John’s AchillesBlog

Hi all,

Hard to believe that it’s been 19 weeks since ATR surgery, and I just had only my 3rd (of 4) PT sessions that were provided by my medical insurance  No massage, cool machines, or even weekly PT sessions - just thirty minutes every 2 weeks to show me how to do several rehab exercises on my own at home!  I guess the only bright side is that it hasn’t cost me much money out of pocket.

The hardest part of my rehab is getting myself to do these exercises every day at home - it is a real grind - and certainly not as fun as going to the gym or doing aqua aerobics!  I know the rehab exercises are critical to getting back to full strength, though, so keep pushing myself to try to do at least one set a day.

In my latest PT session, I was happy to find out that my ROM is back to normal in all directions - Woo Hoo!

Then came my first attempt at single leg calf raises - yikes!

Single leg calf raises are the scariest part of my rehab program now.

My therapist had me try a series (see below), and it made my achilles sore for two days. Now I’m nervous to try them again, so I think I’m going to just go slow and concentrate on the easiest of the calf raise series until my tendon seems ready to move onto the next. Maybe I’m being too cautious - not sure…

I’ve really appreciated  others on this site sharing their PT exercises (thanks starshep, ryan, et al), so in that spirit wanted to provide my latest “homework assignments”:

Bosu balance drill - Double and single leg balancing, progressing to include a ball toss/catch against a wall

Calf raise series:
=> first 2-footed (up with both feet, shift weight, lower on bad leg),
=> second up/down with bad leg with my good foot constantly on my toes,
=> third up/down with bad leg with my good foot constantly on my toes up on a step,
=> last up/down with only the bad leg, my good foot off the ground.

Star exercise - Standing on single leg, place and pickup cones (or plastic cups) in various positions to your left/right/front,

Ladder Step drill - kind of like a football drill where you alternate stepping on the outside of a “ladder”, then stepping into the middle of the “ladder” for about 10 feet (not using a real ladder of course but tape in that shape on the floor),

Side Step drill - shuffle sideways with both feet then touch the ground with your hand at the end of each right/left/forward/backward direction (similar to a soccer drill I used to do pre-ATR),

Box Jump drill (two footed progressing to single leg) - hop into each quadrant of a 4-square box in clockwise, counter-clockwise, and diagonal directions with increasing speed.

My therapist said that once I can do the box jump drill without pain, then I’m ready to start running again.

Given how tough all of these drills are for me, I’m definitely not planning to run any time soon!

To those of you in the early stages of your recovery - take heart - it won’t be too long before life does get back to near normal.

I wish a safe recovery and fast healing to all of you!!

FINALLY…walking in 2 shoes again!

Since my last post 4 weeks ago, I’ve been traveling in Spain and England with my kids and grandkids. After many long days walking around Spain in my boot, I only had relatively minor achilles soreness/swelling, and fortunately it didn’t slow us down much.  The boot gave me a feeling of security when on the many cobblestone old-town areas of Madrid, Seville, and Cadiz and when climbing up and down the hills and steps at the Alhambra in Granada.  I even chanced going out barefoot and in flip-flops  a few time on the Costa Del Sol beaches in Marbella!

Last Friday, the first day back from the Europe trip, my surgeon gave me the awesome news that I was ready to ditch the boot FOR GOOD and go into 2 shoes.  He didn’t recommend wearing my favorite Vivo barefoot shoes for another few weeks, but surprisingly did say barefoot shoes may help with recovery later on.  And, he FINALLY scheduled me for PT.

Two days ago, I had my first PT appointment (nearly 14 weeks after my ATR repair surgery), and have begun a new stretching and exercise PT regimen.  My baseline ROM measurements were pretty good for just getting out of the boot.  On the plus side, eversion ROM is the same on both good and bad ankles.  However, plantar flexion ROM is about 5 degrees less, dorsiflexion ROM is about 8 degrees less, and inversion ROM is about 15 degrees less than the good ankle.  Maybe walking around the house in bare feet since week 6, and Theraband stretches throughout the last 8 weeks (my docs do it yourself home PT plan), contributed to a decent initial level of flexibility for the injured ankle?

The BEST news though is that I can now go back to my old exercise routine!!!

So I’m back to 3-4 days of water aerobics, and 2 gym training sessions per week.  The water aerobics classes are especially helpful, as I can do some minor jumping, heel lifts, and running in the water - things I can’t really do out of the water yet.  Kicking in the pool also seems to help break up my scar tissue, and the hour long classes are a great core and cardio workout.

So while I can’t get back out on the soccer pitch just yet, walking around outside without a boot and getting back to my old exercise routine is a truly wonderful feeling!

Hoping that all of you out there are enjoying mini-successes on your own rehab marathons!

Hi all,

Just finished my 9 week post-surgery appointment, and the doc wants me to stay in my boot another 4 weeks, and won’t begin physical therapy until week 13…arrrgggghh.

To recap, I’ve been in the boot now for 4 weeks already, the first week I was PWB, and my foot felt strong enough that I went to FWB in the boot at week 6 (and essentially walking barefooted when in the house).  Putting the crutches away for good felt awesome…even better than getting the cast off.  My doc had me do ROM work with bands over the last 4 weeks, and grudgingly let me use a stationary bike with boot when I pressed him on email.

I’ve kept up my 2/week personal training sessions at the gym since my ATR surgery, which has really helped keep my core and upper body strength intact throughout the cast/boot period.  I would definitely recommend following a core/upper body exercise program during that timeframe - both for your physical and mental health!

Given that I have had only 3 doc appointments now in 9 weeks since surgery, at an average of 5 minutes time each, I wonder how much my doctor tailors his patient’s rehab plan based on actual progress, or just follows a set conservative schedule regardless of how well the patient is doing?

And lest I seem too hard on my doc, I am thankful that the surgery went well, the incision has healed nicely, and I am walking around very well in my boot.

I have a 3-week family trip planned to visit Spain in mid-April, so it’s probably prudent to keep following the doc’s conservative rehab plan so that I don’t risk a re-rupture, and jeopardize going to the Alcazar and Alhambra.  Wish I could have thrown the football on the beach in bare feet with my grandson, but that will come soon enough.

Slow and steady it is then

Hi everyone,

Seems like I know many of you already from my many days of reading posts over the last 5 weeks.  Before starting with my injury, let me thank Dennis for organizing this blog, and all of you out there for sharing your experiences with this injury and its trying rehab.  Having extensive and timely information is really important when you are hurt and wondering first what you have, then what to do about it, and finally how to cope with it.

I am 52 and very fortunately was able to retire about 1.5 years ago.  As a kid, I loved playing soccer but gave it up in high school and never seemed to have the time, nor was in the shape necessary to play during my working years.  One of my goals at retirement was to get back into the game that I loved.  After getting in pretty decent shape via 2 years of gym training and some aerobics classes, I took the plunge.  Needless to say, ballistic movements are a lot different than gym training, so I had a few (several) hamstring pulls that kept me off the field more than on during the first year.  Then in January, after doing some extra training work on my ballistic running, I decided to take an indoor soccer class at the local community college to get my soccer fundamentals back.  It was during that class that the dreaded “coach some kid must have kicked me when I got the ball away from them” happened.  And so on January 25th 2012 I joined “the club”.

Against norm of the north’s best advice (awesome posts by the way norm, and others), I decided to go with the surgical route.  Surgery went well, and the surgeon noted that the tendon ends “looked very good”, so that he felt a strong tendon recovery was possible.  After 11 days in a splint, and 3 NWB casts (1 per week), I was allowed to move to a boot (non-hinged unfortunately) three days ago and moved to PWB.    I am already wanting to move to FWB in the boot - ok, I admit I cheat sometimes and try it every now and then just because it is convenient.  I really haven’t had all that much pain, except for the first day or so after the ATR, but I realize from “Frouchie” that slow and steady wins the race, and several of you others that no pain may not mean progress with this injury, so am trying to be a little conservative in my rehab.  I have a trip planned with my kids and grandkids to Spain for 3 weeks in April, and want to be as mobile as possible while there - if I mess up and relapse the family will disown me!

My surgeon will review my progress in another 4 weeks (ATR plus 9 weeks).  However, he has said that over the next two weeks I can go to FWB, and then wants me to continue FWB in the boot until I see him next.  My biggest question is how do I know when it is time to go FWB?  As I mentioned before, I have no real sharp pains, just some swelling and it isn’t uncomfortable when I try FWB in my boot for short distances in the house.  Should I continue to follow the 2 week PWB protocol as my doctor suggested, or move to FWB sooner because it feels ok?

As for PT, the surgeon gave very little to perform now that I am PWB, and what he gave me seemed a little odd based on reading through some of the extensive PT plans that you all have provided on the site links.  He has me doing ankle flexion-extension with and without a resistance band a few times per day.  After I sent an email asking him about using the stationary bike in the boot, or doing some walking in the pool at my gym (without boot), he emailed back that all FWB should be in the boot until he sees me again.  I believe that allows for the stationary bike in the boot, but not the pool which I can’t do with my current boot (of course the Vacocast would allow that option, or maybe some other brace?) .  Needless to say, after seeing the PT regimens that you all have shared, I have added many of the exercises that are in Dr Berkson’s 4-8 week rehab program link, and may cheat and get in the pool without the boot after I go to FWB.  Seems like many of us ATR patients are given little in the way of PT in the first 8 weeks, so many of us go with our gut, and sound plans from others, and do a little more!

So I just wanted to say hi to everyone, and thanks again in advance for all of the good advice that I’m sure you will provide me along my marathon

John