From Volley to Folly and Back

Ok, well - I sort of went on a rant about my P.T. session on Wednesday, and then decided to pull down my post, as I felt my attitude wasn’t in the right place and it did nothing to serve other people on this site.  I’ll just say recovery (mine at least) is a swing of lows and highs.

For a recap, let’s just say I didn’t feel I was being led by an ATR ‘expert’ at my first weight bearing PT session.  I had another session this morning and still feel largely the same way, but I also realized she was right on Wednesday about needing to push my flexibility before I get too ahead of myself in other areas such as strengthening.   I was basically at neutral but couldn’t follow through in my step with my bad leg beneath me because of this limiting angle.  I could get around this somewhat with the heel wedges in my shoes, but I really wasn’t seeing much progress in bare feet.

So the last few days I really just focused on stretching and trying to increase my dorsiflexion enough to enable my walking gait to feel more normal.  I started stretching my achilles just to the ‘edge’ of discomfort as my PT suggested (using a towel to pull my toes toward me, sitting in a chair and sliding my feet towards the chair, etc. ).  I assume this is one of the most scary things many of us will do during recovery. After all, at first every time I would put pressure on the tight tendon, the back of my mind is hearing (and fearing) one thing: ‘pop’.  But you can’t be afraid forever, and it took me awhile to stop hiding behind the fears and realize the tendon is strong enough to be reasonably pushed (well, pulled - technically).

The stretching really paid off quite quickly.  I couldn’t have gained more than 5-8 degrees of ROM in two days but it was enough to make a huge difference in my walk.  I ditched the wedges in my shoes and spent quite a bit of time on the gym track focusing on my walking technique.  What a great feeling.  My limp decreased to the point where my walking motion is not ‘interrupted’ by the bad leg.  Right now, it is just limited in the size of step and the amount of push-off my weaker calf can give.  This is just fine for now - I’m not looking to burst out of any starting blocks anytime soon.

Perhaps progress in your walking gait doesn’t warrant a full blog post, but for me it was a big deal so I’m sure someone out there also found this to be a milestone.  I posted my ‘first steps in shoes’ video last week, so I’ll post another one later this weekend showing my shiny new walking gait.

Footnote: Thanks, Stuart, for your comments to my previous post before I yanked it back off the site  My doctor didn’t specifically mention heel wedges in shoes, but she did indicate that I shouldn’t expect drastic improvements in my dorsiflexion before our next visit in 5 weeks.  The heel wedge idea made sense to me, so I tried it and it felt good.  This is where much of the disconnect with my PT was -  I was just really taken aback when she acted like the heel wedge idea was the craziest thing she ever heard, as it seems like such a common technique used by other people rehabbing on this site.

Yesterday I was feeling pretty good about my recovery, having just learned to take steps in the boot during week 5 for the first time.  I decided to get some heel cushions/wedges (Scholl’s) and try on my running shoes.  Wow, feels so much better than the boot!  My ankle and leg are obviously still very weak - having little to no calf strength means I’ve got a good limp yet, and my ankle has weakened enough to where I definitely wouldn’t try the shoes on an unpredictable surface just yet as an ankle roll isn’t out of the question.  The best part about it though, is that after concentrating on and ’shooting for’ the proper walking form, my calf definitely feels used afterwards, which to me means huge progress.  Still have to be careful though - with two shoes on and weeks of inactivity my instinct is to take off running or just start jumping in place!

Here’s a short video of my first steps. (I’m mumbling basically the same thing I’m describing above)

I also took a test drive in my wife’s car (not mine, it’s a manual so I’ll start with two pedals).  Felt pretty good, however I’m not quite ready to hit the interstate towards downtime in morning traffic.  A few more days of practice and strength in my calf should do it though.  The problem now is that with my heel on the floor mat rolling from gas to brake, my calf still gets worn out pretty quickly, so I have to lift my leg from gas to brake.  Fine if you are driving in calm traffic, not good when you are constantly getting cut off in traffic.  I’ll get there very soon though.

I’m just pleasantly shocked at how quickly things are coming back after finally (carefully) applying some weight.

Here’s a smile for my fellow ATR’ers.

As I mentioned before, my wife and I have two very high-maintenance Huskies.

Meet Rafa and Rush:

Rafa

Rush

Cute, right?  Yeah, ONLY when they have had their daily walk.  After all, they are huskies, that’s what they are made to do.  We live in a nice suburban neighborhood and our house backs to a 1.5 mile walking trail that we use every day.  Which made my achilles rupture on May 21 that much more devastating - start of summer, and now my wife is on her own with the dogs.  That is, until I decided on about the 3rd day after surgery that I wouldn’t let this destroy my summer on the walking trail.   The problem is, it’s a hike all the way around and something like a knee walker just won’t do.  Time to get hardcore.  And thanks to craigslist, I found the answer.

Meet ‘The Mulberry Machine’

You laugh at the basket, but they put those there for a reason.  Use. ful.

If, in your recovery, you have ever used one of these things at Wal-Mart or the grocery store, don’t worry - mine goes much faster.  Those are for sissies, this is the real deal.

Simply put, this is the best $350 I have ever spent.  Period.  I’m off the couch, enjoying a little nature, giving my boys the attention they need, and as a bonus have given a chuckle to countless friends, neighbors, and passerbys (picture a petite woman walking two large dogs with a guy on a scooter and my guess is you will smile :)).  But, you ask, where does the nickname ‘Mulberry Machine’ come from?  Well, turns out this thing is useful beyond just carting my broken down body around the trail.  Our walking trail happens to be on a stream filled with mulberry trees, and if you’ve never had mulberry pie or mulberries ‘n’ icecream, you are missing out.  We hauled in over 2 gallons of freshly picked mulberries using the scooter, and it treaded in the grass and carried the load with ease.  Yes, I’m a 30-something year old on a mobility scooter, and regardless of your age, you know you want one too

I had my 2nd post-op visit with the surgeon this morning, at almost 6 weeks.  It’s funny how you look forward to a date on a calendar for so long and the meeting literally lasts for a few short minutes.  That’s pretty typical here I’m sure.  Luckily, it was short but also very sweet.  At my 2-week appointment I had been told ‘absolutely no weight bearing’, so I expected to be told to slowly start applying partial weight, but she took a look at the incision and said it looked good and my next step was to ‘ditch the crutches’  - using the boot as needed and progressing to shoes.  I really like this as it feels like I am now more in control of my own destiny (although I knew I was before and cheated a bit on the NWB, but very cautiously).  So, it’s on to more involved PT.  The thing I really want to focus on is to increase my dorsiflex range so my walking motion is better - still very much of a limp in the boot and I haven’t tested the waters much without it due to the limited motion at about neutral.  And of course waking the calf from the dead will be fun - I saw someone signs of re life this week as I did some swimming (felt wonderful) and also some light thera-band plantarflex exercises.  I will say if you have access to a pool there isn’t anything better at this point in the recovery for boosting your mood and giving your foot more confidence.  I’m ready to get moving again!

Here are a few photos of my first few weeks:

Day after injury #1 - OUCH!  The bruise was still slightly visible at 5 weeks!

Day after injury #2: Another beauty shot of the bruise.  Sexy!

Day after injury #3.  Well hello calf, I remember you - and miss you dearly.

Post-surgery cast.  R.I.C.E., R.I.C.E., R.I.C.E.

2 wk post-op visit #1: Post surgery cast - waiting to give it the boot in favor of ‘the boot’.

2 wk post-op visit #2:Oh lord, please watch the leg with those things.

2 wk post-op visit #3:Whew, freedom - I don’t think the smell was too bad but I wasn’t the one removing it either!

2 wk post-op visit #4: I remember this - scary feeling hangin’ in the air there.

2 wk post-op visit #5:  I little bit of an oversight from the surgery clean-up crew - yuck!

2 wk post-op visit #6:  The stitches’ last seconds.

Today at 6 weeks:  ’The angry red line’.