20 Weeks Post Op

Five months after surgery, my surgeon is letting me go. Saw him today and he told me I don’t need to come back unless I’m having problems and no more physical therapy will be prescribed. Going to miss those guys! At my last session earlier this week, they gave me a black Theraband as a parting gift. Working with them made all of the difference in my recovery.

I did have a setback a couple of weeks ago where I pushed too hard (jumping, squats, jogging) and strained my posterior tibial tendon. Had a very painful couple of weeks where we backed off in physical therapy with less aggressive exercises and the PT worked on it instead of my Achilles with the deep massage. It was significantly better this week. I plan to slowly ease back into activities; the PT suggested adding one thing a week to see how it feels. My surgeon gave me some inserts for my shoes to tilt my foot and to give my PTT a break.

A couple of shoe inserts and a Theraband later, I am on my own for the rest of my recovery.

I have all of the exercises I need to work on my calf, which feels strong, just smaller than my left. I bought a balancing pad to build strength there. I do toe walks, heel walks, monster walks, and heel raises. Double heel raises are easy and I can go up two, shift to one just fine. A controlled single heel raise remains elusive. The surgeon doesn’t seem to be too worried about it. He just says to walk a lot. So, hopefully, spring will eventually arrive (another Midwest snowstorm this weekend) and I can get outside to walk. I plan to continue to focus on upper body and core at the gym while riding the assault bike. Still afraid of aggravating the PTT with rowing and squatting. I’ll add them back one week at a time. I was hoping to get back to Crossfit classes in March, but I’m pushing it back to April, just to be sure. I’m tired of setbacks, so I’m ignoring all of the other blogs that show people doing a ton of activities at five months. My body told me to slow down, so I’m listening this time.

On the bright side, I noticed a definite improvement overall this week. My Achilles feels stronger and more stable. The limp is gone and as long as I don’t go too hard, the PTT feels fine too. Feels much closer to normal than last week. Still have some numbness from the nerve block on the outside ankle, but it has no impact on anything nor pain.

Hoping today’s doctor’s visit is truly my last one!

17 weeks Post Op-Hiking Again

It’s been 17 weeks since surgery and 18 weeks since my injury. Life is getting close to being normal. For the last month, I’ve had three PT sessions a week where I made huge improvements after each session. At my appointment on Friday, my surgeon was pleased with the overall progress but prescribed 8 more PT sessions. My strength markers are 3/5 and he wants to see them at least at 4/5. My ROM is back to normal, my balancing is much improved, and the swelling has mostly subsided. I only get swelling after a really long day, like after working all day and dancing at night. It’s a nice place to be!

He gave me permission to start running again, which is good because I broke out into a run the night before trying to get to my car to beat traffic leaving an event (hee hee). I’m still not able to do controlled single heel raises, but I can hop up off the heel. I can weakly walk on my toes. Every week, PT gives me an exercise that I can’t do (like walking on my toes), and by the next week, I’m able to do it. Two weeks ago, PT was giving me some serious swelling, along with just wearing tennis shoes while working all day. This past week, it literally took me dancing on it for it to bother me enough to ice it. The massages with the plastic tools, which is pure torture, is breaking up that scar tissue that was getting inflamed. I still have some lumps back there, both on my tendon and in the calf itself.

My limp is mostly gone. Later in the day, I have to concentrate more on my gait, so I only limp when I’m lazy and tired or when trying to walk too fast. Working on not doing that anymore. I do get pain going up the inside ankle bone when I spend too much time at dorsiflextion (squatting, standing in “the box” at PT). Even the therapist isn’t sure what’s causing that pain, although he suggested strain from overcompensating for my weak calf. Hopefully, it will go away with time. I have started trying to squat again, just goblet squats and plate squats. My body forgot how to do it properly! Working on form and flexiblity, which is probably aggravating that inside ankle.

This past weekend, I had intended to try walk/running on a flat outdoor path, but plans changed. Ended up doing a 5-mile hike on Sunday–very muddy winter thaw hike. Trekking poles helped mitigate the extra work from the muddy slop, but my tendon did get tired about halfway through. But it was nothing that a little ice and elevation couldn’t fix. Plus, it was just nice being able to do a normal outdoor activity again, especially on a rare 60 degree day in February. Life is getting back to normal…finally.

13 weeks-Making Progress

Not a whole lot to report. PT is going pretty well, although combined with going back to work without the boot has my tendon sore and swelling. Initially, it was causing me to limp more than I want, but the limp seems to get better each day since I started PT.

However, yesterday’s session where he had me doing balancing exercises on the treadmill and heel raises on the leg press, my limp has noticeably diminished today. Swelling is better and tendon feels more tight than painful. I can feel the scar tissue back there, but it’s no longer inflamed like it was last week. It’s much looser than before. The whole ankle feels like it can handle some weight. Still, I have quite a bit of swelling around the tendon.

I thought I was over the icing and elevating stage, but alas, that was not to be. But at least it’s just my tendon and not my whole foot swelling now. So…progress?

I’m still in the stage where progress is moving quickly; so fast that it’s hard to keep up. Life is starting to return to normal.

I am frustrated that PT won’t release me to work on lower body movements. I read other blogs that show people doing squats, using the rower, etc at this stage. He’s telling me to wait three more weeks to be safe. My doctor says I can use the leg press and leg extension machines, but Crossfit doesn’t have machines. So I’m still limiting myself to upper body and core work while biking the hell out of the assault bike in the meantime.

So while most of life has returned to (somewhat) normal, it won’t really feel normal until I can workout again like I used to do.

Slowly, but surely, I’m getting there.

11.5 weeks Post Op-Two Shoes!

Today, my surgeon okayed me going to two shoes. I didn’t tell him that I had pretty much ditched the boot all of the time except for the airport when traveling to San Diego for Christmas. I even took a 1 mile walk along Coronado Beach, then racked up 6400 steps along Crystal Pier. But it’s great to be medically released.

I’m still a bit numb around my outside ankle, so he told me to massage along the tendon to break up the scar tissue around that nerve. It seems to help. Other than that, pain is gone and I’m sleeping fine.

I’m walking slow and I have a limp unless I really slow down and concentrate to roll through the whole foot. I do tabata with balancing on one leg and I’m working on increasing my flexibility to body squat. Still going to Crossfit to work on upper body and cardio.

PT starts on Monday and I’m looking forward to moving on to this phase of this journey.

8 Weeks-Pop Goes the Scar Tissue

I’m so ready to ditch the boot…I cannot wait until Dec 28…

My flight to Phoenix for Thanksgiving went really well. I had asked Southwest for special boarding, so I was wheeled through airports and got the good roomy seat in the first row of the plane. I had taken a hydrocodone on the way there, but I didn’t need it. Only popped a Tylenol on the way back. Thanksgiving was nice as I was able to give my tendon some needed rest since I didn’t have to drive for five days, or even really leave my aunt’s couch. It was finally able to recover from the traffic fiasco from the week before.

My tendon has felt stronger since then (I know it’s still weak, but it’s stronger than when I started taking steps a few weeks ago). I bought a pair of Crocs and I’ve pretty much use them all the time around the house. I typically leave the boot in the car. Walking is still a bit flat-footed and is gimpy, but I can roll heel to toe when I concentrate. I still have one more lift in the boot that I’m supposed to take out next week, but I will probably go ahead and take it out later this week since I’m walking (mostly) fine at home in shoes. I’m also about ready to retire the shower chair, as I only use it for convenience when I wash my hair instead of out of need.

I’ve always hated Crocs. Mind you, I had never tried them on. I merely dismissed them because I thought they looked hideous. I never knew what I was missing! It’s a whole new world!

A couple of days ago, I mistakenly went one foot at a time down the stairs in my Crocs. Felt a small pop in my tendon near the bottom by my heel. Was worried for a second, but everything felt okay. No indications of a rerupture and it wasn’t that loud or intense of a pop. Now, I have a better range of motion than before and some of the pain from swelling has dissipated. So, I’m sure I popped some scar tissue. I’m not supposed to go to PT until I’m officially out of the boot, but I’ve been massaging with a lacrosse ball to try to break some of it up. It’s been working. I’m not having the same level of swelling as before and the pain that was keeping me awake at night seems to have gone away. The pain on the top of my foot is gone and the numbness only remains around my outside ankle bone.

I’m finally able to sleep again. It feels so good!

I’m not doing a lot of exercises, just ROM and some balancing on the injured foot. That scar tissue pop really improved my dorsiflexion, as it’s now a bit past neutral without any extra passive pulling. I use a theraband occasionally to work on plantar flexion, but I’m mostly waiting on PT to start. My foot gets quite a bit of work from just driving…so much so that I’m now fully driving with the right foot and no longer braking with the left. I’ll also press the ball of my foot against the other foot and do some seated calf raises.

I am back at Crossfit, sort of. The owner worked up some individual programming so I can work on my upper body and core until I’m cleared to work on my legs. I was reluctant to go back sooner because I simply couldn’t sleep, so every day was unbelievably exhausting. But I’m feeling pretty good now. Also, keep in mind, I am NOT a Crossfitter. I’m a middle-aged woman who does Crossfit. Scaled like a boss over here. Three years and still working on that first pull-up. But his programming is designed for the specific purpose of finally hitting that goal.

So every week is a little bit better. I’m still tempted to ditch the boot early. I probably will in a couple of weeks if I’m feeling froggy:)

6 Week Post Op Appt

Had my 6 week followup appointment with the surgeon. He says everything looks good and is healing well. I asked him about the numbness and pain along the side of my foot to my ankle. He says that it’s probably a nerve and that it will get better over time. Nothing that is unexpected at this stage of the recovery. I’m to take Tylenol and ibuprofen regularly at the same time and that should help the pain at night. I’m still not sleeping well and it is wearing on me emotionally. Felt really low this past weekend. But he did remove one of the two wedges and it seemed to help with the pain. I am to remove the last wedge in three weeks and I can finally get out of the boot on Dec 28. It’s nice to have an end date for this part of the journey. He still doesn’t want me to start PT until after I’m out of the boot. I’m not sure how much PT I’ll need.

I told him I was walking bootless around the house, and he did not seem too pleased. At the previous appointment, he seemed really sure with the super strong sutures. This time, he emphasized that if I fall without the boot, the sutures will tear apart as I rerupture. So I agreed to back off of the walking (kind of) and I’ll be more careful. The boot is easier to wear now without that second wedge anyway, so I’ll just deal. It took a lot longer for the soreness to kick in. But I’m very anxious to wean myself off the boot, so I’m still going to walk to the bathroom and such.

Some of the pain came from driving last week. Last Tuesday, two tractor trailers collided and caught on fire. The highway was shut down and all traffic was being diverted to a side road…the one I take to work. A 40 minute commute turned into 2 and 1/2 hours of pure hell. It really did a number on my tendon. Today is the first day that it doesn’t feel sore. Doc says it’s fine and there’s no damage. But wow, it was terrible! Driving at this stage is a blessing, but it does come with a price.

Thanksgiving is coming and I’m traveling to a warmer place with family who will drive me around. So at least my tendon will get a bit of a rest, provided I can manage the airport. I might pop a hydrocodone to deal with the pain during the flight.

5 weeks Post Op: Baby Steps

Tomorrow makes five weeks since surgery. And I figured out how to add pictures.

The steri-strips were still on after all this time, so I finally peeled them off.

The first picture is three days after surgery, before she put the steri-strips on.
Three Days After Surgery

This one is almost five weeks later. I’m really happy with how it’s healing! Still some flaking at the bottom.
Five Weeks After Surgery

I’ve started walking around my house in bare feet. Very small steps, but it’s nice to be able to go to the bathroom without needing to put the boot on. Standing in the shower is wonderful! I still use the shower chair, but I’m standing more and more. The more I do it, the easier it gets. I’m hoping to redevelop that padding on the heel that has disappeared so that when I’m clear to retire the boot, I’m ready. I’m not using the stairs or anything crazy, but as each day passes, I’m walking without the boot more and more. Just this morning, I was able to get up, shower, get dressed, and only put the boot on after I got dressed. No pain.

ROM is improving. The alphabet is easy and so is toe crunching. Dorsiflexion is pretty much neutral with no effort, as in I’m not forcing it. I don’t pay attention to degrees and such. I work on pointing my toe and pushing down and on moving my foot side to side. I started using a resistance band (not flexing past neutral) a couple of days ago.

Velcro is getting on my last nerve!

I’m sleeping a bit better. I took the wrap on the ice therapy cooler and secured it flat on the elevation pillow. Whenever the pain starts to bother me, I put lay my foot on top and it cools it off. I’m starting to need it less and less as each day passes.

My pinkie toe is still numb and the top of my foot is still tender. I still get swelling around the ankle bone(probably still sprained a bit). Being up and out of the house for long periods of time is still exhausting and I pay dearly for it the next day. Driving still feels like PT and it wipes me out. I’m still elevating and icing more often than I’d like, but that’s the price I’m paying for all of the early weightbearing, I guess.

But I’m really happy overall with how I’m progressing. It gets better each week.

4 Weeks Post Op: To Sleep, Perchance to Dream?

It’s been four weeks since surgery. Each week gets a little better.

–Second week of driving. It’s getting easier, less tiring, with my injured foot. I’m still braking with my left foot most of the time, but by choice. I can generate enough pressure to brake fully, but my tendon doesn’t like the back and forth movement between pedals. But each day is a bit better.

–I’m grateful to be driving at this stage, but the Boot On/Boot Off/Boot On gets tiresome. I’m forced to slow down. Ain’t rushing anywhere these days. I had a scare last week when going to work in the morning. I accidentally left the recycle bin at the top of the driveway the night before, intending to push it down to the curb in the morning. I forgot. I get in the car, take off the boot, put on my “driving shoe” and pull out of the garage. I spot the bin. I stop the car and jump out to get it. I realized, “Oh, sh**! as I step on my right foot. I jump back in the car, take off the shoe, put on the boot, take the bin down to the curb, get back in the car, take off the boot, put on the “driving shoe” and leave. Whew!

–Trying to ditch the scooter at work this week. Walking in the boot is getting easier as my muscles grow back. I can actually feel a calf muscle! So I’m walking around the school most of the time. I reserve the scooter when I have to race to the bathroom between classes, lol! #teacherlife

But I did overdo it on Monday as I logged 7500 steps. I paid for it dearly on Tuesday. So, I’m pulling it back a bit and sitting more often.

–After reading some blogs, I remembered that my doctor said not to fall without the boot. He didn’t say I couldn’t stand on my foot. So I started with just putting my foot down while sitting, then tried just standing. Felt fine. I then grabbed the crutches and took a few steps. So, now I can go to the bathroom n the middle of the night without having to put the boot on to do it. I can slowly walk with my foot on the ground when using a crutch or two. The downside is that I feel more pain in my heel later, so I’m going to gradually ease into trying to walk.

–I still can’t get a good night’s sleep. My foot swells and random aches shoot through. I’m still having pain from the ankle sprain and I’m positive that I’m having some aftereffects from the nerve block. Still a bit numb in my pinkie toe and along the outside. Compression sock makes me hot and I wake up (if I fall asleep in the first place). I can’t take the hydrocodone because it builds up after a few days and makes me moody, irritable, and weepy. It’s terrible. I tried taking half a pill a couple of days this week and slept fine. But the second day at work was awful! It feels better when I use the electric cooler wrap thing, but the hose attachment wakes me up when I turn over. Tonight I’m going to try lowering the temperature and rearranging the bedding to keep myself cooler, but not too cold to sleep. It feels like when my body heats up under the covers, my foot goes into overdrive. I’m hoping this helps. I’m not sure what else to do.

Almost 3 Weeks Post-Op and Driving!

Just last Sunday, I was feeling sorry for myself for being NWB and solely dependent on others. What a difference a week makes!

The doctor told me last Monday when he took out the staples that I could drive when I felt ready. However, I was still having quite a bit of pain and swelling, especially on the outside of my ankle where it might be sprained. I was hoping I could drive in a couple of weeks.

By Friday, I had ditched the crutches completely and was FWB. I had also changed to using compression socks, which managed the swelling and gave me some support. I also think I just got stronger throughout the week as I gradually started to weight bear. Ordering the Even-up contraption for my good foot was a game changer!

On Friday, I needed to deposit a check and the mobile app was rejecting it. So I thought I’d try to drive to the bank. Walked to the car in the boot, changed into a soft shoe in the car, and went for it!

Tendon felt tight, but no pain. Soft acceleration, but that doesn’t take much pressure. I found it easier to brake with my left foot (automatic transmission). After a few jerky full stops, I got the hang of it and it became intuitive. I just went out again today to practice.  The tendon is tired and my atrophied calf is like “WTH”? I will reach Expert level for cruise control, which gives the tendon a needed break.

Not sure if I’m ready to drive to work again. It’s a 40 minute drive and I teach all day. I am on restricted duty, so I’m allowed to sit and elevate as much as I want. Plus, I still have the knee scooter at school to use if I need a break. I just don’t want to overdo it. I’m afraid I’m pushing my luck as it is.

But I feel so much closer to getting some of my life back.

Still not able to manage the pain from swelling at night without sleeping with the cooler wrap running around my foot. I had to drop the hydrocodone at night because after a few days, my mood started to change during the day. But it seems like I overcome a  milestone every week, so maybe that swelling will be the next thing to go.

2 Weeks Post Op

Sunday, Oct 21

Staples come out tomorrow and I hope he allows me to PWB. I’ve been sleeping on the couch since surgery since my bedroom is upstairs and it’s just too hard to make that journey more than once a day to get clothes. I’ve showered a couple of times using a cast cover (I only take the boot off to ice or at night), but it’s easier to sponge bath in the first floor half bath. The whole thing is starting to affect my mood. I have so much to be thankful for, especially the aggressive protocol that my surgeon is following. But I’m having quite a bit of pain on the outside of my ankle. I stopped taking the hydrocodone early last week as I hated the way it made me feel. But the Aleve/Tylenol Arthritis protocol doesn’t seem to help at all. Icing helps some. I’m also frustrated in that I normally active: Crossfit, hiking. Missed two hikes this week during my favorite time of the year. Missed a 5K last week. Just missing my life as I knew it. Hoping that the staple removal and the ability to go upstairs and sleep in my bed will help my mood.

Monday, Oct 22

Doc took the staples out and said the incision was healing nicely. He gave me permission to walk in the boot as much as I want and I can ditch the crutches when I’m able. He also said I could drive (with the boot off) whenever I felt comfortable doing so, as long as I put the boot on to get in and out of the car.  He said that the sutures are non-dissolvable and are permanent, so the only way I can rerupture is falling with the boot off. He seemed pretty confident, even though this seems really soon based on what I’ve read. The pain on the outside of the ankle seems to be from a slight sprain and he said that being in the boot will help. I did take a hydrocodone to sleep through the pain.