janis’s AchillesBlog

I did a heel raise yesterday in PT! Actually, I did a couple

We had been working on it by having me go up on both toes, then taking the strong foot off the ground and holding the raise with the op foot and controlling the descent. I was able, yesterday, to get the heel off the ground by itself. Now, compared to the strong side it was a pretty pitiful heel raise, but it was off the ground at least a couple inches with no help from the other side.

I don’t know how much longer I’ll be in PT. I know I am going next week, and he talked about addressing some of the awkward landings I will likely encounter functionally when I get back to work. That is why I trust this guy so much. He takes into account what you’ll need to actually do functionally day to day, and step by step he incorporates stuff to strengthen and prepare you for just that.

The area that I was feeling the “zings” on both sides?* The PT massaged them and it definitely felt better and freer for me after that, even though the massage alternately burned and stung. He said the tissue felt like bone, and he was huffing and puffing after doing the massage. It is all soft tissue area, so “feels like bone” was kind of ominous to hear. How arthritic is this ankle going to be? I have had a couple of bad sprains to that ankle, one that healed badly a long time ago, and another recently, that I was smart and did PT immediately after. I massaged the areas myself the next couple of nights before bed. I felt distinct crunching under my fingers in small (fingertip size) areas of the massage. I couldn’t locate the crunch the next time I massaged, and my ankle feels freer than it has in months. My PT said it was quite possibly old adhesions from prior sprains, plus the period of immobility in the boot. It’s not crunching anymore when I massage it, so it must have busted something loose!

In 5 days I go back to the OS for xrays and followup, and I’m hoping to hear the magic words - back to work!

*tried to insert an image, but couldn’t make it work

…It reared its ugly head again yesterday. Outside of foot on the heel, directly below my ankle, starting from the bottom of my foot and shooting up. I have been trying to get 10,000 steps per day in and I’m cleared to do anything I want except jumping/plyo. I was walking the dog on the same flat, paved park path we’ve been using and all of a sudden… Zing.

I limped for a good 1/4 mile after that then the spot sort of numbed out. I finished my 3ish mile walk, went about my day, and when I got to a place where I was going to be sitting awhile, iced my foot. It feels ok now so I guess it’s just more scar tissue breaking up.

This has been a good week of building strength and endurance. The dog is happy to report we’re going for lots of walks. New things this week:

• my physical therapist massaged the incision and tendon, and showed me how to have my husband do it. It was a little uncomfortable, but felt great and flexible afterward.
• I realized I’m going to be a much pickier shoe ho. I’ve already gotten rid of a beloved pair of Merrell low hikers and my Brooks runners, and a few other randoms I frankly never wore, because they rub my heel the wrong way now. This is a first: I tried 3 pairsof shoes the other day, and realized none of them would work with my incision. Maybe it’ll get easier after it’s desensitized, but for now I’m more than a little bummed.
• 3mph!! on the treadmill. That’s a moderately fast walk for my short little stumps.
• I put myself on a 90 day challenge of sorts, hoping that I forget after 90 days that said challenge ever existed and it just becomes my life. Part of that is 10,000 steps a day. I’ve been getting that most days, pretty easily. I love comparing pre op and post op after a 10,000 step day. What a difference. After a 10k day pre op, I would be out of commission for anything but painful waddling for the next several days. Now, I still have a stiff first several steps, but once I get moving it feels great.
• Day 107 post op I have an ortho followup. My physical therapist led me to believe I’ll be released back to full duty after that. I’m ready. The only movement I should avoid at this point, I have been told, are plyometric jumping types of moves. Everything else is GO!

I guess it’s time to get used to waking up for work again…

What a difference this week. Most of the pain on movement is gone. If there is any discomfort now, I’d call it stiffness. Feels like I need a good calf/achilles stretch (but not sure how aggressive I can be with it, so I just stretch it out by walking). Also feeling a faint occasional sensation of adhesion at the incision site. Feels like someone left a strip of double sided tape inside there. I watched YouTube videos demonstrating how to massage that area, but they made me cringe. I should note I’m not a squeamish person at all; my business after all is dealing with literally broken people. The massage technique was just that rough. I do massage the incision pretty firmly every night.

The week 4 PT routine is geared toward building strength.

• Treadmill at speed and time tolerated with emphasis on good heel to toe gait. Today’s new speed record - 2:8mph. Almost normal! (I’m short)

• Squat press 130lbs with balls of feet/toes – sets of 10, at least 50 – at extension weighted plantarflexion for 5 count then dorsiflexion/stretch for 5 count

• BAPS on setting 4, clockwise x100, counterclockwise x100

• Balance board (finally able to use the taller one for everything!) plantarflexion/dorsiflexion x100, inversion/eversion x100

• Balance on op foot on balance cushion, Karate Kid style – non op leg bent at knee up high and arms out to side – x15 for as long as I can stand

• 10 laps walking lunges.  Up on toe when stepping forward.

• Sumo squats with 25lb kettlebell, up on toes at end of rep - 50

• New - weighted with 25lb kettlebell on each side, walk across room, going up on toe with each push off. This was hard and damn near impossible on my op foot. If it’s like everything else that I’ve done, though, I will see results in  how I handle stairs or other routine movements, and by next session I’ll be better at the actual exercise.

Having read about many others’ post op experiences, I have to say, I am really grateful for being a best case scenario case at this point. It’s great to have a physical therapist I trust, that knew my abilities pre op. He pushes me for sure.

Like a good AchillesBlogger, I clicked the ad

http://www.kingbrand.com/Achillies_Tendonitis_Treatment.php?xc=5f63f901a75f4d6ee7be7fc96e165f11e2adc605

I’d like to know if anyone has personal experience with this product. It certainly seems like something I would use after activity or if sore. My physical therapist is also going to check their website out and give me his opinion Monday on its efficacy. If it actually does do some kind of stim therapy with heat it looks like something I’d definitely be interested in, especially for that price.

Anyone?

Much the same as week 2:

• Treadmill at speed and time tolerated with emphasis on good heel to toe gait. I got up to 2.6mph today!
• Squat press 130lbs with balls of feet/toes - sets of 10, at least 50 - at extension weighted plantarflexion for 5 count then dorsiflexion/stretch for 5 count
• BAPS now on setting 4! clockwise x100, counterclockwise x100
• Balance board (finally able to use the taller one for everything!) plantarflexion/dorsiflexion x100 ,inversion/eversion x100
• Balance on op foot on balance cushion, Karate Kid style - non op leg bent at knee up high and arms out to side - x15 for as long as I can stand
• 10 laps walking lunges. Therapist threatened to weight me this week for lunges, but after my glute on the non-op side seized up on the first lunge, he had mercy on me. I had to stop everything and stretch for about 5 minutes. It’s still really touchy. Thank goodness for the hot tub on the back deck.

Something I took notice of the last several days: Sore today because I was active = feels great tomorrow. Feels great today because I rested = will be very stiff tomorrow. So, that’s good incentive to stay active!

Added more activity this week with some weight work. This week’s routine:

Treadmill at speed and time tolerated with emphasis on good heel to toe gait

Squat press with balls of feet/toes - sets of 10, at least 50 - at extension weighted plantarflexion for 5 count then dorsiflexion/stretch for 5 count

BAPS on setting 3, clockwise x100, counterclockwise x100

Balance board (moved up to taller one this week) plantarflexion/dorsiflexion x100 - (still on smaller one) inversion/eversion x100

Balance on op foot on balance cushion, Karate Kid style - non op leg bent at knee up high and arms out to side - x15 for as long as I can stand

I did something on the treadmill at the beginning that tweaked something in my foot the wrong way. Maybe I should lay off the music. A good song came up in my shuffle and I decided I was going to walk “fast” (2.5mph) to it. The zing of pain was in the medial aspect of the heel, nowhere near where anything was cut or anchored. I’ve heard it’s pretty common and it did get better with activity. My PT attributes it to scar tissue breaking up. Anyway, that continued to zing me throughout therapy and during the passive stretches the therapist did after. My frozen water bottle works great for the bottom of my foot, but is too shocking for the sides,so I purchased a freezeable/heatable neoprene and Velcro wrap. It helped quite a bit, then I hit the hot tub and jetted the heck out of the bottom of my heel. Woke up this morning no worse for the wear, and was happy about that.

I think I’ll take the dog for a quick (ha!) walk around the block. I’ve been doing enough pf/df that I think I should be able to handle the hilly streets.

It went well. His evaluation showed I have really good strength and pretty good ROM for 8 weeks out, so we skipped modalities like the electrical stim and ultrasound. We are focusing on relearning a normal gait, strengthening, and ROM.

Today I did:

• 20 minutes treadmill walking, focusing on the heel-to-toe movement of the gait and taking even steps. That was so much more difficult to do than it sounded. The clunky uneven sound of my feet hitting the deck was really annoying me.
• 100 reps each on balance board of: dorsiflexion/plantarflexion, inversion/eversion

That’s it. It was enough to make me pretty sore. I picked up a gel heel insert and that feels heavenly right now in my shoe. At home I’m supposed to do the same ROM stuff as above (seated) plus big ankle circles. He told me I could do flat-footed kettlebell swings if I want and said we may incorporate that next session too.

I will close by saying I know this therapist very well and have been a client for years, either due to injuries or attending the fantastic kettlebell classes he does. He works with my insurance (that pays him a fraction of what my old insurance did), and is actually the person who recommended my OS. I really feel for people who have to go out there post-op and choose a PT on the spot, with no prior knowledge of how they operate.

There was an older lady in the office doing PT at the same time I was. She had painful peripheral neuropathy due to chemo, as well as pretty advanced spinal issues. While I was plodding away on the treadmill, cursing the fact I could only go 1.9mph, she was (barely) ambulating around the office with assistance, while the PT tried to talk her out of jumping in to further surgeries.

After reading so many others’ stories here, I realize how very fortunate I am to have healed quickly and uneventfully. As of now, it looks like I am on track to make the “best case scenario” recovery my OS had described - about 14 weeks total off work. My PT is very confident that I’ll be ready to go back to full duty after my 6 week followup, and that’s the best news I could ask for.

I’m sore but grateful!

Kind of sore on the bottom of my heel (nowhere near where my haglund’s pain was or where anchors are). Did I overdo it?

Per my Fitbit I’ve done a little over 5000 steps today. I did go to the gym with the intention of doing a little something for 20 minutes or so.  After 10 minutes on the elliptical, I was allover kind of fatigued, especially my non op leg. I stopped that at 10 minutes and did 20 on the stationary bike with feet flat on pedals.

Came home, did regular amount of standing while we cleaned out a hall closet. Barefoot, I wonder if that contributed.

Anyone else have bottom of heel soreness after going two shoes?

8 week follow up today. I did not get yelled at. Quite the contrary; OS was extremely pleased with my progress!  First pt appointment Monday with a therapist I’ve been using for years.

I was so taken by surprise that I hadn’t brought another shoe!

Being “me”, I did ask on the way out the door if I could take my dog for a (flat) walk. When he heard I have a German Shepherd, he said, “How about four weeks?” Ha, ok then. Maybe two.