Mary’s AchillesBlog

Nice publish. I just needed to stage out that this is among the ideal deals to the net. Very good.

Congrats! As someone who had to forfeit two half marathons and a full marathon this fall, your tale is inspiring.

i went non-surgical, so i guess i can just kiss my wife for supporting me

Sounds great, MM, keep it up!

Yes…that’s why I’m writing! Just to recap where I started for referenced, mine started way back when (over 2 years ago) with a Haglund’s deformity which I finally had removed July 2009. I was cleared to run again about 6 weeks after surgery, but noticed the pain was stubborn, slow to subside and the tendon kept “catching”. Thinking nothing of it (I had the same thing on my other heel in 2005 and it took forever to finally feel normal), I kept increasing the training load until it finally popped in a race in Jan. 2010. Surgery repaired it in Feb. 2010 (the tear was really close to the heel bone, so they put in some titanium screws and sewed the tendon together). My normally aggressive doc. was uncharacteristically conservative about my recovery, and I was not cleared to even attempt running again until mid-August. Well, I started then, and had “ups” and “downs” for about six weeks, but then around the beginning of Oct. things really started to feel good. Like I said, it still gets tired and sore, but it’s a good soreness rather than pain. I try to take ample rest days and don’t plan any heavy loading like speed or interval

fair play to you my friend as the last poster said , things like this help inspire the rest of us starting out or along the path.

CONGRATULATIONS!!! And thanks for the inspiration - I’m 3 weeks post-Op and it gives me great hope to read stories like yours!!! Good luck with your half!

6 weeks after my op and Im just hoping to walk again :>)

your last paragragh is a good one for me the way Im feeling at the moment .

goog luck

Great news. I had to cancel two half marathons and a full this fall since i ruptured my AT. This gives me hope for 2011!!

Keep us posted
brad

Isn’t that something the “foot and ankle specialist” who did my surgery would know to look for? I don’t think my rupture was on the heel, but it was low I think. My heels have always tightened up and been sore after exercise, but that was explained to me as the result of the tendon under the foot getting overworked (and pulling on the heel) due to too much supination. I would say it is tender to the touch…I will monitor and maybe go back for an x-ray. Thanks for the advice.

Hi Guys,
Gerry, thanks so much for the advice. It’s hard to get my head around the fact that 3 miles of jogging 4 days a week could be overdoing, since I’ve been a 40-70 mile a week runner for so many years. However, this appears to be exactly the case!!! Taking your advice, I took Mon. and Tues. off, and when I ran yesterday, I was able to add another whole mile…so I did 4 miles, still easy but feeling more “normal”, and it felt great!! Heel is a little sore this morning so no running today. It’s not nearly as bad as it was Sunday. Seems to not like running more than one day in a row, so that is how I will go and just try and be more keen on listening to my body.

Pete, that pain in the back of your heel sounds almost like it could be a small Haglunds (this is what I dealt with for so many years). Basically, this is where the heel bone actually grows out and protrudes into the tendon, causing pain. I had it in both heels, and because I apparently waited too long to get the second one fixed, it weakened my tendon and caused my rupture, which was right at the insertion point. I’m not trying to scare you, but pay attenti

Pete, is it actually the back of your heel (where the AT really connects) that gets sore?

If it is any consolation, my heel still gets sore when I overdo it. I wish my calf would get sore more, but it is usually the heel and even the top of my foot. Go figure. I get paranoid that it is where the achilles connects to the heel bone…don’t want that ripping off.

My guess, and that is all it is, is that the problem is overuse, You were unable to run for 31 weeks and also even unable to walk for a good part of those 31 weeks. I really think that to go from zero runs from 31 weeks to running 4 days a week for two weeks is too much too soon. I wouldn’t run more than 3 days a week for probably 3-4 weeks and then increase it to 4 days a week.

Hi Mary,

Thank you for the additional information on the sequence of unfortunate events that lead to your ATR. It has been almost 2 years and three full marathons since my ATR and I haven’t had any problems but recently finding out that some people, such as yourself, suffered ATRs while distance running/racing did concern me a little. You’ve helped ease my concerns.

I’m doing my first triathlon in a few weeks and I’m going straight to a half ironman. Did a 40 mile ride that was immediately followed by a 10 mile run last weekend and I was surprised at how good (or not so bad) the whole thing felt. Much easier than the 20ish mile marathon training runs. I surf a lot and can swim for days so I can hopefully put it all together and not embarass myself too much on race day. No real goals, just have fun and finish. I’ll let you know how it goes.

Good luck with your return to running (& now swimming and cycling) and I hope your heel problems improves as you steadily increase your distance and speed.

BTW, I’m halfway through Born to Run by Christopher McDougall and I’m totally hooked. If you haven’t already read this

Hi Phu,

Thanks for writing! To give you a little background, I started running at age 11 and I’m now 40…so a long time running! I have completed 10 marathons and am presently trying to get into triathlon, with hopes of eventually doing a half-ironman.

Regarding your questions, yes, mine ruptured at the end of a 15K…in the last 50 yards. I was not sprinting, on purpose…for one thing, I was 15 mins. ahead in my age group so no need to (I hopped across the line on my good foot and still took the win and the main reason was I was still recovering from Haglunds surgery on the same heel that ruptured. I had had surgery in July 2009 (the rupture was at the end of Jan. 2010 so I didn’t think I was pushing too much). I was holding about an 8-minute pace when it happened. It was completely unexpected, happening when I landed (not when I toed off) and right around the prior surgery site. The doctor is convinced that due to the location and nature of the rupture, I had tendinosis caused by the continuous rubbing of the Haglunds spur against the tendon for a year or so before I finally had it fixed. Having had the same pr

Hi Mary,

Congratulations on running again. I have some questions I hope you’ll be kind enough to answer. You stated that it happend during a 15k race. Did it just pop in the middle of the race or while your were sprinting to the finish? Do you know of other people who ruptured his/her AT while running? What does your doctor say about running again?

While I was recovering from me ATR almost 2 years ago, I read a lot of stuff and, from what I learned at the time, virtually no one had ruptured their AT jogging or distance running. That was why I started jogging after my ATR and it led me to marathon running and now triathons with a full ironman in mind. I haven’t had any problems but the fear is always in the back of my mind. Especially while I’m doing speedwork or running up steep hills.

Thanks in advance,
phu

That’s awesome Mary! Congratulations and thanks for the motivation, good to see life will be back to normal

Thanks so much for all the encouraging comments!! Yes, this has been a long road but I have learned a lot, thanks primarily to all you guys! I’ll stay in touch and let everyone know how it’s going after about a week

Great news, MM — Don’t Stop!! Your Doc thought you’d be Better Than New, and it sounds as if you’re making an honest man out of him!

MM has been too busy having fun to post frequently, but she’s told us about a rough history of heel pain and Haglund’s Deformity (and surgery!) on both feet — AND she’s a serious runner! So when she writes about running without favoring one heel or the other, it’s not just the usual “same old, same old” that the rest of us ATR folks have faced!

Kewl!!

awesome. sounds like you might actually be better off than before the rupture.

Congratulations! What a great accomplishment. Keep at it and you’ll be better than ever.

I just saw this and agree with Norm. If you can do that many single leg heel lifts, you should be good to do just about anything you want. I can’t even manage 6 of them and I’m running, although not all that fast.

My old conservative surgeon gave me the most conservative guideline I’ve ever heard, for a return to high-risk sports: “When you can do a bunch of 1-leg heel raises without grunting or groaning, you’re ready.”

I haven’t checked your grunting or groaning, but 45 sure sounds like a bunch to me!

I’d assume you’re ready. If it swells, elevate and ice, then run some more!

Sounds good, MM. About that ROM: Your healing ankle can’t dorsiflex as far as your other side, but it can plantarflex at least as far, if not farther? This is what I got from the surgery on my first ATR (8-ish yrs ago), and my surgeon said “Good, that’s what I was after.” It seemed to work fine, so I didn’t mind.

About walking downstairs: A number of us have used walking downstairs as an exercise. If you’re strong enough to step down onto your “bad” toe, then lower your heel down slowly before you step over that foot with the “good” foot, then every stairwell is like doing “2 feet up, 1 foot down” eccentric calf exercises. Doug53 mentioned a while ago that he still “bounces” on his way down stairs, as exercise, and I’ve recently started doing that, too.

WOW glad you are doing awesome!! I envy you a bit, I miss the dancing lol Enjoy every minute of it!!

Tania :o)

Hi Mary

Congratulations!! Such good news.

I’m 16.5 weeks post-op, had my last PT and ortho visit today, and was cleared for all sports. Been doing softball (play left field, hit the cycle last week), doubles tennis, 10 mile bike rides, daily 1+ mile beach walks - pressing toe into the sand. Like you not letting the lack of a 1 legged lift stop me from enjoying life.

Lou

I’ve just looked into these, in response to the raves here and on some other forums I frequent, too. My toes have always been squished together by shoes, to the point where my little toes are totally “buried” into the next toe, and I’ve developed a bump (”bunionette”) on the outside of my foot (at the base joint of the little toe). It’s a challenge for my ski-boot fitter, and if it gets banged too hard by the ski boot, it gets inflamed = BIGGER, so it gets banged harder, and into a nasty spiral.

So the idea of wearing “shoes” that keep my toes spread apart sounds helpful, whether or not it helps my involved calf muscle regain strength. (I just got a flash of a weird image — five-finger ski boots!!)

I haven’t made the plunge to order or try a pair of Vibram 5-fingers yet, but I’ve been playing with a funny little quick-and-cheap work-around. Several companies are marketing different designs of toe separators. Some are marketed to help women polish their toes, and others are marketed for comfort or relaxation as well. A big bulky gel one that’s “closed” (like a ladder with rungs across the top and bottom) is now making the roun

Hi, Great tips! I’ve been reading your other posts on the ATR site regarding the Fivefingers. I am definitely interested because I have always preferred minimalist shoes. I am so glad this is now finally “cool” Will definitely keep you posted on my progress…it will probably be close to the end of summer before I get up the nerve to start running but I’ll probably get a pair toward mid-summer and start walk-jogging to work into it. Thanks again! MM

Yay! We’re cheering, too!

MaryMargaret: I can’t believe I just finally figured out how to post again. Sorry it took me so long but I wanted to comment on the Fivefingers. I have a pair of the KSO Fivefingers and I spend every waking moment in them. They are the only shoes I can wear all day and not hurt at night. I have nice expensive Nike and Asics running shoes and my best results have come from my Fivefingers. I have not been able to get a hold of the Bikilas yet but I do have my name on a few wait lists. Yesterday I did 8 miles in my KSOs.
I am 15 months post-op from my last of three surgeries. I had a complete rupture surgery on my right and then had to have Achilles reconstructions done on both. For the most part, I am pain free in both legs. Occasionally I get zapped if my legs are cold and I am walking down stairs but I am very happy with my results.
I love wearing my Fivefingers (getting stopped by everyone to answer questions sometimes gets annoying) and I strongly recommend them. I do suggest that you ease in to wearing them VERY slowly. They do work your calves. I absolutely detest regular shoes now. I hope they work for you as well.

Hi Mary, Have you been getting in the pool? I am 11 weeks post surgery and went to the pool for the 1st time today. It was heaven! I walked, did heel raises and swam with arms only. It all felt great Are there any other water exercises anyone has found to be helpful? I feel that I have my work cut out for me with the conserative schedule my Doc has had me on. My leg is sooo weak I can’t imagine doing any leg raises outside of the pool.

Hi Mary

Your progress is so rad!!! You are obviously fit. Motivation is a problem, but I think you’ll overcome it. You are competitive.
At 14 weeks, I try to do activities I like, like walking my dog on the beach 1-2 miles a day, playing “lite” tennis and softball. There is a lot you could do to motivate yourself.
Be careful kayak RACING… Your tendon won’t be fully healed for a year. The greatest stresses on your AT occur when landing the foot, NOT during pushoff. You ATR’d when landing your foot. Google search “diyinjuryrehab” for a discussion.

Single-leg calf raises at 12-odd weeks?!?!? Go to the head of the class! (IIRC, that’s a bit faster than the average from the new study from the two state-of-the-art quick-rehab Japanese surgeons, whose study I cite on my blog about studies!)

But if you can do those, what’s preventing you from going up and down stairs TOTALLY normally? Are you still weak or stiff or nervous when you roll over your foot into a weighted dorsiflexed position? Please don’t take the question as a challenge for you to take chances — I’m just dumbfounded at your calf strength, and wondering what it is that you HAVEN’T recovered yet. (I’m still just shy of a 1-leg heel raise, but my stair-walking is virtually perfect.)

That’s wonderful, Mary. Great work!

Doug

Had that prob too on the sensitivity of my heel. I bought new pair of shoes and as Norm, I rolled my heel over a tennis ball while sitting. Also rubbed it in various surfaces (carpet, sand etc). It did go away slowly.

I’m getting a pedicure this weekend!

With my other ankle’s surgery, thought I would DIE the first day I was allowed to walk & felt how sore my heel was. I was sure something was wrong & called my doc in a panic. I never did learn exactly why I had that heel pain on the bottom of my foot, though.

It took about 6 weeks to go away. I generally felt better with a slight heel or a wedge in the shoe when it was bothering me.

Linda

Several of us had that problem with the anti-spam image, but the problem went away when we logged in!

Love your progress. Many of us have had the same feeling in the “bad” heel. I had tons of dead-skin padding there, but it felt like I was standing on an unpadded heel-bone! That sensitivity was pretty slow to go away, too.

My physio suggested rolling my heel over a golf-ball (while sitting). Others here just stayed in Crocs or other squishy padded shoes.

Congratulations! Driving was so liberating for me. I had the same surprise with my calf when stopped at a light. It burned a little because it was working so hard! The tendon felt great though. I have a miata also. Since I live in Maine in only comes out in the summer so I haven’t taken it for a spin yet. I can’t wait!

I think I can post now, after a few days of technical glitches. Yay! The withdrawal symptoms have been AWFUL!

I’m sure it was just coincidence that the site was shut down immediately after I’d posted about seven LONG posts!!

mary - thanks for the update. Yes, the site is back but I am still working a few of the kinks out. Please be patient. Glad that you are able to walk in the boot. It does make a great deal of difference when you can walk with two free hands. happy healing!

MM…glad to see you posting and that you are doing much better.

You’re welcome for the thoughts and the kind words sent your way…we all need them from time to time. Maybe someday you can encourage me. I go back to surgery on August 6th, 2010 to have my other AT on my left foot.

Hang in there and keep us posted.

Dear Chris

Your father’s story makes me feel fortunate with what I have. I’m not a physician, but hope the reason for the surgery was to close the wound. Your father can walk without the Achilles Tendon with the proper orthotics. And there is always the possibility of splicing some other tendon, etc. in there to restore function later.The open wound is/was vulnerable to infections that have dire consequences for the nerves,ankle, foot, etc.. And the movement of the tendon may have been preventing skin from forming and closing the wound.

Good luck in the future. My best wishes and hopes are with you and your father.

MM, I love your (continuing?) transformation from moaner to bitcher! I hope you don’t mind the language, I mean it in the best possible way. We all have reasons to complain, and some of that is healthy. Heck, I’ve been trying to get some of our colleagues to bitch more to their health professionals than they’re willing to do. That’s part of a healthy coping mechanism, and it’s good to “see the dust” left over from you coping!

Chrisbroe, that is one awful story! I hope somebody here knows something that can help. Is your Dad diabetic, or does he have another underlying circulatory or autoimmune problem that keeps his wounds from healing?

A 2″ gap in the AT isn’t “fatal” to good healing under good circumstances — I think I started around there 14 weeks ago, and I’m just getting rid of a subtle residual little “dip-limp” in my gait, in two shoes, all without surgery. But if they removed the AT, they probably also removed the sheath that surrounds it, and that may be enough to prevent good healing by itself. Plus, if your Dad’s condition means his body doesn’t heal well anyway. . .

I’ve thought and written a few times in

My dad, 87, has ulcerated feet. In an effort to allow the skin to form over the exposed left achilles tendon, a wound vac was applied for three weeks to no avail. The exposed achilles tendon sparked a surgical procedure that resulted in a good two inches of tendon totally removed and now there’s this gaping wound that you could put your fist through, (nearly). Is this normal? They’ve cut off the tendon. Cut through it for two inches and into the ankle back area. I’m totally upset and unsettled and in shock. I had nightmares worrying about it. Please tell me that it’s worth it to cut off a man’s tendon so that the skin can heal, and that the downside of this gaping wound is not as bad as just leaving the exposed achilles tendon alone and hoping the skin would eventually cover it up. chris

Sorry you’re stuck in casts, Sydw. I did “boot all the way” in a more progressive region (Toronto, Canada) than you seem to live in. Eight years ago (first ATR) I was stuck in a series of cast before I finally got into a boot. Maybe you can help bring the word of modern science to your region, for the sake of future ATR patients?

I was supposed to remove my 2cm of heel wedge at 6 weeks, well AFTER I started physio and became FWB. I discovered I’d actually been on THREE cm of heel wedge. I took them out, and it was quite uncomfortable. So I replaced 2cm for a day or so, then dropped down to 1cm. When I took out the last 1cm wedge, I miraculously felt MORE comfortable walking that way than I did with the smallest wedge!

All these little adjustments and smooth transitions are “easy peasy” with a boot, but out of the question with a series of casts. That’s why the young folks aren’t all studying to be cast-makers. . .