11 weeks post-op.

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.

5 Responses to “11 weeks post-op.”

  1. I’m reading through your points nodding my head for most of them! Except for ditching the boot so quickly. Good for you on that!
    I had a lot of front ankle issues after my surgery last year. My PT told me it’s other tendons and ligaments working harder than they should be to compensate for the weak ones that should be doing the work. There are a lot of tendons on the top of the foot/front of the ankle. Be careful - once those guys get irritated it can be hard to calm them back down again.
    It’s nice you’ve found some shoes that seem to work. I’m currently wearing Mizuno wave enigmas (a couple years old - probably time for something new). Mine are also bright blue & yellow! While they’re comfortable, I find the heel cup too high and causes my Achilles to burn after not too long. Once I’m fully in shoes it might just be time to go running shoe shopping.
    Enjoy your long weekend. Take it easy! Eyes on task…..!

  2. If you get pain on the outer part of your ankle between the ankle bone and bottom of your foot it’s probably the nerve that runs through there. I asked my doc about it since I was getting pain there and he said that’s normal. The nerve gets annoyed by the surgery (for me). It’s mostly back to normal but, sometimes, reminds me I’m not healed yet - LOL!

    I was lucky - or perhaps it was my diligence with my ROM exercises - I only had issues going down stairs for about a week. Now I go up/down with no issues. And if your PT person told you to do dorsiflexion exercises - DO THEM! They won’t have you do things you shouldn’t do. You just have to not push them. My doc said be gentle when I push on the wall. So when the stretch starts feeling a bit painful (as opposed to just stretchy) I stop pushing forward and keep the stretch at that point.

    And if you’re not comfortable walking barefoot - don’t! For me the doc didn’t want me to do it because of loss of bone density due to 6 weeks of NWB and possibility of stress fracture. I’m actually doing a bit of barefoot walking (on carpet now) even though, technically, I’m not supposed to do it until next weekend. I’m barefoot when I do all my PT exercises and last night I just stayed barefoot until I went to bed and when I got up at night. 2 days ago my foot didn’t really like flexing as I walked barefoot, but that seemed to be gone last night. Of course that could be because I had just finished my PT exercises and things were all warmed up and exercised.

    Keep on keeping on! Once I’m out of heel inserts and get to do 10 minutes of running a day (next weekend!!!) I think may have to go running shoe shopping too! I’ll try my skechers that I bought not too long ago to see how they do. They may be good enough. Of course I’ll probably use my 10 minutes a day to chase the dogs around the house. My Schnauzer keeps looking backward at me as I walk around the house chasing him - he doesn’t quite know why I’m so slow - LOL!

  3. Forgot one kind of funny observation; after so long laying my foot off to the right when I rest (to keep pressure off the tendon and incision), I have to consciously make my leg go straight when I walk or rest now. It naturally wants to turn out to the right. Getting better now, but it was funny a week ago…like my leg had a mind of its own. Why are you pointing that way?!

    RE: stretches. The main reason I was lagging on the dorsiflexion stretches is that was the one place where some warning bells went off. I’ve told myself this entire time to stop when something doesn’t feel right, and until maybe 2 weeks ago, those stretches felt *wrong*. Hard to explain. I felt most of the stretch right at the repair site, not in the calf or anywhere else along the tendon.

    Add in the fact that the PT people were aggressive early on about actually pushing my foot to stretch it past neutral and that freaked me out. When the PT didn’t mind mashing on my foot like that, I lost confidence in her approach…it’s more like she sees 1-2 cases like me a year and doesn’t have any consistent methodology. So much about this process is about confidence and faith in the treatments; unfortunately, I’ve had mixed results with providers and feel more comfortable making my own modified plans.

    Now that I’ve started walking it’s like the entire area is loosened up and the stretches feel much better. I feel it in other areas, if that makes sense, and the repair site and tendon are almost secondary. So now I have no problem following my PJ-modified protocol. :) I just got off on the wrong foot (ha) with a therapist so eager to see dorsiflexion that she tried to lean on my foot to make it move.

    And who knows? Maybe that’s standard practice. It didn’t feel right to me so I trusted my gut. If I’m a late stretcher, well, I’m a late stretcher!

  4. Today I am at the point i can put full weight on my bad foot in the boot without my Achilles hurting. However, my ankle has gotten so weak i cant stand the pain it causes when stepping. Who knew so much was going to take a hit.

  5. Great observations, pj! I now recall all of this during my first AT recovery, and am getting there with my second! The getting used to two shoes is so different for everyone - glad your body took to it so well! I’m just getting out of the boot, and am not ready to be out of the boot in my own yard (too lumpy, making the ankle go all over the place), or in social situations with lots of people around. Actually, I’ll probably use it at work for a couple days, yet, just so I can keep up with the others! LOL!

    Yes - Eyes on task. Mind on task. That will save us from a lot of stupid things we take for granted every day, but can be a hazard!

    Keep up the great work!!!

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