An Ironman’s recovery from an Achilles Tendon Rupture

Three days later and I’m still busy doing a lot of stuff like………………walking, woo hoo!!!

Every day feels better and better and much progress is being made. My walk is starting to look like a walk but there is still a bit of a limp since the Achilles still fairly tight (especially in the mornings).

I’ve been to physio (at Physiobility) 2 times this week (one more tomorrow) and the treatment continues to be awesome. Lots of hydrotherapy, ultrasound, massage, and laser. The last massage was very painful as he got right in there to break up scar tissue. The benefit was that I gained more flexibility the next day. A bit more swelling too though.

I continue to do all of the stretching and range of motion exercises on my own. While on the computer, I also roll a golf ball along the bottom of my foot for a deep massage, especially going after that sore heel area. It also helps stimulate the feet, and smush up any adhesions/scar tissue.

I got on the bike Wednesday (indoors) for 15 minutes. I was not riding all that fast or forcefully but I was pleased to be back riding. The Achilles loosened up a lot by the end of the ride. I wore bike shoes but did not clip into the pedals on the left side. Not enough strength or guts for that yet. I’ll try riding again today.

I took a few pics of myself to see how much my left calf reduced, but as you can see I actually looks bigger. However, the reality is that the muscles are all mush. It it likely bigger due to swelling and the fact that my right leg was taking most of my weight as I took the picture. But the good news for me is that I did not sustain major shrinkage. After seeing a ton of pictures on these blogs I was very interested in seeing how bad the atrophy would be. While the size is sorta there the strength definitely isn’t.

Let the recovery continue.
Thanks for reading. Happy Healing.

Hoss

One day after seeing the surgeon and the hospital physiotherapist (getting permission to weight bear), I was still using crutches (eventually graduating from 2 to 1) to support myself while getting around, and I used the boot for going out. The Achilles will still really tight, sore and my feet was swollen like a pregnant woman. Still fairly pleased though because I never thought I would be allowed this much freedom at this point. I did a lot of range of motion exercises too that day, gave it a blast of ultrasound and put on compression socks at bedtime.

The next day, was much better. The heel was sore, but the Achilles was tight but I had a bit more range of motion when I got out of bed. It felt so good that I decided to go with just one crutch for support. This I used mostly for going up and down the stairs and for going out. Most of the day I went without any crutches. Although my walking didn’t look glamorous I was excited to be at this point in the recovery process. Basically my left side would weight bear, the right side would take a step, then I’d lift the left to catch up and then repeat. I avoided any pushing off with the left whatsoever. I did some more range of motion exercises, ultra-sounded the area, wore a 2xu compression calf guard for going out, and compression socks at bedtime. Much of the same for Sunday, just a lot less activity.

Today when I woke up, as usual, my Achilles felt tight and my heel was sore. Having a crutch at bedside definitely helps in the morning. I got ready and headed to my first physio appointment.

A few weeks ago I started physio on my right leg at a Toronto SEMI, and while I liked the treatment I was getting, it was a bit too far away and mostly in traffic (anywhere from 1 to 1.5 hrs both ways). With a bunch of physio clinics 5-10 minutes from my house I visited a few and decided to pick a place called Physiobility. I’m glad I did.

After a very in depth assessment with Tony. I was put into a hydrobath, I got my achilles massaged and manipulated, I received an intense ultrasound and laser treatment, and was shown some more exercises. I was out of there 1.5 hrs later. Probably the best treatment I’ve ever received by a physiotherapist. He was very knowledgeable, attentive, and we were on the same page in regards to my expectations for recovery.

Today the swelling on my left foot went down drastically, it almost looks like the right today. On top for the rest of the night is some more stretching, elevation, icing and some ultrasound.

Til next time. Thanks for reading.

Hoss

I just got back from the hospital and my 4^th post-surgery visit with my surgeon. He examined my leg (poked around, manipulated and checked the function of the Achilles) then said, “No more cast for you. You can start physio,” then walked away.

I was shocked. I’m thinking, “What, no boot?” I had a ton of questions but he already moved on to see another of his many patients. However, the way things worked was that I now had to wait for the physiotherapist to come and see me. My surgeon was going to give her instructions and I would get the run down.

I did manage to ask him where the rupture was, and he showed me that it was low. He then briefly showed me what he did. I decided to ask the physio all my burning questions.

I met with the physiotherapist a few minutes later and lucky for me, she is a fellow Ironman athlete (a fast one too) so she knows exactly what kind of condition I need to return to.

We had a nice chat about racing, etc., she answered all my questions about recovery, etc., and she put me through a bunch of exercises to do every day. I also got a referral note to start physio at whatever clinic I determined to be suitable and was on my way. I get to come back to see the surgeon in 4 weeks.

So what came out of my surgeon/physio visit today? Here are the main points that I can remember:

1. No boot for me. I am good to go with full weight bearing. The only thing I am not allowed to do is any pushing off motion on my left side. It was suggested I put some wedges/heel lifts in the heel of my shoe to help with walking.

2. I can get rid of my crutches at any time I feel comfortable. I will still use it to help me walk for at least another week. The Achilles feels tight and weak so when unassisted walking feels comfy I will slowly ditch them.

3. Be very careful when going up and down the stairs, etc. I am to make sure I have the whole foot solidly placed on the stairs.

4. Start physiotherapy ASAP. Lots of range of motion stuff, stretching, light strengthening with a towel, and no pushing off with the left side (such as heel lifts). I do get to try one leg balancing on my left side. Building up the time and confidence. I have my own ultrasound machine so I will give the area a few daily blasts.

5. I am allowed to ride a bike. Only indoors on my bike trainer for now, but that is huge for me since I love riding. Plus, I’ve put on a few pounds in the past few months due to my inactivity and it is time to start making a dent in that weight gain.

6. No running. No kidding huh? My physiotherapist said until I can do a bunch of one-legged heel raises on my left side, and then don’t even think about running.

7. The list of exercises I was given can be done as much I want throughout the day. I already started a bunch of these yesterday on my own and I know my range of motion has increased since yesterday. I look forward to trying a few of the new ones she gave me. The Achilles is a bit painful and tight but it gets better each day.

8. I inquired about the availability of a brace that the surgeon could prescribe for when I go back to regular activity. Apparently, there are a few that are available and they provide extra stability in the ankle area. I’ve seen a few on the internet but if I can get it covered by insurance that would be great.

During this recovery process, I will also be making use of compression socks to help speed recovery. Compression wear is supposed to encourage healthier blood flow and increased circulation. Undoubtedly, there will be swelling in the area due to the physio exercises do that will help control that as well. I forgot to ask the surgeon and physio about these but I’ll try them anyway.

I picked up a few types (Futuro and T.E.D) in a Pharmacy in Lake Placid last week and they were fairly inexpensive at $15-30 a pair. These are all the rage right now with triathletes. They wear them during races, and especially for aiding recovery after races. Those fancy versions cost $60 plus but these do the same thing.

That’s it for now. Thanks for reading.

I was supposed to get my 3^rd cast removed tomorrow but I kind of took matters into my own hands yesterday.

I was in Lake Placid on Sunday to watch the Ironman race and take pictures for a magazine; the only problem was that it rained all day. My cast got soaked. It seemed to dry out but I was skeptical. Then I took a shower on Monday night and a ton of water got in there too. I woke up on Tuesday and my leg still felt wet and soggy. I later smelled something rancid. Yup, it was coming from my cast. It sorta smelled like a dumpster behind a restaurant. I immediately called the hospital fracture clinic and was lucky to get an appointment that afternoon.

Once I got back to the cast tech, he cut it off and revealed all of the wonderful nastiness that lay underneath, along with the full aroma of the wet, dead skin. Everyone on duty came by to have a look at the monstrosity and take a whiff. I was thinking, let us scrape the dead skin off and send me on my way. The cast tech was adamantly against that and said I could pull all the skin off and leave nothing underneath.  Instead, he gave me some paper towels to dab it, then put a plaster splint one top (like the first cast) and wrapped it with cotton and gauze. He told me to take a blow dryer to it to dry out the area.

At home, the smell was still bothering me and I could feel that the area was still moist and was only going to stay that way until Thursday. I did not want things to get worse (infection, rotting, etc.) so I pulled the cast off, peeled off all of the dead skin, and carefully washed my foot. The foot was tender and looked extremely wrinkled, but it was now dry and should return to normal in a few days. This was not going to happen with it all wrapped up.

One day later, the foot has improved a ton. A lot of the wrinkling is gone and some swelling has gone down. When I go out, I put on the walking cast for protection but I let it go free when I move around the house. I even test it out every now and then and put some weight on it. I am not ready to put a ton of weight on it yet. At least not until I see the surgeon tomorrow. Won’t he be surprised when I crutch in there without a cast? Another post will follow after that appointment.

Thanks for reading.

See all the pics below.

Cast is cut off.

The grunge is revealed. 

Remains of the plaster cast I removed.

More looks at the nasty foot.

Nasty look #2. 

Nasty look #3.

Nasty look #4.

Washed foot.

My leg the next day (today). The indentations above the 3 incisions are from the walking cast.

Another look at the cleaned up lower leg.

Walking cast.

I’ve still got 2 more weeks to go in my glorious pink and purple cast. So not much else to do but play the waiting game until my freedom. Yes, it will be to a walking cast but showering and moving around will be so much better.

This week, I’ll be heading Ironman Lake Placid to watch a race I was supposed to be doing for the 10th time in a row. It sucks that the streak is over but not much I can do. Many are still asking if I’m going to race this weekend. Yeah right! If someone paid me 1 million dollars I might risk it but that ain’t happening.

Somehow I don’t think most people realize the severity of this injury. They think we can stretch and ice it down for a few months and just head back out there like normal. Won’t they all like to spend a day or two in my/our situation.

The pain from my new cast position has virually disappeared. It only comes as I stretch it out in certain positions and even then it subsides as I stretch the tendon more. I’ve now added this activity to my own rehab and exercise routine.

Last night, I experimented and put more weight on my left side while standing. It felt awesome. But that was the extent of it. I did not try taking a few steps without crutches because I did not want to push off that left side and re-injure myself. It was a good little test for me though. No use in risking a few brief moments of possible satisfaction for going right back to the drawing board. Baby steps is fine by me.

I hope everyone is doing well. Will post again soon. Til then, check out the following information on plastic water bottles. If you haven’t replaced yours already, you might want to consider it. As most of us know during this healing process, it is better to be safe than sorry.

www.greenlivingonline.com/HealthNutrition/get-rid-of-plastic-water-bottles

www.choosetoreuse.net/

www.teamrunningfree.com/blog/2008/01/18/the-safest-alternative-to-plastic-water-bottles/

I’ve got a few things going on this week.

My left Achilles is still very achy from the new casting position. Sometimes just out of nowhere I will experience some random bouts of pain and tingling deep in the Achilles area (maybe it is the Achilles healing in the new stretched out position). Putting weight on the left side brings some pain, but especially if my heel is on the floor and toes are brought upwards. ie: sitting in leg straight up and off the floor. Elevation must be done with my foot outwards or inwards to avoid pain.

I am doing a pre-emptive strike and started physiotherapy on my right foot. My right side had an achy Achilles before this all happened, along with a sore muscles on the top of the foot. With all the hopping around and pressure that the right side has been burdened with for the past 6 weeks, I don’t want to end up rupturing that side too.

I saw Dr. Stoddard (one of the best sports docs around these parts) at Toronto SEMI on Monday, and had my first physio session on Tuesday. It is a bit far from my home but since I am not back to work for another 6 weeks, I figured it is worth the drive to go to a top notch sports medicine and rehab clinic. We made a plan of attack to get going on my right side, and then go full speed ahead on the left once the cast comes off. My physiotherapist has dealt with a few ruptures before so that I a huge bonus. She was extremely thorough in her assessment and treatment. Also, being an extremely active guy who wants to get back to triathlon ASAP, I’ll be seeing a podiatrist to have them examine my feet to see what triggered the ATR and what has caused my Achilles tendonitis in the past (and currently).

Being bored as heck, I figured it was time to update my tattoo collection. Got the new tat on Monday after my appointment with the doctor (with tattoo shop being right around the corner I figured why not save a trip with those high gas prices). I wanted a more sinister design but compromised with the wife and got this. The Jolly Roger. Sums up what I am feeling right now and for the next 6+ months.

By the way, don’t you love peeling dead skin off your feet? I can’t stop. Sick I know. But it has to be done. And the skin just keeps on coming. Once I get the cast off it is going to be a sad scene.

Til next time.

H

Today (July 3) I had my second cast removed and the 3rd one put on.

I had my mind set on a pink cast but saw the purple, loved the colour and changed my mind somewhat. The cast technician told me this is my last cast so not going back on the promise I made on this blog, I added some pink to the cast (so I didn’t wuss out brendan and screwdriver). Check it out below. I dressed it up with one of my dogs once I got home. More pictures can be seen in my Cast 3 page post at the top.

Sawing off the cast was quite a cool process. It is still hard to believe how that thing can hack off the cast and still leave your leg without a scratch. Reading the many blogs on here prepared me for the loud and somewhat scary ordeal. Therefore, I was relaxed (that would end minutes later) throughout.

As soon as my cast was removed, I helped convince a kid (who was a bit scared to get 2 casts removed) that everything was going to be ok. He started off scared as heck, but at the end he wanted to see the saw cut off more.

Once my cast was cut off, the surgeon came in, took a quick look, and told the cast tech to get me to neutral (if I could handle it) and put the new cast on. I was excited to hear he wanted my stretched right out until the cast tech started doing it. Wow! Or should I say “Owww!” Man was it painful. It gave me a quick reality check to remind me that I am not even close to 100%.

As he continually stretched my Achilles and tried to put my foot in a neutral position, all that kept going through my mind was re-rupture. The pain was excruciating. But he convinced my to put up with it because the more he could stretch me out and cast me in that position, the better it would be for my recovery. Once he was satisfied, he applied the first layer of the fiberglass cast, then added a few layers of purple, re-confirmed I wanted to add pink, and proceeded to add pink stripes. We had a good laugh at the end result along with the others in the room. I got some weird looks coming out of there but who cares. Who is going to mess with a surly looking guy with crutches?

I say surly because this new neutral position was more painful indeed. It almost reminded me of the first 2 weeks all over again. Fortunately, only certain positions brought out the pain so I could easily get relief by varying my foot position.

I was told I have another 3 weeks in this cast, and then I get to go in a walking cast. I can’t wait to gain just a bit more freedom and start the physiotherapy. As we have learned from the many unfortunate re-ruptures that happened recently (my cast tech told me of one that happened to someone who slipped in the shower), we must remain patient, and smart about our recovery. I say this especially to the 25 plus people that have joined this community of bloggers since I suffered my ATR 35 days ago. This is getting to be an epidemic. Scary stuff! Thank goodness for this invaluable site. You are the man Dennis!

Going back to last week, to celebrate Canada Day, I had my first shower on July 1st. This may sound gross but I have been cleaning myself via baths (I hate baths), sink showers/baths, and baby wipes. My shower is especially slippery so I did not want to risk slipping or getting the cast wet. I felt especially gunky so after reading a few blogs, I got the urge to shower so I taped 2 plastic bags to my leg and had the best shower ever. Some water still managed to seep in despite the detailed taping job. I will add another 1 or 2 bags at the top of my leg next time to solve that problem. Otherwise, all went well.

Right now I’m investigating places near my house get physio. I’ve also made an appointment with a top notch sports medicine doctor to investigate issues with my right side and to get advice about rehab for my left side. I believe the right side could have ruptured just as easily so I want to head that off at the pass. Maybe he can pinpoint what it happened.

Until next time. Happy healing everyone!