to the bench) and reversed the process when it was time to get out. I had been worried about the slippery pool deck, but it really wasn’t bad.

My first PT session was interesting. I’ve worked with this therapist for over a year, so he knows my AT, foot  and whole lower leg area very well. He remarked on how nice the scar is, that in a year it will be invisible. He was also very impressed with how “clean” my tendon and insertion felt, and how nice and strong the AT felt. He commented on how extreme the atrophy in my calf is, and said we’ll get to work on that once we get my toes working right. So, after all the stretching and massage on my AT, insertion and calf, (which all felt very good!) he started in on my big toe and forefoot. He said that he thinks there is a good probability that it IS gout, and like the Doctor said, if it’s not improved by next week we’ll get it tested. Regardless of what is causing the stiffness, he doesn’t want me to put FWB on it until my next session next week. (Darn, I really thought I’d be walking out of there w/o the crutches…sigh) He gave me exercises to work on to keep the mobility he got out of it yesterday. I left with my foot feeling the best it has since before the surgery! That feeling pretty much ended by bed time last night, but although my toe/forefoot is very tender and extrememly stiff this morning, there is much less swelling than usual. I like having the exercises to do, too–makes me feel like I am making progress even though I am now “behind” where I was expected to be because of the toe/forefoot issue.

Today was my week 8 post debridement and repair surgery check-up. My Doctor walked in and joked that he’s been checking the police logs, and he can see that I haven’t killed anyone in the 8 weeks of no running, so I must be doing OK. Ha!

He was NOT happy that I am still not FWB. It’s sure not for lack of trying! I asked about the possibility of that forefoot pain and stiffness being gout. He said it could be. We will watch it for another week, and if it’s still an issue we’ll do some tests for gout. He thinks it might just be that the foot is just not used to bearing weight and it is rebelling  a bit. He said is is very good that the FWB attempts don’t hurt my heel or AT area. He DID write me a prescription for PT for “Gait Training in the Boot” to help get me off the crutches. I start tomorrow! I can’t wait to ditch the crutches! (I’m happy because he hasn’t been too big on the idea of me starting PT up till now– he really wanted me to wait a while longer) I like my Therapist– and since he knows me and what I have been doing right along, I feel like I will make faster progress now!

So, the good stuff today besides the PT prescription were: #1- The x-ray showed that the bone and tendon are healing well.  I am not forming new “boney growth” where it doesn’t belong and the screw is staying put.  #2- I get to sleep Sans Boot from now on! #3- my ankle ROM is good and the tendon feels strong. #4- the inscision has healed beautifully.  I should be able to start walking around the house w/o the boot by my 3 month appointment.

The “bad” stuff  is : #1-still no pool running, although I got the OK to swim with a pull buoy. (ugh, but I’ll take it at this point!) #2- still no spinning or any type of stationary biking. #3-the calf atrophy is considerable for this point in recovery  (looks like my forearm, and I’m pretty thin!)

The Doctor did say that once I get comfortable with FWB, I can start hiking on my beloved trails! If I can’t run my trails, walking them will be the next best thing! This is my “carrot” now

It’s 7 weeks today since my debridement/repair surgery. I’ve been PWB for 2 weeks now and that has been going fine. My incision looks really good and doesn’t hurt at all, so I know I’m making progress.

My next appt with my Surgeon is next week (8 weeks out from surgery). He would like me to ditch the crutches by that appointment. The problem is, I can’t quite figure out  HOW to put full weight on my “bad” foot! My boot is a knee high non-hinged rocker boot that is a bit higher than my other foot with a shoe. I am supposed to stay in the boot as I go FWB. I can stand with both feet on the floor (although the boot foot hikes that hip up much higher) I’ve tried one crutch on the boot side, but it feels not quite right. I’ve tried just stepping on the foot w/o crutches, but what happens doesn’t resemble a “step” at all, and is scary! The pain isn’t in my heel where the bone was removed, nor in my achilles or ankle…it’s across the base of my toes on top and under my foot. It’s not really “pain” as much as stiffness, tightness, weirdness. Results in red and blue toes after each try. I’ve been playing with how much to inflate the boot. My thought is more compression probably make the toes more red/blue but might be better for my heel and AT. Less compression makes it easier to feel my whole foot.

 I know many of you have been through this step already, so I could really use some guideance on how to ditch these crutches! Maybe I’m just being a great, big Scaredy Cat??

Thank You!!!

It feels longer than 5 weeks since I had the bone growth removed and the tendon repaired…

I went into my appointment overly optimistic that my Surgeon would let me start doing more. (actually, I know now I was being kind of unrealistic!)  My Husband came along with me to the appointment be “second ears” for following the Surgeon’s directions (and to be a “tattle-tale” as well–humph!)  I sometimes hear what I want to hear and Hubby was going to make sure he also knows what is OK and Not OK for me to do.  He believes that I needed the surgery to correct the degeneration because I suffer from “TSTS Syndrome”, which stands for “Too Stubborn To Stop”.

The Surgeon said that the incision is healing really well and everything looks really good. He also said that I may start to slowly go PWB, taking most of the weight on my crutches this week, and easing off over the next 3 weeks to FWB when we meet again for my 8 week post-op. He said that these next 3 weeks are very important where the tendon will start growing roots into the insertion where the bone was removed.  And I have to Be Careful. I still have to sleep in the smaller boot. (I can’t WAIT to sleep bare footed!)

I asked about the numbness/tingling I still feel in my toes and the lateral side of my lower leg. He said it is from the nerve block and will eventually go away. Imagine still feeling  some numbness from that nerve block 5 weeks ago!

I am a Personal Trainer, Spinning Instructor and Running Coach as well as a trail runner. I am really active by nature and it’s been VERY hard on me to sit still all this time. It’s my right foot so I still can’t drive. (I’ve been leading my classes and running clinics from a chair, but at least I am partially back to work!) Going into my 5 week post-op, I had thought that maybe I would be given the “OK” to get into the pool for some deep-water running and I’d be allowed to get on the Spinning bike with the boot and no resistance. Doctor said “NOT YET” to both those options. This is when my Loving Husband decided to “tattle” on me and told the Surgeon that I’d been doing 1.5 miles on the crutches around my neighborhood. The Surgeon laughed and told me to “Cut that crap out.” He said that will cause shoulder problems. Aparently I was kind of arguing with him (with Hubby quietly laughing at my side). The words “red-head” and “fiesty” were mentioned. The surgeon pushed the door shut behind him, leaned into me and said  ”Now Listen. I’m an Endurance Junkie, too. I had this same surgery and I know what the recovery is like. You have to be patient a little while longer. Remember that I told you that your’s is the worst achilles I’ve seen in nearly 30 years of doing this.  Let’s find something that you CAN do until we meet again.”  He vetoed every one of my suggestions, but finally said that I can TRY the rowing machine with my right leg hanging off the side. I’m not sure how that will work, but I’m going to give it a try tonight! If that proves to be impratical, there is always the Upper Body Ergometer. I don’t really enjoy it all that much.

As for the PWB: well, it’s fun to put my foot down and get it moving! BUT, it swelled into a big ballon foot by last night, so I did Too Much Too Soon. I’ll keep it elevated today and try again tomorrow.

Hi! I’ve never done a blog before, so please have patience with me!

I’m a 46 yr/old female trail & ultra runner in New England. I also happen to have an autoimmune/connective tissue disease that sure doesn’t help achilles problems!
I had my surgrery 2 weeks ago today. It wasn’t ATR surgery. Officially it was called “Achilles Insertion Debridement and Repair Surgery”. My Doctor said I had a whole lot of things going on in there and it was the worst achilles he’s seen. (gee–how nice to excel at something…!) He commented that he can’t understand how I’d even been able to walk on it, let alone run on it.  Thankfully, my Doctor is also an Ultra Runner and said the surgery was absolutely needed if I want to keep running, and if I didn’t do it soon then the AT would rupture above the area it was tearing vertically, causing the need for 2 surgeries and much longer healing time. Yikes!
The surgery involved removing chunks of excess bone in 2 places from my calcaneal bone (not spurs, but not quite Haglunds, either) Then cutting out the calcified area in the middle of my tendon, which was so bad that it was causing a vertical tear in the achilles. The two healthy “sides” of the tendon were tied back together so that they can grow together to form one healthy tendon, then the tendon was screwed into the back of my heel. My incision is lower than those of you who had ATR surgery.
The surgery ended up being a bit longer and more involved than my Doctor first thought. I wasn’t supposed to be “put under” but instead have a local. But sometime during the surgery they had to put me out.  I had a bad reaction to the narcotics and nearly had to stay overnight in the hospital. Doctor told me that the percocet he prescribed would probably also cause a bad reaction, so take it only if desperate. I took 1/2 on the second night post-op. Yup– bad reaction! But thankfully the pain was only really bad that second night after the local wore off, and after that I was able to manage with Tylenol and Advil.

I thought I would be able to go back to work next week, but I can’t drive (against the insurance to drive with right foot in a boot) I work as a Personal Trainer, Spinning Instructor and High School Assistant Track Coach–all very active jobs. Crutches are not really all that conducive to my work anyway…and since I can’t even carry my own coffee cup, how the heck did I think I was going to carry equipment or demo exercises???? Sigh…

In the meantime, I’ve been crutching up and down my hilly street just so I don’t go totally stir-crazy! My neighbors think I’m odd.  I went to the parkinglot of my favorite trails on Sunday for laps on the crutches while my Hubby and my 9 y/o went for their run in the Woods. We were all supposed to run a trail running festival in Maine in May. I was to run the 50 Miler as I do each year, but they were to run their first 5K! We decided that they will still run the 5K and I will be the cheerleader this year. So– into the Woods they must run to train. My usual running friends were there and each took a slow walking lap in the lot with me. That was the best part of the last 2 weeks. I know I can get through this, and having friends and family supporting is wonderful! Trying to keep a good attitude.