lynneachilles’s AchillesBlog

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Agree with the sciatica comments. Therapy could be good but since you don’t have money I would try yoga. Or find the money. It’s worth it.

Hi Lynne - my name is Lynne as well! I am so sorry for you and I think the others above have given you very good advice. It does sound like your sciatic nerve something my mother has been dealing with. She has done many of the things mentioned by the others above but the one thing she says has helped her the most is getting in the pool. She is lucky to know someone with a warm pool which helps loosen her up but I think any pool will help. She “power” walks in the shallow end and the does pool running with a aquajog belt. Not sure what you can do that part with your achilles but you could do some of your leg swinging exercises in the pool. I hope you start feeling better soon - pain is just no fun.

I certainly don’t have a solution but feel for you. Please don’t forget some of the basics in dealing with pain. These things can easily be forgotten when the pain causes you to think about relief/cause/cure.

You may not be able to do certain exercises but remember to exercise the parts of your body that you can exercise whether that be core, arms, certain parts of leg etc. etc. There are literally hundreds of exercises that do not require equipment and are easily done. When you are battling pain, you deserve to give yourself the best nutrition possible and at the same time not too much. Do what you can during decent times to give yourself mental breaks. Stay hydrated. If you meditate/pray/have quiet moments, this is the time to get back to that.

These things may not address causes but they might assist your ability to resist pain. i don’t want to make it sound too hokey or simplistic but the body is very interconnected and parts have a way of either helping mend or break down other parts.

Use the internet and youtube to educate yourself about what might assist with your pain. If PTs are not accessible, there are numer

Hi… I’m only a new ATR, however I have longstanding back/ glute problems. Have you asked your physio or doctor about this to determine the cause and also to help with pain relief/ antimflamatories if needed?

I have found heat or ice (depends on season/ activity) can really help, usually heat for me. I use a heat pack. Sleeping with a pillow between your legs on your side. Hot baths/ swimmimg to relax (obviously depending on your Achilles progress). Changing positions every 15 mins (ie sitting or standing or lying). Stretching can help but for me building core strength is important (mine is awful) and your physio could help with that. Swiss balls can be great with this. What shoe do you wear on your good foot? Is it supportive?

You have prob already tried all that but it’s those things that can make a small difference for me. Good luck. Hope you feel better soon!!
Purple

Kind of sounds like a pinched sciatic nerve.
Have you tried yoga? I have used yoga to relieve sciatica. There are several poses I have found helpful:
gluteal stretch: put the leg with the most pain across the bent knee of the opposite leg. Then put both of your arms through the opening around the bent knee. Pull toward your body, Repeat on the opposite side
pigeon pose: bend your pained side leg in front with the knee bent 90°across the front of your body. Then extend your other leg straight behind you. Fold from the waist forward.
I have also had acupuncture that also helped.
When you walk, be sure you put full weight on your heel and roll forward to the toe on both legs. Take care.
With wishes for pain relief.

Agree, i had not used one until 2 months ago, saw one at my gym, about size of a frisbee and that thing will immediately strengthen your feet and help with balance

am 10 months post op from rupturing both at same time

I used the foam balancing pad a lot especially 12wks- 6months because it really helped with my balance and mobilisation issues in a relatively controlled environment.

There was a guy (tempted to say starshep?) on here who posted a video on how to train yourself to walk properly again (might be a link on a comment posted on one of my blog entries?) that was probably the single most useful video for me.

CyberCacique1 on youtube posted a series of videos on his atr recovery (search Achilles tendon rupture update - I think there’s 16 episodes in total) some of which include exercises.

Others I found during my recovery just covered the basics and we’re not very indicative of the ‘perfect’ way to complete the exercise.

Happy healing, I hope this helps.

Andrew

A wobble board, or foam balancing pad would be a good investment (For balancing) and later for calf raises.

I also felt like balancing did wonders for improving my ankle stability. I would stand on my ATR leg an bounce a ball off the wall and catch it (or play catch with someone else.

At 22 weeks this was my workout
Hydrotherapy

10-15 min. run (3.5 mph)
Sidestepping (4 mins. at 2.2 mph)
Backwards walking (2 mins. 2.2 mph)
30 squats in the shallow water
15 single leg squats in the shallow water
30 calf raises in the shallow water
5 controlled heel drops in the shallow water
30 single-leg calf raise in the shallow water
30 double step ups
Land Workout

20 min. bike ride (11 miles)
30 quad curls at 105 lbs.
30 hamstring curls at 120 lbs.
30 squats
30 Leg presses at 240 lbs.
30 single-leg presses at 120 lbs.
50 Calf raises at 160 lbs.
3 Controlled Heel drops with 160 lbs.
50 Single-leg Calf Raises at 80 lbs.
3-5 Single Leg Calf raises at 120 lbs. (max for now)

I also started out doing single-leg calf raises and controlled heel drop in the pool and on a leg press machine starting at about 40-60 lbs an

Lynne, I don’t have them. But I don’t think there’s any trick to “perfecting” them either, and I don’t think you’re likely to do harm by doing them “imperfectly” either. As long as you’re making your calf pull on your AT, hard enough and often enough to help, and not too crazy hard, which could cause a setback, you’re fine.

2-leg heel raises are good. Start by favoring your injured leg, if necessary. Do 50:50 if you can, and shift even more weight to your injured leg, as it strengthens. You can use a bathroom scale to measure your progress.

“2-up, 1-down” is a great exercise at the right time, too.

Balance is developed by balancing! Start by standing on one foot, eyes open. See if you can get as good on “that” leg as on the other one. After that, try harder balance tasks like bending down on one leg, jumping or hopping and balancing. Eyes closed is a good challenge, but you can easily fall, so do that one carefully, maybe in a doorway. Other than that, I can’t think of any “wrong” ways to rebuild your calf and AT and balance. Just do it, do enough, and don’t overdo, I’d say in general.

Thanks, will be printing this and doing it tonight God willing.

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Hi there, thanks. I know this might sound like a silly question but have always been better with visual instructions. When i attempt to walk on tiptoe on injured leg it practically gives in before i even begin. Is the 2 up, 1 down on the stairs?

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Thanks very much..
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Lynne I know you already read my six month blog post, so you know that you are not alone. The wobble (balance board) is a wonderful tool to help rebuild your calf. I do my calf raises on this board to help activate the gastroc more. As far as tip toeing up the stairs, even if you can’t do it yet, attempting will help to improve your strength also. Finally I’m going to repeat what Norm said, make sure to rest a day after heavy workouts to give your muscles time to repair and rebuild. Good luck

Hi N rom just a quick thanks I’ve been reading up on so e of your advice the walking downstairs the normal way without crutch in boot worked a great, to be honest when I first read it I thought no way, but it was easy peasy

What Deb said! There’s a slow gradual (and sometimes “zig-zag”) progression of strength in the AT and the calf muscle(s), and you can “work” them at home on the floor and on steps, and you’re also exercising them just with ADL like walking and maybe some jogging if it feels OK.

At each step in strength, a new kind of exercise becomes available, so be aware and inventive. E.g., “silly walking” on tiptoe takes less strength than doing a 1-leg HR. So does (obviously) a 2-leg HR, and you can do them 50:50 or 40:60 or any other “mix”. There’s also “2 up, 1 down”, which you may be up to.

Basically ANYTHING that makes your calf and AT work, will make them both stronger. Be incremental, don’t overdo or do harm, and give yourself a day or two off between workouts to let your tissues repair and rebuild. And hang in! It really is more of a marathon than a sprint, and you’re well into the “frustrating plateau” that so many of us hit.

Comparisons are odious, but I’m guessing that my well-blogged experience at 21 weeks would seem familiar. (I think I was close to that when I posted that “Swelling and elevation are getting OLD!”)

Hi lynne,

First off, you are not alone. I’m at 23 weeks and still limping and feel pain with push off. The good news is that in the last week alone, this feeling has improved and I’ve been able to ditch the cane, limp and pain are also better so hang in there!

Some ideas for home PT:

- stand facing bottom step
- step up (one step) right leg, left leg; then down right leg, left leg (repeat 10 x, then switch to start on the opposite leg for 10x)

- step up right leg, tap left toe on step and alternate legs (repeat 10 or 20 x)

- you can also add a knee up instead of a toe tap (yes, this sounds like step aerobics!)

Also, my PT just added eccentric heel drops off the step. Help support your weight using stair railings (preferably on both sides). Start on toes and slowly lower your heels (together, straight legs). Doesn’t matter if you only go up/down a little at first because it will get better.

Finally, use a small pillow for one leg balance exercises and add challenges (i.e. twisting to engage your obliques, leg lifts, bending to touch ground, etc.)

Those are just some thoughts for you to try!

Good luck

Hi there, thanks for the encouragement. I felt so guilty when posting my thoughts earlier as i know there are people worse off always. I am sorry to hear what you are going through and wish you all the best, hopefully i can be of some encouragement to you as well,

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Hi Lynn. I’m also at 21 weeks on my first leg and 4 weeks on my other leg. Are you able to get anything like this where you are?

http://en.wikipedia.org/wiki/BOSU

And/or

http://www.overstock.com/Sports-Toys/Cando-Economy-Balance-Board/4455013/product.html?cid=202290&kid=9553000357392&track=pspla&ef_id=UKclaQAAQykoRDvo:20130403141812:s

I got these for home and was able to replicate a fair amount of what we were doing in PT before my “setback” (contra-lateral rupture) and they weren’t very expensive here.

Can definitely relate to feeling frustrated and depressed.

WOW! I heard the saying you never know who has it worse than you, but location is everything! I’m sorry for the mishaps with South Africa but believe me Bermuda is far from a paradise itself. I’m without work, transportation, friends, and on top of that my daughters are more aware of my injury than anyone else on the island. It’s just been rough for me here mentally due to the hardships with finding work, since leaving all I had in the states to come here, and also the added strain I’ve placed on my marriage with just not being able to provide! My wife is supportive, but its my mental that keeps me in the gloom, but I pray everyday for the gloom cloud to dissolve and let the more happier, fun side be present! I hope things get better for the both of us and let’s just keep each other uplifted and updated!

Thanks very much, i have not been on for a few weeks as i have been feeling very depressed about all of this. I am trying to find a cost effective way to heal properly, my physio funds are nearly run out so i have to think of alternative options..thanks for your thoughts. I need to try and get more motivated as i find exercise so hard as well.. I am managing heel raises a bit better as well as balancing on both legs. I am 20weeks and doing calf stretches and a bit of squats. My hip pain subsided around the time i started walking down the stairs properly, you see i was walking down one step at a time without bending ATR leg when walking down. I do also find that i still limp from time to time, especially when walking for long periods of time, in a mall or in the park.

I am very motivated by your positive attitude and never giving up… thanks
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Hello Lynne,
I logged in after not visiting the site for a year… when one gets there it is a sure good sign! I ruptured mine 4 years ago.
Looking at your story I can tell you I had lots of pain in my hip - that has been sensitive before when I worked out too hard - and I suspect all the limping and trying hard to walk but not being able to walk normally etc is causing it. As I got better it disappeared.
As for the difficulty with the heel raises maybe it is your weight that makes it harder than average: you mentioned you were over weight so it is more work for your muscles - and they are weakened.
I would recommend the pool exercising: (I had a long recovery as I re-ruptured mine so I was very weak) even if you can not swim trying to walk and do heel raises in the pool first (you are lighter - so it is more gradual) would be more enjoyable and eventually you can even try to hop in the water. I found that very helpful. Maybe you will be able to try some “aquafit” classes - those were the first things I could do during my recovery.
This injury takes very long to recover from, it is depressing, but do not give up. It will hap

Will do as soon as i can..

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Thanks Norm, much appreciated..take care
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Yes, i want to have a long, hard think about all of this. Her attitude about the heel raises seems to indicate that she has a “personal” goal on me being able to do this..

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Thanks,
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Thanks very much for this..i am not even sure what an eccentric heel drop is..lol. I will research it now. I am in South Africa so not sure what it is called here. Maybe im just being silly. I will keep trying and keep posting..

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Thanks very much, i have been doing that as much as i can..

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im on my 12th week post op and still not able to walk properly..went to the pool today and that felt great…while in the water i was able to do one leg heel rises!!! actually while in the water you feel like you are not injured..until you get out of it..;-)…so go to a pool and work on your heel rises!!!

What those folks said. Also, if you want to monitor your progress with calf strength, just pushing down on a bathroom scale is one easy way, unless you’re already too strong. I.e., if you put the ball of your foot on the scale, and push as hard as you can, you can read your strength off the scale — UNLESS you can lift your body weight, in which case you’ll just read that. Then the solution is to add some weights in your arm (or a backpack), or hold yourself down by grabbing a counter etc., and read your max force.

Another nice trick if you have easy access to deep water like a pool, is to see how shallow you can go and still do perfect 1-leg heel raises. And it’s useful and fun for exercise to, to do multiple heel raises in the water, maybe siding toward the shallow end as you maybe continue to get stronger.

That “damned heel raise” is the “standard standard” for calf strength, so it’s logical that PTs and the crowd here should fixate on it. I used to myself, until I realized how good life can be — including competitive athletic life — without it. (My fingers are smirking as I’m entering “competitive athletic”, because my w

Personally I wouldn’t worry about it. I’m at 21 weeks (today) and still not near doing a one-leg heel raise. I work a lot with the weighted leg press machine and double heel raises. I just started doing controlled heel drops, which I can’t do very well, but I just started this a few days ago. Take it slow, stay focus on the little gains, and Ryan is right, maybe a new PT would do you good.

If the patient/ therapist relationship is frustrating you, I would consider find a PT that fits your needs better. YOu should be asking yourself, what do I want from my recovery? Where do I want to improve? What kind of functionality do I want/need? I hope you find these answer and continue well with your recovery.

One other thing: you wrote:

> My tendon seems to still need much strengthening

At 16+ weeks, your should be close to healed. Your inability to do a heel raise is not due to the tendon; it’s due to a weak, atrophied calf muscle. It has to physically regain the strength, and you have to re-learn how to control and activate it. Don’t do anything dumb of course, but with careful controlled movements, you should good confidence that your wimpy calf won’t have the strength to re-injure the now healed tendon. Confidence IS often a big part of it (heel drops and isometrics are good for that).

Lynne-
PT’s have all sorts of different approaches- some are like a drill seargent. Others are like a spa. Different approaches work for different people; my guess is that your PT is just trying to push/encourage you… but may be having the opposite effect. Perhaps you need to find a PT more compatible with your approach.
Regardless, my advice is to stay focused on the things you CAN do, the improvements that you make. Can you do an eccentric, controlled heel drop? Can you lift up with two feet, and then hold it on one foot? How about light weight calf presses on a leg press machine? Are you making progress there? The heel raise is essentially the finish line. If you worry only about the end, it’s easy to lose sight of the progress along the way. There are lots of accomplishments you should be aiming for and checking of along the way- which gives you some positive feedback and a way to gauge your progress (or lack thereof, if that’s the case).

Everything will come together in good time - sounds like your physio is good because they keep pushing, but also bad because from what you have written, the bedside mannor needs work.

Exercise that worked best for me was doing a full lift on both legs and (using the kitchen worktop for some support) then removing the non-atr leg and trying to control the natural lowering of the ATR heel, repeated this for as many time as I was able to twice a day.

NOTE: I am not sure if I was doing that at 16weeks though, might of been later….but I was a little behind in progressive rehab.

Keep doing what you can and never give up trying, sooner or later it will come - I am at 40weeks now, healed a little long and stuggle to do a full single legged lift even now - I think I was at 20wks and could only do half a lift, people recover in different ways and at different times, just keep calm and carry on

Happy healing

Similar situation to me Lynne, I am no physio and your condition may be unrelated to mine - but I found learning to walk and more recently run again a real challenge and not doing it right cause me hip pain on my ATR leg too.

One thing I did find though, because I waited until it really hurt to start off with before I realised what I was doing wrong, it took a few weeks to fully recover (because I continued to exercise through it to stay on track with my atr recovery, when really rest is recommended)

Lynne-
Just an uneducated guess here:

Take another quick look at my boot walking video:

youtu.be/XZ4apPM2Wl4

When I got tired - say on a long hike - I sometimes found myself doing that in two shoes too. It’s a way to subconsciously “protect” the Achilles- using other muscles to walk; reducing the load on the injury. And, it’s hell on your hips and knee.

So, pay attention when your walking. Make sure that as you’re pushing with the injured leg, that your knee is going forwards, not backwards. Just watch what you do with the “good” leg, and make sure you replicate that with the injured leg.

Heel up, knee forward, roll onto and then push off with the toes. It’s unfortunate, but we all have to “relearn” how to walk properly after this injury. For many of us, it doesn’t just come naturally.

Like I said, that’s just an uneducated guess. But, it was the root cause for some knee and hip pain for me until I figured it out.

Hi Lynne,
When I went FWB both of my hips were screaming 2 different tunes.
My good side was complaining of overuse especially my glutes.
My bad side hip was initially complaining of a rock hard IT-band and I believe now is complaining about an inflamed bursa.
My good side stopped complaining almost immediately after I started using an EvenUp (for those who are new to FWB…figure out your even up strategy right now!)
As for my current (bursa-I believe) hip pain…I have doing massage once per week, but it seems like temporary relief, my PT has me doing “side lying clam” exercises http://www.youtube.com/watch?v=Sh41nNC8bck but I believe that might be inflaming me more.
And finally my yoga instructor is pointing me to rest it…. try not using it at all and certainly no stretching into the pain. My body is telling me that my yogi is right.
Good luck.

Hi there, no i have been in 2 shoes for about a week and a half now. I am finding the discomfort mostly when sitting, i dont know what to do. Should i go back to the orth surgeon to consult about another issue. Is this perhaps sciatica..

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There’s lots of good-side discomfort and pain around here, though maybe not identical. Are you still in the boot?? If so, have you built up your good-side shoe so it’s as high as your boot, i.e., so your hips are straight when you walk?

This won’t solve your hip pain, but I’ve detailed a trick for walking downstairs normally even when your ankle ROM is severely restricted. Probably easiest to find on my blog page, or by searching the site for “down stairs” or such.

Eat chocolate today and don’t worry. You will get there. I don’t remember when I was able to do 1 heel raise. They will come! At 16 months recovery now and I can do endless heel raises.

I had my 12 week doctor appointment today and my surgeon still insists I not return to running until the 6 month mark. I see that ryanb was running at week 16. I am walking now on treadmill at 4.0 speed for 30 minutes per day and riding stationary bike for 30 minutes per day. I cannot do any single leg heel raises yet but I can skip on my bad leg (not the best but it is a skip). Has anyone else started to run around 12 weeks and if so what have been the results? Do you have to be able to do single bad leg heel raises before running?

At 16 weeks, I posted a short video of my progress:

achillesblog.com/ryanb/2011/12/15/16wk-update/

At ~1:11 it looks like I’m doing single heel raises, however what you don’t see are my arms. I’m leaning onto a bar on that rack, taking a very significant fraction of my weight off with my arms. At ~1:18, I’m doing single leg calf presses on a seated leg press machine. Look carefully at the massive weight moving in the back ground… yep, 1 little plate, which is about all I could muster, smoothly, with a full range of motion

> How much strength is needed in the achilles for learning how to swim?

Way less strength required than a heel raise

If your doc has you in 2 shoes, you can swim. Heck, I even did a little swimming while PWB.

Hi there kkirk

Thanks for your comments, i will look into the hydrotherapy suggestions. Also, i must say i cannot do any toe walking, am trying really hard..

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Hi there Ryanb, thanks so much for your encouraging words. It is much appreciated. I cannot swim and would like to learn. I have scheduled an appointment for the end of this month. Do you think that is too soon to start learning how to swim. How much strength is needed in the achilles for learning how to swim?

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