kimc’s AchillesBlog

For those of you early on in your achilles journey, I am just one more successful recovery story. If you’re anything like me, you look for those stories on this blog because they give hope. It’s a long recovery, so hope is a tonic. At least it was for me.

Eighteen months ago I never would have dreamed my achilles could be this strong again. I was a runner of 37 years who hadn’t been able to run for two years because of chronic tendinosis and a huge Haglund’s deformity. I limped 24/7. So eighteen months ago I had surgery to repair my badly diseased tendon after exhausting all the non-surgical options. Slowly, ever so slowly, I was able to begin running again. But it was a long, slow return.

Earlier this month, 18 months from surgery, I ran my 8th marathon in hopes of requalifying for the Boston Marathon. I had qualified twice before but had not been able to run it because of the achilles injury.  On the day of the marathon, it did not look promising. It was very warm and humid and we hadn’t had anything but cool, mild weather for training. The heat and humidity nearly did me in but my achilles was not an issue. The last 3 miles were the hardest ones I’ve ever covered. I realized I may not make it in….but then I realized that I had already WON!!! I was running again. I had successfully completed training for a marathon (without 1 day off because of injury) and I was running a freaking marathon! I think that realization pushed me through.

I did finish. And qualified.  So come April 2016, I plan to be at the starting line for the Boston Marathon. Pretty darn close to a miracle and certainly a dream come true.

That first year after achilles surgery or an ATR is a long, slow recovery - as everyone on this blog can attest. It absolutely helps to have goals. It helps to have patience. It helps to remind yourself over and over that we all heal at different rates, but we do heal. For all of us, time is the ultimate healer. And the healing and strengthening continue well after the first year. For all of you who are in the earlier stages of the journey, I wish you all the best.

A few days ago I hit that one-year Achilles Marathon milestone. One year since surgery for chronic, severe achilles tendinosis and Haglund’s excision. At that time I had spent two years chasing a non-surgical cure with no success. I had been a runner for 37 years but could not longer even walk without limping. I didn’t know if the surgery would lead to me being able to run again, but knew I didn’t want to be limping and avoiding activity for the rest of my life.

The recovery is long, no two ways about it. Progress is not always measurable. Patience wears thin. Hope surges, hope wains. But TIME leads to more and more healing, even when you can’t see it or feel it. This blog was a regular source of information, comfort and encouragement. A big shout out to the achillesblog community for the incredible support it provides!

I am happy to report that I have returned to running - something I love to do. At 11 months I ran a half-marathon on a hilly, part-trail-part-road course (1:50:40 - 8:27/mile pace). I’m not back to my previous race paces but can put in 35 miles a week and feel good doing it. This far exceeds my expectations.  Goals for 2015: Run a marathon in the Spring, qualify again for Boston, and actually get to run Boston now that my achilles is healthy! If training for a marathon proves too much for my achilles, then so be it. I’m thrilled to be running again and feeling fit. I’m thrilled not to be limping around and avoiding “doing too much.” I’m grateful for a successful result. Grateful for the journey.

Yesterday, after showering at the gym, I found I had left my street shoes at home. Not wanting to put back on my sweaty gym shoes, I decided I could wear my shower flip-flops to get out to the car. I haven’t been able to comfortably wear flip-flops for years. Just shuffling from my gym locker to the shower was a deal. Well, I noticed that walking to the car wasn’t really a deal. Four hours later, as I was getting ready for bed, I noticed I was still wearing them. Just another reminder about how much has changed. Just another reason to be thankful for all the healing that has taken place.

This past weekend I ran in my first race since surgery for achilles debridement and Haglund’s excision nearly 9 months ago. It was a 5 mile race on a flat course and the weather was fairly mild for summer. Perfect for my “first” race back. I have to say, it might have been the first race where I didn’t look at my watch, and where I just took in everything and everyone around me. It was awesome! I’m not running at the speed I used to, but I really think that will come. It was still fast enough to win my age group (40:04) - of course, there were only three women in my age group! Showing up counts at this age:)

Today I noticed that I’ve completed 16.44 miles out of the 26.2 year-long achilles recovery marathon! I’ve run seven marathons, and I always thought of 16 miles as the “halfway” mark. I’m back to running and that has improved greatly the past few weeks. So, to commemorate this 16 mile halfway mark, I’m sitting on the deck enjoying an IPA and the mild June evening. Cheers achilles mates!

My last post was at 4 months post-debridement and Haglund’s removal. At that time, progress was very incremental and not easily seen. As I approach six months post-op this week, I am really surprised at how much has changed. I think the surprise comes mostly from not thinking about it all the time. Maybe patience actually becomes practice sometime after those first few months.

Today I was out on my bike. At some point I realized I was landing on my surgical foot every time I had to stop, and I wondered when I first began doing that. I remember when I first returned to biking, I always forced myself to put the other leg down first, which wasn’t the “normal” way. I’ve been riding my bike for two months, but just hadn’t noticed that I had reverted back to “normal.” Don’t know why that made me so happy, but it did.

Running has finally taken off. Although my surgeon approved a return to running at 3 months, I just couldn’t get it going. Lots of start and then stop. Turns out I needed an orthotic adjustment (and maybe a few more months of healing). I am currently running 5 miles every other day and it feels really good. I am taking lots of precautions at this point: warming up, walking at least 1/2 mile first, stretching after, and 5-10 minutes in icy water (heel and achilles). As long as I follow these precautions, the tendon feels like I could go for another run the same day. If I short-change the stretching or don’t warm-up, the achilles let’s me hear about it. I also use Kinesio tape, which I think really helps keep swelling to a minimum.

Back on January 1st I signed up for a May 4th half-marathon in my city - because it sells out in hours. Wishful thinking, I know. I did the same thing in 2013 and 2012 - but my chronic injury kept me from running those years. This year I won’t be ready to run 13.2  miles, but I’m going to show up at the starting line and run the first 5 miles. That will take me within a few blocks of my house. I’m going to run home, shower, and get on my bike to go cheer on my daughter who is running her 2nd full marathon. I have not been this excited about a race in a long time. It’s a whole lot of awesome:)

Today marks four months from surgery. While my recovery has been on the easy side of achilles recovery scenarios, I did find myself wondering if there has been any measurable progress this past month.

I remember reading a post whose writer noted that “progress is measured in millimeters.” I’d like to find that post again to see if the writer was at four months or thereabouts when he/she posted that gem!

At 12 weeks I was cleared to begin running and  I began by interspersing slow and short jogging intervals with walking breaks. I’ve also done some running on the Alter G. Neither activity bothers me at all when doing it, but I haven’t been able to ramp up the activity without consequence. (By ramping up I mean increasing minutes, distance, speed, or frequency - only one thing at a time, though). All in all, I’m certainly no worse for the wear, and am just beginning to grasp that the return to running may indeed be measured in millimeters!

On the bright side, if I wasn’t so focused on returning to full running, I think I’d feel mostly recovered in terms of  the daily life.  I am walking without pain and getting in some major mileage that way. It gets me outside and on the running trails, and that in itself is a tonic. Walking doesn’t leave me hobbling afterward, as it did pre-surgery. That’s a gift I notice every day.

On Monday I’m starting a cardio tennis class. Ron - did you take note of that? I’m not a tennis player, but I’m producing a fundraising video for community tennis center’s capital campaign and thought this was a perfect opportunity to jump in and try something new. (Class description says all abilities, all ages, all fitness levels welcome).

I went to my 12-week visit with my surgeon dressed for a run: the shoes I’d worn in my last race (Ocober 2011), my Boston marathon shirt from 2012 (which I didn’t get to run, but my step-son lives in Boston, so he picked up my race packet), and a new pair of running gloves. Ipod was charged up, Garmin charged up.

Surgeon gave me the okay and said to take it easy and slow. I did. Three miles alternating short intervals of jogging and walking. The first jog intervals were around 13 min pace, but as my neuromuscular pathways began to remember how to move, they steadily decreased to 9:45 with no increase in effort. Believe it or not, the nonsurgical foot and ankle felt more stressed than the surgical one.

We’ll see how the achilles feels tomorrow, always the true test. In the meantime, I’m enjoying the afterglow. Best way to start the day:)

Saw my surgeon the end of last week for a nine week check-up (and my last freebie, cuz insurance deductibles kick in again January 1st!). He reassured me that the daily minor swelling is normal as this point and may continue as I increase my activity level.

Thoughts at this point in the journey:

1. The surgeon told me I’m 80% healed, but the remaining 20% is what will take the rest of a year. That 20% is very apparent to me but not at all apparent to those around me. “Are you running again?” Not yet.

2. Listening to the achilles is key, especially once you’re in two shoes. I’ve found it’s important not to change more than one exercise activity on any given day, that way if my achilles reacts, I know the culprit. I’ve been walking, cycling (heel only so far), deep pool running, and lifting weights. None of these activities hurts or strains the achilles while I’m doing them, but sometimes the achilles is sore and swollen after. If the soreness and swelling is still significant the day after, I rest. In week 7 I walked 3 miles on the treadmill because it felt great. Ended up having to take a 5 day break from activity because it was too much, too soon.

3. It’s very easy for something to accidentally affect the achilles. Today a 30+ mph wind caught the door as I was entering church, with one arm full of music. I instinctively braced against the force of the door, afraid I’d lose my music. My achilles still hurts from that. Skipped my workout this afternoon and iced a couple of times. I think it will be okay tomorrow, but if not, I’ll take it easy as far as activity.

Progress:

• Walking without a discernible limp. Everyone comments on how I’m walking so much better than I did before the surgery. Of course, I had been limping for 2 years every time I got up from a seated position….so “better” is relative.
• One-legged heel raise at 9 weeks. At my surgeon’s request, I tried a heel raise at my last check-up. We were both surprised when there was lift-off, and I did three of them. Of course, I was pretty sure my achilles was acting up the rest of the day because of it, so I skipped my scheduled pool run that evening.
• Able to walk up to 3 miles at 3 mph. Cycling up to 60 minutes at a time, still using heel-only on the surgical leg.
• Surgeon gave approval to begin closed-chain PT activities, such as eccentric calf raises “as long as it doesn’t hurt to do it.” I have PT tomorrow, so am anxious to begin strengthening the gastroc and soleus muscles.

Happy New Year everyone!

Would appreciate some info from those of you in the know.
1. How soon is it safe to use a foam roller on the calf? I just began the transition to 2 shoes and certainly feel some soreness in the calf muscles. I think the foam roller would really help, but wonder if it’s too soon?

2. Tendon feels and looks lumpy. Surgeon said the uneven collagen distribution often evens itself out, but PT can work on it, if not. My PT said it wouldn’t hurt to wait on this. Thoughts and experience on this?

3. There is one really hard, small bump at the incision site - feels tender, is a little more red/pink than the rest, and almost feels like there is something really hard in there. Anyone had this?

Thanks everyone!