Oct 22 2010

Week 12 notes and 13 video - on my own, frustrating plateau

Published by elsurfer at 5:12 am under Uncategorized

I only had a little bit to update here the last 2 weeks as not really much changed during week 12. I started feeling the frustrating plateau. (the clip is below if you want to skip my rant :)

I met with the OS last Thursday and all is well. He looked at my foot and basically said to come back in 6-8 weeks. He confirmed that I didn’t need to see the PT any longer and I finished up my last PT appointment the Friday after. Of concern to me was the “thickness” of my AT. He said that I’d always have thickness, however it would go down and also smooth out with time, but would never be normal like before (any other 1 or 2 year post-opers care to comment on your thickness? has it gone down? any problem with shoes rubbing?). Also asked about the sutures that were used to sew up the tendon and they were off the semi-permanent type which would take years to dissolve as opposed to several weeks I will continue to lotion, work and mold the AT area in order to get it to thin and smooth out a bit more.

So the last two weeks (weeks 11 and 12 post-op) I hadn’t seen huge leaps in progress. It’s not like I’m all of a sudden now doing 10 full single heel raises effortlessly. Admittedly, I’d been taking it way too easy from therapy isolated exercises that are meant to build strength. I believe the tendency to slack off was due to the fact that I’m walking 90% normally and have spent more time doing my regular exercise routines (mtn. biking, Motocross and Martial arts) without too much need of a strong calf on the ATR’d leg. I realize I need to change this and plan on doing some more exercises that I will show on my week 13 vid.

My PT trainer pointed out the fact that there is exercising and that there are therapeutic exercises meant to get the leg back to normal. Just going about day to day activities isn’t enough - even over time, as other parts of the body tend to compensate for the weak calf leaving the calf weak.

Here is where I stand now at 12.5 weeks:
Good:
Able to do about 12-15 single heel raises at the bottom range (2-3″ off the ground)..
I’m wearing dress shoes now.
I haven’t iced or raised in about 1.5 weeks (don’t know if this is good or bad).
Confidence in day to day activities. I don’t really think about missteps on even ground.
Calf/AT tightness on a scale of 1 to 10 is about 1.5, It just feels more weak as opposed to tight.
Heel pain is gone as I start to shift weight to the ball of the foot naturally when standing.

Bad:
I still get a little stiffness (in the calcaneous area / back of the heal) in the morning or when the leg has been immobile too long.
Upper range single heel lifts are non existent. (4-6″ off the ground)
Still a little swelling, but not too bad.

Ugly:
AT thickness.
Getting calf strength back is going to be a concentrated effort, it won’t come back naturally.

-edit-
I wrote the above about 5 days ago, but as of this clip (week 13), some things have been incrementally improving and I’m a bit happier about my progress. I went to the gym last night (for the first time since the injury) and started blasting away at my exercises including leg presses and weights. Surprisingly it’s wasn’t stiff the day after the gym. Going to try to stay religious at it, because there’s no PT there to push me.

Here’s the week 13 clip.

4 Responses to “Week 12 notes and 13 video - on my own, frustrating plateau”

  1. doug53on 22 Oct 2010 at 8:57 am

    Hi Surfer,

    A quick thought about your “heel descents,” if I may.

    You drop through the upper part of the descent pretty quickly, presumably because that is where the weakness is greatest. It might be more helpful if you spend a little more time going through that early part, even though that means keeping some weight on your other foot. In other words, when you first feel your heel start to descend, stop the weight shift, or slow it way down, and fight the initial part of the descent longer.

    Good luck,

    Doug

  2. philon 22 Oct 2010 at 10:22 am

    never thought Id enjoy watch a vid of a man do exercises ;>)

    your a determined man .

    keep it up and be safe.

  3. elsurferon 22 Oct 2010 at 3:21 pm

    phil, I will wear some leotard spandex for your viewing pleasure next time - lol ;)

    Doug, your thoughts are always welcome. I’ll definitely be working on that. There’s nothing at the top range. I hope in a couple weeks there’ll be something to show. I weigh 220 so the calf has a lot to bear and it comes down pretty quick.

    Two weeks ago, on the “toes pointed out” double heel lifts, there was nothing there either (big umpf! and the heel wouldn’t move!), now it’s relatively easy. I hope the upper range develops quickly as well. I’ve got some other “step up/ step back” exercises with weights I’m doing at the gym - just don’t want to look like a dork filming it in public.

    Tonight, 2 hours of Karate, tomorrow 4 hours of MX enduro riding, Sunday rest. Life marches on. Keep healing and stay positive you all.

  4. normofthenorthon 23 Oct 2010 at 1:32 am

    That’s still very impressive at 13 weeks, Surfer, plateau schmateau!

    In addition to Doug’s notes, I recognize a little “cheat” on the video, that you’re falling into, as I do. On many of your 1-leg calf raises and your 1-leg descents, you’re bending your right knee. My strength is still similar to yours (MONTHS later!), and I find myself bending my knee because (a) it makes the lift WAY easier, maybe because my soleus is stronger than my gastroc(?) and (b) it feels so NATURAL — Heck, my foot is rolling forward, so why shouldn’t my shin roll forwards, too!

    I’m assuming that keeping that knee straight is better for isolating the gastroc, and also a more realistic test of strength and progress.

    All that said, I’m still mystified at how relatively effortlessly I got to the point of my first REAL 1-leg calf raises 8 years ago, after my first ATR, a surgical repair, and too many months in too many casts. When I got out, at ~17 weeks, I could walk perfectly, and could do a TINY number of quite NORMAL calf raises, too! Even after my PT bullied me into doing too many of them, which caused pain and a full 1-month setback, I was soon able to do them again (though I took it easy).

    I never did a bunch of concentrated exercises isolating my calf muscles, but by ~10 months, after lots of bicycling and sailing and walking and climbing stairs and such, I could do as many 1-leg raises as I wanted to. This time, I’ve been doing way more real exercises — though nowhere near as many as my PT etc. recommend. But at 10 months my 1-leg raises still look like yours at 13 weeks!

    It’s true that (a) I’m 65 now, and it’s also true that (b) I skipped the surgery this time. But (a) I was no spring chicken last time, and I’m still young at heart — and I was still playing competitive 4-on-4 volleyball with a bunch of 30-somethings when I tore this thing last December! And (b) all my fave studies show that op vs. non-op (using “my” protocol) does NOT make a difference in strength (on average, statistically speaking). But my “plateau” is longer this time.

    Anyhoo, keep healing and strengthening, and keep us posted!

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