myblownachilles

My first post in months - was reminded of you guys by a colleague at work telling me her husband did his ATR playing Ultimate frisbee on the weekend.

I’m a few weeks ahead of Sam at 9 months post-op and also managing about 2″ heel raise, but was at about 1cm heel raise or less only a month ago. I slacked right off the targeted exercises in early December because I wasn’t noticing the achilles being a problem any more. I got a reality check in January when I went in a 2-day mountain bike race. Apart from my fitness level not being up to scratch, I also found that with sustained efforts I couldn’t keep the power output even between injured and non-injured side, and consequently kept having to stop and stretch my lower back which was going into spasm.
So I started doing some targeted exercises again, and found that while strenght wasn’t a problem at neutral or in doersiflexion, plantar flexed strength was rubbish. I’m doing a modified version of doug’s exercise above.
Basically I give my bad leg as much assistance as required (but as little as possible) to reach FULLY plantar flexed then lower down as slowly as possible staying i

Yeah, like Sam: about 2″ high single heel raises now - still not as high as the good foot. I started at 5 months or so, and it took a LOT OF practice! First up on 2 heels then placing more and more weight on the injured heel.

Just checked the site (less regular now) to find this covnersation.
I’m just over 8 months (36 weeks) and can just about get to 2″ with single calf raise.
I was told to do some walking on the balls of my feet/tiptoes including up and down the stairs, and then walking onthe heels.
But guess time and perserverance are what really help.

I’m 2 years and have about 1 inch. It is still improving though.

7 months after ATR and still only able to raise heel 0.5″!
General fitness (cycling, running etc) A-OK though. My physio tells me it can take up to 12 months for a good raise!!!!!
Sorry to say it, but I’m glad to learn i’m not the only frustrated non-raiser here!
All the best.

Interesting view of the US-Canada border. Here in Toronto, I’ve gotten a lot of ultrasound, electro-stimulation, laser therapy, massage, etc. from my physio from the start (which was at 2 or 3 weeks). Only in the last couple of weeks has he been putting me on the exercise machines, and expecting me to show up an hour early to wear myself out before he works on me.

Usually I’m scrambling just to get to see him on time, so that part hasn’t happened. Today I had my 3-month follow-up with my “surgeon” (remember, there was no surgery!), in the same clinic, and I was going to do some 1-leg seated calf raises with a 20# weight on my knee. It’s a bit simpler than using a bucket full of water at home. But I forget.

Unlike you, madman, I’ve never really gotten the bug for doing a bunch of sets of a bunch of reps of the same exercise. I love playing sports I love, and I love getting the “burn” and the sweat and the exhaustion of having played crazy hard and crazy long. And I know that isolating and working weak muscles, over and over and over, makes perfect sense. And I know that my Gastroc and Soleus (calf) muscles need lots of work. B

Thanks everyone…This is yet another reason I love this site. It provides for a quick reality check. I will just keep on plugging away at my exercises.

JustPeachie- I am still doing my PT just not through Kaiser. Their PT office pretty much sucked and the $20 co-pay was getting old when I could do all of the exercises at home. I am quite a freak when it comes to my schedule though…I don’t miss any sessions. With a history of hockey, football, rugby, and lacrosse I learned the value of PT when coming back from an injury at an early age. If the PT was worth it I would have kept going.
I am a home grown Canadian living in the states since fall of 93 and my physio experience back in Canada was much different…ultrasound, electro-stimulation, laser therapy, massage, and range of motion / resistance training. Here in the states it was a little massage, exercises and that was it so the decision to go it alone wasn’t a hard one. Even my surgeon recommended it. On the other hand though, the attention I received from my surgeon here was better than anything I had back in Canada. He wanted to schedule me for surgery the day after a saw h

Almost 23 weeks, not happening,

I like Doug’s exercises, and elsewhere I’ve posted some details of the ones I’ve gotten from my Physio, too. Including seated heel lifts, with weight. (It’s probably on my own blog pages.)

But what do I know? I’m a member of the same club as the rest of you! After about 13 weeks (and no surgery), my leg can now do just about everything it used to do, EXCEPT the “push-off” at the end of a walking stride, and a 1-legged heel raise. I’ve been really close — or so it feels — for maybe 3 or 4 weeks.

On the other hand, I also have a cautionary tale, from 8 years ago, when I tore my first AT and had it repaired surgically: On the first day when I could do the “push-off” at the end of a walking stride (about 4 months post-op), my Physio told me to do some 1-legged heel raises. When I told her it was too hard, because I couldn’t do anywhere near 8 “reps”, she responded “Just do as many as you can”. Stupidly, I did, and cranked off 3 or 4 (grunting and groaning) before I ran out of gas.

It was literally A MONTH before I could walk properly again. And I had the first real PAIN of the whole rehab, right where the AT meets the top of

Hi Paulette,

I wouldn’t worry too much about the width of your tendon, the details of the scar (as long as the incision is sealed up), or morning stiffness. The width and stiffness will get better with time, and the scar issue is only cosmetic, (and massaging loose it might help). You really should work on that calf strength, though.

One exercise that is fairly “one size fits all” is to stand up, put your weight on your good foot, and get your injured heel up in the air as much as it will go with the ball of that foot still on the ground. Then slowly shift your weight from your good foot to your injured foot, and fight to keep that heel up. When your calf can’t hold the weight, keep the weight there and “fight” the heel’s descent to the ground as hard as you can. Do enough of this to make your calf tired the next day, but not the day after that. Take that next day off, then repeat the following day. On the off day, do some light exercise, perhaps seated calf raises.

One particular advantage to this exercise is that it works the calf at the plantar flexed end of its range, which is usually the hardest part to get back

I’m 20 weeks 5 days post op and I still can’t do it. If I stand on both feet with my weight on bad foot I can do them, but if I hold my could foot up off the floor, the bad leg won’t even think about it. My concern is more with the thickness of the tendon now, about 1 1/4 inches wide. Also the top of my scar is stuck tight to the tendon and I’m still quite stiff in the morning when first putting weight on my foot. Are you still doing PT, I stopped the first of the year do to insurance and not doing a very good job with my 3 exercises daily. I guess I keep thinking it is just going to get better on it’s own, but not so sure anymore. Paulette

Placer….

Good to hear you’re out tearing it up…..I bet it feels great to be doing fun stuff again.

I’m at 16 weeks today…and I tried the single calf raise with my Surgeon. I was able to raise myself only a quarter inch off the ground. But he says I’m on track to doing better, he said it just takes time.

Just hang in there!!

Just got a text that some of my Indiana friends are on their way out here for the week, so I’ll definitely be skiing at least one day next week!

Thanks fellas!

Ultidad- like Gerryr said , the first couple runs feel a bit weird but the tentativeness goes away pretty quick. Take it easy and stick to the safe stuff…no need for any surprises:)

DUDE WAY TO GO!!

Yeah I getting totally jealous as well.
Keep doing what it is your doing, its working out well for you.

So glad you’re doing well.

I’m jealous…hoping to get up for the first time this season sometime next week.

Normofthenorth…You should be good to go. That puts you just over 17 weeks. The only reason I didn’t ski my regular haunt on chair 10 was the visibility. The AT didn’t bother me much at all. You will have a great time up at whistler…I grew up in Kelowna BC and had multiple family trips there every year.

Our condo is booked for the week of April 11 at Whistler, 17 weeks after I was slammed into an AirCast boot (no surgery). If my progress continues, I expect to have fun, and to ski the runs I usually ski. . .

We’ll see, and I’ll try to share.

Thanks for the well wishes…getting out again was kick ass!

Gerryr - Not that you need to be told but you need to visit your bro in the wintertime!! ( I assume you already do) Jackson to the Wood must be just under an hour drive…add 30 -45 minutes and you have all of Tahoe basin. I live south of Placerville so I take 88 up and it takes me about an hour fifteen to get there.
I need to point out that my technique was stellar early in the day but after lunch fatigue started to set in and I should have called it a day about 5 runs sooner…at that point it was just keeping the wheels on the wagon.

Frouchie -It sounds like your rehab is going quite well…I tried some of those cone squats i read in another post of yours…makes me realize how weak the leg really is. I think the good leg compensates more than we all realize.

WAY TO GO!!!

I’m happy you were able to do so well. One slope down and many more to slide under you skis (boy that doesn’t look right, plural for ski).

Hope all goes well for you and your daughter this weekend. Again HAVE fun.

Feels good to go skiing doesn’t it. If your quads were burning, you are probably sitting back a bit. I can tell within probably 100 yards if I’m sitting back because my quads get tight. Your shoulders and knees should be in line with your toes. This is something I worked on for 3 years before I finally got it right this year. I actually think the ATR helped because I didn’t want to put pressure on the incision. Have fun this weekend with your daughter.

I’ll be teaching skiing tomorrow and working as a mountain host Saturday and Sunday and that will be the end of my season.

BTW, one of my brothers lives in Jackson.

Well I was able to get damn near a full day of skiing in before the quads decided to refuse to respond. The AT held up just fine. Gerryr was right in that the first couple runs were peculiar…the boot rubbing on the incision was weird (almost irritating) at first but seemed to subside after a couple runs. The mountain got a foot of snow the night before and it was lightly snowing all morning which made for some lo-vis conditions with a lot of surprise bumps once the runs were ripped up so the tendon got a fantastic test. Sun came out in the afternoon for a couple hours (can I say how awesome that is!) before another storm rolled in. Legs are a little stiff today but not bad…surprisingly the AT feels great. The injured leg definitely has a long way to go to re-build the muscle, when it would get tired I would coast on my left ski, when i tried to ski just on the right leg I could feel the big difference in strength. I was able to get a few runs in at high speed when the sun was out…really putting some pressure on the AT in the turns without issue.

The only bummer is today is bluebird up there so I went a day early.

Headi

Good luck and have fun. Just be aware that it will feel pretty strange the first couple of runs.

GOOD LUCK and HAVE SOME FUN!!! (I’m sooooo jealous)

Tell us how it goes!

Good luck! I don’t believe you’ll have problems, been on a ski boot

CONGATS…..MY MAN!!!

You’re at 16 weeks and got that much of your life back….aaawwwwwwhhhhhh…I’m so JEALOUS!! I’m 12 weeks 2 days, so my day is coming soon I hope.

Happy for you, just remember “Slow and Steady wins THIS race”.

Thanks!!! its a definite spirit lifter and a total 180 from that first month of NWB status wondering if you will ever be the same again. Now if I could just get a calf raise out of the bad wheel all would be good.

Just visualize what you will do when you get to certain milestones in recovery…Once you are in a boot and FWB many doors open back up!

You are stoked, bro! I can’t wait to be at 16 weeks. Keep up the healing spirit!

I do too….but I have to get the other AT fixed in August 2010…so I figured it had to do with that one being messed up.

2011 I hoping to be all fixed for the next 40 years.

Slow and Steady wins THIS race….remember that.

Good Luck.

I think the leg-length imbalance that comes from having one foot in a normal shoe and the other in a fat boot or walking cast is more serious for some of us than the medical folk understand. For both of my ATRs, that imbalance bugged me enough as I became FWB, that I beefed up my “good-side” shoe so it was about as fat/tall as my walking boot, and my whole body seemed to appreciate the change.

One relatively cheap and easy way to do that is to get your hands on a “cast shoe”. It’s a big clunky shoe-like thing with nylon-and-velcro “wings” that meet together on top of your shoe. (It’s meant to hold a walking cast up off the sidewalk, I think.) Most surgical supply shops should carry them, and there are a lot of them online, around $20.

Currently, I’ve got a flip-flop — a cheap Chinese “massage sandal” — slipped right inside a “cast shoe”, and that’s what I put my “good” foot inside when I’m walking around the house. The height off the floor matches my hinged walking boot perfectly. When I go outside, I wear a clunky clod or $hit-kicker (like a low-rise boot, the kind Merrell sells a lot of) with a couple of extra footbeds ins

Yes, I had pain and these weird little spasms in my “good” calf. They seem to have gone away now that I am in 2 shoes. Good thing, too, because they were making me very paranoid- thinking it was some kind of signal that my OTHER AT was gonna blow!

I too have experienced a tightness in my good calf when I told my PT she mentioned it is because your favouring the other leg so much that the other leg has to do more work.

I think everything gets out of whack in both legs. I would prefer calf pain in the good leg to the achilles wierdness I am experiencing in the good leg. It is either the result of picking up the slack or severe paranoia…or a little of both in my case, most likely. I am also getting a bit of the “pins and needles” in both feet now after not having them for 2 weeks - no idea why except that perhaps I am spending less time with the foot elevated? I figured they were gone for good…anyone else had intermittent pins and needles?

yep…. the good leg is still taking most of your weight probably, and balancing real carefully for both… take it easy.

WAY TO GO!!

I myself have started ditching the boot once I am in for the evening. I’m waiting for the day for the PT to tell me that I too can be rid of the boot.

Fantastic! Isn’t life without the boot great? I never want to hear the sound of Velcro again!

13 weeks and 3 days for the official heave ho!! At 11 weeks I was removing the boot when I got home for the evening so I could work on PT.

how long did it take after your surgery for you to ditch the boot?

One, two buckle your shoe! That’s great news. Keep on going.

Doesn’t that feel weird when they massage right along the incision? It hurts and yet it feels great. Today was the first time I rode the bike without my boot on- felt strange. I wanted to do all my other exercises without the boot, but when I asked my PT she said not yet.

Whoa! those things look sweet. Every review I just looked at was gushing over the Dragons. If they live up to the hype this could be foot nirvana.

The first two are useable but in pretty rough shape…decomposed granite really tears the rubber and plastic up. They are now my outside boots. Taking care of the new “inside” boot

If I were buying boots now, I would first try the Tecnica Dragons. I know several instructors who are using them and they all rave about them. I like the Diablo Pros, except for getting them on and taking them off.

Man, you seem to be the first one who wore out the boot and needed replacement!

Thanks for the insight Gerry. I am actually pushing to see if I can get outsooner but we’ll see how PT goes. How do you like the Diablo’s? I am rocking some Tecnica Agent 110’s right now from last season but have my eye on the Tecnica Agent 130’s. I should be able to get a sweet deal if I am purchasing so late in the year…but I digress…I actually tried to get in the boot last night and was able to get in with a little work with in the warmth of the house. I was a bit cautious getting the foot out though. It definitely felt weird when I took a few steps around. I shouldn’t have done it cause all it did was tease me. I had a look at my pass and that makes it even worse. I can’t wait to get out and make some turns!

Let me know how things progress.

Based on where you are now, you should be able to ski by the end of February. Depending on what kind of boot you have, it may be more than just a bit painful to get it on and you may have trouble buckling it. I just spent most of two days in my boots, Tecnica Diablo Pro and getting the left one on was not easy due to the stiffness of the shell. Getting it off was really quite painful. When you buckle it, be sure to start at the toe and work your way up the boot as it will make a difference in comfort. Also be prepared for everything to feel quite strange for the first couple of runs.

Hi! good to hear your news - had my cast off on the 25th too - am in the UK and have not had surgery but 8 weeks of cast (was put into plaster 3 hours after the rupture) - now in normal shoes with light support under my heels and can walk slowly with a stick! the relief! was given heel supports only for my right foot (the one I ruptured) but have got some more for the other one to even myself up! Good luck!

Thanks for the advice on the boot and additional heel wedge….I have moved to wearing one of my hiking boots on the good leg to try and balance things out. Just one day in a running shoe and the air boot and I started to experience some minor pain in my left hip and also on the inside of the right knee ( my ATR is on the right leg). The hiking boot puts me almost level so I am going to get another heel wedge for the good leg and see if it helps.

Also…what is with the damn pain in my heel? it was pretty sore come the end of the day in the boot. It seems to be subsiding now though. I am thinking it is due to the lack of use for a month. I probably did a bit too much the first couple days.

I would agree with ultidad, even though I never had the heel lifts. But, I did find it really important to wear a heavy backpacking boot on my uninjured foot so both hips are as level as possible. A discrepancy can lead to hip, knee and back pain. The heavy backpacking boot was the only thing I could wear that accomplished that.

And congratulations and not getting a cast.

I found that putting a heel lift in my non-injured shoe helped even out the lift discrepancy caused by the boot. You don’t want to be limping around and end up with back or hip pain.

Yay!
I also ditched the crutches today!

Alright!

Thanks for the insight. Last time I was in all signs pointed to a boot at this time. If a cast is brought up I plan to refuse it….Thinking of leaving the crutches there as well. I have another pair at home anyways. I have been gingerly putting weight on the leg over the weekend and it feels fine (albeit in a cast) if the current cast wasn’t so akward I think i could limp around instead of crutching it (probably why they make it akward!)

Looking forward to some mobility. I live on acerage and the area has been going to sh!t while I have been a useless pile this last month.

I agree with Doug. In fact I would go so far as to just tell the doc you will not accept a cast. I got a boot the day I ruptured mine and my foot has never seen a cast. The orthopedic surgeons here don’t do casts for this. The boot allows you to take a shower and wash your leg, do range of movement exercises because you can take it off and sleep without it when you feel comfortable about doing that. All the cast will do is delay your rehab. The longer you don’t use that leg, the longer it will take for you get strength and range of movement back. Trust me, I know about that because the infections I’ve had seriously delayed my rehab and I lost a lot of muscle mass in my calf from nearly 3 months of not being able to use my left leg.

I was at PWB 2 weeks after my repair surgery and was supposed to be at FWB 2 weeks after that, except the first infection hosed that up.

Hi Madman,

Keep in mind that you are not entirely a passive bystander in this decision. Ideally, if the doc wants a cast again, you could ask about the risks of a boot relative to the cast and get a straight answer. If the risk is acceptable to you, you could insist on no cast. They can’t put a cast on you if you refuse. This would obviously be an uncomfortable situation. It’s your call whether it is worth it or not.

Other removable options might be a half-cast/splint or a full cast that is split (bivalved). Both options use an ace wrap to hold things together.

Ortho docs sure seem to love their casts, but many patients seem to hate them. I feel very fortunate that my doc uses the splint/ace wrap only, and then into shoes.

Good luck,

Doug

Thanks for the input dsut4392. I definitely plan to take it easy…Just want to get some turns in with my 5 year old. I will have to hold back on what I really want to do. I seem to be a quick healer but have to keep things in check. I most definitely do not want to take a step backwars in the recovery process. I was told to stay off my leg until i get a boot or walking cast on the 25th but I have been cheating a bit…some very light pwb has taken place without issue thus far albeit on crutches just messing around.

From my experience, 4-months post-op sounds feasible for skiing. I’m at 4.5 months, and have been mountain biking for the last month or more without the boot. I have let my rehab slip since the 3 month mark, but if you keep up the gym work in particular you should get reasonable strength back.

I’m planning to ski at the 7-month mark, but only waiting so long because it’s coming into summer here in Oz and January sounds like a good time for powder in Japan.

Personally I would still take it pretty easy at the 4-month mark, my surgeon has advised me to avoid forceful eccentric loading until at least 5-6 months post-op.

As ultidad said, rupturing while skiing is not unknown; the ski boot prevents excessive flexion and provides some support, but it doesn’t change how much load you _can_ put through your tendon by pushing down on your toes (which is determined by contraction of your calf muscle).

From what my surgeon has told me, I don’t think that March is too much of a stretch for you. I ruptured on 9/3 and had surgery the next day. Living in Denver, we take our winter sports very seriously. My surgeon has told me that he thought I could start skiing as early as December, although when I asked when I should get fitted for new boots (mine are dreadfully old), he kinda backtracked and said that I should wait as long as possible. I plan to get boots in Jan and go up as soon as they are ready (~3 wks per the boot fitter). The good news for me is that I am using the injury as an excuse to get my first pair of custom-fitted, custom-insole boots (at age 46). One word of caution: most people might tell you that being in an alpine ski boot is the safest thing for your achilles, but a colleague of mine ruptured his while downhill skiing. I guess nothing is 100% safe. Good luck, Ron

Much thanks for the comment Smoley! Good to hear from a fellow skier. I am going to try the quad exercise tonight, I have been trying to keep up the rest of my body with free weights but the leg is a concern. My calf looked like it belonged on a corpse when the took the splints off and put the cast on. That was only 9 days. I can just imagine what it will look like come 11.25.

Congrats on your two little groms ripping up the slopes. We have ski girl #2 in training. She just turned 1 but will be hitting the bunny run next winter. Our 5 year old has plenty of ski dates scheduled to keep her happy until old Dad can get back on the mountain.

Isn’t it awesome how kids have no fear!

Placervillemadman - If doc says it’s not out of the question then that’s a great thing to aim for. Just make sure you exercise the muscles that you can still work on, because your whole leg suffers when you are NWB in cast, not just the bits you can’t see. Take it from one who knows!
Doug53 gave me a great one for the quad (the first muscle to go): Lie on yor back with your hips and knees at 90 degrees (as if you were sitting on a straight back chair). Cross good ankle over bad ankle and drop feet to your bum. Now grasp a short imaginary rope between your ankles. On the end of the rope is a weight - lift it! You have to keep your ankles pressed together or the rope will slip. Use the strength of good leg to work bad leg.
It’s a great one and you don’t want to have a mishap skiing because your knees are shot.
I mainly wanted to respond because I have two ski girls myself. They’ve both skied from age 3 (now 8 and 10) and will tackle ANYTHING. We do nearly all our skiing in Austria and those maniacs will put a path down a sheer rock face 2 feet wide and call it a run! So I know what you mean about the proud Daddy moment!
Best wis