Made it to the Middle: Weeks 4-12

Hi Again Achilles People –

I initially thought I’d be posting on this more often, but life returns back to normal(ish) when finally weight bearing so I’ve been spending less time on recovery research. I have been keeping notes for the past 8 weeks which I’m posting below in the hopes its useful to someone - as reading your stories has been very useful to me. THANK YOU ALL!!!!

General Overview: Healing slowly but surely. I feel the improvements week over week and happy to take my time with it. I’m at week 12 now which I thought would be a WOW moment but its really just another step.

Therapy: 2x week

Gym: 2x week (nothing more than a sauna / stretch / bike)

Helpful Amazon purchases: Dynadisc, Therabands, Footless compression sleeve, Collagen Peptides (a powder nutritional supplement I’m convinced is helping)

Next Goal: Become fully 2 shoes without the constant fear that any sudden movement will send me snapping. And to do a single leg calf raise (dream big)!

The posts were going to my spam before which I’ve fixed. I’d love to hear your stories and recovery tips – keep them coming! Cheers!

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WEEKS 4-5 – The hardest mentally

Starting to get veryyy stir crazy. Many protocols are PWB at this time so was tough mentally. Since I was pretty much at 90 degree flex w my foot I practiced standing a few times with 20% weight on the injured foot. Felt great, but I knew it was a long way away from use. Still very little swelling and I didn’t need to ice/elevate much (although I would elevate anytime I was resting)

Diet: Fruits, veggies, collagen, vitamin C pretty much every day

Exercising: Single leg raises from various angles, ankle ROM, sit-ups, simple stretching (back arms), breathwork every other day

WEEKS 6-7 – I got my hands back!

Post op with the doc. He confirmed things look great and removed the antiseptic protective film from the wound. It looked way better than I expected! His protocol is for 6 weeks WBaT with boot with single wedge. That surprised me because (a) he skipped the PWB and (b) 6 weeks with a wedge won’t prep me for 2 shoes. I asked because its a bit cautious compared to other protocols I’ve read. He agreed, said he’s always cautious, and there’s nothing about my specific surgery that is causing this caution. With that we agreed to wait a few weeks and if I’m ready to remove the wedge can discuss.

Was shown how to use single crutch and was gradually able to remove it after a week. Feels AMAZING getting my hands back. Finally removed the boot to sleep and wrapped the ace bandage tight like a sling to not lose ROM. At week 7 started a new PT within my insurance network. He felt my ROM was good, no pain / swelling, but strength pretty weak as my protocol was a bit conservative. I took steps for the first time without the boot. Felt like walking on a peg leg! No ankle muscles firing at all to keep it in place.

Week 6 Exercises:

Ankle ROM

Towel curl – Use my unrolled ace bandage and curl it up twice

Dynadisc - ankle pumps, then clockwise / counter

Week 7 Exercises:

Towel curl – Use my unrolled ace bandage and curl it up twice

Dynadisc - ankle pumps, then clockwise / counter

Single leg stands 30s x 3 (holding onto wall as needed)

Standing squats (2 legs)

Ankle pumps with green band resistance (all 4 sides)

WEEKS 8 – 10 – Better Every day

Feeling more comfortable around my apt without the boot on. Went to gym for first time and did stretches and sauna. Twice I’ve felt a little tug in the ankle followed by freedom of movement which PT later said it scar tissue breaking away. At week 9 started the Assault bike at the gym – feels great! There’s a peg for your feet which I use when going hard and for more casual speeds will use my heel to push the pedal (I wear sneakers with the single wedge). At week 10 I went on a “ski” trip and spent most the time in the hot tub / sauna which I think really helped flexibility. Added messaging the scar to my personal routine which never gets easier and is especially unfun when the PT does it. Still feeling sore after long uses and take an Aleve 1-2x day. In general I’m better and more optimistic each day

Week 8:

Boot: 1 wedge, always on except sleeping

Exercises:

Towel curl – Use my unrolled ace bandage and curl it up twice

Dynadisc - Ankle pumps, then clockwise / counter

Single leg stands 30s x 3

Standing squats (2 legs)

Seated heel raises (3 sets of 10)

Standing heel raises – leaning against wall, small raises (80% of weight on good foot)

Ankle pumps with green band resistance (all 4 sides)

Practice slow barefoot walking – focus on the toe maintaining contact and the glut working

Massage the scar – perpendicular, then up the leg

Week 9:

Boot: 1 wedge 80%, 0 wedge 20% of day. Removed inside apt for small practice walks

Added Exercises:

Standing calf stretch – first with leg straight, then bent to get both calf muscles (3x 30s)

Standing heel raises – leaning against wall, small raises (70% of weight on good foot)

Week 10:

Boot: 1 wedge 60%, 0 wedge 40% of day. Removed inside after work hours

Added Exercises:

Standing heel raises – leaning against wall, small raises (60% of weight on good foot)

Ankle pumps with blue band resistance (all 4 sides)

Single leg step downs – starting at 1 inch height

WEEKS 11-12 – The end isn’t exactly near

Had my 12 week post op a week early since the doc was traveling - all looks great! Received permission to lose the boot… which is wild because I feel nowhere near ready for that. Decided to do Week 11 getting myself to 0 wedge and Week 12 will start with the shoes. During this time I’m still doing PT 2x week for aggressive scar massaging (ouch) and supervised stretches.

Went to Zermatt during Week 11 and did way more walking/hiking than expected and found myself needing to add the wedge back in by the end of the day. Foot was also crazy swollen almost the whole trip I think due to the flight/altitude. Week 12 I’m back in the city and doing boot (no wedge) commuting to/from work and sneakers at the office. Still in slight disbelief that I’ll be able to brave the subways without the boot. I also live on a 5th floor walkup apt which I’m not flexible enough to tackle properly. Finding it so weird that I’ve been wanting to get to this point for so long and now I’m so scared for it! Hoping it’ll come with time.

Week 11:

Boot: 1 wedge 20%, 0 wedge 80% of day. Removed inside and after work hours

Added Exercises:

Standing heel raises – small raises (50% of weight on good foot)

Single leg step downs – 2 in height

Single leg stands – trying for no hands - 30s x 3

Around the clock balance – Stand on bad leg and tap good leg to the front, side, back, and behind like a curtsey – 3 sets of 5

Week 12:

Boot: 0 wedge 20%, SNEAKERS 80% of day. Wearing boot to/from work

Added Exercises:

Around the clock balance – Stand on bad leg and tap good leg to the front, side, back, and behind like a curtsey – 3 sets of 5

Standing heel raises – balanced weight going up, 60% weight on bad foot going down

Single leg step downs – Actual stairs, very slowly

And so it begins… Weeks 0-4

Hello Achilles World. I’m currently 4 weeks post op and found the stories here inspiring and immensely helpful. I’ve been keeping track of my own recovery and sharing in the hope its helpful to others. Will keep this updated as often as I can.

About Me

38 yr old female living in NYC. Very active but had taken the past year off running/high impact due to bruised cartilage at ball of foot and mild plantar fasciitis. At time of injury was working out about 2-3x week either yoga, spin, elliptical, beach volleyball.

Medical Background:

I had a compound fracture (mid interior calf) while skiing as a kid and my right leg never fully progressed to the same strength as the left (I’m a righty). Some permanent nerve damage on the interior lower leg with high sensitivity mid-calf, no feeling mid ankle, limited foot/ankle mobility compared to the left. Due to the extreme sensitivity of the mid calf I wouldn’t massage it or stretch it properly. This is the area where the Achilles connects to the calf and I have to think its all related. I asked my doc who said maybe yes, maybe its just bad luck. My PT says absolutely.

Injury to Operation 11/20/19– 11/27/19

The classic story. Playing indoor volleyball going for a shot at the net…could have sworn my teammate fell on my right calf with a loud echoey pop. I turned around but he wasn’t there…. So then looked to see what from the ceiling must have fallen to make me fall/make that sound. The idea that it came from me was baffling. Was more in shock than in pain. It felt like the heel of my sneaker blew up since my heel was 3 inches higher than it should be. After about 2 min of googling knew exactly what it was. Skipped the ER and went right to an ortho 2 days later.

Timing was extra unfortunate since my insurance coverage had unintentionally lapsed a few months prior. I found a great doc who worked with me to keep costs low. He did the Thompsons test to confirm the full tear and had another doc examine me for a second opinion which saved me the MRI fees. He also explained surgical vs non surgical options and the reasons not to postpone treatment until Jan when I have insurance. I assumed surgery would be cost prohibitive but it was surprisingly affordable… $7,500. It would need to be done at the surgical center vs hospital which was fine by me. By this time I had done a ton of research and knew I preferred the surgical route. We scheduled it for the first available slot which was 7 days from injury.

During this time I was not in much pain. Just some throbbing from the swelling and had absolutely no ability to move my foot (only the toes). Doc put me in a cam walker boot with 3 heel lifts and said I could walk around with it. I found my swelling was way worse if I walked so spent most of my time w my legs elevated.

WEEK 0 – Surgery 11/27

Open surgery. Said the tendon tissue looked healthy and he had strong grabs while stitching it back together which is what I wanted to hear. I was put in a soft splint/cast to allow for swelling. Didn’t feel any pain for 24hrs and when the nerve block wore of it felt like a giant papercut. Stinging/burning. Not ideal but definitely a manageable level of pain. I was expecting way worse so I took the Percocet’s at first but stopped after a few days with OTC stuff.

One mistake I made was not straightening my leg ever the first few days. This caused the incision to heal tight so when I did straighten it was like pulling a scab…. Would try to do this a few times a day. Tried my best for a healthy diet with lots of fruits/veggies but it was Thanksgiving week/weekend and was only mildly successful.

WEEK 1

Overall felt “fine” but a few things came up and I’d freak myself out. I knew there was a risk of infection and everything would make me question it. Including my “papercut” wound which would flare up from time to time (especially nighttime). Noticed a bright Cheeto colored orange residue on my toes which was alarming. Finally cleaned my feet w nail polish remover and that worked (must have been some surgical sterilization). Also would have weird spasms in my lower heel or calf muscle and I’d often doubt that my tendon was still connected.

WEEK 2 – First Post-Op

Doc confirmed the Achilles is attached and there is no infection J Wound looked pleasantly thin with some bruising around the ankle. Already seeing some calf atrophy. He used absorbable stitches so nothing to remove although he did have to trim some stitches that were exposed. There’s a purple film covering the wound which I was told not to wash off. He wrapped up my ankle in an ace bandage to keep it covered. Moved into the boot with 3 heel lifts and told 4 more weeks NWB. I knew that was his protocol and also knew there are other ones that allow weight bearing earlier out there so I pushed for him for PT approval. He agreed for mobility but said absolutely NWB for 6 weeks post-op (booo!!)

First days in the boot – takes some adjustment. Muuuch harder to sleep and more swelling than ever before. Noticed bruising around foot / ankle. The boot is heavy and a too big for my tiny legs. Felt like I was bouncing around in there. Figured out if I wrap my leg in a sweater and place it in the boot before bed it helps me sleep better. Also remove the top plate from the boot.

I felt way too tender to start any PT so put it off for a week. Here’s what I did instead:

Leg Extensions – laying on the ground raised my leg (w boot on) on back, sides, stomach

Ankle Flexes - up and down a few times (boot off, ace bandage on)

Toe Wiggles – a few times a day

All followed by ice and elevation. Constant elevation.

First shower was nice but scary! My foot was soooo shakey without the ace bandage. I started “shower baths” which I put about 3 inches of water in the tub and that gives my heel some cushion when I sit down. Then turn on the shower to wash up. Its actually nice!

Also finally went back to the office for work. Would need to lay down to ice/elevate a few times while there. I also got a knee scooter which was a bit too cumbersome to use w crutches so I’m keeping that at the office for when I’m PWB. Wishing I got the iWalk instead. In general every day is better but its like 2 days progress, 1 day setback and those setbacks are a bit of a mind fuck.

WEEK 3

First PT apt! Went really well and I was grateful to have someone look at me and confirm things are progressing properly. She said overall swelling was quite minimal which is good – but I should expect it to come once I start moving around a bit. There is bruising in my lower ankles which is apparently normal. I have about 10 degrees ROM now. She confirmed the leg extensions and to do the ankle ROM stuff as often as I can 3-5x a day. She saw I was using 3 heel lifts and removed 1 right away. Also massaged the area for adhesion. It doesn’t hurt but I find this is the hardest for me to do bc of the old trauma to that area.

Throughout the week kept up the exercises. Leg extensions w boot on, ankle movements with ace bandage on. Muscle twinges esp in the lower calf would come and go. Especially noticeable in dark, rainy winter days or post holiday parties after drinking a few too many. Also after doing any ankle ROM. Taking NSAIDs as needed for that.

WEEK 4 – PRESENT DAY

Had planned on weaning myself from 2 heel lifts to 1 (starting w a few hours a day) but I found that I was already comfortable with 1 lift. I guess the ROM stuff is working! Also trying to remove the ace bandage during my exercises to get more strength in the foot as it still shakes when its not wrapped up.

Its Christmas this week and I’m happy to be at my parents with my whole family around. The only negative is that its impossible to eat healthy – I really love food and wine so much - and the lack of cardio is making me feel icky. I’ve been adding some planks / sit ups to my leg exercises which helps. Am also staying more diligent with a few Kundalini Yoga breathwork poses which I (try to) practice for 10 min each morning. Always helps but its like any meditation impossible to get yourself to start doing.

That’s all for now. And if anyone’s actually read this far down I do have a few questions:

- What have you found successful for minimizing scaring ?

- Any cardio ideas you can do from home?

- I have a ski trip planned at 9 weeks post op. Obviously not skiing but I thought it would be nice to breathe mountain air w friends. Not so much worried about flying but if I slip on ice. If I’m wearing a boot it should be ok?

Thanks for reading!

Lauren