An Ironman’s recovery from an Achilles Tendon Rupture

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.