An Ironman’s recovery from an Achilles Tendon Rupture

Like many others who have reached this point in the recovery process, there is nothing much happening. Just good and steady healing and improvement. Despite the lack of huge developments, I will continue to post each week in the hopes that some observation or experience might be helpful and so I can look back to see what happened. Like it or not, I’m here at least until that one year mark.

I continue to get physio 3 times a week, and my limp is pretty much gone. I only do so when my heel starts hurting from too much time on my feet. Nothing to do with the actual Achilles at all. My balance is tons better (working on the balance board — front/back, side to side, squatting, and closed eyes). One legged strength is slowly getting better on the left side too.

My physiotherapist continues to do deep massage to mush out the scar tissue. I still have a bit of a bump at the bottom incisions but the surgeon says that is normal. Last Friday, my massage therapist gave me a deep massage on my gastroc, soleus, achilles, etc., and while it hurt like heck during the massage, afterwards I felt like I never had any injury whatsoever. She totally stripped the muscles and wiped any tightness away. I’ll be making bi-weekly or weekly visits if possible. I definitely suggest doing this to help your recovery. Make sure you find a massage therapist that is not scared to get in deep and knows what they are doing. I had one who did a light massage one week earlier and that did not do the trick.

I continue to ride the bike as much as I can (highlighted by a 1 hr 22 min. ride while watching the Olympic Marathon on TV) and I’m up to pushing 180 watts for at least 10 minutes. I can do more but why push things at this point in time. Just steady aerobic riding as often as I can to shed all these pounds I’ve put on since the ATR. I was 172.8 lbs on the day of the rupture and I am 185 lbs today. I expected much worse actually so I’m quite happy it is only a 12 lb gain.

The fun begins next week because school is back in session and I return to work. My heel will get a real workout since I’ll be a lot more active. I will make sure to get my sit breaks though.

Thanks for reading,

Hoss.

I’ve included some pictures below. They are not the greatest quality but not bad for a cell phone camera and you should be able to still see the little bump near the bottom.

After the plateau last week, things have been pretty awesome since then.

I’ve gained more flexibility, strength, and the bump (scar tissue) at my lower Achilles is steadily going away. Yesterday, I actually clipped in and out of my bike pedals. The heel pain is still pretty strong but really only surfaces when I spend 20+ minutes on my feet.

I saw my surgeon today (the ole wait for 2 hours and see him for 2-3 minutes deal) and he was happy with the progress. He said the heel pain was normal and commented that most of the plantar faciitis problems are due to issues with the Achilles tendon. I know exactly what he means because I remember my bout with plantar faciitis 10+ years ago and this feels just like it in many ways.

Physio has been going great. My physio is spending a lot of time mushing that scar tissue out of there and its getting better each day. I can feel the strengthening with the bands is making a big impact. My one leg balancing is getting better and my balance board work (started yesterday) was surprisingly good.

I’ve been doing some ebay scavenging and have picked up a few products that have helped in my progress. Here is what I got:

Bauerfeind AchilloTrain - Really helps when I have to go out and walk around for an extended period of time. It will get heavy use when I go back to work in a few weeks. http://www.painreliever.com/bauerfeind_achillotrain.html

J Fit Fit Stretch - Especially helpful in increasing flexibility. You can get the same deep stretch as lowering your heels off of the stairs but without putting yourself under that stress and jeopardy in this point in the recovery. http://www.jfit.com/Preventative-Fit-Stretch-P106800110.aspx

Pro Tech Achilles Tendon - This is for when I return to activities like running or tennis. You can never be too safe. http://www.runningfree.com/detail.aspx?ID=12744

* Other than the Running Free site, I don’t endorse any of the sites. They are there for information purposes only.

I also got more compression socks, and a bunch of insoles and arch supports to use when going back to work (lots of time on my feet) and when I resume running. Even with my insurance coverage, I can’t see myself forking over another $400-500 on top of their coverage to get orthotics made by a podiatrist.

By the way, I’m loving the Olympic coverage. The Men’s Olympic Triathlon was awesome. Way to go Simon Whifield. It is quite interesting to find out of the many athletes that have dealt with Achilles problems in getting themselves to the Games. Morbidly, I also can’t stop staring at all the athlete’s feet, thinking that a rupture will occur.

Happy healing everyone, and thanks for reading.

Hoss

I’ve read about reaching a plateau in the healing process and I think I did so a few days ago. I’ve got plenty of soreness and swelling and no great improvements in flexibility.

On top of that, I had a bit of a slip 2 days ago while putting on my cycling shorts. I heard a bit of a click but suddenly the heel pain went any and so did a lot of the tightness. Very eerie! I was just hoping I didn’t re-rupture the darn thing. All foot movement was fine and the tendon felt intact when I poked around. But the middle section felt (site of the rupture) was softer and more pliable than the rest of Achilles so maybe I tore away some scar tissue? This could have been my mind playing tricks on me too since I couldn’t recall how it felt before. Since all felt good, I rode the bike for 30 minutes anyway but took it easy.

After a few days of kid glove treatment and icing, I feel tons better today. 

I had some physio today and he checked out the area and said all was OK. He also thinks I just jarred some scar tissue loose. At any rate we put off the start of my strengthening exercises for another day. This didn’t prevent him from doing the super deep and painful massage of the tendon of course. Man does that hurt so good.

Back on the bike tomorrow and I’ll resume my stretching routine. I will definitely say that the more active I am the more heel pain I feel. But cycling relieves that pain big time along with elevation and staying off it of course.

Thanks for reading

Hoss

PS: I almost forget to mention that while volunteering at a race 3 days ago, it completely slipped my mind that I was injured and I ran 6-10 steps. Once I realized what I did, it completely scared the crap out of me. I will not be trying that again anytime soon. My slip and potential re-rupture scare has set me straight. I’ll grab a seat when changing my clothes. You can’t be too careful.

Bike Workouts (for those into that sort of thing):

Monday August 11 - 35 minutes (8 minutes x 125, 150, 160, 150 watts)

Tuesday August 12 - 30 minutes @ 125 watts

Wednesday Aug. 13 - off

Everything seems to be coming along just perfectly. If there is anything I can say to those in the first 4-8 weeks it is one word - PATIENCE.

I (along with a bunch of other bloggers) wanted to rip that cast off and start the recovery process right away. But after going through 8 weeks in a cast I truly believe to you should be patient, let the body go through it natural healing process and once you get the last cast off, get going on the PT and active recovery process. You will not be running marathons anytime soon so take it easy.

This patience has paid off for me and I think my progress is fairly rapid. I’ve actually scaled things back a bit to make sure I don’t push it.

Right now:

• I walk with less of a limp every day (both feet straight ahead). Right now I can hide it well with some effort. The Achilles is still tight but that reduces every day and that leads to less of a limp.

• There still is a lot of left heel pain. This reminds me of my bout with plantar fasciitis. Whenever I’m on the computer I make sure to roll a golf ball under my foot and smush those areas out. I also ice my heels while watching TV and started ultrasounding it yesterday.

• I am riding my bike with more wattage every day. I’m up to 150 W (for 5 minutes). This was my easy pace wattage when I was healthy. But I was doing it for 4-6 hours at a time. I’m not going there yet with this injury. I’m still not clipping my left pedal in yet but it is getting there (no rush though).

• I’m drinking too much beer. That has got to stop. I think?

I think this progress all due to a bunch of factors:

1. My physio treatments - hydrotherapy, deep massage (extremely painful), ultrasound, and laser.

2. Staying consistent and doing my stretching, range of motion and other exercises.

3. Icing and ultrasound at home.

4. Wearing compression socks at night (sometimes during the day too) to reduce swelling while increasing blood flow in the area.

5. Riding the bike. This increases my range of motion big time, adds a bit of strength work, and burns a few calories too.

6. Reading everyone’s blogs and lots of insight and tips along the way.

I hope this is helpful. Happy healing to all. Thanks for reading.

Hoss