30 weeks seems like a long time when you look at a calendar, and I guess it is a while, over one half of a year at least. However, looking back from now the only bit that seemed slow was the first 10 weeks, this was the time that my life was greatly affected by my injury. From 10 weeks forwards, I felt that good progress was being made, and at whatever the pace is, that feels great.
I see that there are plenty of new members to our ATR ‘club’ here on the blog, and I guess the only thing I can offer as advice is that things will return to normal eventually. I would say I am 95% there now. I cycle to and from work every day, I can stand and climb on my bike and even managed to fall off the other day without doing myself an injury (not counting my bleeding elbow and shoulder pain!). I can do small single leg heel raises, but am just letting this come along at a steady pace.
At the start of the process back in February I was concerned, and the road in front of me seemed long, but as long as you are making progress along the ‘road’ then it’s all good. I progressed at my own pace and felt that a week here or there did not make much difference in the grand scheme of the recovery process, no sense in taking risks.
So, good luck to all and I will be sure to keep checking in and reading peoples stories, it is interesting to read the experiences of others. The site is full of knowledgeable and helpful people who offer great advice on the recovery process and where I feel I can add to it I will be chipping in. I will continue to blog so that people can see that normal life does return, but maybe with long gaps in between.
TTFN
James
September 21, 2012
So, my physio discharged me yesterday at almost 23 weeks.
It could have been down to the fact that due to some transport disorganisation on my part I had to cycle from work to physio, which is kind of out past home and off in the other direction towards the countryside. Still, upon arriving I was well warmed up, went on the stepper, did to two footed heel raises and some single leg heal ‘twitches’ (that’s all I could manage). Some balance board (while catching a ball) and some jogging on a small trampoline.
She had a look at my ankles during the raises and reckoned that my prognosis was good and it did not appear that I had healed long and in time would be able to calf raise again at some point once strength allows.
Declaring that she was not required any more, instructions were to keep cycling with my clips, it is calf intensive and made a massive difference to my recovery. Looking back, it took guts to get back on my bike but I am glad I stuck with it. Maybe if summer returns to the UK (we had 1 week last week) then I may do some evening rides.
Also, regarding my cramps, she said to stretch after exercise and before bed and that should help.
So, my journey continues, just under self care and I will continue to blog.
Hope everyone is well, I see we have quite a few new members, off to catch up on posts.
J
August 1, 2012
Hello all, it’s been a while since my last post, I guess that as you sink back into a more normal lifestyle the ATR begins to drift backwards in your mind. Last time I wrote I was at 14 weeks, and here I am 8 weeks later!
Things have been steadily improving over this time, visits to the physio have been every 3 or 4 weeks at this stage. Every day I have been cycling the 10 mile round trip to work and back and this has been helping my recovery a huge amount. My physio said just do normal stuff, continue to work on pushing off the ball of my foot while walking and the strength will return and more or less that has been happening. My calf is slowly growing, and now I can climb hills on my bike for short times while standing and can set off / cruise along out of the saddle also.
I would describe progress as steady and say that perhaps every 2 weeks I have made progress that can be quantified when looking back retrospectively. I managed my holiday to the Le Mans classic at week 19, plenty of walking but I took my hiking boots and did them up tight and all was fine. Every eveing my ankle was swollen but the achilles was all good. This daily swelling has eased off a bit now at 22 weeks.
The one thing that reallly bugs me still is a few times a week I awake at night with really bad cramp in my lower calf muscle, like last night. Although last night has reminded me to blog today, the pain was almost unbearable and it did not subside for at least 5 minutes, and still hurts today. I guess now that my tendon is healed the pull of the cramped muscle is no danger, but it certainly feels pretty horrific and sends you into a bit of a panic at 2am!
Looking forward, I guess it is more of the same, calf muscle growth will hopefully continue but physio says 6 months to a year is not unusual for normal size to be returned! I have no interest at this stage of returning to the badminton court, I ebayed my shoes as they were 1 week old and loaned my lovely racket to a mate at work as it had just been restrung and that seemed like a waste! Cycling and swimming are enough for me at present and with 2 young kids to entertain I would describe myself as ‘risk averse’ at this stage in my life to further injury. Maybe one day I might give it another go, we’ll see.
I am off to read some posts and see how people are doing, happy heeling to all and I will check back again soon.
J
July 26, 2012
So, I am approaching the 14 week mark now and it has been a while since I blogged, sorry for my absence and I hope everyone is doing well, I will be off the the main site to check on people after this.
Things are going okay, I have my first physio for 4 weeks tomorrow as she sent me away last time to work on my walking and to just regain confidence in my foot. Overall that has gone well, I have been driving to some nice places with my wife and kids at the weekend, doing plenty of walking and finally got rid of my limp (98% of the time) last week at 13 weeks. That is not easy, it is difficult to shift!
At the weekend I decided to try my bike, I have a CX bike with SPD pedals, first I tried with normal shoes and went round my village a few times, it was ‘okay’. Then, I spent some time staring at the soles of my SPD shoes thinking about moving the cleats backwards, but then my shoes would catch the wheel so I thought this would be more dangerous than leaving them where they were. Finally I juust threw them on and went round the village again. IT felt better than normal shoes and my foot felt much more stable and predictable. Luckily I have a pair of Northwave MTB shoes so they are quite comfy and have a Vibram sole, I think this helps. A couple of pointers for thos thinking about getting back on the bike.
- Screw the spring tension right out on the ATR pedal
- When setting off, which I do with my right (bad foot) on the pedal, start not clipped in with the pedal more tawards your heel, for a short instance all your weight is on your foot and it feels safer this way
- Use your good foot to pull up and assist your bad foot in pushing down
- Concentrate and look ahead for dogs and other hazards!
- Remove both feet from the clips at junctions
Yesterday and today I have done the 11 mile round trip to work and back and each way takes about 5 minutes longer but I quite enjoy my relaxed ride in. I do not have to go on any main roads as I have a disused railway line to ride to ride on, this is very useful.
Other news, I still get quite a swollen leg, ankle and foot every day by the evening time which returns to normal size while I sleep. This does not seem to be getting any better at this stage, did anyone else suffer from that out there at this stage??
Also, people think I am better now because I am driving, walking and cycling slowly, I have to reasure them that I am still not anywhere near back to normal yet. I think you have to have medical knowledge or have suffered an ATR to understand the implications!
Good luck to all, off to see how people re doing!
May 31, 2012
Thursday night I decided to have my first evening out without my boot, someone was leaving at work and was going for a few beers and a curry, I set some simple rules for myself before leaving:
- Don’t drink more than 3 pints
- Don’t try to cross the road unless there is a big gap in traffic
- Always (ALWAYS) look where I am walking
- Don’t go too hot on the menu choice due to bed to toilet transit time!
It went well, and I enjoyed the freedom of having no boot in a social environment.
Saturday I decided to have a go at driving, my right foot being the injured one this has not been possible for me so far. I did a few laps of my local area then drove to the shops. It felt fine, but was hard work to begin with.
Yesterday I did some more driving and then 2 hours of gardening (Aircast back on for mowing the lawn) and yesterday evening I was really feeling like I may have done too much, my AT felt tight, my calf was hurting a bit and I had concerns. This morning however, my AT and ankle felt really good, a bit like your legs feel after a long bike ride, tired but well exercised.
So, I think that I have learnt from this weekend that it is okay to push, within limits, and in return you get rewarded with some progress, all be it fairly minor. Obviously this is a long road but every degree of ROM returning is a little step in the right direction. I drove today, 300% easier than Saturday, such a difference for 2 days.
My next goal is cycling (actually on a bike, rather than he physio exercise bike). I have this in my schedule for end of week 12.
Happy healing all.
May 7, 2012
Went to physio on Tuesday in a bit of a subdued frame of mind, felt that i had stalled out a bit and was getting frustrated. My PT suggested that we ramp things up a bit as my last wedge was due to come out and I was probably not feeling the love for my boot any more.
So, I did some bare foot walking on the bars in the physio gym, it felt great, the muscles in my foot working again and feeling some movement and circulation, difficult to descride but certainly good. I got a bit carried away and wandered up and down about 20 times.
Then, into two shoes and onto the recumbant bike where I found out just how much strength you lose in your calf by not using it much. I asked my PT to turn the resistance down, but it was already as low as it could go, so I did 4 minutes and burned 6 calories before stopping. As someone who usually cycles 50 to 60 miles a week I found this alarming.
Finally, I practiced walking smoothly in my shoes for a bit until I got a real bad cramp at the base of my calf muscle, so bad my PT had to massage it out, and I went back into my Aircast (no wedges) to go home.
The next day I awoke expecting the usual sort of day but my leg and foot felt amazing, good flexibility and ROM, no tightness in my achilles, just some swelling across the top of my foot. So, when I got to work I decided to 2 shoe it in the office for the day, brilliant, feels like a huge step forward.
I saw a post a few days ago about shoes, I have a 6 year old pair of Berghaus Trek Walking boots that I have been using, just the left one for the last 8 weeks but now I am in both during the day at work, they give great comfort and support to my ankle. So, courtesy of Amazon UK I managed to pick up a new pair on offer for wearing indoors at home for the next few months. They make me feel safe, supported and unlikely to go over on my weakened ankle, they work for me so just thought I would share that.
Anyway, hope everyone is groovy and looking forward to the weekend, here in the UK we ar suffering the raniest ‘drought’ I have ever known.
April 27, 2012
Here I am at 8 weeks post op, things are going okay but some frustration is starting to kick in now, I have not been blogging for a week or so and have been catching up with how everyone is doing today. I guess I have been having an off week and trying to ignore my foot and boot, get on with some work and other activities and put it out of my mind. It is strange how this thing messes with your mind a little bit!
Focus was returned yesterday when I went to my 5th PT session. It went okay, down to one wedge in my aircast boot now, I am allowed to carefully wear shoes in the house and other ’safe’ places if I feel comfortable. My range of motion is good, I can flex up past 90 degrees now and it does not feel too tight but when walking without shoes it brings home the work that I have to do from this point forwards, which seems a bit scary. My PT says ‘now the real effort of rehab can begin’ and I can start to get some strength back into my leg and this is no understatement, my leg feels week and prone to damage, a strange feeling!
I guess on reflection I underestimated this element of the process, I thought that at 8 weeks I would feel more normal. Still, I am determined that after the next few weeks I can do some leisurely cycling on my bike to help with the process and next week at PT I have the all clear to do some cycling on the recumbant bike, but my PT wants me to do stretches every 2 hours to try to improve my ROM during this week.
I miss driving, my wife drives me everywhere and I am not a good passenger, at least that is what I have been told! I have a manual (stick shift) right hand drive car so have to be able to do an emergency stop before being given the all clear to drive, a few weeks to go yet I think. Still, with the cost of fuel here in the UK at the moment maybe this is not a bad thing.
That is all for now, happy healing to all.
April 20, 2012
6 Weeks post op today, things are going okay. I had physio yesterday, my PT is pleased with my progress. On my last PT visit at 4.5 weeks I was told to start getting some more weight on the leg, this is easier said than done and is a scary prospect. So, I played with some weight transference and over last weekend I had some soreness around my AT, so I backed off for a few days.
My PT said that she might confiscate a crutch at yesterdays appointment if I had made no progress so Wednesday I did some 1 crutch walking around the office. The mental block that I had to overcome to put my weight on the leg was huge. In the end I was encouraged by my workmates at the office to give it a go with their assistance, and it went okay. Yesterday at my PT appointment I demonstrated my progress and requested another wedge out of my boot then did some walking in the gym with the bars, it felt okay.
Today, fed up with the weird feel of one crutch walking I tried some walking in the boot, and it feels good, no pains and although the pace is slow, it feels so great to be mobile without the sticks.
Vital statistics at this stage:
ROM: I can get to 5 degrees from flat with my leg straight and flat with leg flexed, side to side I can do about 15 degrees each way
CALF: It has not shrunk much but is a bit saggy, seated calf raises hurt my calf, but this feels good as it demonstrates a connection to my heal which is nice!
SWELLING: My toes and foot still have some swelling, my toes are about 20% bigger than my good toes.
SCAR: Dressing off now, it looks good, very narrow and a neat job. Finally I can have a bath, which feels amazing!! I will try to post a picture soon, need to find some instructions.
SLEEPING: I still sleep with the boot, tried without once, slept for 4 minutes before waking after flexing my foot in a panic, boot back on!!
I have some extra PT exercises which include stretching my knee as I am struggling to get it more mobile again, it gets better by the day though.
That is all for now, Happy Easter to all and more soon!
April 6, 2012
Here I am just over 4 weeks post op, my foot seems to be okay and is feeling more and more like my foot again. I don’t really have too much pain although it does swell up during my day at work but soon goes back down in the evening. I have been doing ROM exercises 3 or 4 times a day just to flex my foot ‘not into pain’ as my physio stated, it feels good and works well in the morning, not so well in the evening.
For all those out there who have been here before a question:
I can move my foot up to about 15 degrees (flexed down) through to around 35 degrees (flexed down). Getting to this point was easy but now I feel I am at a bit of a wall. I am not concerned as time is on my side but how quickly do people find their ROM returns from this point on, and what do they find helps it along the path to normal. I should state that I am not a very flexible person anyway, my good foot only flexes to about 10 degrees upwards so that is my goal.
I have physio this Tuesday, am hoping to lose a wedge from the boot and get some more weight over to my bad leg, both these things are listed on my protocol, although feel I will need to lose another wedge or two before I can FWB on my leg and walk okay. I have experimented with some more weight, feels okay apart from my 3″ heel!
Happy healing to all and hope all had a nice weekend. I had a nice few hours out and about at a local National Trust property, sat in the sun (22C here today) in the wonderful garden and watched my kids run around. I wanted to run with them but that might be some way off. I must say though that getting out and about felt great and watching the world go by was good enough for me!
March 25, 2012
My boot and I are quite close these days, he follows me round everywhere, and I mean everywhere. Bedroom, bathroom, kitchen, work…. I am allowed to be separated a few times a day to do some ROM exercises, but I never let him out of my sight.
The ankle is starting to free up a bit now, I can’t get back to neutral yet, put the swelling has gone down a bit and my foot is starting to feel like it is attached to my body again now. I am back to work during the week, chained to my desk. Even going to the copier seems like a hassle but my workmates are very helpful, they fetch me a coffee, give me a lift to/from work and keep up the banter to keep me cheerful, all small things but right now they help a lot.
A few things have bothered me but they don’t seem to be anything major:
- Heel pain, for the first 4 nights in my boot my heel felt like someone was putting knitting needles in it, that has eased a bit now.
- Sometimes my foot swells a bit at night, this causes major pins and needles in my toes, real painful. I have now learnt that letting air out of my aircast boot fixes this. It feels like nerve pain but I think is just where the boot goes tight.
- The wound was tight to start with, this has eased a bit now.
- When I talk to people they are unable to get their head around the recovery timescale, people arrange stuff for me or suggest things that are just not possible for me to do at that time.
My physio seems nice and is confident we will do okay getting me back on my feet again. I am allowed to PWB and next appointment is in just over one week to check progress. Then I will be 4.5 weeks post op. If it helps for anyone reading this who has just torn their AT the time is going quite quickly, although my wife assures me it is going very slowly! I miss my car and my bike and my children are wondering why my foot is not fixed yet.
Happy healing to all!
March 18, 2012
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