gunner’s AchillesBlog

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To iver15: I also went non-surgical for a full ATR done playing football on september 1/11. I saw my ortho today for the 12 week check up and I am pleased to report that everything has healed well and i have regained strength enough to date that I can do most of my bootcamp stuff including jogging, boxing, kicking a soccer ball , running upstairs etc. I have good ROM and have not healed long or too short. I still have a limp and the achilles is tight until warmed up. I have been out of the walking boot for 2 weeks.
I think golf by January is doable for you but the swing may be off since it may pull thru the Achilles. I am not a golfer myself but the strength and things I can do have really improved in the last couple weeks. I was worried about the non-surgical route but that is all they are doing now at RCH hospital in Vancouver BC and the outcome i have had has been very positive. I will say that i have been religious in following my physio’s recommendations and in getting active. Have a good trip!

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Hi Gunner. I noticed its been a additional 5 months since you’ve posted last. Has there been any improvment in the strength of the Calf since then? My Orthopedic will have me in a cast for a total of 4 weeks then I will be moving into a Vaco-cast from then on out. I’m an extremly athletic individual and hope that I’ve made the correct decision moving forward by going non-surgical for my repair. I originally injured my Achilles on Oct 20th, 2011 and have a golf trip scheduld for the end of January, 2012… Do you think I have a shot to play?

I also went the non-surgical route as I have a strong belief that our bodies are meant to heal themselves over time.

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Clice here UGG Tall Boots!Thanks a lot for the great writeup. By the way, how could we communicate?

if you are cleared for exercise by your trainer consider buying a pair of the five finger barefoot walkers made by Vibram. They do a great job strengthening the muscles in you feet and calves, not to mention the other benefits of barefoot walking. I had the surgical repair and was back playing soccer at 4 months and 3 weeks. The 10 days with the barefoot shoes gave me more confidence than anything else i had done. I am still unable to fully sprint, but I think it is mental. My body is holding me back a bit, but I will eventually work through it. I do get some calf cramping similar to what you are describing but do not feel it is anything more than an out of shape calf muscle. The achilles tendon turns to muscle fairly quickly. At this transition my leg continues to be tight. I am constantly comparing my repaired leg with my other one to try and determine where i am at in the healing process. Your body will remain tight until well after the repair is complete as a method of protecting you.

Opting to forego the surgery has certainly caused you to have more atrophy than i have experienced. I am at 5 months and 1 week an

I’m 21 months out - had surgery. I’ll admit that I haven’t done intensive strengthening, but I’m back to playing ultimate frisbee and cycling full-out. My calf size is still noticeably smaller and I find that when I am running and try to jump for the frisbee off my ATR leg I don’t get very high.

Things seem to be working fine, just tight and cramps up when swimming distances. I also am having some knee problems, same leg, had arthro surgery 4 years ago, so not doing a lot of serious walking. But thru airports and occassional 2 mile walks, the AT feels normal.

I wish I had something to tell you . . . . Can you tell if the muscles are all connected up right . . . flexing and all?

Did you notice the calf going through further atrophy after you began walking? Has it increased, stayed the same or decreased in size?

I worry a bit about this myself since I am just starting to realize the atrophy in my Gastroc N. at 15 weeks.

משרד עורכי דין ואינדקס משפטי, חיפוש עורכי דין לפי שם משפחה

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Welcome back, Sully, and glad you’re doing well. Wii Fit could be an answer to this tough winter, though more post-heart-surgery for me than post-ATR.

I haven’t noticed Gunner around here since the site returned from a month-long outage. I didn’t check, but Gerry and I may have been among the last posters before it went down. (Anybody remember Bart Simpson’s “I didn’t do it!”?)

Hi Gunner

Glad you got back on the tennis court. And took it easy.

I went back to tennis at about 5 months, and found myself really weak pushing off on backhand shots. Right-handed, ruptured left Achilles. Compensated by buying a racquet better suited for backhand.

At 12.5 months, finally getting some good push off that foot - I walk the beach 2 miles a day, try to push on the ball of my feet as much as possible.

Also working out on a Wii Fit. I find my balance and strength improving greatly from using it. Got my Wii Fit Age down to 39. I’ll be 67 in August.

I’ll echo what you said about not getting any respect. Last year at the ski area someone I knew asked where I had been and I told him about the ATR. He actually thought is was funny and not a big deal. I quickly and bluntly disabused him of the notion that an ATR is something to joke about. Haven’t seen him at the ski area yet this year. Maybe he ruptured his Achilles tendon - that would be karma.

Thanks, Gunner. One of the main “take-home messages” I got from this open-heart surgery thing is that “ATR patients don’t get no respect,” to paraphrase the late Rodney Dangerfield.

In many ways, my lifestyle, my wife, and I all suffered MORE “pain” and dislocation from my recent ATR — even with a painless and fast non-surgical rehab — than from my open-heart surgery! Heck, I couldn’t carry a cup of coffee across the kitchen without a wheeled chair for a MONTH post-ATR! Post-OHS, I was almost completely self-sufficient as soon as I got home, 6 days post-op! Couldn’t lift heavy things, not easy reaching way high, and moving slowly, but pretty close to fully functional.

But post-ATR, everybody sees a stupid sports injury to an ankle, and wonders why I need so much help. Post-OHS, everybody’s amazed to see me alive, sounding and looking so much like myself after my heart’s been stopped for 4+ hours and my lungs collapsed, etc., etc.

I’m not saying this hasn’t been incredibly major and serious and scary surgery. But it gathers sympathy and “respect” out of all proportion to the actual disruption to my daily lifestyle. ATR rec

teresa1: thanks for your reply. I started in the pool at 9 weeks post ATR (non surgical route). After about two weeks in the pool walking and stretching, I began swimming a few laps, started with 5 laps, I believe (in a 25 yard pool, so 250 yards). Increasing every day, I was up to a mile in no time. At our pool there are a number of triathletes training with a coach who once coached the S. African Olympic swim team. I picked up some tips from him then got a plan from swimplan.com. Worked that for a month or so, then moved up to 2000 yards, then 2100, then 2500 and now 2700 or a little better than 1.5 miles. I use kickboards at points and swim all four strokes at times, but about80% of the workout is freestyle.

Hope that helps.

Hi Norm: I hope you are well on the mend and fully satisfied with your progress. Have you left a blog or note with the key lessons you learned from the open heart experience?

It is amazing how conditioning is specific to an activity or sport. Cardiovascular fitness is one thing, the muscular and flexibility requirements specific to each sport are quite another.

All best wishes to you and your family for a great 011.

Great, gunner, and I agree completely, even though I haven’t been in a pool myself for a LONG time. (Maybe as part of the cardiac rehab — though I know they definitely DON’T recommend it for the first few weeks. Something about drowning, I think!)

About switching from one form of exercise (and fitness) to another: When I was a grad student at Princeton, and probably in about the best shape I was ever in, I used to play squash at lunch time. I was a pretty solid squash player, having “played with” my undergrad team in university. After a while, I found myself wondering if swimming a few laps in the pool might be even better exercise.

So one lunch time, instead of playing squash, I went to the pool and swam a few laps. Afterwards, I thought I was going to DIE. But I stuck with it for a while, and got so I could swim laps for 45 minutes or so and feel pretty good afterwards (except for the chlorine). Eventually I got bored, and tired of the chlorine, so I decided to go back to squash. So I did — and I thought I was going to DIE.

It took just about as long to become comfortably fit at squash again, as it had to become comfort

Your post is very inspiring. I’m interested to know how long you took to get up to that distance? How did you go about building up to that goal. I used to swim a mile about three times a week, and at week 16 post surgery am just about able to do about three quarters of that distance. I was in the pool the day after my cast came off and it felt so good. Do post your progress on your open water swimming. Best wishes.

Appalachian Trail = AT = Achilles Tendon!! Love it!

Hiking up slopes (and dragging a sailboat up the beach on a dolly) was a challenge for me at around 6 months (when sailing season began), but nothing I couldn’t handle. How un-wimpy are YOUR heel raises?

Quite a handle there. Yes, swimming is great for rehab and beyond. You can do things in the water a lot sooner than on land - walking, stretching, etc. While I was there, i decided to start swimming as well to get some cardio and got hooked. Fabulous exercise.

For those who have trouble swimming, there are plenty of coaches around who will help for a modest fee. Lots of triathletes are taking lessons, if our small town rec. pool is any indication. best to you.

Great story, One I need to be reading. I’m 5 weeks post op and feel good.
When cast comes off in 3 weeks I’ll be into rehab.
Swiming sounds like a good habit during rehab by what your saying and others. I’ll be doing some of that I think
Stay away from the tennis for a while and keep climbing!!!

Gunnar, I’ve enjoyed reading through your blog and it gives me hope for a full recovery from where I’m at–10 days post-injury. I’ve decided on the non-surgical route, thanks to Norm’s considerable knowledge, and I feel more confident seeing the progress you and others have made.

I know you are a big fan of the VacoCast. Can you tell what are the main advantages over a hinged boot, in your opinion?

Thanks, Grace

At almost 9 months now, I am finding that I have more weird pains on the good leg. My low calf/high achilles tends to get sore on that side quite easily for some reason? But generally I can do everything I need/want to, including tennis. I am finding that I am holding myself back less and less - when I started playing a few months ago, I was definitely dragging the bad leg.

Big test coming up as I am going upland bird hunting next week and that requires a ton walking over uneven and sometimes nasty terrain. I haven’t been on the site for months, so I hope all are doing well.

Thanks Norm. Haven’t had that particular sensation with the foot. I was having some problems with pain in the top of my feet before the AT tear, especially after walking 18 holes. Orthotics helped a bit. Then down for four months. When I started back to walking, I was so elated about the AT recovery, I forgot about the foot problems, and a few others, as well, that were dormant during my confinement in activity! But now the foot pain doesn’t seem so bad in light of the AT abyss! best to you

Thanks for saying such nice things about my addiction, Gunner! Glad you’re feeling so normal after your non-op treatment. Me too — and me too also with the wimpy 1-leg calf raises. (I was hoping that you’d be demonstrating super-strength by now following a UWO-like protocol — though at 7.5 months it’s still reasonable to be doing wimpy raises, with any treatment.)

At ~10 months, my only funny symptom on the “bad” leg is a bit of foot cramping first thing in the morning. I often start the day with extreme plantar-flex stretches, still in bed, and my left foot sometimes cramps up when I do that. It’s new, since the ATR. My wife suggested I start with a dorsiflex stretch, and that seems to eliminate the cramping, when I remember! If not, it goes away in 30 seconds, especially with a little dorsiflex stretching. No big deal. (My OTHER ankle still “cracks” at the first PF stretch of the day, almost 9 years after its ATR surgery!)

As time goes on, it’s rational to stop worrying about the healed AT, and (unfortunately) to start worrying about the other one. Most people escape without tearing the other side, even if they resume the

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Hi Norm: It all makes sense and “dread” would not be the right emotion in re tearing the other AT, but I find the prospect of another lay off and lay up quite depressing. I’m sure I’ll take the plung here pretty soon, since I’ve lost the juice for competitive golf and need competition like a drug! Will keep you posted.

Actually I’m also thinking of entering a Masters swim event and doing something really crazy like making an attempt at the English channel!

best regards

Especially if you wait until you can do a bunch of 1-leg heel raises without grunting, you should be able to play 100% aggressive tennis with no fear for your healed AT. When I returned to aggressive volleyball after my first ATR, I told everybody that my healed AT was the one part of my body I had the MOST confidence in.

Unfortunately, I was also right to be LEAST confident about my OTHER AT, and it did end up popping, 7 years after I returned to volleyball. (That’s why I’m here now!)

For me, there was no “slower game”. In fact, I found ways to play MORE aggressive forms of volleyball — court 4s and beach 4s and even 2s!! — after my comeback, despite being almost 60 at the time! But I waited before returning, at around 10 months.

My experience may not be average, but it corresponds generally to the stats: You’ll be at much higher risk of rupturing your other AT than either (a) re-rupturing the same one or (b) an average person.

OTOH, now that you’ve discovered the quick and relatively painless way to fix a torn AT — without surgery, following the UWO protocol, and with a spiffy VacoCast boot — that still-unlikely pr

Thanks for the blog and comments. Good stuff! I definitely need to exercise more, that’s for sure. Thanks for being examples to me!!

Hi Tony: I started at 30 at 3 weeks, went to 15 at 4.5 and to level at 6. Had no problems whatsoever, in terms of swelling or pains. If you’ve got the terry cloth liner properly vacuumed and the boot straps at the proper tension, I can’t imagine why the boot itself would cause any discomfort, which would mean there is something going on with your foot/ankle. If it doesn’t fix itself, I would definitely go back to the doc right away.

Mine only has three settings so it must be an older model, although I just got it in early march. As I’ve blabbed to everybody here, I could not be happier with this device and am sorry to hear you’re having problems.

Keep me posted and best wishes.

Gunner- i just moved to the Vaco cas pro today after 4 weeks in a cast. I have it at -15 degrees (At least I think that is what is meant when the boot is set halfway between 1 and 2) and i feel pain across the top of my foot. I also feel something like shooting nerve pain along the outside of my foot to my Achilles. Did you notice anything like that? I dont think you had the PRO series which they now have. it is adjustable in 5 degree increments.

Sounds good, Gunner, and not unlike my experience — WAY back then at 20 weeks.

Keep getting stronger!

Tennis and volleyball are pretty similar, to an AT.

In addition to the normal runs and turns that tear some ATs, they both sometimes involve the “classic” move that tore both of mine, and is responsible for maybe 40-50% of all ATRs: You’re convinced the ball is going behind you, so you’re backing up with some speed, but you suddenly realize that it’s really in front of you, so you “fire the jets” as hard as possible to reverse your backwards momentum and lunge forward.

That “move” happens ALL the time in volleyball, especially on front-row defense. Not quite so frequently in tennis, but it sure happens. (A good deceptive opponent will force you to make that move often! “Here comes a long lob — NO, it’s a drop shot!”)

If an AT has become weaker than its calf muscles — i.e., if it can be ruptured — that’s the move that will do it first! The “reverse gear” produces maximum stretch, and the intense attempt to get going forward applies maximum stress (and eccentric loading) to the tendon at the same time.

(I sometimes ask people to imagine they had a big rubber band or bungie, with a weight tied to the end, and they were

Hi Norm: Its not my calf that troubles me about running. It’s my feet and back which took me out of running about 12 years ago (after 5 miles a day for 20 years or so and hundreds of 10ks).

The big thing I’m concerned about is tennis, where there are, probably like volleyball, ,moments when its almost irresistable to push off going forward to get a short ball. Given my ultra competitive instincts, even the fear of reinjury or popping the other AT may not be enough to prevent disaster.

If any tennis guys see this, I’d be interested in whether any of have returned to full speed on the court.

best regards, dr. norm

Sounds, good, Gunner! I’m afraid I’m getting lazy about working the calf, too, because life is so back to normal. (I never DID do many 1-leg calf raises, actually! )

For me, the main exercise — cardiovascular and calves — is bicycling, which I really just do for a handy and healthy way to get around in the city. Today I cycled for almost an hour and a half, which is a lot for me. I try to keep the balls of my feet on the pedals and “work” my ankles hard to do the work.

But at 7 months I’m still only doing wimpy or pseudo 1-leg heel raises. Full stride push-off, normal bicycling including mounting and dismounting on the recovering foot, and even lifting my heel off the floor with my knee bent, but not with it straight.

Mikek753 seems to be the leader in our little non-surgical group, for getting back that much calf strength. I’m pretty confident both of us will eventually catch up to him, but I’m not sure when.

As you know, my very conservative surgeon from 8 years ago (when I had my first ATR operated on) told me to hold off on volleyball and other high-AT-stress sports until I could do a bunch of 1-leg heel rais

Hi Norm: You’re right on the heel raises in the pool, so it seems if I continue working up the steps, its just a matter of time. I don’t plan on pushing the jump rope, just wanted to see how it felt and do a little each day.

Kudos on the letter to Michigan. Still think you should write an article…