Week 13: Belly up to the barre!
“You can’t expect to be any further along than you are right now” is what the Doctor said to me today. (I may or may not have been ever so slightly whining about my slow progress.) Not sure I believe him but I guess that’s a pretty good place to be. Strength and range of motion is good and the tendon has filled in quite nicely. I asked him about the tender bump above the rupture point and he said that is a good indication that I’m healing. He would be more concerned if there wasn’t a bump! Who knew? I guess the tendon ends don’t just heal at the rupture site all neat and tidy. I learned something new.
We went over things that I have been doing and should continue doing. I almost laughed when he said to increase incrementally–little does he know how familiar I am with that word. He said to practice the exaggerated soldier walk and really lift off on the ball of my foot on the injured leg. Walking is good and that I can gradually increase mileage. No jogging until I can do a set or two of single heel raises. I’m allowed to in-line skate if I want but to start out for 15 minutes and increase time gradually (add 5-10 minutes each time.) I may feel great and may want to go longer but need to remember that it is important to see how I feel the next day too (that’s the part I tend to forget about.) I can go back to yoga as long as I’m careful not to over stress the tendon with balancing postures. Skiing in December/January should be no problem since my ankles will be in a fixed boot. (I may not share this tidbit with the family–I was kind of hoping for a tropical vacation this winter for a change–so mums the word.) I can continue PT but he thinks that I’ll do just as well on my own. He recommends that I talk to the PT next visit and see if more visits are necessary–he will approve them if needed. As for shoes, I can wear regular shoes now and just need to make sure they have a 1″ differential between the sole and the heel. I was surprised to hear that my running shoes aren’t really high enough and that I should add a heel pad or two to take the stress off the tendon while the healing continues (thanks for the tip on the gel pads, AndrewC.) My next appointment is in three months–I wonder what I can accomplish by then? Single calf raise, maybe? (Dream of a single calf raise is more like it.)
These weeks in two shoes are kind of blurring together. I switched back to the elliptical this week, lowered the ramp and tried to concentrate on lifting my heels as I step. I added an extra mile to my walk on Monday which I regretted on Tuesday. (Hello? 50% increase is not incremental.) I won’t be doing that again any time soon. I also had a mis-step on the stairs–I let me foot hang off the step when going up with the laundry basket. Ouch! The closer I get to normal, the more careless I seem to get. Need to watch that!
I expect this week will be more of the same–I will keep slogging along if you guys do the same!
In lieu of the calf close up (which looks the same as last week,) I’m going to share my calf routine which I perform at the barre (my stair rails.) For those of you have taken ballet, I’m doing plie and releve in first, second and fifth position. It works the calves differently and adds some variety to the standard shoulder width calf raise. I also do the pigeon toed version (toes together and heels out.) These weren’t prescribed by PT so be advised. I don’t see how they could hurt though. I do think you have to build up to them–I’ve only recently had the calf strength to do them. You’d be surprised how different they feel from the standard shoulder width calf raise!
First position:
Second:
Fifth:
Pigeon:
See you next week 
August 1st, 2013 at 3:11 pm
Looking forward to being able to get my foot off the ground via my calf instead of just lifting my leg.
Great progress.
August 1st, 2013 at 3:22 pm
Well done Kelly. If you want to give your soleous more of a workout then add some bent knee. Remember the going up is not as important as the going down which should be done slow and controlled.
August 1st, 2013 at 3:36 pm
Hey Kelly,
As usual, thanks for the update and all the pictures. I have never done ballet but I’m going to try your moves to help me strengthen my calves. Single leg heel raise…here I come! Good luck with everything!
-eye
August 1st, 2013 at 3:45 pm
@HT: Lol! It’s a slog but you will get there! Keep us posted
Thanks for the nice comment!
@Stuart: Thanks! You are absolutely right–I meant to say something about coming down slowly. That seems to be the key to all of the calf raises. Thanks for pointing that out! I’ve done bent knees too–it seems easier than the straight leg for me now though. Weird?
@eye: Thank you! Good luck and remember incremental. I started with just a few
August 1st, 2013 at 3:49 pm
Kellygirl- I like the drills, but the tutu looks a litte wierd on me:) Thanks for posting them.
August 1st, 2013 at 7:03 pm
Woo Hoo! I am green with envy, but so very very happy for you. Way to go. Your pics are inspirational. Thanks for posting.
I think I’m going to cry now.
August 1st, 2013 at 9:42 pm
@BD: Lol! Let me be the judge of that. I want to see the tutu! ETA: I do the soldier march regular speed.
@Anne: Your set back is only temporary. I have no doubt that you will recover fully and quickly! We are all here to cheer you on. Hang in there!
August 1st, 2013 at 10:56 pm
It all sounds great, KG. And the photos look great — in both senses!
I expect you to attain full symmetry without having to ATR the right leg to get there!
August 2nd, 2013 at 4:20 pm
@Norm: LOL! My husband is doubtful about regaining symmetry. He already suggested a right foot ATR to even me up. Thanks for the encouragement though. I’m not giving up!
August 2nd, 2013 at 4:41 pm
Kellygirl, How did the KT tape workout, I’ve been trying it on my good leg but not sure if any benefit is just from the placebo effect. Watch out for the skiing that’s how I ended up with my ATR. Although I’m still not sure how I managed it whilst wearing a ski boot.
August 2nd, 2013 at 6:36 pm
@ukskier: Honestly, I couldn’t really tell a difference. I still have calf tightness and a limp–not sure that tape could help with that. Perhaps down the line–when my limp is less pronounced and my calf is stronger, I will give it another try.
You’ve got me a little worried now about skating and skiing now. Do you have a blog? I’m envisioning you doing a triple black diamond…please tell me it happened doing something I would never attempt!
August 3rd, 2013 at 1:00 am
I’m curious about UKSkier, too. When I skied a week in Whistler at 17 weeks post-non-op, I felt WAY safer on the mountains — including a bunch of steep-and-deep single diamonds, and at least one “yard sale” fall! — than I did walking around Whistler Village (or even the condo) in shoes! (The Whistler single diamonds are tougher than all the double-diamonds around here, and in most of the East where I’ve skied. I’ve only done a few of the double-diamonds there.)
We’ve had a bunch of skiers here who tore an AT, but I can only recall ONE previous AchillesBlogger who actually tore an AT while skiing, and that’s mikek753 . And he was jumping a cornice when he did it — something I would never attempt on purpose — though I did it once by accident in Whistler in a white-out!. He ended up going non-op and documented a pretty good recovery — complete with videos — until he disappeared. Too busy skiing and such, I hope!
Bottom line: Ski boots (unlike snowboard boots) are generally stiff, supportive, and protective enough (1) that doing an ATR in one usually does require an extreme move and (2) that returning to skiing can usually be done surprisingly early post-ATR.
Now let’s hear about this exception to the rule!
August 3rd, 2013 at 10:01 am
@Kellygirl, I really should have started a blog especially considering the amount of useful information I’ve received from reading other peoples.
But I’m not much of a writer and never got around to starting one. The short history is I ruptured in the morning whilst skiing and had a percutaneous repair the same day. Then spent 2 weeks in a cast and a further 10 weeks in a boot. Thanks to Norm and many others on here, I knew enough to argue against the 12 weeks in a series of casts that was being recommended. I’m now 14 weeks post ATR and have been 2 shoes for 2 weeks. BTW, I’m considering my ATR whilst skiing as exceedingly rare so don’t let it stop you skating or skiing.
@normofthenorth, I would agree that this is not an injury normally associated with skiing. As background, I was skiing terrain that I guess would be graded single / double diamond and the snow condition was variable spring snow. I’d taken a small fall but had ended up with all my kit and no reason to think anything was wrong (no pop or pain), I’d even stood up and dusted myself down. However on going to ski away it was obvious my foot wasn’t flexing correctly and oddly my first thought was the achilles rupture. As you can imagine I’ve given a fair bit of thought to how this could happen within a ski boot. My assumption is that at some point the ski stopped but my body continued over the top of the ski boot flexing the boot to its maximum and then hyper-extending my leg until the point the tendon just let go (Although I had virtually no separation of the tendon and would have expected there to have been more).
Trawling around the skiing forums I have come across a few more occurrences of ATR whilst skiing, with hyper-extension and a softer (AT style) ski boot (in these cases) being a possible contributory factor.
However, I’m pretty sure that the number of cases of ATR whilst skiing are small enough to be statistically irrelevant.
When you returned to skiing, how much dorsiflexion did you have at 17 weeks, one of my concerns is that ski boots are naturally designed to dorsiflex the foot ( some more some less ) so did you feel the need for heel lifts to reduce the angle ?
August 3rd, 2013 at 10:43 am
Great update as always Kellygirl, I swear I couldn’t get so high on my toes pre injury as you can now. I’m sure that dancing has had a good effect on you long term. My phsio this week was cracking the whip getting me to get higher before I then had controlled lowering of heels, can really feel the difference today, a bit sore!
August 3rd, 2013 at 1:36 pm
@UKskier: Thanks for chiming back in! Ok, my boots are stiff– so I’m not going to worry. Plus, here in CA I’m more likely to be skiing on sheets of ice at a leisurely pace, bringing up the rear behind my kids. Nice analysis–I guess we’ve all had time to think about these things.
@micah1: Thanks! I can’t get nearly so high in trainers. I’ve been doing all of my exercises (including the four way theraband) in bare feet. It makes a huge difference to me. I really have to engage the toes which I think is helping to build balance. Great to hear from you!
August 7th, 2013 at 1:14 am
I swear your legs look like you never had an ATR. My bad leg looks like something Frankenstein would reject. There’s a big bump above the tear that my doc said was likely the sutures but would go away eventually, there is constant swelling making me look asymmetrical and my legs are hairy. OK, the last one probably doesn’t count, but I must say your injured leg looks pretty darn normal to me. Your shoes are nice to. Something tells me you are rehabbing right and well - great job!
August 7th, 2013 at 12:14 pm
@ekiar: Lol! Thank you. You crack me up. Despite me rehab diligence, I assure you my leg looks like it had an ATR. It’s substantially smaller than the other. It look like the ugly, skinny stepsister who could use a few cheeseburgers to bulk her up. She’s hairy too but I keep the hairs at bay with a depilatory