heelpatch

MD was sort of implying that I should wait 16 weeks (4 months) before returning to play, so I didn’t feel like I was taking much of a risk by playing soccer again last Sunday.  It was an uninspired performance, but the tendon/ankle/calf felt fine.  Looking forward to next week’s MD appointment as I expect it will be my last.

Played soccer again on Sunday. Only played about 20-25 minutes per half again, but performed much better. Strength is still a work in progress and I’m still experiencing some stiffness and swelling when inactive, but I’m not complaining. MD appointment in 2 weeks. Expect him to pronounce me cured and send me on my way.

This probably falls in the category of “kids, don’t try this at home” but I played in my first post-surgery soccer match on Sunday.  I didn’t play particularly long (20-25 minutes each half) and I didn’t play particularly well, but the tendon/ankle/calf were pretty well tested and felt strong.  Eight more games this season (more if we make the playoffs).  Next (and probably last) MD appointment is in three weeks.  Not much else to report.  Just gradually increasing strength and decreasing residual tightness and occasional swelling.

Ankle/tendon/calf feel strong; around 75%.  Ankle joint still is stiff at times but loosens up with exercise.  I can bicycle forever.  I can run at least 3 miles.  Yesterday morning, I made a couple of hundred (soccer) drives split about equally between feet and then I stacked half a cord of firewood by myself in the afternoon.  Skipped game 1 of soccer season on 08/31.  Game 2 is this Sunday.  Close call whether to play some minutes or wait another week.  Still have 4 more days to decide.

Finally have been able to do some light running.  MD said brisk walk 10 minutes, jog 10 minutes, brisk walk 10 minutes, increase jog by 3 minutes a week.  After only 5 minutes of brisk walking, I couldn’t help breaking into a jog, so I’ve been doing brisk walk 5 minutes, jog 20 minutes, brisk walk 5 minutes.  Surprisingly, I’m not feeling it much in the tendon at all.  Feeling it more where the upper calf joins the back of the knee–no pain, just very tight.  Biggest complaint at this point is the swelling I still get in my ankle joint when I sit at my desk at work all day.  Soccer season started last Sunday and I’m itching to play.  MD wants me to wait 4 more weeks (i.e., 16 weeks post-op).  I’m thinking 2 more weeks, but will just have to see how things go.

Saw MD again yesterday.  Infection has cleared up and there is a healthy looking scab on the last little bit where the surgical wound has not fully closed.  Continuing to make acceptable progress on strength.  I can do a few single leg heel lifts without cheating now.  MD actually seemed impressed I was able to do that so soon.  He recommended double leg heel lifts with lightly weighted bar across shoulders.  While I did not exactly get a ringing endorsement, we have a tacit understanding that I will start some light running.  Basically MD said “since you’re going to do it anyway, this is how to do it.”  Have another follow-up appointment in 6 weeks.

Infection responding reasonably well to erythromycin.  Cellulitis is all gone and there is less stiffness in the ankle joint.  Wound still has not completely closed, but there is a healthy looking scab over the last little open bit–about the size of a match-head.  Making acceptable progress on strength.  Discontinued PT.  Have been taking 8-10 mile bike rides which feel completely normal–not really working the tendon or calf muscles as much as I would like.  Can do a single leg heel lift with just a little cheating–best indication yet that the surgery actually accomplished something.  See MD in a week for follow-up on infection.  Will try again for clearance on some light running.

Nine weeks as of today.  Saw MD for followup on infection.  It’s responding to antibiotics but isn’t completely gone yet.  Culture indicates it’s a fairly benign bacteria.  MD switched antibiotics from keflex (sp?) to erythromycin and scheduled another follow-up in 2 weeks.  MD nixed running yet, but said I could bicycle as much as I want.  Strength has improved noticeably to about a 3 out of 10.   Ankle joint is still pretty stiff.  Still have a slight hitch in my stride because of the low strength and stiff joint.

Fifty years old.  Left achilles.  Probably ruptured in two phases.  First was while playing soccer on 04/19/09.  There was no archetypical pop or sense of being hit from behind.  There was just a tearing sensation followed by moderate pain and swelling.  After 2 weeks, there seemed to be some improvement, so I foolishly tried to play soccer again on 05/03/09 and experienced a further tearing sensation followed again by moderate pain and swelling.  Had MRI on 05/05/09 which radiologist interpreted as moderate partial tear.  Suburban orthopedist recommended conservative treatment; i.e., no surgery.  Got 2d opinion from one of the downtown ankle “rockstars” on 05/13/09 who said functionally speaking it was a complete tear, I needed surgery and it wasn’t even a close call.  Surgery was 06/09/09.  In recovery room, MD scoffed at “moderate partial tear” diagnosis and said he found tendon was just hanging on by a thread.  In fairness, there may have been some further tearing while climbing down a ladder between MRI and surgery.  Was in a plaster splint (really more like a cast) for 2 weeks to 06/22/09.  Then was in a fiberglass cast for 2 weeks until 07/06/09.  Then was in a brace with wedges and doing physical therapy for range of motion for three weeks to 07/28/09.  By that time, I had regained almost all of my ROM but strength was nonexistant.  At 07/06/09 some infection and swelling was evident at site of surgery which MD said to treat with hot soaks.  At 07/28/09 infection and swelling were essentially unchanged and MD started to treat with antibiotics.  From 07/28/09 to present, PT has started to focus on strength which has improved but still has a long way to go.  Antibiotics are working, surgery wound is almost healed and swelling is almost gone.  Am walking with almost no limp.  Have a followup with MD on 08/11/09 mostly to check on infection.  Hopefully he will clear me for some light running then.