20 Weeks and the healing value of sloth, er … I mean rest

I’m 20 weeks post-op and seem to be recovering at about the same rate as most, with the frustrating consistency of inconsistent improvement.  But those of us 5 months into recovery know all about that.

Mind you I’m not complaining; I can walk without a limp (most of the time), laugh at stairs (bounding up and down) and rarely need to cool down my repaired bits at night. Do miss the routine of ice and bourbon though.

No rehab for a week, gasp!

Was forced to do no rehab for 7 days (except for elastic bands and wall stretching) due to a nasty intestinal malady. While I suppose other folks made of stronger stuff would have been more active, I’m not one of those people. A diet of rice, apples and countless trips to the comode is my excuse.

Now here’s the cool part, I’m walking and moving around much better than I was a week ago. The forced “recovery rest” apparently allowed my body to catch up to the work I’ve so diligently done since starting post-op rehab and exercise.

Athletes know rest is key to long term success, duh!

To any athlete this is an obvious phenomenon, rest is an essential element to an intelligent workout regime. Maybe not a forced whole body timeout for a week but certainly any weightlifter will tell you that muscle mass is built up in the rest/recovery phase of an effective workout plan.

And as a reasonably fit and active person I know all about this.  A good ATR recovery plan is not a 24/7 activity, most exercises are performed at most every other day whether it’s under the guidance of a physical therapist or self directed.

Given what I experienced then, should complete and periodic “stops” not be part of a long term ATR rehab plan? I have not seen anyone bring this issue up in our active little ATR clubhouse. I think the reason is we’re intensely focused to recover and the thought of not doing something active for a whole week is an anathema to “serious” recovery.

So follow recovery junkies, am I onto something or just rationalizing a week of sloth, the circumstances notwithstanding?

12 comments February 9th, 2012

Progress Plateau Progress …

It’s been 17 weeks since my achilles tendon was repaired (Complete tear of tendon and significant calf muscle involvement).

I’m walk’in with no or barely noticeable limp (when I try to walk too fast) and can comfortably do normal daily activities. Driving can be a little painful (and cause a lot of swelling) if it’s for too long, it is in effect a strenuous rehab to keep the foot on the accelerator.

Net, I”m learning that recovery is non a linear path. Damn frustrating at times.  Here is a brief history of my recovery.

Had conservative recovery protocol after surgery, non-weight bearing for 9 weeks in hard cast and boot then transitioned from PWB to FWB in boot over 3 weeks. Finally began 2 shoes (with .25″ heel lift) in mid December, starting at an hour a day indoors.  Took about 3 weeks before I was able to be in 2 shoes full time (well 99%) including outdoors.

Now the boot is a memory although not tempting fate by tossing it!

Started structured PT after 12 weeks although did as much walking as pain would allow as soon as doc gave me the OK to PWB.

See physical therapist 2x per week for 1.5 hours per session plus 20 minutes of stretching every day and the gym 2-3x per week.  Do a lot of walking everyday and take care to do it the right way, driving off the ball of my repaired foot with every step.  I pay for that at night with swelling, my evening ice pack and bourbon have become a sacred ritual :)

Followed a modified rynab diet and supplement regime for the first 14 weeks, surprisingly still like jello although not 4 packs per week!

So why the blog post title Progress Plateau Progress…?  Because that is exactly what I’m experiencing now. Not complaining, was told this would happen, sort of like the retail 80/20 rule.  In 4 months I’ve come a long way, but that last bit (like running and jumping) will take another 4 - 8 months.

So to all you recovering ATR’s remember everyone’s recovery is different. But be forewarned that it’s a long slog, just like we were told it would be.

3 comments January 19th, 2012

2 Shoes, Ministry of Silly Walks

Finally got the OK for 2 shoes at 11 weeks post surgery. My recovery path has been conservative; NWB till week 8, was full bearing a few days after that. Start PT later this week and was told by the surgeon to walk without a limp, no mater how slow I go.

And slow am I walking. With time and PT it will get better but right now I feel like I’m in the Ministry of Silly Walks (If you don’t know what it is, check out Monty Python on YouTube). At a pace Tim Conway’s old man character would like.

2 comments December 13th, 2011

Another great thing about sleep

I’ve discovered another great thing about sleep.  Every morning I’m walking better than the day before.  Is that cool or what!  Yeah I’m stating the obvious but it was not to me when I started walking in my boot 3 days ago.

I got the OK to start PWB  on Thanksgiving day and progress to FWB at a pace I’m comfortable with.  It’s been 8 weeks since surgery so my leg has been inactive for quite a while. After a few days I’m able to walk slowly without a crutch although do use it when outside.  I suppose waiting 8+ weeks before starting weight bearing does have some benefits.  Ankle flexibility is surprisingly good, it’s at zero degrees pretty easily.

I have no idea if this is appropriate progress or not but to me it’s wonderful having the use of my arms again.

During my NWB period I slept in the boot, which I hated.  Who’s comfortable sleeping with a high tech moon boot on a bunch of pillows?  I certainly was not.  Waking up in the morning was my own personal Ground Hog Day and like Bill Murray, I dreaded the the alarm knowing that today would be the same as yesterday, boot still attached.

Now waking up is great, no boot and walking better every day.  Of course the pace of recovery will soon become maddeningly slow but today I’m relishing the progression to becoming a fully functioning biped again.

Only things I’m not happy about are the popping sounds emanating from my cranky ankle and chronic knee soreness. But having not used the ankle or knee for 2 months that’s to be expected. Just have to remind myself that there is a lot of scar tissue to be broken up.  I’ve been through that before when rehabbing my knee 20 years ago. Ah the memories …

2 comments November 25th, 2011

A shoutout to our partners

It’s easy to forget that our partners (wives, husbands, whatever) suffer from this injury in big ways too.  The list is endless, especially in the early stages of post injury recovery.

Suddenly the time we don’t spend doing stuff like picking up the kids after swim practice or any activity that requires a functioning achilles tendon falls on them.  Not to mention the increased stress level that the whole family shares in spite of our best efforts to contribute to household activities.  Which in the first few weeks of recovery is mostly well intentioned, not particularly helpful and often counter productive.

I do not suggest walking your 75 pound energetic golden retriever 2 weeks after surgery while on crutches, trust me on this.

So, I try to thank my wife every day for all the extra stuff she has to do. Try is the operative word because I don’t manage to do so as often as I should but I’m aware how fortunate I am, even if I don’t always articulate it.

For sharing this experience our partners deserve a medal and buckets of gold, which of course they won’t get.  But acknowledgement and appreciation for what they do for us, let’s make sure they always know that.

Of course my wife does remind me at times, especially on those days when all the extra stuff really piles up that the moment will come when I will be a fully functioning human again able to pick up my share of the family schlepping. And I will do so, gratefully and with good cheer.

I suspect payback will be a bitch but fair is fair :)

4 comments November 21st, 2011

8 Weeks Post Surgery Update

Have not been here for a while, the support and advice found in so many posts contributes to recovery, thank you everyone!

The good news is I’m healing well, my surgeon is more conservative than many at 8 weeks, so I’m just starting PWB but I should be transitioning to FWB within a week or two, Yippe!  The bad news is I lunged for that shot on the tennis court back in September which caused this mess but there is nothing for that now.  Lost the point too, damn.

My doc does not want me to start PT until I’m FWB and not using crutches at all, probably around 12 - 14 weeks.  Is that typical of many recovery timelines?  I’m comfortable with how things are going albeit with the usual frustrating moments so not going to change anything, just curious.

5 comments November 21st, 2011

4 week checkup and advice for Ryan Howard

Had my 4 week post-op checkup today.  Good news is I’m healing nicely, stiches finally removed, did not look too gnarly.  And I am out of the hard cast and into a snappy hightech, adjustable “soft” cast.  Sadly I’m going to be in it for a while yet, still NWB and that won’t change until Nov 21 at the earliest.

Discussed my conservative treatment with the surgeon.  His reasons are my repair was more extensive than most and, there is a higher probability of healing long when starting weight bearing and PT too early.  Of course exactly when it’s too early in the treatment timeline is a matter of conjecture.  He’s very clear though a longer recovery minimizing the possibility of healing long is preferable to accelerating the process and possibly having less use and strength of the injured leg.

I’m taking the long view, my physical condition is more important a year from now then next month.  Although that does not mean I’m not frustrated and impatient.

For whatever it’s worth Dan Marino (A great NFL quarterback from the 80’s and 90’s) suffered an ATR, came back quickly but was never the same.  He said later he rushed his recovery, healed long and did not have the push off his back leg to be the quarterback he was pre-injury.  Ryan Howard of the Phillies (Baseball for you non yanks) heed Marino’s advice and don’t rush your recovery!

2 comments October 28th, 2011

“Good” achilles and calf pain

I’m 4 weeks post surgery NWB and still in hard cast, hopefully that comes off at my next doc appointment in 2 days.  I’m quite active and adept on crutches and knee scooter.  Here’s my concern, by the end of the day my “good” achilles and calf hurts!  Sore, achy and occasionally sharp nerve pain.  I’ve taken to being very careful when moving, not twisting or stretching when planting my leg.  Anyone having the same experience? Needless to say I’ll discuss this with the doc when I see him.

4 comments October 26th, 2011

A subtle recovery milestone

Well it’s 2.5 weeks post surgery.  Only reason I’m even mentioning it is I noticed a subtle but positive milestone in recovery.  I’m still in a hard cast and will be for another 5 to 6 weeks.  But my leg feels different … in a good way.  Sort of “whole” for the first time since the injury.  Might be some wishful thinking but I’ll take it!

3 comments October 14th, 2011

Snug hard cast

Just had an interesting discussion with my surgeon regarding how snug a hard cast should be.  My concern was the cast was overly snug, exposed toes are red and even mildly purple’ish when leg is not elevated.

The doc said a snug cast is preferable to a not so snug cast following the first few weeks of surgery.  I take that to mean the less the repaired bits move, especially during the beginning of the healing process, the stronger the repaired bond will be.

Of course if the leg gets painful or I cannot feel my toes than the cast will need to be removed and replaced, but that has not happened yet!

Makes sense to me, the inconvenience of elevating my leg while at my desk is a fair trade for maximizing the quality of the healing process.

My assessment of the surgeon’s healing and rehab approach is he’s on the conservative side.  He’s had the same surgery which I think helps and he had to do more repair on me than typical for an ATR so I get where he’s coming from.

In any event there are just 11 more days to getting a removable cast, although I still won’t be allowed to weight bear at all till 6 weeks post surgery, ahh!  Not to mention I’m warming up to my shiny blue cast :)

Add comment October 10th, 2011

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