kickstand’s Nonsurgical

I’ll be at 3 years on July 11, 2014…

All’s well and back to normal though I still have my Achilles–healthy one mostly–on my mind when I do anything strenuous.  On December 17, 2013 I hit my goal of squatting 6 plates which equates to about 310 pounds.  At 51 that was an amazing accomplishment in itself.  I’ve since reduced the weight to a maintenance weight at 250 pounds.  I’ve not experienced any pain, tenderness, or discomfort in my calf, foot or Achilles.  I learned how to use proper form using the Stronglifts 5×5 program (http://stronglifts.com/).  It worked really well for me.  My weight is down to about 5-10 above college and I feel stronger.

I still will not play basketball but I did play beach volleyball a year after tearing my Achilles.  That was very strenuous on my Achilles but didn’t hurt or feel threatened.  I iced it good and kept an eye on tightening but all went well.  I’ve probably played beach volleyball a half dozen times now but for whatever reason I will not play basketball.

Measuring my calf I still notice that it is about 1/4″ smaller in diameter from the healthy one but I can live with that.  The Achilles is still thicker than the other but not as noticeable to most unless they look carefully.

Hope this gives some inspiration to those recovering from this devastating injury.

Wow! Like everyone else out there I doubted I’d ever get back to any form of normalcy. But now over 10 months later I’m progressing well and am starting to feel a lot more confident in my routine. I’m still a bit nervous about anything that requires quick side-to-side movements or jumping but I have worked out steadily for the past 7-8 months. I finally quit going to PT after about 3 months because I was doing as much at home as I was at PT. The only thing I wasn’t getting was the ultrasound treatments, which I was getting twice a week… oh, and I wasn’t getting hit with the little copay each visit.

Anyway, I started with mostly upper body weightlifting and after the first month or so I folded in some leg exercises. I did mostly leg lifts and leg curls with light weight and some calf raises without weights. It wasn’t long before I was able to do more weight without discomfort. I made sure I stretched ahead of time and ice afterwards. I also warmed up on the stationary bike but not each time.

For the past 2 months I have been doing deep squats every other day in the mornings, adding 5 pounds each time. I read a lot about squats and found that I was doing them all wrong before on my Smith Machine (typical workout machine that guides the barbell along its track). What I learned is first you have to do squats with a barbell, which strengthens not only the core but the whole body more closely to natural movement. I do deep squats with the barbell lower on my back which helps avoid knee injury and work quads, gluts, and hamstrings. I’m careful not to lean forward on my toes and keep my heels planted on the floor. I started with just the 45 pound barbell and gradually have worked up to 185 pounds in the 2 months. I also am doing 225 dead lifts.

I have to say that I constantly think about my Achilles when doing my exercises.  I’m not one of those crazy guys you see in the gym all the time. In fact, I’ve never squatted over 100 pounds and always had to drop them out of my workout routine because of knee pain. At the 185 pound mark (goal is a 200 pound squat) I feel pretty good and do not feel any pain in my Achilles. I do sometimes feel a small amount of tightness but no pain and usually it is gone by the end of the day. I weigh now 227 pounds. I dropped down to 220 before starting my workouts. If you’re saying “oh, he’s a big guy” remember I’m 6′-4″ tall so I’m not one of those meaty guys at the gym. I will say now I’m leaner and stronger than I was when I weighed 238.

I’m not sure if I’ve read about anyone else doing squats as part of their rehab but I thought I’d share my story and ask if anyone has experienced any problems from doing them. I will say that the Internet has information all over the map on whether or not they are good or bad. Overall, doing squats has strengthened my thighs and calves, which I read will always help protect from damage to joints and tendons. At 50, I think I’m in as good a shape as I’ve ever been!

At my 12 month milestone I plan to start jogging on the treadmill and ride my bike at least a few times a month. I rode it for the first time 3 weeks ago and it felt great except that it was a bit awkward from not riding in so long.

Hope this gives encouragement to those just getting started on their path to recovery! Feedback is always appreciated!

Saturday I woke up and decided it was time to "take the next step" if you will. I’ve been tip-toeing around the house without the boot for some time now and, well, it was time! Besides, last Thursday while walking around at my daughter’s school the boot actually broke. I couldn’t believe it only after 3 weeks the side brace snapped like a twig. It sounded like I’d stepped on a plastic pen and cracked it or something. Fortunately, I was able to get a new one the next morning.

So, I took that as a message from above that it was time to get on with the program and moving towards normality. Saturday seemed fine walking around the house sans the boot as I’d been doing the past few weekends but now knowing the next time I ventured out the door I would not be wearing it things felt different. I had to attend a wedding Saturday evening so that would be my test.

Except being held up twice in traffic for accidents and accidentally sitting down at the wrong wedding, which was all the way on the other side of the Balboa Yacht Club, all went well. I was surprised that I was able to walk as much as I did. I was wearing dress shoes with a decent sized heel with my heel gels so that helped. I didn’t notice the soreness in my heel as I had in the past. I did have to keep my stride down and take shorter steps than I was able with the boot. I could definitely feel the tightness in my tendon if I walked either too fast or with long strides. I have the notorious limp but it wasn’t too bad. Some of my friends said they almost couldn’t tell anything was off.

As tempted as I was to get out on the dance floor and join the fun I decided that was way down the road for now. So after nearly 5 hours trouncing about I called it quits and headed home. I didn’t have any specific pain, swelling, or irregularities. In fact when I woke up the next day it felt just as it did when I woke up the day before. I spent a few hours walking around at a picnic today in tennis shoes and had about the same experience. Tomorrow I go in to work for an all day "no boot" day. By the way, I did keep the boot in the trunk during the wedding but I left it at home today for the picnic.

In case you just started reading my Ortho doc doesn’t want me to start PT until the end of 12 weeks, which means I’m in 2 shoes for 2 weeks before starting PT. He doesn’t recommend starting PT until then. Everyone I speak to swears by the PT so I’m looking forward to it.

For now that’s it. I’m still VERY happy I opted not to have surgery. While I haven’t reached the 6 month mark where I could really give it a work out I do feel it is strong and healing just fine. Thanks to all the bloggers here that gave me inspiration in my tough decision to go the conservative route!!!

BTW, I didn’t do a week 9 post since not much happened. I felt that I was walking over the top of the boot more confidently and could feel my muscle tone coming back. My calf feels much harder as does my thigh. I’ve had to go to the Chiropractor 3 times this week for adjustments and massages due to a killer pain in my opposite shoulder and neck. I figured it was due to my odd stance and walk while in the boot and possible just from walking after no using my injured foot for 6 weeks. Anyway, I’ll keep up the adjustments and massages for a few more weeks since it seems to really help. Normally after a massage the aches come right back a day later but this time the treatments seem to be lasting permanently. I would definitely recommend deep tissue massages for those in casts, boots, or newly in 2 shoes!

Refresher: It’ll be 8 weeks since my ATR on July 14th. I’ve been in the boot now for almost 2 weeks. The ortho doc gave me the green light to go into 2 shoes at the end of the 4 week boot period.

I went to the doggy beach in Huntington Beach this weekend (Labor Day) and gave my boot a "run" for its money in the sand. I gotta tell ya walking in sand is not the easiest thing in a boot. You really have to be careful not to over extend your tendon. A few times the sand wanted to send my foot in the wrong direction but fortunately if you walk slow enough you don’t have to be too concerned. What was concerning was what I’d do if my dog (a small Cavalier King Charles Spaniel) got en-snarled in a vicious fight with one of the other larger breeds that were looking to chew their way to dominance!

I took the boot off to get some badly needed sun on the pale area that was covered in Cancun with the cast. And as I was sitting there enjoying the beach with the family and watching Uno happily play in the sand I realized if one of the other dogs decided to make him a chew toy I had no way to get to him quickly without re-rupturing my Achilles. Well, that wasn’t going to happen and if it did they’d probably have to drag me away in cuffs for tearing all four tendons on the poor dog that chomped on Uno. I can’t say I’m a violent type but a man has his limits!

Anyway, I didn’t make the news that night but ironically my daughter’s friend’s brother did! I should really be thankful that all I had to worry about was hobbling over to rescue my dog. Our friend’s son was nearly shot when some thugs showed up uninvited to his party and robbed some of the guests. His roommate wasn’t so fortunate and ended up being shot in the chest. He’s in critical condition and recovering but will have a much tougher route to recovery than any of us ATRs. Apparently a girl at the party who also was shot was the reason he wasn’t killed. Seems the bullet was deflected off of her finger before hitting the roommate. Crazy circumstance! The university is one of the greatest in the US but happens to be located in a rough area of the city. Our friend’s son is a senior and a great kid and student.

Oh yeah, my Achilles. Well, not too much to report this week. Like others here I’m really nervous about going into 2 shoes. Most days my tendon feels flexible but it is still slightly tighter than before. It seems to be tighter at various times and after I walk more. I do walk around a bit out of the boot at home but I’m extremely careful not to stumble. I don’t have any noticeable swelling but I suspect there still may be some because parts of the bottom of my foot still feel "unfamiliar" when I walk on it. I’m putting a little more weight on the front of my foot and I notice that it’s starting to feel more natural again. But I stop immediately whenever I feel a tug on my tendon.

As I mentioned before, I have a lot of motion and can barely detect a difference between the good foot and bad. However, I do feel the tightness when I pull my foot all the way towards me even though I can reach the same distance as my good foot. I think PT will help with this. My foot itself is pretty loose and I can move it like before with no problems.

My calf is still loose and there clearly is a difference in muscle size primarily right where the muscles meets the Achilles. My thigh and gluts are feeling strong again but I think I need to get on a stationary bike to get things moving along. Today is Labor Day so I’ll try to spend some quality time swimming in the pool before hitting the tasty barbeque ribs!

Oh, and I had time to customize my blog page with widgets and a new header. Check out the page I added on Thetus and Peleus, the mythical parents of Achilles. I’m sure you’ve all read something but I thought it be fun to post it here! Just think, if Thetus had dipped Achilles’s heel in the Styx river maybe none of us would have to worry about ATRs!

Reading other blogs about their procedures I thought I’d clarify my protocol a bit.

If you didn’t read from the beginning, I’m now in a boot at the end of 6 weeks in 2 week interval fiberglass casts. My boot is the Ossur Equalizer Walker model W0600 which extends up over the top of my calf muscle. It’s not fancy like the Vaco boot but when I questioned him on why they did not use the Vaco boot he said that is primarily used when you use the boot in lieu of casting since the foot angle can be adjusted as you progress. Makes sense to me. My boot online runs about $52 versus the $290 Vaco. If I was going more aggressive then I’d likely choose the Vaco.

So the day I received my boot my ortho doc cleared me to walk and cycle as long as I wear the boot. I was also allowed to swim without the boot of course. No running or jogging at all. He also said I should do some ROM movements when sitting around but no other exercises like toe lifts or stretching. After he examines me in 6 weeks he’ll start me off in PT. But again, I have almost full ROM already and he thinks since I did not have the surgery that I may not need as much PT. My Achilles is still tender to the touch and slightly tight when I bring my toes towards me but I have nearly the same range as my good foot.

I’m not pushing things now. I’m happy with taking it easy in the boot. While I’m a believer in early motion and weight bearing I still think you have to be patient and give your body the time to heal. And again the danger is stumbling forward without the support of the boot which will likely result in a re-rupture. Incidentally, 3 days after receiving the boot I did just that in the garage! I actually stumbled and caught my weight on the boot foot. I can safely report that the boot performed wonderfully and I didn’t even feel stress on the tendon! Knock on wood though because this has made me a humble being.

Going forward, I wear the boot for 4 weeks FWB (skipped PWB) then start using 2 shoes. He recommended I use a gel insert under my heel for support. I go back for a follow up with my ortho doctor in 6 weeks at which time he will start me on PT (he didn’t want to start PT until after the 3 month mark). No sports activities until after 6 months. I can live with that!

Oh, and I’ve dropped down to normal doses of vitamin C and only drink the protein supplement once a day now.