minor setback - hopefully

Tonight I pulled a muscle or something similar high on my calf right below the back of the knee joint. Put ice on it, but so far no reduction in the pain and disfunction when pushing off.   Occurred doing forward/backward hops - maybe I’m pushing that a little fast.  Any thoughts from anyone who’s had something similar?

PT - Week 14

Very encouraging PT session yesterday.  We agreed on a final set of exercises for the next two weeks (and beyond); leading to the “graduation test” - jumping rope.  Josh’s exact words: “when you can jump rope, there’s nothing more we can do for you”.  My last session could be in two weeks.

Here’s the deck of exercises:

1 - squats with increasing weight

2 - double heel lifts with increasing weight

3 - heel lifts followed by eccentric lowering with 75% weight on the recovering leg

4 - lateral and forward/backward hops

5 - single leg stance on a pillow throwing or bouncing a ball

6 - soleus machine

7 - one legged heel raises on the pool steps, moving higher to increase weight bearing

We actually talked about the possibility of writing an article of some sort with the doc to give the option of non surgical repair a wider hearing.

Yoga anyone?

On the subject of stretching, I’ve been impressed with the flexibility and tone my wife has achieved through several months of basic yoga, which appears to be at least 50% stretching of various sorts.  I’m wondering if anyone has discovered yoga moves or positions to be helpful in the ATR recovery process? 

Swam a mile yesterday for the second day in a row, this time using a training program from “swimplan.com”.  I’m definitely getting hooked on this form of exercise, particularly since it poses no threat at all to the precious AT. 

Let’s all of us Yanks raise a few heels in honor of those who protect our freedoms today.

A stroll on the beach

Hi everybody.  Just back from four days at Hilton Head.  What a great way to rehab!  In the hotel gym in the morning, a long swim in the ocean and gradually longer walks on the beach.  My gait is getting more and more normal but still a small hitch in the step which seems to be borne more from muscle memory than any pain or resistance. I hope that time will work it out and will take up with PT on Tuesday. 

While sitting there watching the folks walk by, we were amused  by how many limpers there are in the world.  Not suprising I guess in a retirement heavy area.  My wife thought that, compared to most of them, my limp was less noticeable, so that’s a good thing. 

I’ve just been scanning and catching up with the talk and feel compelled to make another shameless plug for the VacoCast.  Every other boot I have seen in the past 13 weeks pales in comparison to this remarkable device to which I believe I owe part of the tribute for a very strong recovery.  It is relatively unknown in the southern US, and perhaps elsewhere, but well worth the effort to search and acquire on the web.  The rep in Mass. believes the relatively higher cost ($120 US retail vs. $40 for the standard boots) leads docs to stay with the cheaper version and pocket the extra $80 in the insurance mark up.  If that’s the case, shame on the docs. 

I will never forget the oohs and aahs in the docs office when we first put the VC on at week 3 and I took it for a test stroll!  A harbinger of a great partnership in the ATR journey.

Easing back into golf and tennis

I’m wondering if any one has any insight reentry into golf and tennis.  After hearing several others say they are back to sports at 17 weeks or so, at 13 weeks myself I’m beginning to think about a transition plan.   thx

12 weeks PT

A really interesting PT session this morning.  Josh has had lots of experience with pro athletes in Birmingham (Alabama); is young and energetic (already owns his own clinic); and seems totally invested in my recovery since he cautiously (not willing to go to far with the doc - his primary referral source) advocated for the non surgical route. 

Here are the questions I posed to him and the answers:

1. Electric stimulation?  response: can be valuable early on, especially after surgery.  would be of little or no help at my stage of recovery

2. one legged heel lifts?  response: not much value in trying now, except in the water.  Until I can do about 60 with 20 or 30 pounds weight on each arm or 60 in the water; there’s not any value in moving to one leg.

3. crocs?  response:  fully supported my approach: crocs are ok for casual use; go for more support for extended walking/lawn mowing, etc.

Here’s the new exercise regimen, all to be done twice daily:

heel raises with increasing weights held in both hands (30-50 reps)

squats as tolerated, 30 reps, add weights to both hands in second week

“quick feet” - shuffling feet forward onto a 3″ surface; not landing on the surface just sort of grazing it; 30 seconds, 3 reps

standing on one leg, throwing or bouncing a ball - 30 sec. reps, 5times

step downs: step down onto good leg from 3 inch height 30 times; progress to 5 inches as tolerated

Onward and upward

Cut the grass today

After much dissatisfaction with the lawn service, today I took the plunge and mowed my lawn. Set my Honda self propelled on the slower pull setting and traversed my sloping terrain with little trouble.  Wore my hiking boots which seemed to add a little support.  Total time about 50 minutes; end result pretty good - a tad sore but I think primarily because that’s the longest time I’ve walked so far.  It felt quite good to not only exercise the leg but do something constructive for a change.  

Listening to the exchange on one foot heel lifts, I tried today (12 weeks) and got no traction at all.  My PT specifically said to keep to two feet, even in the pool, so I’ll check it out with him this week. 

Wondering what’s the earliest people are getting a one legged heel lift?

walking tall (sort of)

Took my first “walk” today: 1/4 mile with hiking boots, which feel much more secure than the crocs.  I’d say about 50% of normal walking speed - but a start.  Also today did 30 minutes of fairly vigorous biking on stat. bike and swam 2/3 mile at a good pace. 

Only concern at the moment is somewhat increased swelling.  Perhaps its the volume of stuff I’m doing.  Doesn’t exactly “hurt” but seems to be asking for a little elevation from time to time and does not go down very much, even after a nites rest.  I will bring this up with PT on Tuesday. 

I’ve pretty much given up on standing on one leg close-eyed.  Thanks to Norm its comforting to know my difficulty may be more age related than ATR driven.

swimming with the tide

Just got back from the pool.  One of the best (and few!) serendipities from my ATR has been “hydrotherapy” which I began about 3 weeks ago (I’m now 12 weeks and change since dday).  My regimen included 5min. each walking forward, backward and sidestep, 120 heel lifts and balancing on the bad leg, all in chest deep water.  Its hard to describe the invigoration these few steps created in the first days.  Perhaps what a young bird experiences in the maiden flights!  Of course, I rapidly doubled the time spent on each activity, which, in my mind contributed substantially a big leap in strength and flexion. 

At PT last week, the therapist was so impressed with my ability to “step over cones” (anyone else had that on their regimen?) that he went next door to get the ortho doc (my golfing buddy).  The doc could not break away but, responding to the description, cleared me to completely discard the beloved vacocast with the exception of times when lots of steps on lots of stairs and elev. changes would be required. 

My current on land regimen includes 5 exercises:

60 heel lifts; 30 toe crunches; 2 achilles stretches (dorsiflexion) on the floor holding for 15 seconds; 5 round trips stepping over cones forwards and sidestep; and standing on the one bad leg for 15 seconds 5 times.  In this last balance exercise, he asked me to progress from standing to standing with eyes closed to standing on a pillow to pillow with eyes closed to pillow throwing a ball to someone.  I quickly mastered all the “eyes open” drills, but find it incredibly difficult to make it 5 seconds, let alone 15 with eyes shut.  Its some comfort to realize how difficult it is with my good leg as well. 

Back to the water.  I have several friends who have been raving about our new rec. center pool and the benefits they are deriving from swimming as their primary cardio and conditoniing tool.  I grew up swimming competitively until, at age 13, I had severe swimmers ear one winter, took up basketball, and never looked back (hence the name “gunner”).  So it’s been 46 years since I have swum regularly except for a few brief forays into triathlon training, which never amounted to more than a few distance swims. 

But being in the pool, seeing guys training, many my age, I could not resist moving into a lane and firing out.  First day I did 20 laps - 16 free/4 backstroke(my childhood “stroke”).  It felt terrific.  Of course, after 9 weeks of inactivity, that’s not saying much, but I was hooked.  Each day I added two laps so today I did 44, well over 1/2 mile.  The guys were right - this is a great workout - especially for someone with a mending achilles; weak ankles; and periodic low back pain. 

So I commend to you the great power of water in our journey.

Greetings from Georgia

I communicated quite a bit about 4 weeks ago, then the site went down a few days after I finally signed up.  It’s now been 10.5 weeks since a high tear playing tennis.  After much help from Norm and others, I elected to choose the non surgical route.  In a hard cast for three weeks until I finally convinced my good friend the ortho surg (who was more worried about me having an excuse if he finally beats me on the golf course) to set me free.  Again, at Norms’ advice, I acquired a Vaco cast, which when it arrived in the doc’s office, created quite a buzz.  It was a godsend both from a lifestyle standpoint and enabling therapy.

I have been following the rehab protocol produced by the Ontario study and it seems to be working well.  Phys. therapy once a week including pulsating ultrasound and my once regimen at least thrice daily.  This week I ventured into the pool for thirty minutes of walking and progressive swimming beginning with a third mile.  What a great feeling.

The boot has been at neutral now for two weeks.  In the house I can get around without at times.  Hopefully, I’ll say goodbye to my dear boot in the next two weeks. 

The ATR seems to be “firing” on almost all cylinders as my PT describes.  Still not fully as strong as the good AT when I push against his hand on the ball of my foot and working on that. 

BTW, I ran into an old friend in the therapy room this Monday and was describing the no surgery decision.  He asked how my recovery compares to a surgical repair.  Not sure, I asked the PT.  He graded my progess as better due to the tremendous flexibility I have which would take much longer to acquire after surgery ( although he has no experience putting someone in a boot right off the bat!)

In any event, onward and upward.  I have become somewhat of an evangelist for the non surgical approach, and especially for researching what’s happening in other parts of the world where there is less emphasis on surgery and lawsuit avoidance.