Softball again!

I’ve been running for several months now — though I took the last three weeks very, very easy (no running) after tweaking my other Achilles.

It didn’t seem like a big deal, and I wasn’t concerned about a rupture — but I’ve never had tendinosis and didn’t want to start, so I took it easy.

That said, it’s better, and so tonight I joined my softball team for the first time. I’d planned to play with a group of neighbors a year ago, but the Achilles rupture/surgery changed all of that.

I planned to play this year, but hadn’t been able to get my scheduled worked out, what with travel and work.

Tonight, I played. Started out hitting as the extra player, and running carefully to first base, but ended up in the outfield after a teammate injured his knee (ouch, and I hope it isn’t serious — but we fear it is).

Long story short: I was careful, but only because of the other Achilles. Everything went fine. I was able to run and change direction, and it was only between plays that I was concerned. Once the action started, I just moved instinctively, like I wanted to. Didn’t try to explode, just to begin running and then increase my speed (speed being a relative term).

And what a strange feeling to consider the surgically repaired Achilles to be the stronger one.

I don’t know that it is — I think I was just favoring the other one when I didn’t need to — but it’s cool that I’m so confident in it.

Another milestone.

Almost a year out … going well

As many others have said, it really is amazing how quickly time has passed. (Try to tell me that during those first few weeks and even months post-op, and I’d have sputtered in frustration — time did not pass quickly then).

The one-year anniversary of the rupture is coming up, and I’m almost back to normal. I sometimes forget about it, which is a pretty good indication things are going well.

I’m running, and although I had a bout of minor knee irritation, that’s pretty much gone away. I’d never had any knee issues at all, but back in December when I first started running again, 20 minutes on a soft (bouncy) treadmill with a bad (not yet normal) gait apparently irritated a bursa pad (also known as a fat pad). For weeks and weeks, the thing was an issue, which was frustrating. But the pain has gradually gone away, and has not been an issue while running or walking in months (sometimes when the knee is put in one position or another, the bursa pad reacts, but the key there? Change position).

I’ve not had any issues with the achilles. It’s fine. (I ice the achilles — and now, the knee — religiously after running, which has really helped).

I’m attempting to rebuild the calf muscles. The left calf is strong enough now, but it remains significantly smaller than the right (uninjured leg) calf. It’s a cosmetic thing but I’m working on it with calf raises.

Here’s something I recently wrote about returning to running. (It’s my day job).

Those of you who are on the road to recovery, keep it up. Time really does pass, and you do get better. You know that marathon gadget many of us are using to track our recovery? It seemed like I would never, ever get through New York City. But as I rebuild my mileage base, I’m trying to figure out when and where to run my next marathon.

Take heart: You’ll get there, and soon.

Everyone else: Thanks. Achillesblog was a fantastic resource and also a huge source of encouragement. … Celebrating others’ successes (and being inspired by them), commiserating with the occasional setback (and knowing the successes are coming).

I keep checking back in and reading, and I’ll keep doing so.

“Return to Running” program

27 weeks, 5 days, 2 hours post-op, I have been cleared to begin the “return to running” program.

I’m walking w/o a limp, though it sometimes takes a step to convince myself of the Achilles’ integrity and the calf’s strength. Things have been getting better and better, and on good days it seems I could break into a run.

Now, I get to try. Sort of. I’ll start at week 3 of an 8-week program.

“Alternate walking one minute and jogging two minutes times 7 repetitions. The next day run five minutes and walk one minute times 4 repetitions.”

It accelerates gradually each week.

I’ll try it this afternoon.

UPDATE: OK, tried it, did it. … Felt weird but good. No real pain.

More important, the morning after: It feels sore — the foot/ankle, NOT the Achilles. I’ll go again today, and tomorrow, and … carefully follow the program.

What a great feeling, finally.

You’ll find this dumb, but maybe you’ll understand: I love to run, but I had put away my thoughts of running a May marathon in 2010. … So last night, after that “running” experience, those thoughts began sliding into my brain again.

I know that’s unrealistic — I find it hard to believe I could build up a mileage base — and I’m going to be very careful and follow the doctor’s program, but it was great to actually have those thoughts.

Maybe the half-marathon. … Hmmm.

Question re: discomfort/pain while walking

Almost 15 weeks post-op, and three weeks in two shoes. Walking has been getting better, though slowly — it seems every couple of days, I realize I’m walking much better than I was.

Anyway, things seemed great — a couple of days ago I was walking with a push-off, and without a limp — but I fear I’ve overdone it.

There was much discomfort today. I don’t know how to describe it other than it felt vaguely painful … kind of like a mild sprain might feel. Felt as though I were stretching the thing beyond what it wanted on every stride — even when I shortened the stride significantly.

I don’t know what I expected during the rebuilding-the-walk process. Pain-free? Painful? I don’t know. So I don’t know whether I should be concerned, and back off — and what that backing off would actually consist of — or whether I should grit my teeth and go on. (Note: I’m icing as we speak).

I’d be interested in advice from you guys further along the recovery timeline. Does this experience sound like something you went through? If so … does it get better without rest?

Thoughts?

Almost 12 weeks, 2 shoes, slow going

Wow, long time since I posted. Not sure anyone was waiting anxiously, but …

OK, I’ll try to keep it short.

Went to two shoes “in the house” — meaning, only when I’m at home — about three weeks ago. It was freeing, and the crutches are now long gone.

On Monday, I got clearance for two shoes everywhere, though the doc suggested I try it for a few hours a day when not at home, then gradually increase the “walking.” Considering I’d been on vacation the previous week, and thus had spend a lot of time at home — and in those two shoes — I wasn’t too keen on that idea.

So for the last two days I’ve been hobbling/limping around all day in running shoes. It feels freeing. The only real problem I’ve got going now is not pushing too fast, too hard, too soon.

I’ve been doing PT stuff on my own in the pool for a month now, and I now walk normally in the pool, complete with calf raises incorporated into each stride. This makes the limping on dry land tough to take, but I know it’s a process. I also know the tendon is gradually stretching out, bit by bit, and the calf muscles and other muscles are getting stronger, little by little, and the gait is getting better at the same pace.

I’ve got a significant lump of scar tissue near the top of the tendon that’s going to have to be dealt with. It’s painful as I get to full plantar flexion (only when weightbearing, and only on dry land — OK in the pool). The physical therapist’s ultrasound treatment helped, as have her massages, but I cannot wait for this to break up.

Overdid it some today, but I don’t think there’s going to be much of a setback (we’ll see tomorrow). The swelling is not bad at all. And ice is my good friend.

Otherwise, things are going well. I don’t see the doc until late September, and at that point he thinks he’ll clear me to use the elliptical trainer. It’s hard to see being ready to do that, but then, where was I a month ago?

Still have the goal to return to running on or before Dec. 1.

Question about soreness

OK, question for anyone out there — anyone meaning someone further along the marathon course than I am:

I’m 6 weeks, 4 days post-op. I’m PWB (75 percent) progressing to FWB as able, doctor’s orders from last week (see most recent blog entry).

I’ve begun careful “walking” — hobbling — around the house w/o crutches (still in the boot, of course).

Also, “walking” — not quite as much hobbling — on one crutch when at work.

It has been going pretty well. I can see the tendon is ready for FWB, if not for stretching and real walking (even in the boot, it’s a very, very limited, tentative thing right now).

But the foot is now swelling regularly (it wasn’t swelling much at all in the last few weeks before this increased activity. Also AT is very sore, when it wasn’t before.

That’s OK, I figure.

But also, there’s a dull (not sharp) pain that occasionally occurs near the back of the heel.

I’m pretty sure it’s the Achilles. It occurs only when the foot makes initial contact with the ground. Not with any push-off (not that there’s much push-off going on).

Not all the time. But sometimes. And when it does … it has the feel of a dull sprain, or something. As though I’ve strained the thing.

Since I’m doing all of this in the boot (and believe me, we’re not talking about much activity yet), it’s unlikely the tendon has been stretched beyond its current capacity.

When I flex the foot up, down or sideways against no resistance, there’s no pain at all — even at the far outer limits of those flexes. (Which in dorsiflexion is right at 0, maybe a little better but not much).

Thoughts on the occasional dull, sprainlike pain? Again, it’s occasional, meaning … every 10th (?) time the foot makes contact. Also, it’s Day 2 or 3 of all this activity.

But the pain is real, and it’s a little (not a lot) concerning.

Anyone experienced anything like this? Thoughts? Thanks in advance …

George

3rd post-op appt.: Boot to 10, time for FWB

Had my third post-op visit Tuesday morning. The doctor was pleased

They moved the boot from 30 degrees to 10, and even though I’ve been flexing the foot to what seems to be 90 degrees (zero or neutral, whatever), putting the foot into the boot at 10 was … quite a stretch.

For two days now, it has felt a little uncomfortable (although it’s much easier to get into the boot now than it was that first time).

Funny thing: The doc also noted during the exam how little swelling there was, and how the repaired tendon hasn’t gotten nearly as big as some others do (which I’m glad of, as long as he says the tendon is healing correctly, and he does).

What’s funny about it is … with the new angle, and with partial weightbearing (75 percent, or 100 percent if I can do it) … the foot has begun swelling again.

Oh, well.

The increased weight-bearing is freeing, but I’m being careful. Still scared. I’ve read all the other accounts and seen that so many of you have started weight-bearing much earlier, so probably I’d be fine. But … I’m tentative.

One side note: In the last week, I’ve begun swimming, 40 laps per workout in a 25-meter pool — all crawl, no kick. I know it has helped me regain some level of fitness. More than that, it has done wonders for my mental state.

Things are going well. I can almost taste the day the crutches drop away. Still can’t quite envision life without the boot, but I know I’ll get there fairly soon.

Also, although I haven’t blogged much, I check the main blog several times daily and read the updates. This community has been a huge help throughout this process.

Update: 2nd post-op, into the boot

Had my second post-op visit on Wednesday (July 1). It was a great feeling to get the cast (no. 2) off. The incision has healed nicely. The calf has withered away to almost nothing, of course …

The doctor put me in the boot at 30 degrees plantar flexion. On July 14, at next post-op visit, we’ll change the angle; I don’t know if he’ll go all the way to 90 degrees then, but …

By then, I’ll be able to get there and beyond, I’m determined. Non-weight-bearing still — though he said I could put up to 10 percent of my body weight for balance as I crutch around.

Makes things slower, but I’m doing it with the goal of strengthening the tendon/calf.

Also, no physical therapy just yet. Not until late July, which would be almost eight weeks post-op.

However, I’ll be doing some of my own. The doc wants me to gently flex the foot up and down as far as possible a couple of times a day (using the muscles, not any external force). I’m doing so religiously already, with the goal (mentioned above) of being at 90 degrees or better when I see him again.

The boot is heavier than the cast, but it was fantastic to be able to take the thing off and just let the leg hang out. And also, to move it around. Feels like I can finally begin making some progress.

I can now swim, though no kicking yet. So finally, after more than a month of having my fitness ooze away, I can begin to recover that, too.

This doctor is clearly on the conservative end of the spectrum. But as I’ve said before, he’s really good, no question. I’ll follow his instructions. And push the envelope at the same time. If that makes sense.

The goal remains Dec. 1, running at my former pace for 1 mile. (And then, I’ll hope to accelerate the mileage, if not the pace, in relatively short order). That’s a long way off — but I’m a long, long way off from having that ability.

Wednesday was a good day. And another reminder of just how long this road is going to be.

Next milestone: Tuesday, July 14 and a new angle in the boot. How well will I be doing then with flexibility? Better than the doctor expects, I hope.

12 days post-op, cast off! … Oh, new cast on

Well, that was an adventure in mixed emotions.

Had my first post-op visit today with the surgeon. His assistant removed the cast, which felt fantastic. The cast was big and heavy — and had gotten bigger (actually, my calf muscle had significant atrophy — and I was more than ready to stop lugging it around.

Also, I was ready for (hoping for) a boot. Not that I expected PWB — I knew it would still be NWB — but I wanted a boot for so many reasons.

Instead …

Well, good news first. No infection. The incision looked good. It’s maybe three inches long, running vertically from just above the inside of the heel. Doesn’t look like I’ll have much of a scar - just enough of one, though.

They removed the sutures, and everything’s good.

Except, of course, for the new cast. I asked the doctor about a boot and he explained the different philosophies but said he’d rather err on the conservative side. So here I am, two more weeks.

I can’t explain how good it felt to have the leg and foot hanging free. I won’t explain how bad it felt to have the leg and foot casted again.

(Note: I trust the doc; he’s a fantastic physician and a very good man, to boot. But it was disappointing).

They’ll take the cast off again on July 1, examine the wound again. Barring complications at that time, I’ll go into a boot.

I know it’s only two weeks, but man, that was difficult. The foot was free for a moment. And then it wasn’t.

OK, an encouraging thought.The new cast is much smaller, and it seems lighter. It’s also brighter, as in bright red. The kids chose the color …

I’ll just remain patient. Somehow.

Getting started on the long haul

I’ve skimmed enough of others’ blogs to know I face a long road to recovery. Might as well blog occasionally about it.

I’ll probably stick to the milestones and any setbacks … but we’ll see.

First, the vitals:

I’m 40, active and fit. Ran my seventh marathon in early May, took the necessary time off to recover and resumed running, though I hadn’t gotten all the way back to¬† my normal intensity.

On Sunday, May 31, 2009, I was playing basketball in the street with some neighbors when I changed directions, pushed off hard with my left foot and — POP! — the Achilles tendon was torn.

It didn’t hurt, but I definitely heard the thing go. And I knew what had happened; any doubt was removed a moment later when I examined the leg and noted the soft, squishy nothingness where a tight tendon had been.

Six days later, on Friday, June 5, 2009, I underwent surgery. The surgeon had hoped to do a minimally invasive repair using the Achillon system, but upon examination in the moments before the procedure determined he’d need to do the traditional open repair.

I woke up later to find my foot numb and immobilized in a cast.

Spent the next week lying on the couch, resting and elevating, with very little activity at all.

Went stir crazy.

I’m eight days out from surgery now, feeling better and trying to stay patient. I know, I know — be patient! I will, but it’s not easy.

My first post-op appointment is Wednesday, June 17. I assume they’ll remove the cast to check the wound. I don’t know if I’ll be recasted or half-casted or splinted or given a boot.

I’m hoping for aggressive rehab protocol, but I trust the surgeon. He is the team orthopedist for a major NCAA Division I athletic department and has performed procedures on elite-level Olympic athletes.

Anyway, I’m lying on the couch, typing away — and wishing I could go for a run. Knowing I won’t, not for a long while.