Freaky looking adhesion/DF issues

As I’ve walked in two shoes with limited DF, my AT has become more swollen from the yank on the push off.  Now I can see a large "sticking point" that wasn’t there before, and it seems to be where the AT "sticks" on stretching.  Does anyone have experience with this?

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It also looks pinched from the side - the good leg doesn’t have this catch in the AT:

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I’m gaining strength quickly in the calf as I just began working it this week with seated calf raises and therabands.  Unfortunately, the leg is completely atrophied, so it will be a long haul.  I experience the same "hitch" in the calf raise that I’ve heard about from other posters.  I also have a harder time with standing leg lifts on the good leg since my injured leg’s outer muscle isn’t as strong in supporting the lift.  It looks ok from the front - but the skin is taut around my ankle bones from swelling near the heel and I need an extra half size shoe:

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The right leg looks really bad from the back - no calf muscle at all.  Here’s a pic of my DF - it’s pitiful - and this is with the heel in my shoe:

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My DF is really bad since I stopped wearing the boot.  The boot kept my foot in a constant flex - I thought I was imagining it - but I actually went backwards in DF this morning after sleeping fairly PF’d last night. I’m considering wearing the boot to bed…ugh.  I’m having a hard time getting flat today. :(  I put my foot in the boot for about 30 min this am and cranked it down to +10  - now I’m in pain.  Of course, it’s PT day, so I win "idiot of the week" award since this will make the PT’s "massage" particularly painful now.  What is it with Mondays and motivation to "get this injury done??" sigh.

The doc said I’d have good days and bad days.  I think I’m creating my own bad days with lack of patience.  The good news is that I’m getting MUCH stronger on the stationary bike - almost ready for my road bike again if I could just lose the fear of hopping off at the end…I also feel more comfortable "pushing off" in my stride - but still have to do it on purpose since the "habit" is a limp now.  I’ll let you know what the PT says about the adhesion…it doesn’t seem like anyone really knows anything about this stuff - but the hole and sticking point at the back of my AT (looks worse in person) gives me the creeps.  I want it gone.  Blessings, Kim

15 Responses to “Freaky looking adhesion/DF issues”

  1. Those lines look like the stich/suture lines in the tendon - I am sure it’s normal in post operative recovery.

    Stay positive, I am sure this is just part of recovery for you :)

  2. Stay positive Kim! One day at a time…. :)

  3. None of this looks very unusual for 11 weeks post-op, KJ.

    When you flex and extend your ankle, do you see the skin behind your AT getting dragged along with the AT? If not, it’s not an attachment, its something else. If so, they can usually be largely broken up by PT, massage, Graston (aka torture!) massage — at least to the point where they don’t interfere with your activities. (I still have a very small but visible attachment at the bottom end of the scar from my first ATR surgery when I PF hard, but it hurts nothing but my career plans as a leg model!)

  4. Steady as she goes and one day/week at a time. Mine swells and feels thick & stiff most of the time. I just don’t let it slow me down, bring me down or get me down. Your leg looks a lot like mine, I’ve got the same “hitch” in my ATR and I lost an inch in circumference in my calf. Focus on the good leg and make the bad one do the same thing.

    You are doing great! Keep it up and stay the course.

    Blessings & I’ll pray for healing and strength for you.

    Scott (aka: Skutr)

  5. Thanks, all. Most days I’m pretty good - but setbacks are discouraging. I really appreciate the prayers, Scott. I’m sure Mark needs them more right now - I feel bad complaining. I also DROVE to PT today with my right foot - hooray!

    Norm - thanks for the “aha moment!” That’s EXACTLY what happens - the skin is tight from the heel to the adhesion, and above it is loose. The adhesion is what’s hindering my DF! How the heck will they fix that?? The massage stuff hasn’t worked so far…and when it (hopefully) finally rips loose, it’s going to freak me out. They’re suctioning the thing, rubbing it hard with the tool - it just won’t break loose.

    They measured how far I could walk in 6 min. today - I was going to say how pitiful - but I guess I should say “how exciting” instead. 2 months ago I was just praying to walk at all! Thanks for the reminder to be positive. They measured me at +14 passively (they push) today - but it didn’t look that way to me. (see pic above) Maybe they’re just throwing me a bone on a self pity day, lol!

    I’m so grateful for this blog - thanks for the encouragement and tips. I’m going to pray about this stinking adhesion - the Bible says we have not ’cause we ask not. I’m going to start asking away!!

  6. Andrew - the thing I’m pointing at is the little shadowed indentation at the top of the scar - bigger than most adhesions - but that area is indented and sticking there. The scar parts are fine - just a little puckered when swelling.

  7. hey Kim .. I wouldnt worry about it … like Scott said ~ one day/week at a time .. I think the pics look pretty good considering you’re only at 10+ weeks since treatment, etc .. Even though you’re ahead of me, I think all these ups & downs ~ good days and bad days .. are all part of the process .. keep plugging and things will change and look more normal, etc .. Good news on your strength returning fast ! that’s great ! keep it up ! Best ~ Mark

  8. Kimjax– I have been rubbing a dot of foot cream into my scar 4-5 times a day—anytime it feels tight. I stretch my AT as I massage the cream in. There is a pretty significant loosening for me after I do my cream massage as the skin softens. Probably any cream would work, my Hubby found one for me that has tea tree oil, balm mint and some other “cooling” herbs. Feels and smelles nice! My PT said that whatever I’m doing to keep it up, because my incision is healing very well. But, my incision is smaller and lower than yours (remember I didn’t have ATR but bone removal and tendon repair). My DF is slightly hindered from the tight scar tissue, but more from tightness and stiffness in the front of my ankle. (yeah, my AT is doing fine but all my set-backs are coming from my toe, forefoot and the front of my ankle! I always gotta be different…) When I do the bent knee stretch you show in your last photo, it “catches” in the front of my ankle where your’s is bending, and my big toe screams from the pressure on it. I’m about as far away from the wall as you.

  9. Again, learning more and more about the ATR’s and the recovery process - cheers to norm for the info and apologies to Kim for the misinterpretation.

    I understand the situation, here’s hoping for you Kim that the adhesion(s) break down sooner rather than later because it sounds to me that your flexability is much better than the adhesion currently allows.

    Best wishes :)

  10. Thanks, Andrew! It’s feeling much better (more flexible) today - you never know what you’ll get till you wake up each day!

  11. You got it now, Kim. PTs usually DROOL at the chance to break up a stubborn adhesion, and I think they usually succeed, eventually. Lots of ATR rehab steps are NOT “No pain, no gain”, but I’m afraid this one definitely is. Good luck and keep workin’ it.

  12. norm - I hear you, but since the adhesion is right where the AT sutures were, it worries me a bit to beat up on it. I can definitely feel it sticking in several places - but each day it feels better upon waking. I’m getting there!

  13. Hi Kimjax! I’ve re-ruptured my AT on the 18th of Jan this year at physio…long story but I’m 14wks post op now and doing well(doing my own physio thank you). I live in South Africa and I honestly think the PT wasn’t done correctly. All I can say is Listen to your Body!
    I know that you’ve had a adhesion. how is that doing? I have one and I just want to know if yours is better with the treatment you got? And also if you can tell me if your calf circumference is back to normal? Really hope you are doing well. Regards Wenda

  14. Hi wenda
    I hear you pt I have a real lump and pain fom my first pt, what happened can I ask, was you op or non op first time

  15. Hi Wenda - I’m a year postop this week. :) My swelling never went down until about 10 mos. postop - and in the last couple of months I’ve been able to fit in old shoes, etc. My ankle bones no longer have a “sea of swelling around them” and everything looks pretty normal. :) My skin now moves easily around the AT - which seemed to be attached in the early days. The lumps are smoothed out but it still looks like a stack of coins. :)

    As far as the calf circumference - I worked out (hard) and faithfully 6 days a week and saw no gains until the last couple of months. Honestly, it felt like my lower leg was just a stick between the thigh and foot and the thigh was doing all the work. I JUST started seeing calf muscle really come back about 2 mos. ago, but it is MUCH smaller than the good calf. I’m still making lots of progress, though, so hopefully it will get better. (I’ve only recently seen some calf definition begin. )Unlike most AT recoveries, I’ve got some mechanical “issues” with healing very short and am still only able to manage a gimpy run do to lack of DF - but it gets the job done. I’m full speed on my road bike and don’t want to chance losing power with an elongation surgery, so that will have to do. I’m done with racing at my age - so as long as I can burn calories and play with the kids, I’m good. HTH, Kim

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