My leg doesn’t work right.

This weekend marked one year since surgery. What a roller coaster ride it’s been. I’m happy to see that marathon tracker stopped at the finish line over on the right side!

I don’t have much to add to the other anniversary posts, but looking back I thought it might be helpful to note how my recovery fit roughly into quarters:

1st quarter / March-May = shock, depression, the daily grind of getting around on an iWalk or crutches

2nd quarter / June-August = rapid improvement, ditching crutches, PT, driving again, lots of milestones

3rd quarter / September-November = Plateau City. I’m sure there were small improvements but overall I felt stuck.

4th quarter / December-February = another spell of improvement and increased sense of overall ability.

I still have stiffness and reduced mobility in my right ankle, and there’s still a nodule or adhesion or something toward the base of my incision, and that can be painful sometimes. I figure that stuff will improve in the second year as I work on flexibility and strengthening.

Not much more to say these days, thankfully. Good luck to anyone just starting out and I hope some of my past posts are helpful. Thank you, too, to everyone here who helped me out along the way.

Today marks 11 months since surgery, and it’s also a milestone I picked out the day I got injured. I was Googling recovery timelines while I waited in the ER and decided that I’d shoot for running the annual 5K race held by the nonprofit where my wife works. So, 2/10/18 has been on my mind a lot for nearly a year.

I’m happy to say that I completed the race and managed to come in a little under my goal time. Even more important: I came out of the event pain free and ready to continue training for an 8K race in late March. I have to remind myself that staying injury free is the main goal…it’s easy to get caught up worrying about times.

This week marks 10 months since my injury so I thought I’d post another quick update. After what felt like a 2-3 month plateau, I finally made some real progress in December. I attribute that to one particular day early in the month when (I’m totally guessing here) I had scar tissue finally release or an adhesion let go, or something happened that freed up my ankle. I had two flashes of pain that day, once when descending some stairs and once while grocery shopping. The first occurrence was in the lower Achilles area, the second was around mid-Achilles, and both were toward the lateral side of my ankle.

Both times I stopped dead in my tracks - I think I had flashbacks to the actual injury. After the initial fear wore off I realized that my ankle mobility had improved and some nagging tightness and pain on the outside part of the ankle had vanished. For months I’d felt like my foot wasn’t pronating properly, almost as if it was stuck. After this happened (whatever it was) my gait felt normal. It was like night and day, really.

The next day was a scheduled running day and everything felt really good instead of being mildly tolerable with nagging soreness. I’ve continued to progress and now I’m up to 25 minutes of running with no ill effects. I even did a trail run yesterday in some ice and snow, something I wouldn’t have tried a month before due to a fear of ankle instability. (I’m sure I could run for longer intervals but I’m making a conscious effort to slow things down as I’ve been known to add too much time/mileage to my running plans in the past.)

It’s nice to finally have a sustained period of time where I can finally say that my ankle is approaching normal, or a new normal. There’s still stiffness but only occasional pain. I can even walk barefoot around the house without too much discomfort, though I avoid that 99% of the time. I still don’t have a lot of push-off strength and I wouldn’t be particularly quick or explosive around a tennis court, but it’s getting there.

I have no idea what happened in early December. I had been making a concerted effort to massage my Achilles, the scar, and the bump down at the base of my incision. Maybe that helped loosen things up? Who knows? I’m just glad something changed because for most of autumn I was worried about a lack of progress.

It’s another lesson in individual recovery timelines, I guess. I couldn’t help wondering if I was behind or lagging in my recovery, when in reality each recovery is its own beast.

Today marks 8 months since my injury, so we’re not quite 8 months post-op but close enough.

It’s been a strange couple of months. For a while I felt behind and got discouraged because I wasn’t comfortable running at the 6 or 7 month marks. I’m not sure why that bothered me so much given how recovery timelines can differ. I guess I thought the random nagging stiffness and pain would let up…and it didn’t. There’s still never a day where I forget about the entire thing and move around normally. That can wear me down sometimes.

About a month ago I had to remind myself that I’m still doing more each week and there’s plenty to be positive about. I can ride my bike, for example, with almost zero issues. That’s probably the activity that feels closest to pre-injury normalcy. So I can ride around with my son in his bike seat and I get 30-60 minutes of exercise 3-4 days a week.

I tried to have a month of positivity based on those rides and doing more in-home exercises like calf raises, single-leg balance games, and stretching, and wouldn’t you know it: my ankle area started feeling better. I don’t know why it never sinks in, but I feel best when I’m sticking with a regular routine of exercise and stretching. If I take two or three days off everything gets tight and sore again.

Over the past 3 weeks I’ve added in some basketball shootarounds at the court next to my son’s favorite playground. I call it working on my Old Man Game, because I move just like the old guys I used to play against when I was young and had not a care in the world. Injuries? What are those?! Shooting, especially actively getting my legs into a shot, along with chasing missed shots turns into a light workout where I can try some semi-explosive movements without going too far.

Today I fired up my Couch to 5K app and went for my first official run. Well, walking/running intervals based on the first week of the C25K program. It felt weird, like I’m running with someone else’s foot attached where mine used to be, but I think I can continue on the plan and gradually increasing the running intervals each week.

So it’s been another one of those up-down-up cycles. Like I wrote earlier, it can wear me down, but I’m glad to be on the upswing again. If I have any advice to offer right now, it’s to work hard at sticking with your exercises. It’s easy to let them slide when you start feeling better and getting back into other daily routines, but there’s still a huge benefit to putting in specific rehab work (as boring as it may be).

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!

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.

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.

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.