My leg doesn’t work right.

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.

Wow, an hour-long wait for a 5 minute visit and here I am - cleared for 2 shoes and driving. I tried unsuccessfully not to get my hopes up so I’m very glad everything worked out.

The doctor recommended easing in to the unbooted life. I think I’ll follow my physical therapist’s suggestion of starting with an hour a day of practice at home. I can use my son’s nap time as a safe hour or two to walk around without fear of toys, cats, or the toddler chasing them tripping me up. I’ll probably keep the boot on when I go outside. Our front yard has soft soil and enough small depressions to make me nervous right now, and I’m not confident enough to manage curbs, stairs, etc. when we’re out and about elsewhere.

The driving thing was anticlimactic. I went in halfway expecting to face some kind of crazy test - jumping jacks! vertical leap! - but it was almost an afterthought. The doc said he tells patients they can drive whenever they feel comfortable. He didn’t have any firm rules or major concerns. I could have asked at my visit 3 weeks ago and he would have said the same thing! I don’t think I was ready then so it’s probably for the best that I didn’t get ahead of myself.

I decided to give my original PT place one more try. I have an appointment tomorrow. I’m hoping that they’ll modify the plan a bit now that I have my doctor’s permission to take off the boot.

I forgot to mention last week that occasional bouts of fatigue still surprise me. It happened more in the early days, but even now I’ll have a day where I’m dog tired for no apparent reason. I guess it’s the healing and recovering and PT work catching up with me.

Here’s a random gadget I’ve found useful over the past month if anyone gets sore feet: a Moji foot massager. I got one a few years ago because it felt so nice after a long run. At this point in my recovery both feet tend to be quite sore at the end of the day; the Moji is awesome for relieving all the aches and tension. (I swear I’m not on their payroll!) Anyway, if anyone has found the standard tennis ball or golf ball foot massage lacking, you might give it a try. I have to use it every night or I get cranky.

Not much news this week. I put PT on hold for a while because my insurance provider has limited my number of covered visits. I’m supposed to get 20 and they’ve decided 8 should be enough to cover this. Haha…I wonder if someone coded the problem as a sprained ankle, rather than a complete rupture? Who knows anymore in this crazy insurance landscape.

Apparently I can get more visits approved with a note from the doctor so I’ll ask him about that at my visit next week. I’ve burned 6 already so I didn’t want to use up the last two quickly. It’s not a huge deal to miss PT right now, anyway, because aside from a 5-minute bike warmup I’m really only doing ROM stuff I can do at home. I don’t get enough out of the 1 to 1.5 hours to justify the trouble of getting a ride over there.

I might use this break to check out another PT place and reset the whole process - I’m not quite sold on the current clinic, to the point that I was already thinking of looking elsewhere before the visit count became an issue.

Enough about provider issues! I feel good about my ROM progress and I’m moving around in the boot a lot better than last week. It’s nice to be able to get out and do more things, like an all-day outing to the Greek festival we’ll be checking out tomorrow in Charleston.

My heel still gets sore by the end of the day. I’m not sure there’s much to be done about that (beyond my heel cushion insert). I’ve taken a few tentative steps out of the boot and it feels odd but not impossible to manage, so I’m still hopeful about getting the go-ahead for two shoes and maybe even driving next week.

I’m not thinking much in terms of strength yet. I do try some isometric *not sure of the term - no real resistance* calf tensing/releasing each day. I can feel a little more every time, if that makes any sense. When I first started it felt like there was one tiny string trying to do some work. Now it feels like a group of muscles slowly waking up.

That’s about all for week 9. Still hard to believe this all happened. At least the shock of the injury and surgery are slowly fading away.

It’s been a fairly uneventful week. PT 2x week continues, and until today’s visit I was considering dropping that to once a week or taking a week off to conserve my insurance-covered visits (20 allowed for the year).

We did some new things today that went beyond stretches that I can do at home - riding the exercise bike, doing some leg presses on a shuttle, and working with a BAPS board (round wobbly board for ankle ROM). More new stuff next week, maybe even water therapy.

PT has been different than I expected. Not having been before, I imagined working one-on-one for thirty minutes to an hour with a therapist who focused on explaining details, performing complicated and fascinating procedures, etc. I don’t know where that image came from - maybe my idea of what a pro athlete’s life might be like? In (my) reality, the therapist who did my initial evaluation assigned me to an assistant. For the first 3 visits he ran me through a basic warmup and standard ROM stretching routine, all while moving around among 2-3 other patients in similar states of disrepair.

I’m glad they added complexity today because I’m not sure those first few visits accomplished anything I couldn’t have done at home - other than generating income for the PT facility.

In boot news, I’m more comfortable walking in my Breg. I’m still not taking the smoothest steps, but I’m definitely not as clunky as a few days ago.

The best development this week has been adding compression socks to my piles of recovery gear. I wear one on my bum leg for most of the day and have much less swelling. That makes the ROM exercises easier (and more fruitful, I think) and my overall comfort level is much improved. I also swapped out my full-length SuperFeet insole for a heel pad and that seems to be better for managing heel pain.

Onward and upward. I have two weeks until my next doctor checkup and most of my energy is focused on making my foot appear accelerator-worthy.