Filed Under (Uncategorized) by housemusic on 17-01-2012

Another month has passed and here I am updating my blog. First, I want to thank everyone for sharing their stories. Even though I do not post very often, this blog has been my daily companion since September 16, 2011.
This past month has brought little change. Considering my diligence with physical therapy, I expected definite progress. Unfortunately it seems my healing process has reached a plateau and I am stuck at the same low functional level as I was on December 17th.
When compared to my update one month ago, the only improvement I can report is the ability to walk downstairs… if the steps are relatively shallow. However, I still limp, even when walking slowly, I have pain with each single step and little pushoff strength so I walk as little as possible.
I also have substantial pain in the “good” tendon. The surgeon attributed this to the extended time using crutches which aggravated my pre-existing Achilles tendinopathy (been having issues for almost one year).
For the moment he cannot offer a solution. He suggested I do a little therapy, and once the surgically repaired achilles is strong, he will do a PRP treatment. On this note, the PRP treatment is not 100% guaranteed, and insurance does not cover, but at this point I will try anything that can give me a chance to live an active life.
At the personal level, and after much reflection, I have come to accept the losses and limitations I suffered with this injury. My life changed so dramatically and so quickly that I’ve had trouble adjusting. However, I am slowly adjusting. A book called “Injury, learning to live again” has been helpful. Though it is geared for car accident victims, it has some practical advise.
Good luck to everyone with their healing!


ryanb on 18 January, 2012 at 11:05 am #

At about 4 months, I seemed to hit a similar plateau, and was getting kind of frustrated with the lack of progress.

So, I made some pretty big changes to my rehab and workout schedule, to get things kick started again. The most important change was probably to devote 2 days a week as “Achilles” days. At 4 months, the tendon is essentially healed, and what now faces us is rebuilding all the strength, balance, and flexibility that has been lost from the extended lack of use. These “Achilles” days (Mondays and Thursdays for me) are essentially modified bodybuilding workouts, focused on the calves (VERY light, high reps to start) My calves need to rest between sets; so I do alternate abs/core during the workout too. In addition to the calf lifting, I do a lot of balance work (bosu and such) and have recently added some plyometrics. If I’ve got the time, I do other stuff on these days (skate/ride/cardio); but the 1st priority is this Achilles workout. I know you used to be a serious weightlifter, so you understand that for strength and muscle building, more that 2 times a week is probably over-training.

The other thing you mention that gives me pause is that you say you’ve been walking as little as possible. I think that’s exactly the wrong thing to do. I’d slow down, ease up on the push-off, maybe even use trekking poles… but I’d be walking as *much* as possible. Perhaps just work on “rolling” your foot; lifting the heel first, making sure the tips of the toes are the last thing to leave the ground, before trying to “push off” too much. The trick is to not over-do it so as to cause further injury. Again, as a weightlifter, you understand the difference between good and bad pain.

If what you’re doing isn’t yielding satisfactory results… change it up! If you haven’t already been doing so, I’d really recommend spending lots of time on a spin bike. It’s a good way to start rebuilding calf strength that’s almost zero impact and low stress on the Achilles.

kiwiclaire on 18 January, 2012 at 11:17 pm #

I went into 2 shoes with a slight heel raise at 8 weeks - from 9 weeks I built up my walking on a flat smooth path concentrating very hard on no limp and used treking poles to help with this - shortening stride if needed so that each stride was even, trying to keep an even rhythm.
I am now at 11 weeks and aim for 30 mins twice a day if I can. My philosophy is that you must practice/exercise/build up the sensory system that controls the firing of mucsles which gives us smooth co-ordinated movement; just doing strength and stretching doesn’t do that. You have to practise and grove the movements you want to be good at. (think of the hours tennis and golfers spend grooving their swings)
However, walking is definitely not the total answer as I now need to work more on range of dorsieflexion otherwise I can’t lengthen my stride and I’m working hard towards a single heel raise. Was interested in Ryan’s comment on twice a week workouts - I don’t know much about strength training, but am doing my heel raise exercises little and often through the day - maybe I should have more concentrated work outs less often.

ryanb on 19 January, 2012 at 9:00 am #

Claire- I just put up a new page on this topic:


jjniss on 23 January, 2012 at 2:07 pm #

Monty Python and Purposeful Walks

I’m at four months too and recently posted about hitting a recovery “plateau”.

Agree with ryanb and kiwiclaire about walking more not less. I strategically approach walking as therapy. Remember we are re-teaching our body to walk again, and you can only do that by walking. But do it the right way without limping and only for as long as you can do it; be it 15 min at a time or walking in a pool (highly recommended but somewhat ego deflating).

Of course walking more and better means you’ll experience intermittent pain and swelling, that happens so just be smart about it. Don’t be a dope like I am and occasionally walk way too much due to bad planning, with next day payback.

It’s amazing how easily you can fit 30 minutes of exercise a day in little bits; toe raises, wall stretches, balance (get a bosu board or failing that use a very firm pillow),etc. And ryanb’s 2x per week calf workout frequency is great advice.

At this stage of our recovery (4 months+) regaining calf strength and whole body balance is key. I did not get into 2 shoes till 11 weeks although walk pretty normally now. Yet at 8 weeks could not have walked in two shoes, physically and emotionally was not ready.

I do not have any illusions that I’ll be able to do all the things I could do before my injury. But at 57 that reality was already painfully evident pre-injury. My ATR in some ways has hastened inevitable age limitations but it’s also been a positive wake-up call (cue Monty Python’s “Bright Side of Life”).

Exercise has become part of my daily routine, that 30 minutes of exercise I mentioned earlier plus the gym, purposeful walks, whatever it takes. I will play tennis again and go back-country hiking/camping. But I’ll also adjust my game from scrambling on the court to dictating play (hopefully anyway) and when hiking take more frequent breaks to rest my leg.

And one more thing, keep posting! I can’t over emphasize the value reading and writing posts in this space has had on my recovery. This process takes a long time and as I’ve discovered, it’s a group effort.

housemusic on 23 January, 2012 at 10:26 pm #

ryanb,kiwiclaire and jjniss,
I really appreciate you took the time to read my less than stellar four month report, and thank you for the advice and encouragement. This has been a difficult journey, and sharing it with those who are going through the same experience is what makes this forum so special.
Let me clarify I still have pain in my operated tendon which makes it uncomfortable to walk for long periods. The doctor said it is common to have pain at push off for about 8 months post op. I was not happy with that answer, but I am also tired of pain, so I usually do the stationary bike for 20 minutes a day as this is the one activity that is completely painless.
In response to ryanb, I spent 30 years in bodybuilding, not powerlifting. My goal has always been the same: gain as much muscle size as possible in my lower body.The calf training method you are using on your Achilles Day is very similar to what I used to do, except I would use maximum weight possible for 15 reps, and hit them every three days together with abs. As I see my calves turn into pencil sticks, i miss doing those workouts, however, the PT did not clear me to go to the gym. And to be honest, I’m not looking forward to it as I have lost all the muscle it took years to build, and I am also much weaker…tough for someone who used to train heavier and harder than a lot of the big guys. Ultimately, I know I have to leave my ego at the door and go back to what I love…

ryanb on 24 January, 2012 at 7:49 am #

Think of it this way: all those years of bodybuilding give you a huge advantage over the rest of us. You know how to train your calves. You know how your body responds to differnt types of training. You know how to fuel for muscle growth. You know what sort of rest intervals work best for you.

For most of us, when we go to (re)build our atrophied calf muscle, we have to learn all that stuff from scratch. You’ve got a real leg up on us (so to speak).

jjniss on 24 January, 2012 at 3:10 pm #

I remember the surgeon warning me that my calf muscle would atrophie, did not really understand the severity of it until my leg was out of the hard cast. Wowzah.

My “good” achilles tendon hurt until a few weeks of doing PT. Presumably the pain dissipated because I started to do some of the same therapeutic exercises on the left tendon as well as the repaired right tendon. Also, I wear .25″ heel lifts in both shoes now which relieves tendon stress. Not sure that will ever change, we’ll see.

As for gym exercise, I can do the elliptical machine without any tendon pain, but the stationary bike not so much. After 5 minutes of pedaling the tendon starts to bark and does not stop. Must have something to do with the anatomy of my healing and scar tissue, we’ll see what happens over time.

Net, we all heal differently but we do heal. As a long term body builder you have more physical reminders than most about progress or frustratingly, the lack there of. But as rynab said, you have the knowledge and experience to work your calves, most of us are doing it for the first time.

chippy on 24 January, 2012 at 5:45 pm #

Hello all; happy to be apart of the family. Ruptured my Achilles on Sunday skiing down a steep bump run. Crossed my tips and rear binding didn’t release on my right ski until too late. Not sure if it was the forward motion or when I came back on all my weight against the top of the boot squishing my calf muscle. I remember that motion the most with my leg bending back, it should have snapped. It didn’t feel right when I tried to stand, I thought I’d broken my leg within the ski boot and it was all held together by the buckles. No sharp pain but good amount of pain when I tried to stand. It felt all wobbly in the boot. Eighteen years in Vail without a free sled ride down the hill with ski patrol, now apart of that club! Surgery was last night within 30 hours of injury, very pleased my doctor came in to fix me on his day off. Feeling like that was a good first move on my road to repair. 90% rupture above ankle repaired with some sewn in fiberwire I believe, will know more about the procedure next week upon my first visit. I’ve been pretty much pain free and comfortable the last two day’s, I’m sure my day’s are ahead of me reading your stories of pain. Keeping a very positive and optimistic mind about my bodies ability to recover quickly and my motivation to achieve a successful recovery. The extent and consequence of my injury hasn’t really set in yet, I’m seeing this as a challenge right now. After reading your blogs today I’m getting some reality on the length of the recovery and some of the struggles. It will set in soon. I’m hoping to be strong around my family, keep moments light in times of frustration on my part and the parts of others helping me. So happy to be with you all and to find the resources and support of this site. Good wishes.

housemusic on 26 January, 2012 at 3:41 pm #

Welcome to the club and truly sorry to hear about your rupture. At least you were skiing in Vail, I hope to go there one day (though not this Winter…).
It may be a good idea to create your own Blog. That way you can post regular updates and we can follow your progress. This is a long term, slow healing injury. For this reason, I post once a month, other people post more or less often. In all, I find this blog to be a great support system. This injury is very unique, and the only people who can truly understand what we are going through are those who have experienced the same. Good luck on your healing!

mulberry bags 2012 on 24 September, 2012 at 12:31 am #

I remember the surgeon warning me that my calf muscle would atrophie, did not really understand the severity of it until my leg was out of the hard cast. Wowzah.

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