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:


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.

10 weeks post-op. Shoes and clearance to drive.

May 18, 2017

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.

9 weeks post-op. No news=good news.

May 13, 2017

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.

8 weeks post-op. The PT parade.

May 5, 2017

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. :)

“Look at that!”

April 28, 2017

After telling myself I’d take the PWB process slow and steady, I ended up testing out some unassisted steps in my boot last night and it went better than I thought. I gave myself 5 minutes to shuffle side to side along behind our couch, holding on initially, and mainly focusing on shifting weight from one foot to the other.

That got me over some of the fear of putting weight on my healing side, I guess. I tried a few shuffle steps from there and ended up in the kitchen, then down the hallway to the bedroom, and then I quit while I was ahead.

This afternoon and evening I practiced some more and managed to prepare dinner without any crutches or iWalk…what a treat after so many days stumping around in the iWalk. The best part, though, was my son following me around saying “Look at that! Look at that!” and “You’re walking! That’s good!” Kind of an emotional moment, to be honest. It’s 2 months to the day since my injury and this is the first time I’ve walked anywhere near normally since then. It’s been hard to deal with not being able to be active with my son, so his delight at me moving around - even in a still-limited capacity - meant a lot.

It’s kind of fitting, really. I’m not sure how much of this he remembers, but about a year ago the roles were reversed and I was helping him with PT exercises. He was a little delayed in starting walking, so we did leg strength and coordination exercises every day at home for about 7 months. We used the same timer and checklists that I’ve been using for myself. And ultimately, we were after the same result - learning (or re-learning) to walk.

Still a long way to go, but it’s nice to have a bright spot, that’s for sure.