It’s been awhile….I work for myself and the 1st quarter is also crazy town….but I figured I’d check in.
So things have been going ok, I’ve managed to get a lot of the limp gone…I’m still a bit weak on pushoff.
So it’s 18 weeks since surgery 14 weeks since partial re-rupture at this point it’s mostly a wash I think. I’ve had to go to a new PT due to scheduling and travel conflicts. This PT is more aggressive. I have some concerns I’d like to share and see what you all think:
1. I’ve experienced very little discomfort throughout PT (wondering if maybe that’s a sign of going too slow) except when doing 1 legged leg press with half the foot on the machine.
2. At this PT they have me working on the agility ladder but I cannot land and go on the top of my ATR foot at all (it’s weak-ish)
3. I can’t do an unassisted 1 legged heel raise unless i am leaning onto something.
4. Balance is good, not great but good, on one leg.
I can do the elliptical for around an hour at a pretty strong pace, pre-injury pace, with no issue
My concerns are:
1. The agility ladder, I feel it might be too soon for that kind of impact but I don’t know if I’m just being overly-cautious. She said that she understands the caution but to get the strength back i’m going to have to push a bit. this scares me
2. Balancing on 1 leg on a small bosu ball. I am fine if my heel is on it mostly but she was having me hold for ten seconds with more of my front foot on it and it was pretty uncomfortable. I mean, it wasn’t painful like ouch but it was like a burning muscle sensation like when you get to the last set of a free weight exercise and it BURNS
At this stage how have you all gotten on with this kind of stuff? Do you think it’s a bit aggressive or am I fighting myself too much?
So far I’ve been pretty fortunate with respect to swelling, pain, and discomfort. I’ve had minimal throughout the process.
Gait has been cleaned up quite well, I’m back to using my stand up desk during the day with no problem, and I’m back to going to the gym and doing 30 or so mins on the eliptical at a pretty good clip.
Now, we are moving to what I think is going to be a tough hurdle. Calf strengthening, single leg calf raises, etc.
My only issue with walking at the moment is a slight limp on push off. So today we did the leg press with surgical foot (ball of) on the bottom with the heel off. 20 pounds to start. I am to straighten the leg and push down with the ball of my foot and roll back by dropping the heal.
20 pounds was too much so we went down to 10. Now I wouldn’t call this “pain” per se, like I didn’t feel like grabbing my tendon or stopping the motion nor did I feel any sharp pains.
I did feel the pull though and the muscle fatigue/achiness one feels when getting near the end of a tough weight set. I was told that was normal and to expect some of that during this time period. Being that it’s really the first time I’ve ever felt anything like that in the tendon area I was pretty nervous. So I’ll do a little more RICE today than normal and try to more mentally prepare myself for this new challenge. Being doing nighttime elevation as well, as I work my previous workout routine back into the mix.
Nothing else has changed, things are pretty much back to normal now re: working, working out, playing with the kids, driving, shopping, etc. So for that I’m grateful. Hopefully I’ll get this thing strengthened right up by the end of April in time for vacation, which will require a fair bit of walking. I can walk for awhile before any noticeable fatigue sets in but that push off needs work…
Also, went back on the bball court yesterday just to shoot some free throws…at the same end of the court where I had my ATR back in December.
Onward and upward.
Not too much to report on, really loving the Brooks sneakers though. If I’m out for long periods I still due the gauze and magic tape around the bottom of my scar as that is where the shoe rubs.
Have my 3/mo OS follow up today..nothing major, poked/prodded, went over PT. Expects me to be able to resume full athletic activities within 2-3 months which is excellent news but not to rush things (I doubt I’ll personally get back into anything high impact at all really…just walking and jogging is fine with me..swimming, etc)
PT down to 1x per week on Wednesdays, mostly for gauging progress and tolerance. All exercises are being done at home. I’ve grateful that my PT and OS are not money grabbers and give me honest advice (like, I personally don’t need to go to PT 2-3 x per week, didn’t necessarily need 2nd surgery after partial re-tear, etc).
Doing squats now, fast walking, seated heel raises, double toe raises, and some light work on leg press.
Ankle still swells from time to time, no pain really just occasionally some achy-ness if I’ve done too much the day before. Walking step over step upstairs now, but not down yet. One legged balancing, etc.
Have totally ditched boot (sleeping w/out it is so nice), scooter, and iWalk. Walking barefoot is going ok when needed.
Went back to the scene of the crime for the first time last week to do some light bike and elliptical work, walking by the court was a fairly powerful moment.
Overall just going day by day, certainly noticing marked improvements in gait and push off. Hoping to keep that going, the process day to day is slow but as with other milestones it feels longer than it really is.
Focus now is on cleaning up the gait and then moving into some more dynamic stuff with some light jogging maybe in a couple weeks.
I have vacations coming up in about 2 months and I’m hopeful, as long as I don’t do anything foolish or have an unfortunate accident I hope to be pretty close to 100% with respect to walking and normal activities (not anything dynamic mind you). Both my OS and PT feel that is a very achievable goal.
Hope you all are moving in the right direction. Onward and upward.
Not sure if earlier boot and WB helped, I was told it would, in lessening atrophy (which hopefully is one less battle to have to significantly fight)
As it stands today:
1. Surgical leg is my right
2. Surgical leg’s calf
3. Non-surgical leg calf
I got this cool stick tape stuff from my PT, goes on super smooth and thin almost feels like it’s just my skin. Very helpful with keep some small gauze there to prevent excessive rubbing by sneaker:
Tegaderm Film is the product
So was expecting this to take a bit longer but…(2nd PT appointment this week, I do Wed/Fri)
All in shoes now! (Brooks Addictions and Brooks Beasts, quite comfy). No heel lifts…and…ok to drive! After my 1pm call I’m so going to get a coffee!
Did some foot over foot drills over bars that resembled one of those ladders you would do side shuffles on.
Did some side to side steps over the ladder as well.
Did some stuff on the treadmill to get a less flat push off.
Did massaging, everything feels good..no defects, nice and solid.
No crutches in house, stairs one step - two feet for now, 1 crutch out in the world given the conditions (I’m in RI, TONS of snow and ice).
Hard to stay neutral, that emotional roller coaster is really high now but I’m trying to keep it level..who knows what lies ahead.
Onward and upward
I literally almost cried at PT after taking a few steps. What a feeling.
Anyways, quick dateline…9 weeks post surgery, right foot ATR, 5 weeks post partial re-tear
Scar, tendon all feeling and healing well per PT. Did some massaging, bike with no boot, walking, stretching.
Will gradually transition to 100% in shoes over next week. I have flat feet and over pronante so I learned the nike frees are bad for me
Picked up some Brooks (beast and adrenaline brands) on the advice of PT.
Went from 0 degree boot right into the Nike free’s (which are almost like going barefoot) and no heel wedges. Things went well.
PT feels no need for heel wedges at this point.
Will continue PT x2 per week and at home exercises:
- heel raises
- laying hip thrusts
- baby squats
- Free DF/PF
Goal is to be 100% in shoes and driving within the next week - 10 days.
Not sure if it’s been helping but here’s what I’ve been doing diet wise:
- lots of protein
- lots of water
- 1000mg vitamin C supplements per day
- Ligaplex I
- 2-3 servings of Jello per day (for the gelatin)
Routinely icing throughout the day, no pain just habit I guess.
Only slight discomfort today was ankle on the bike but nothing bad at all.
Now the key is to not overdo it and get cocky with the recovery process. I’m very happy, thrilled even, given the re-tear at week 4 and my current timeline. Trying to maintain an even keeled attitude, for the last 9 weeks I’ve tried really hard to not get too high or too low and not overthink things. I plan on keeping that mindset b/c I’m at a vunerable stage now in shoes. I plan to ween off the boot slowly over the course of this week and next while taking it super easy.
It’s nice watching things get tucked away..the iWalk, one crutch, etc.
Onward and upward
I’ve been thinking about getting fitted for some going forward. After some hesitation after looking at some un-stylish ones online I found this site which has some good looking ones
Anyone using or planning to use orthotics on a regular basis or just going back to regular sneakers? I have flat feet and over-pronate quite a bit.
Brief background…surgery 12/11 partial retear 4 weeks later, 4 weeks post-partial re-tear now, 8 weeks post surgery.
Completely on one crutch at 10 degrees, moved to 0 degrees. To be at 0 and one crutch until next week when I will hopefully be going into a shoe. PT impressed with DF, may not go with heel wedges but a gel insole instead.
Did towel curl, upward hip thrusts while lying down, some standing leg weight training. Did bike for 10 mins.
Said any defect very difficult to find at this point, perhaps very small spot on right side but very small (this is much better than 4 weeks ago). Thompson test negative.
Did some seated heel raises as well and theraband exercises.
At this point, given strength in tendon and repsonse to treatment we are treating it like i’m 8 weeks post op vs 4 weeks post re-tear. If there’s pain will pull back a bit but so far tolerating all the advanced stuff the last couple weeks.
Onward and upward as they say.
February 2, 2015 · 1 Comment
So the OS did a Thompson test, felt the achilles, and basically said that my hole was gone and it filled with “something”. It feels like muscle/tendon to my PT and I and I would think if it were just scar tissue or something then it would be more noticeable after rub downs, walking, etc. Oh well.
So he said he really didn’t know the next steps regarding how long to stay immobilized in the boot, longer vs shorter given the partial re-tear and our lack of knowledge of how significant it is.
Was basically told it can just be up to the PT and I now, if something hurts back off if it doesn’t keep going.
While I was expecting this to some degree as I was told I’d probably be in and out so long as the wound looks good and I’m not in pain (wondering if I should even go to the 12 week follow up..for what?)….I was a little dismayed that while we don’t know how bad the re-tear was there has been considerable progress w/out pain over the last month:
- 30 to 15 to 10 in my boot, removal of larger wedge at bottom of boot.
- 0 degrees on bike for ten minutes w/out issue.
- 0 degrees PWB at PT, went back to 10 just to be safe and to check with OS to get his approval
- Much more noticeable continuation of the tendon than from 4 weeks ago. Seems fully intact
- Negative Thompson test where 4 weeks ago was positive
I don’t know, maybe I’m being overly-sensitive about this but to just dump it off on the PT and make no real comments on the considerable improvements in just 1 month, while also getting my weeks post op wrong (he thought it was 6 vs 8), I feel like the OS has mostly checked out on me.
Maybe that’s actually a good sign, who knows, but it’s also now given me the confidence to just go ahead and try things and not worry too much so long as it fits into the protocol that the PT put out.
Have PT tomorrow so that’ll be an interesting conversation but all in all happy with the noted progress just would have been nice to see the OS as invested in my case as both I and the PT are. Maybe that’s asking too much.
8 weeks post rupture, 7 weeks post surgery, 4 weeks post-partial re-tear.
Started transitioning to 1 crutch today and that was a real tough mental block. Got over it, did a few steps ditched the crutched and had glorious, unassisted (save for the boot) steps. Was very pleased with this. PT cancelled yesterday due to huge snowstorm so I have a follow up Friday and 8 week post op with OS next week.
Going to stick with crutches and limited FWB tomorrow and this evening as well as iWalk for stairs until I give it some more time. I learned my lesson about being measured in my enthusiasm before so I’ll celebrate this recent development and move on to the next challenge with a deep appreciation of the length of the road ahead and the challenge of shoes/vulnerability of that phase.