Jul 02 2012
6 Months - Things I Can Do
So its now been 6 months - this was my goal to be “back in the saddle” so to speak… Not nearly as far along in recovery as I was hoping - I guess my friends who’ve had this injury too were right, this will take at least a year.
Current status is that the achilles is tight and still requires alot of stretching each morning. ROM is probably around 90%, but getting to that range takes some stretching and the limits of extension, etc. are uncomfortable at best. When trying for full extension onto the ball of my foot there seems to be a spot at about 85% extension where there is a “hitch” which is very weak - kind of like a car door when it moves past the partial open point - it just gives in to the last bit… Calf strength I would put at about 50% - 60% - I measured 1″ difference between the calves about two months ago, just measured it now and am at about 3/4″ differential - progress there I suppose - I have some muscle on the outside of the calf, but not even close to filling it out on the inside. Still no jumping, and no 1 foot calf raises. Still doing strengthening exercises and working on longer and longer trail walks and moving into light jog/walking at short intervals.
In order to keep sane and positive I am trying to focus on the things I can do vs. the thing I can’t do. I have been out rafting and stand up paddling on local rivers. Not hitting any larger rapids on the SUP yet, and duration is best at 1-2 hours or so, but I think this is great PT for strengthening the foot & ankle muscles. I can bike up to a couple of hours and about 10-15 miles of hills (only cardio I can get), but not really on single track yet - downhill riding on uneven terrain and standing in the pedals is not there yet. Hiking on trail up to 5-6 miles is about the max. Working: lifting and carrying up to around 100 lbs. is getting easier and a bit less frightening.
Anyhow - here’s hoping this info is helpful to folks who are earlier on this journey. Peace to all…
Just wanted to post to say that I have the same hitch as you….I am about 4months and a week and I have been working on my one legged heel raise..I get a bit off the floor but that’s it…to help this along I have been doing seated clad raises with weight on my quads and I have noticed the hitch and wondered if this was Normal…..your post was definetly reassuring but I would love to hear of others had this issue as I sometime wondered if this is because of healing a bit long…..also has anyone resumed crossfit/heavy lifting and at what point…I am a little afraid to add weight to my lifts…..
Pablo,
At six months your progress is good when compared to my own case (I’m 10 months post op). Healing is a highly individual process and many factors will affect how fast and well you get back on your feet…Age, health status, fitness level prior to injury, surgeon’s skill, PT protocol, support system during healing, etc. etc.
Like you, I concentrate on what I can do and I work on that.
My motto: consistency and progression.
Completing a single heel raise is meaningless to me. All I want is to regain my health, my fitness level and my quality of life.
Hiking uphill 6 miles is quite an accomplishment and should give you plenty of reason to be optimistic! Keep doing what you can and do it with purpose and joy!
Emily, at 4 months post op you are still early in your healing. I started doing heel raises in the pool at about 4 months post-op, then graduated to doing them on the floor, then I increased the reps and only at 7 months I added weights. The calf machine is my best friend and favorite exercise.
I also have to add some people progress much faster. I am on the slow side, so you both seem to be somewhere in the middle.
Good luck and stay positive!
Pablomoses– I found your post to be inspiring! Especially the trail hiking and jogging parts
keep up the great work and great attitude!
I’m looking forward to being able to start jogging again, too. I am a running coach and during the Spring and Summer I teach adult Beginner Running Classes (which was very silly back when I was on crutches!) But the groups of newbie runners LOVES the idea that I will be starting back with exactly the same walk-run progression that they have started with. The hard part for me will be when my high school Cross Country team starts back up for the season as they take off like deer in the woods and I’ll be lumbering along wishfully.
I am 17 weeks post OP and feel about the same as you guys. I think I healed fast and got to a stopping point. I can’t do one leg calf raises but now my leg at least feels like it “could” do it.
I do a lot of angled calf raises to build the muscle and to work it out. I am 35 and feel like my “prime” healing days are behind me but setting goals does help my sanity.
My 1 year goal is to play in a 3-3 basketball tournament at a real low level and this is after hurting myself playing basketball. Without a goal I feel like I could stop now and just let me leg heal slowly and be a couch bum BUT that would not make me happy.
Plus my wife used to think my runners legs were sexy, so I can’t let the little lady down
You folks all seem to be experiencing a long “frustrating plateau”, though far from setting records or breaking new ground. Andrew, your AT should be ~100% healed, though it and your calf should both strengthen with more exercise. Some people never regain full (visual) symmetry after all the calf atrophy, though many do. If you’ve ever seen body-builders, you’ll see a remarkable variety of calf sizes and shapes (much more then biceps or traps, etc., IMHO). That indicates how hard it is to build up calf mass…
Yea being it is my dominate leg (right leg-> left handed) I hope to get it back and I will work very hard on it, because frankly I look kinda funny
It has been a while since I felt I could/would hurt my leg by doing things. I only avoid some of the bigger/longer activities due to swelling (after) and fear of knee/ankle damage. Since I lost most/all of my muscle mass my ankle and knee both feel very loose and stability is not quite right.
I don’t want to pull a Derick Rose and turn a limp into an ACL injury
Hey all - I’m WAY behind you at 8 weeks - but how do you start calf raises? My PT told me to start lifting my heel off the ground while sitting - is this a calf raise? Would you just work from there to weights, and then standing calf raises? Love hearing about all the activities you’re able to do - even with the “hitch!” Thanks! Kim
Hi Kim, Yes - the seated calf raises at first are what I started with - I was also doing alot of seated stretches - I particularly like the “toe stretch” where you are seated and put just your toes on the floor and push your knee out forward letting the heel drop as much as it can. Good luck and be patient!
Norm, i agree, I have a friend who’s had this injury years ago and his calf is still alot smaller… not sure how much that has to do with staying the PT course or not.
Thanks for the reply Andrew - I am also doing alot of “angled” calf raises, either leaning on the kitchen counter, or in a Downward Dog yoga pose… I’m with you on not being able to just sit & wait it out, plus, at 40 I worry about getting back to doing what I love to do if I do not apply myself.
EastcoastRunner - I’m sure you’re going to be up and running soon… I’ve never been a runner, but it seems that the light jogging I am doing now is the best way to actually engage the atrophied calf muscle - so maybe I’m going to have to become a runner due to this injury?
Emily - I think getting a heel off the floor at all at 4 months on one leg is great!… Per the hitch in the extension, I think it is getting better with use and exercise, but it is still really weak at the extension - and progress is glacially slow. I try to do the angled calf extensions mentioned above adding just enough body weight so that I can get through to full extension… & hopefully over time it will come back. As a rock climber, this is an important motion for me to be able to do strongly!
Cheers to all - thanks.
There are several reasons to find the top end of a 1-leg heel raise way harder than the start. The worst reason could be that your AT healed too long, so your calf is totally contracted before you get to full height. But there are others with more hope of fixing themselves with PT and exercise. The simplest is just the geometry of the AT, heel and ankle. As the toes drop and the heel rises, the leverage gets worse and worse — for everybody! So if you’ve got fractional calf strength, you’ll probably have fractional 1LHR height.
As I’ve often posted, I’ve found that my wimpy (~1/2-height) 1LHR still gives me enough strength to run and jump and cycle and play comp volleyball (beach and court) without any noticeable deficit. Surprising to me, but I’ll take it!
Thanks Pablo. I am seven weeks post surgery and looking forward to getting active again. It is good for me to have realistic expectations. Right now my question is anout numbness and tingling when i have my leg down in the boot. I am spending a lot of time elevating it.
baezlyons - I wonder if the numbness / tingling you are getting is from pressure points in the boot? I did alot of “modification” to my aircast boot with duct tape and cutting up a blue camping foam pad to create some shims & cushioning til I had it reasonably comfortable… But no matter what - long day in the boot didn’t feel good… good luck!
Thanks Pablo. The foam sounds comfortable, i will give it a try.
Pablo I’m 9 mo post surgery.
I still can’t do a single leg calf raise either. I know that when I do it will be 100% recovered. “fingers crossed”
I lift 3 times a week at the gym with free weights, for about 2 mo now. When it’s legs I do squat/leg press/leg curl, and of course the calf machine etc.
I am having a little bit of a confidence boost after I do a leg workout and wake up after a good nights rest my achilles’ feels strong. But no matter how hard I try I just can’t seem to get my single leg calf raise more than just 1/4″ off the ground. It feels like my foot doesn’t have the strength, more so than my calf at this point. Very strange and frustrating!!!
I’m also experiencing pain in my right heel and knee from what I think is subconsciously using my right side more. Today at the gym I did a little walking on the treadmill uphill at 4.0 speed. I flipped around slowed it down and walked backwards for awhile like I was taught in PT. Really trying to concentrate and focus on using my left.
How about you?
Hey Garrett,
I haven’t been doing much work in the gym, although I probably should. Mostly doing calf raises, lunges, 1-footed exercises, etc. for strengthening – and trying to either jog or bike every day. The jogging is pretty slow and weak, but I feel like that is going to be what gets the strength and “bounce” back. Jogging also gets me to the point where I can feels soreness and actually stretch my calf – from the beginning, I haven’t really been able to feel a stretch in my calf – I have been assuming this is because I don’t have much of a muscle there… Currently jogging about 2.5 miles with some hills in there, and riding between 10 and 20 miles… So I’m finally at the point where I can actually get some cardio going again.
I am about the same with the 1-foot calf raise, about 1/4” is all I can get. I try to do a lot of partial weight bearing full extensions with the injured foot – either seated, or leaning on a counter top, even if I am driving, I try to drive the ball of my foot (left!) into the floorboard next to the brake pedal. I think this is the most frustrating/scary thing for me: when doing those full extensions there seems to be a “dead zone” where I have almost no push at about 80% - 90% of the extension…
The good news is that on most fronts I am still seeing progress (however slow) - not going to get worried until I don’t see progress.
Went surfing for the first time last week and that went OK… Longboarding in mellow conditions was fine – I got out on the shortboard in more consequential waves and wasn’t able to get to my feet on a few that I felt I should have…. Oh well – great to be out in the water!
Peace, and keep on pushing it!