PT Graduation

I’m 32 weeks out from surgery and as of today I am a physical therapy graduate! The last couple months have been all about heel raises. Progress was very slow as I was doing 2-3 sets of assisted heel raises per day. I could barely do 1 unassisted heel raise when I found the perfect way to add more to my busy day. Any time I was waiting for the kids to get dressed, brush their teeth, etc. I would do assisted heel raises while waiting. Two weeks later, I was able to do 10 unassisted heel raises for my PT. We gave it one more week, then today I did a few minutes jogging on the treadmill without a problem and said farewell to my PT. I still have alot of muscle loss to build back and will continue to do heel raises until I feel truly normal, but I’m glad to be past this milestone.

Sand Dunes as Dorsiflexion Therapy

I’m about 2/3 of the way through physical therapy. The objectives have been to improve (in this order) dorsiflexion (upward movement of the foot), balance, and strength. At the start of PT, I could move my foot only 3 degrees above horizontal. I was improving by a degree or two per week and had gotten up to 11 degrees a week ago. I’ve been controlling swelling with a compression sock and doing stretching exercises. Over the New Years weekend I went on a couple hikes which included climbing over sand dunes. It was no problem at the time, but I was pretty sore the morning after the second one. I could hardly walk when I got out of bed but stretched it out before going to my PT appointment. When the therapist measured my dorsiflexion it was up to 16 degrees! The goal of PT was to get it to 15 degrees - when compared against my good foot it’s almost the same now. Of course, I can’t say for sure it was the sand dunes but it’s hard to argue with success.

Back in the Saddle Again

I saw my doctor a week ago, and he gave me clearance to ride my bike again. Biking is a fundamental part of my lifestyle: I use it for transportation any time I can, it’s my primary form of exercise, and a vital source of sanity. I started out nice and easy on a flat bike trail with slow acceleration and letting my good leg provide more than its share of the power. It went great! I did 13 miles that first day and have followed up with more short rides since then. I am thinking about my bad leg less now, and going a little faster, but I’m still staying away from hills for now.

My PT is going well too. Initially I could only raise my foot 3 degrees above horizontal and had a lot of swelling. I found a compression sock to help control the swelling and my foot can now move 8 degrees above horizontal. So far my exercises have mostly been for strength and balance while the PT manipulates my ankle to improve range of motion. I’ve noticed a big improvement in strength and balance and I’ll be starting some stretching exercises soon to work more on range of movement. Things are starting to feel a little bit normal, which is a great feeling given where I’ve been.

3 Degrees of Motion

I’m 3 months out from my injury and surgery, and have fully transitioned out of the boot into two shoes. That actually went pretty well. I got some running shoes (even though I don’t run) and wear them all day (even though my feet yearn to be free) to provide support to my bad leg. At the end of each day I’m a little sore and I swell up like a balloon, but I feel stable and can get around with no problems.

Today, I started physical therapy. It was just assessment of my current condition so the therapist can devise the right way to torture me next time. I could only flex my foot 3 degrees upward and 28 degrees downward, with targets of 15 and 50 respectively, so I have alot of work ahead. The good news is that I can balance on my bad foot for a full 30 seconds and my walking is relatively good. My homework is to extend my walking stride, use a giant rubber band as resistance to work my foot in each direction, and to balance with my bad foot on a foam pillow and move my good leg around like the positions on a clock. I’m pretty excited about the homework - it’s almost fun to do and I’m motivated to improve my range of motion and strength. I’ll probably do it more than the suggested 2 times a day as long as I don’t get too sore. I’ll have 18 P.T. sessions over the next 2-3 months - I’ll see how much I can improve in that time before I’m off on my own.

Lose Inches Without Diet or Exercise Using the ATR Method!

Of course, those inches don’t come off the waist but rather the calf of the injured leg. I am nearing the end of almost 3 months in a boot, so I measured around each calf at the widest point to see the difference: one and a half inches of muscle gone. That is going to take alot of work to bring back. When people asked about my injury, I said it would be about 3 months in the boot and then I would learn to walk again. Apparently I wasn’t kidding! I’ve stood without the boot on and my ankle is so weak there is just no meaningful control helping to keep me vertical. It’s a good problem to have considering where I’ve been, though, and that’s what PT and exercise are for.

Taking the Slow Road

I’m 9 weeks out from surgery and I saw my doctor today. Everything is going great, but we’re taking the transition from the boot slowly. My rupture was at the top of the Achilles tendon, where it transitions to muscle. Because of where it is, the transition to two shoes needs to be slower than what is typically done. I took the first wedge out of my boot 4 weeks ago and I just took out the second of three wedges. By the time I see my doctor again in 6 weeks, he expects me to be in two shoes but how I get there is up to me and my comfort level, as long as I don’t stretch the Achilles too much, too fast. Although a part of me wants to defenestrate my boot right now, I guess I’ll try to go two weeks, then take out the last wedge, maybe spend a couple weeks wearing no boot in the house and boot outside, and then a couple weeks exclusively in shoes before my next appointment. As much as I’m getting tired of the cumbersome smelly beast shackling my leg, I really don’t want to screw things up so I’ll try to take it easy.

De-wedging: A Reality Check

I was rocking the silly walk with 1 3-inch heel a month after surgery - I looked funny but I could walk almost normal speed without crutches and felt stable doing so. Today, I had a follow-up appointment with the doctor and everything is healing very well. He took a wedge out of my boot as I anticipated and said I’d see him again in a few weeks. I can’t walk with abandon as before, as it gets sore if I walk too much. I’m sure I’ll adapt soon, but it reminded me of the length of the journey and that it wouldn’t always be easy. The doctor said I might start PT in 4 weeks or so - I didn’t think to ask if that meant I’d be two-shoed or not, but I’ll take whatever comes.

The Hobble Phase

I am full weight bearing now, with surprisingly no discomfort when I put all my weight on my booted leg. You all might have noticed that getting around is a little awkward in a boot with a 3 inch heel and an immobilized ankle. I manage a silly walk without crutches which works but is more of a forward shuffle. What I’m wondering is if you all think it is worth it to “walk” and try to improve or if you just kept using a knee scooter or crutches even for short distances. Has anyone had any secondary injuries resulting from silly walking or crutches? I want to keep making progress on my mobility, but I wonder if at this point I just need to wait 3 more weeks until they start taking wedges out of my boot.

The Couch Phase

I’m new to the Achilles recovery thing, having had surgery 4 days ago.  You all are more familiar than I with the various stages of recovery, and I am perusing the site to learn more.  Being on the couch with my leg elevated all day every day for two weeks is pretty boring, even if I am able to work on my laptop.  I am hopeful that my healing is going well under my cast so that I will be able to move on to PWB.  I have a few mundane questions for those of you who have been through this: 1) When I get to PWB, is that when I can start more or less standing on two feet to brush my teeth and shave etc., because standing on one foot is getting REALLY tiresome. 2) I don’t have any pain when I’m lying on the couch with my foot elevated, but it’s pretty uncomfortable when I stand up and it feels like my leg fills with fluid.  How long does that feeling last?  I’m sure I will have more questions later - thanks for your help.