21 weeks post-op.

August 5, 2017

I guess I’m officially in the “Well, I don’t have much to say at the moment” phase, but I thought I’d post a quick update.

21 weeks since surgery, 22 since the injury, and as others have mentioned recently I think progress is best measured month-to-month at this point. I don’t see much difference if I look back a week…but if I go back 2-3 weeks I can see a lot of changes. The big one for me right now is that my calf raise exercises don’t hurt as much, which allows me to do more strengthening work without getting scared that something is wrong. I had some pain in my ankle tendons and the lowermost part of the Achilles that made me cautious; now, as the entire area gets stronger, it all feels better. I’m not quite to the point of a single leg calf raise, but it feels close. (I’m also not rushing that.)

I spent a week in Colorado and experienced my first extended period of time in an area with inclines/declines. I managed okay. Going down trails, especially with little rocks making it treacherous, was an adventure so I didn’t go crazy with the hiking. Mostly it felt good to walk around and feel my leg working. I still think about almost every step, and my ankle feels stiff and uncooperative more often than not, but there’s a lot more functionality there, if that makes sense.

That’s about it! A long road, and a long way to go. Good luck to everyone who’s in the early stages. Well, any stage, for that matter.


18 weeks post-op.

July 18, 2017

A little late with this update, mainly because I seem to have arrived at a plateau and don’t have much to add to last week’s note. I’ll admit to slacking off a bit with my exercises earlier in the week - it’s easy for me to do when my leg feels ok - not great, but ok - and I can go about my daily activities reasonably well. Sometimes I want to ignore the entire recovery process and pretend nothing ever happened. Hey, my ankle’s a little stiff! No big deal.

This week’s plan is to update a weekly exercise spreadsheet I used to print out to track my progress. Something as simple as having a piece of paper taped to the refrigerator does wonders for my workout consistency.

What I noticed over the last few days of reduced exercising: My ankle and calf actually end up feeling worse each morning, even with the rest. The stiffness and soreness are more pronounced. I guess it pays to continually work and stretch each day after all. :)

I think that’s the tough part of this stage for me. The first three months provided me with plenty of milestones and achievements. Now in the fifth month post-op each week has become basically the same. I do notice more strength in my calf muscle, but that development is happening a lot slower than the earlier progress.

Random details for week 18: I’ve almost retired the compression sock. I still wear it on occasion, and my foot swells without it, but it doesn’t feel necessary now. I’m walking fairly well most of the time. I do get some stiffness and pain (the pain near the heel, or sometimes in the peroneal tendons), so I still end up limping on occasion if I’m on my feet a lot. My ankle is super-stiff in the morning. I do a round of Theraband exercises as a morning warm-up before I even put my feet on the floor. Then I do a set of gentle calf raises, and then I feel like I can walk around.

We have a trip to Colorado coming up soon. That should break up the rehab monotony a bit. I’ll be interested to see how any sort of incline/elevation affects me. Here at sea level I enjoy a nice blanket of oxygen and not a hill in sight!


17 weeks post-op.

July 8, 2017

This week I learned how much is too much when I spent Tuesday working on some long-neglected beds and shrubs around the house. I dragged a tarp full of leaves, mulch, and dirt (and my son) from the back of the house to the front, and that required a lot of pushing off with my legs. I managed to do the work okay, but was quickly reminded that my right leg doesn’t have much power and the lack of strength puts stress on different areas of my leg. At first my right knee hurt below the kneecap, and then my ankle and Achilles hurt. My limp definitely returned in full force.

Nothing about the soreness felt particularly bad…more like a warning. It did take about 3 days for everything to settle down, though. Perfect timing for more yard work this weekend. :)

I treated myself to a pair of Vionic sandals for my birthday. They’re expensive, but they’re pretty nice. I hate wearing socks and shoes all the time - I was always barefoot or in sandals before the injury - so it’s nice to have comfortable sandals. And what better way to celebrate turning 42 than getting orthotic sandals and walking around slowly.

I’ve started one-leg calf raises in the pool. I can do those at about 4.5 feet of water. Any closer to 4 and it gets too tough. Also doing light jogging, jumping side to side in 4 to 5 feet of water. It’s a nice way to ease into those motions.

Out of the pool, I’m putting most of my weight on my right leg when I lower from a two-leg calf raise. I haven’t been as dedicated as I should be with the calf raises. After the yard work issues I decided to make it an easy week.

Aside from the temporary return of the limp, walking has been okay lately. Sometimes I feel a pinch on my Achilles when I push off, sometimes it’s all swollen and stiff, sometimes it’s fine. In a way every day is the same, and every day is different. It’s slow progress and each day the stiffness or achiness moves around.

I hope to get in some more exercise this week. It’s easy to get complacent once things start feeling better.


16 weeks post-op.

June 30, 2017

Sixteen weeks. Wow. Four months since surgery, a little over that since the injury. That feels extra crazy today for some reason.

Steady progress at the gym, with some random soreness as I add weight to seated single-leg calf raises, increase reps of standing calf raises (still 2 legs), and extend my time on the exercise bike. Also have some leg press and leg extension work to tease my right leg back into shape. They have one of those bumpy/knobby foam rollers there so I use that to torture myself. I have one of the smooth rollers at home. Those bumps make a big difference.

I stepped on one of my son’s mini-basketballs with my repaired foot when I stood up from the dinner table a few nights ago. A consequence of my “No playing basketball in the house…unless your mommy’s not here and then we can do it” flexible rule style. Stepping on a ball or toy was a huge fear of mine early on, so when I almost fell I had the fleeting thought - “this is it! re-rupture time!” - but I twisted my ankle a bit and nothing bad happened. Good to get a slip like that out of the way. Everything feels so much stronger around the ankle these days.

On to month number five!


Beach PT

June 25, 2017

Finally got around to working on photo uploads. I made a scar page so my stitches and scar can be preserved on the Internet forever. There’s even a surgery pic.

Here’s a quick shot of my beach PT routine:

beach

That’s my son running away from me at the bottom right, and that sort of thing makes up a large part of my PT these days. He’s still a lot faster than me so I have to keep hitting the gym and working up to sprint work ASAP.


15 weeks post-op. Later, doc.

June 23, 2017

I had my last appointment with my orthopedic surgeon on Tuesday. That was the first time I walked into his office without any kind of assistive device, cast, or boot. It’s amazing to think about how anxious I was during earlier visits compared to slowly strolling in there in two shoes. He liked how everything looked and saw no issues with my self-directed PT plan. Unless something comes up, that’s the last doctor visit for me. He’s had 4 ATRs come in since my injury - it’s a small town Achilles rupture epidemic!

The doctor gave me a rough timeline for the next 2-6 months. He thought an attempt at light jogging would be okay in 3-4 weeks, maybe a return to “easy” tennis somewhere around the 6 months post-op mark. That’s faster than the plan I had in my head, which was jogging by fall and tennis at the 1 year post-op mark. So I’ll proceed along as I have to this point - letting my calf, ankle, and foot tell me when they’re ready to do things. They’re surprisingly good at communicating via stiffness, aches, and random twinges. I’ll probably end up somewhere in the middle of the doctor’s timeline and my original plan. I have my eyes set on a 5K in February and with continued good luck that should be a reasonable goal. No reason to rush the jogging when I’m headed into a brutal southeastern summer.

I’ve started light strengthening work in earnest this week. Of course, all that means is that I’m doing seated and standing calf raises (2 legs only) and slowly increasing repetitions. I’m also riding the exercise bike for longer periods of time. Combined with the theraband exercises, I finally feel like I’m working to get stronger rather than working only on mobility/flexibility. Oh, and I also try to balance on one leg for as long as I can…I do that whenever I think of it, maybe 10 times a day for a couple minutes’ worth of attempts. The stay-at-home-parent life gives me lots of little opportunities like that.

The bike and calf raise work are making a big difference in my walking. My gait feels a lot smoother, especially at that last stage of a step where I’d normally push off. I can’t say I feel any real push-off strength; it’s more like the muscles are waking up and remembering how they’re supposed to move.

I also started up a YMCA membership so I can go to the gym. I’ve always hated gym workouts but I have to say it’s different now. I have a new appreciation for how my body works, and a new understanding of how bad it feels when things go wrong. The simple act of lifting a weight seems miraculous. I picture the muscles and tendons moving and stretching and I marvel at all of the mechanisms involved. We’ll see how long that feeling lasts. I have to say, they sure have some fancy exercise bikes/stair climbers/whatevers these days. I sat down on some kind of recumbent bike and started pedaling - 5 minutes into the program a notification popped up telling me that a cooling fan was about to start. Then I felt a nice breeze out of small vents on the display that I hadn’t noticed. Welcome to the future!

I wear my compression sock about 50% of the time now. Still use an ice pack at the end of the day. Overall, the foot and ankle swelling has diminished. It’s still there, though, so the ice in particular feels good.

That’s about all for this week. It’s a welcome change of pace to feel more relaxed, and even a little excited, about the next recovery phases. The early weeks are such a mess of shock, fear, confusion, and impatience. For the first two months I could barely stomach the thought of walking, running, jumping, etc. Now I have to slow myself down when I’m exercising because I can’t wait to do those things. I know all of our timelines are different - I hope everyone currently healing reaches a similar point of relative calm (however long it lasts) sooner rather than later.


14 weeks post-op.

June 16, 2017

Fourteen weeks and all is well.

I managed a beach trip without too much trouble, so that was nice. Those outings are such a big part of our lives that it felt good to realize I can still go (early on I worried that I wouldn’t be able to go out there much this spring/summer). I won’t be jumping around in the waves any time soon, though.

I’ve experimented with taking off my compression sock at midday. My probably illogical, completely made-up theory is that my leg won’t learn how to pump blood properly if I keep helping it with compression. Therefore, I’m reducing the amount of compression sock time gradually. I don’t know if that has helped at all, but I can manage a half-day without too much swelling or discomfort.

I’m going to try a bike ride around the neighborhood this weekend. Riding with my son (in his bike seat) was one of my favorite pre-injury activities so I hope to start again soon. I won’t go out with him until I’m sure I feel comfortable getting on and off, etc. I want to feel confident that my leg can hold up to a sudden tip or fall in one direction. Which, now that I type that out, might be a few weeks off. Seeing re-rupture stories on the Achilles injury Facebook group makes me conservative about these things.

Not much else to report this week. That’s a good thing! Hope everyone has a good weekend and good luck with the rehabbing, recovery, and maybe even relaxing.


13 weeks post-op.

June 9, 2017

Steady progress this week. I realized on a couple of occasions that my ankle mobility has improved enough to make a difference in my gait. Every other day or so I have an “aha!” moment when I notice a change.

PT this week: walking with my son. Our paces match up well and I can focus on slow, proper steps. I do theraband exercises and simulated/exaggerated steps and slow-motion running motions to work on light strengthening and balance. I’ll probably revisit “real” PT in another week or so. I don’t feel compelled to check in with them at the moment.

It’s funny how quickly I’ve forgotten what the early weeks were like. Last night I started grumbling about how annoying it is to always wear shoes around the house (I never used to wear shoes in the house). What a pain to slip on my running shoes every time I get up! Poor me! Of course, in the early weeks it was the cast that was frustrating. Then the iWalk and crutches, then the boot. I need to remember that this stage is easy compared to living with all of the other devices I’ve had to use.

The thing is, even with steady progress all I really want is to go back to normal. Completely normal. Rewind to March 2 and decide to hold off on tennis for a while. I still have a moment each morning when I forget that anything’s wrong, and it still sucks to come back down to earth and do 5 minutes of stretching and mobility exercises so my ankle doesn’t feel frozen when I first get out of bed. It’s a pendulum, and quite a ride. Excitement, hope, resignation, hope, excitement. Wash, rinse, repeat.

So, my goal for the weekend is to stay in the excited/hopeful zone for as long as possible. The weather is nice, I can get out and about, and if the worst thing going on is wearing shoes in the house, I don’t have much reason to complain.


12 weeks post-op. Cruising along.

June 2, 2017

Week 12 has arrived and it kind of snuck up on me. Early on I was fixated on this week because my doctor kept telling me “The tendon itself won’t fully heal for 12 weeks.” It automatically became an important milestone - like life could begin again and rehab could start in earnest after week 12. But instead of being a big moment, it’s another week of slow and steady progress with no major issues. I’ll take it. The first 3 months drained me so I welcome the uneventful weeks.

Random observations:

  • Of all the activities in PT or at home, walking and getting on with daily life appears to be my best rehab prescription. Each day my gait feels better and my ankle gets more flexible. I still do my basic ROM exercises, but for the most part keeping the house running and chasing after my son provide plenty of work.
  • Going down stairs got slightly easier this week. I’m not confident alternating feet yet, but I can do it (last week I couldn’t, or didn’t want to try).
  • I’m now thinking in terms of a non-limping percentage of my walking each day. As in, Thursday I didn’t limp maybe 40% of the time. I feel like I default to a limp and have to make myself even it out. I hope to see that get better each day or week. I’m definitely ahead of where I was last week.
  • I’m still surprised by the muscle loss in my right quadriceps. I expected the calf to shrink. I guess I didn’t think about the whole leg essentially being out of commission for a month. To remedy this I go up stairs right leg first the entire way instead of alternating - the reverse of how I went with the iWalk! Time to get in gear, right leg. I’m supposed to add some leg presses to my PT routine soon and I’m sure that will help.
  • Aches and pains come and go on each leg. I’ve come to expect something different each day. Might be my left (good) Achilles ticked off about something, my right hamstring getting tight, my toe hurting. There’s always something. Nothing alarming, so that’s good.

That’s about it for this week’s wrap-up. It’s amazing how surgery day on March 10 can feel like it was 100 years ago or yesterday depending on how I look at it. Even a month ago I was wondering how I’d manage a trip we have planned for late July. Now it all seems possible. So for anyone out there in the 0-8 week range feeling gloomy, I hope you experience the same change in mindset that I did. A lot of things that seemed scary or impossible don’t look so bad now.


11 weeks post-op.

May 26, 2017

First time in a while I haven’t had some kind of appointment during the week. My pool PT didn’t work out (canceled one day, I’m out of town the other day), and I don’t see the doctor again for a month. I thought I’d post some observations after one week out of the boot. Sorry this got kind of long. I’ve been jotting down random things all week.

  • Surprisingly, I took off my boot after the last checkup (5/18) and haven’t put it back on. I got used to the combination of security and freedom it provided from weeks 3 through 10 so I was sure I’d wear it 50% of the time this week. I never felt the need. So long, old friend.
  • I think it was ericbabula here on the blogs who said “Eyes on task, mind on task” and I say that about 1000 times a day. Seems like I spend most of my time scanning the floor/sidewalk for threats. It’s nice to be out of the boot and it’s also terrifying to be out of the boot.
  • My ankle and Achilles are still quite stiff. I don’t have the best flexibility even on the good side, so the repaired side has some major catching up to do. My last measurements were 5 degrees dorsiflexion and 44 degrees plantarflexion. Admittedly, I’ve avoided most of the early dorsiflexion stretching my PT recommended out of fear of tendon lengthening or “healing long.” I hope that doesn’t come back to haunt me. The plantarflexion feels good so I’ll take that as a positive sign. Also, the entire joint seems to have loosened up now that I’m out of the boot.
  • Everything feels safe and stable as long as I’m wearing shoes. Barefoot walking feels bad - like there’s too much instability to do more than stand in the shower for a few minutes. I can’t imagine walking barefoot or in sandals for any significant distance; then again, a few weeks ago walking at all felt impossible so I’m sure I’ll get there.
  • When I have discomfort, it’s as likely to come from the sides and top/front of the ankle as it is to come from the Achilles. Or even the foot bones themselves. Or the bottom of my heel. I’m very aware of the tendons on each side. It also feels like something locks or gets impinged at the front if the foot dorsiflexes too much. That’s been the only truly painful area - once or twice I’ve over stepped and got a shock of pain right there.  My uneducated guess is that the swelling prevents normal movement in that area (I still have a decent amount of swelling, especially by evening).
  • My gait has improved each day. It’s kind of fun to wake up each morning and feel the difference. I’m limping, but not nearly as much as day 1 in shoes. I don’t have much push-off strength. I mainly focus on making and repeating a proper motion. That means I walk super slow right now. I figure slow and safe is the way to go!
  • I really have to watch out for those moments where my brain reverts back to the old days and thinks everything is fine. I guess putting on shoes again triggers muscle memory and patterns or routines. A couple times I’ve put on my shoes first thing in the morning and set off like nothing’s wrong. That lasts about 1.5 steps until I remember how slow I have to move.
  • Stairs are tough. Going up isn’t too bad - I can walk up normally, alternating feet, as long as I make sure to plant each foot carefully. Going down *has* to be bad leg first with no attempt to alternate. I can’t flex that foot enough to take regular steps down, and I can see how easy it would be to get a really bad, hard stretch on the stairs.
  • If you’re on Facebook, the “Achilles Tendon Rupture Group” is really good. It’s a closed group so you have to send a join request. Nearly 2000 members and lots of good discussions and encouragement.
  • I’ve seen a few other posts about shoe selections so I’ll add this in case anyone searches on shoes for the recovery period. I have a pair of Merrell Moab Ventilators with orange Superfeet insoles that are comfortable and stable trail/everyday shoes. I wanted some running shoes to add to the rotation (all of my other shoes are too flat or minimalist for comfort), so I tried 4 types: Adidas Adistar Boost, Saucony Omni, Mizuno Wave Inspire, and Brooks Adrenaline. I settled on the Brooks Adrenaline in the end. It was an easy choice - great cushioning, a generous offset (12mm) that almost acts as a little wedge, and they’re bright blue/yellow for an appropriate level of flashiness. Second choice would have been the Mizunos, then Saucony, then I would have thrown the Adidas away because they were terrible.

Onward to week 12! Hope everyone else is making good progress. Enjoy the weekend.