25
Jul
13

Discouraged at Week 22

Even though its been a while since I’ve posted, I feel like I have not made much progress over the past six weeks. My surgery was on February 19th and everything has gone smoothly. I started PT at week 8 and have been doing it ever since and pretty good about doing daily heel lifts, exercise bike, and some other home exercises. I occasionally hit the pool and also do the treadmill 2-3 times a week.

I’m getting frustrated to almost be at the six month mark and still be limping. The main problem is trying to toe off to support most of my body weight which I still cannot do completely. Its a slight limp but its still there and only gradually improving. I have full ROM and its mainly an issue of strength. I really don’t think I have healed long.

I still cannot do a single heel lift. I cannot even get my heel off the ground! I have been making some progress trying to walk on my toes and very slowly feel the strength coming back. I can do more on the leg press machine now than I could a few weeks ago and continue to do two up one downs four to five times a day.

I didn’t start wearing two shoes comfortably until week 12 so I probably developed significant atrophy. I’m a healthy 33 year old weekend athlete and thought by now I would be running and jumping and back to normal but I am definitely not there yet. I understand that it takes six months TO A YEAR for full recovery and so I just need to keep exercising at home and be patient but when this first happened I was thinking, “OK, only six months and I will be back to normal!” but in my case that is not true.

Its been helpful and encouraging to read everyone’s blogs and progress on this site and it definitely keeps me motivated. I try not to compare myself to others so I don’t get frustrated. Its funny because I thought going the operative route would help me get back on my toes faster (pun intended) but I don’t think that is true.

Please chime in if you have any words of wisdom or advice!


14 Responses to “Discouraged at Week 22”


  1. 1 hattrick30 July 25, 2013 at 6:19 pm

    Best of luck to you, I’m 30 and consider myself fit and athletic.. I just went to 2 shoes at ~13 weeks a few days ago and it’s extremely weak right now. I’ll be rooting you on (partially for my sake knowing it’s possible to get through it!). I didn’t go to a boot for about ~4-5 weeks, I forget exactly due to my Achilles tearing from the calf muscle, so I assume my recovery will be extended due to more atrophy than most, sounds like you’re in a similar situation.

  2. 2 kellygirl July 25, 2013 at 8:25 pm

    Sorry that you are feeling discouraged. I can relate–especially to the weakness in rolling off the toe. I asked PT about this and she suggested the walking forward and back exercise (posted in my week 12 update.) She said to really concentrate on rolling forward/backward on the injured leg s-l-o-w-l-y and to really get on to the ball of the foot when doing so. It’s exaggerated compared to a normal walking step but I really feel it when I do it right. My limp (which sounds just like yours) is supposedly a combination of weakened calf and weakened muscles in the foot. The balance exercise (with the bands) will help too–at least that’s what she told me. I am at 12 weeks and a single calf raise is but a dream.

    KKirk says that this journey is full of plateaus. I’m sure you just hit one and will start the climbing again soon. Hang in there.

  3. 3 kkirk July 26, 2013 at 2:23 pm

    Sorry to hear that your discouraged, but if you read back at my blog, I felt the same way around the same time. I think many of us hit a plateau, where improvement becomes much more gradual. Just keep up with your therapy and exercises and in a few more weeks you will see even more improvement.

  4. 4 normofthenorth July 28, 2013 at 12:12 am

    I think several of my most frustrated blog posts came pretty soon before I made some progress. The one about “This Swelling and Elevating is Getting OLD!” was like that for sure. So it may be a good sign that your complaining about this “in public”!

    Keep working your calf, of course, but don’t try to rush it TOO much. At one point in my second-ATR rehab, when calf strength was frustratingly elusive, I started getting pains in my foot that my PT told me were because I was over-taxing the tiny foot muscle that pulls on (IIRC) the big-toe tendon. That’s the muscle-tendon pair that lets ATR victims point their toes, but without much force — nowhere near enough to stand on a step or do a heel raise. But without much calf strength (I think I DID heal long, at least the connection to the Gastroc), I was working it hard enough to make it complain.

    My general impression of the relationship between age and recovery speed is that there hardly is any. Or if youngsters really do get back to full speed faster than us oldsters, it’s still so much slower than they expect — while we’re often faster than we expect — that the effect is dwarfed by the expectations. When I did my first ATR, at around 57, I happened to bump into an undergraduate woman (girl?) who had surgery almost exactly the same time as mine. My rehab was held way back by an ultra-conservative surgeon — and maybe some extra because he thought I was old — but I still left her “in the dirt” at every major step of the journey. I have no idea why.

    Obviously, that’s a tiny sample, and even my impressions from hanging out here for the past ~2.5 years aren’t a scientific sample either, but that is my impression. I’ve never seen a statistical analysis of the relationship, tho’ UWO and some other big studies could probalby check their data for one. These days, there are probably more 40s, 50s, and 60-somethings doing ATRs than there used to be, so a bigger range of ages, so it might be easier to find out if age matters or not.

    Meanwhile, even if your future progress moves more by the month than the week, I suspect you’ll end up in good athletic shape on or before your ATR-iversary, like most of us. ‘Til then, just hang in, keep working it, and don’t lose the Mental Game!

  5. 5 normofthenorth July 28, 2013 at 12:14 am

    Aggghhh! Please turn on that 15-minute “AJAX Editing” option in your settings, so I don’t have to stare at my “it may be a good sign that your complaining”!! I’m WAY more literate when I can fix my errors!

  6. 6 bionic July 28, 2013 at 2:30 am

    Chances are as norm says you’ll hit walls and then break them down. However something of a long shot of which you might want to be aware…

    I have rolled my ankle a number of times pre-ATR. Each time the part that would get better last was my dorsiflexion (restricting heel lifts). The front of the ankle would get sort of stuck. Physio worked on breaking down scar tissue at the front of the ankle after my sprains.

    Having my foot fixed is causing me to be aware of a possible need to mobilize my ankle as much as getting my achilles going again. Ankle mobilization rehab might be something to keep in mind. I am far too early on to know if PTs consider exercises to mobilize the ankle joint post ATR. I wonder if for some people that might help.

    Despite all that, my guess is as norm suggests, that it’s most likely just a wall that you will just bust past one day.

  7. 7 debuff July 29, 2013 at 10:19 am

    HI, I’m at 13 weeks. My therapist stressed that the key to not limping is to put your full weight on your heel with your toes lifted. Then slowly push the middle then toe down lifting the heel as the toes hit the ground. It made me slow down but keeps my spine aligned.

  8. 8 superjewgrl July 29, 2013 at 6:35 pm

    Hiya…..
    I’m really glad you posted this. Some people are posting such rapid results that I was getting performance anxiety.

    I read somewhere (on this site) that to eliminate a limp, walk slower and take slower strides.

    Keep up updated on your progress. You’ll make it.

  9. 9 kellygirl August 1, 2013 at 1:19 am

    Thanks for the nice comment, Eyechilles :) It’s great that we have this site (and each other) to keep us all moving forward. Hope that you are doing well!

  10. 10 eyechilles August 1, 2013 at 12:22 pm

    Wow, I am so thankful for all of these quick responses and the ATR community. This blog truly is a wonderful resource and can be so motivating even six months after injury. The progress does slow down significantly a few weeks after getting into two shoes because you don’t have as many milestones to achieve such as weaning off crutches, going into two shoes, getting out of heel lifts, etc. As the others have pointed out, I have obviously hit a “plateau” in my recovery. My limp continues to improve slowly and I can gradually feel the strength creeping back. I had high expectactions and some of them may have been unrealistic because I was biased from reading the blogs of people on this site that where doing things earlier than me even though I was fortunate to not have any complications, bought the vacocast, did PT and exercises religiously, etc.

    Kevin, thank you for reminding me about your blog. I had read all of it when I first got back from my surgery and was in bed for two days straight after surgery but it was refreshing to read it again and see your long but successful road to recovery.

    Kelly, thank you again for all the details and pictures you always provide in your blogs.

    Norm, you should get a nobel prize for continuing to share your insight and wisdom on this site. Your technique for tackling stairs by rolling the bad foot off the edge of the step has been a lifesaver for me!

    And to all the others, thanks again for the words of encouragement. I will update my blog soon with more details.

  11. 11 hillie August 1, 2013 at 2:21 pm

    Hi

    By now you’ve certainly discovered how different we all are.

    I am now well past the one year mark but well remember how difficult it was for my body to ‘remember’ how to lift that heel. At about week 16 I was seeing a decent physio but was keen to up the pace. I went to a sports physio and one of the first milestones that we achieved was the heel lift. He had me do what he called eccentric lifts, where I went up on both sides, then down first of all on only the injured side. It was hard for about 10 days then almost overnight I could do it easily albeit not as many reps as the physio was calling for. Remember though - I did this under supervision the first time - then 3 times a day at home (when I remembered).

    After that I was put through an increasing tough regime - my guy normally trains leading rugby players and I think that he forgot sometimes that I was more into mountain and hill walking. I wanted sustainable strength not quick burst capability so much. To be fair, he had initially asked me what I wanted to achieve - I foolishly (?) stated that I wanted to be stronger in my legs than I was pre-atr. Heavyish packs, long treks, etc… Well, we achieved what I wanted, with much (most) of the improvement by the 6 month mark. In under 12 months I could readily and consistently keep up speed steep slopes in poor conditions.

    You’ll get there, sooner than you may think.

    H

  12. 12 Jake August 5, 2013 at 12:56 am

    Hi there eyechilles,
    In one of your blogs you mentioned that you went on a trip overseas. I’m 5 weeks post OP and got my cast off today and went into the big black bulky boot. I ordered the Vacocast and will swap out once I get it. I will be going to Europe with wife and another couple week 8 post OP. How was your experience? Was it enjoyable? Were you able to get around or were you uncomfortable? This is a very tough decision for me to make since our trip is 15 days away and everyone is looking for me to make a decision.
    Any insight you give me will be helpful.
    Thank you so much in advance and good luck to you
    Jake

  13. 13 eyechilles August 5, 2013 at 12:50 pm

    Jake,

    I went to Ireland and Italy around Post Op week 6 and although it was challenging, it was an enjoyable trip and certainly worth it. We had to attend a family wedding and even though I wasn’t looking forward to making the trek on crutches, I am really glad I went on the trip. Looking back, I am really glad that I didn’t let my ATR stop me from having fun.

    I definitely think you should go on the trip to Europe otherwise you will regret it in a few months when you are back to normal and missed out on this opportunity. That is the advice someone else gave me and I am glad I took it.

    A few things you can do to make the trip easier:
    -Get and aisle seat and something with extra legroom if possible (I called Delta and they did this for me)
    -Ask for a wheelchair around the airports (huge help…esp in Europe)
    -Compression socks to keep the swelling down during the long flight
    -Aspirin for DVT prophylaxis (my doctor had me do this)
    -Some of our hotels provided bath chairs which made showering a little easier

    Hope this helps and hope you have fun on your trip.

  14. 14 superjewgrl August 5, 2013 at 6:23 pm

    Hi Eyechilles -

    When you went to Europe were you in a boot or cast?

    I go to Europe about once a year and I end up walking 5-8 miles a day. I can’t imagine that in a cast, but I can in a boot. (Mind you I spent only spent 1 day therapeutically in a boot before I re-ruptured)

    This is so funny because my friend asked me today to meet up in Montreal and Toronto at the end of August and I had to say, um, I will be on crutches in a cast. That ended that conversation.

    I do agree with everything you said about not letting the ATR injury interfere with your fun. I think if it was a beach vacation my response may have been different. :)

    Glad you had a great trip.

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ATR Timeline

  • Name: eyechilles
    Location: New Orleans
    Injured during: Football
    Which Leg: R
    Status: 2-Shoes

    343 wks  2 days Post-ATR
    343 wks
       Since start of treatment

  • eyechilles has completed the grueling 26.2 ATR miles to full recovery!
    Goal: 365 days from the surgery date.
    Achilles NYC Marathon Course Sidebar Image

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