So, had my 12 weeks (strictly speaking that would be tomorrow) check-up today with the physio, and my OS popped by to check in as well. Following my OS having a quick discussion with the physio and a check of the scar, I have now been officially released by him to the care of my physio for the remainder of the recovery.

Happy to report that I’ve now managed to build back some muscle in the calf, exactly 0.5cm at the widest point (circumference) compared to the previous measurement. The difference to the healthy leg is still significant and noticeable (1.2cm on the measurement), but moving in the right direction. All the rotations and plantar/dorsiflex ROM is equal to the healthy leg, both with open chain and closed chain (understand the latter typically recovers a little later when you can start stretching, you can test by seeing how far you can have your foot from the wall and still push you knee to the wall while keeping your heel on the ground).

Otherwise went through an escalation on the physio exercises, the specific rehab work now involves heel raises standing on an edge of a step (starting from negative), initially with going up with two feet and coming down on one, and in the next couple of weeks moving toward single leg. Also standing heel raises with knees bent leaning on knees (escalation of sitting heel raise), as well as a couple of different squats (with weight encouraged) and balance work (on balance board, bosu-ball etc). Finally tried out running on a treadmill for 5min (with slow pace), and it worked well, according to her my step was effectively normal and it felt perfectly fine. So I’m now also cleared to start running on the treadmill, initially with 5min run, 5min walk, 5min run etc, and building up from there. Outside of the specific rehab exercises, I’m cleared to do most things (including rowing now that the closed chain rom is good), apart from things involving jumping and similar explosive moves.

So very happy with the progress, especially getting back to running feels exciting!

Finally, inspired by Donna, here are the milestones of my ATR recovery so far:

- 20 Oct 2014 – Full rupture of AT (and plantaris tendon) playing basketball. Quickly diagnosed and put in a splint to await surgery.

- Surgery 3 days later – Done under spinal block, standard surgery with the addition of the Lynn technique (plantaris tendon used as “cover” for AT repair). Foot put in plaster cast, set at nearly 90 degrees.

- 2 weeks post-op – Stitches taken out, moved to Aircast boot with no heel lifts, and directly to FWB (within the day, didn’t use crutches since). Also started PT with some simple exercises three times a day.

- 4 weeks post-op – Second physio, added some resistance to the exercises with a theraband etc.

- 6 weeks post-op – Moved to two shoes, for the first week avoiding strong push from ball of the foot. Physio expanded to involve squatting, stationary bike etc.

- 9 weeks post-op – Walking getting to normal with a normal push, added training on elliptical to workouts

- 12 weeks post-op – Released by OS to care of physio for rest of recovery. ROM completely normal, can manage a (kind of) single leg heel raise, cleared for running on treadmill and most other activity apart from jumping etc.

That’s it up to today, in hindsight it feels like the first 12 weeks have actually gone by fairly quickly, and I’m very happy with the progress so far.

Just a very brief update this week, as not that much has happened, will try to update a bit more next week (and also include my milestones following Donna’s example) when I’ve had my 12 week check-up.

Things continue to move along incrementally, I’m starting to see some proper muscle definition in the injured calf, and the strength is slowly returning. I’ve continued to follow the physio protocol, I’m sure I’ve never done anywhere near this much work on my calfs before… On the heel raises, I have continued to incrementally increase loading towards the injured foot, which is managing it better and better. I can (kind of) do a single leg heel raise on the injured foot now, I can get my heel off the ground, and when going up with two feet, I can hold myself up with the one leg, but starting from the bottom I can’t get myself all the way up with one leg. Based on recent progress, I expect that will happen in the next week or so hopefully. One point here to everyone doing these is to focus on the eccentric contraction (i.e. coming down slowly, rather than just up-down quickly), this has really helped me build strength. I’ve also continued with the cardio on bike and elliptical as before.

Otherwise walking is completely normal now (although at times still need to think about it a bit more), I’m back to walking to work now that I’m back from holiday, so getting a bit of pure walking in that way everyday as well (about 1.5km each way). Looking forward to my appointment with physio and OS next week, if there are no issues (as I don’t think at the moment that there will be), it should be the last one with the OS, who will release me to the care of the physio from there on…

And here is once again a picture of the scar today, at 11 weeks: