pocketrocket’s AchillesBlog

Wow time flies when you’re having fun (ironic!).  I’ve been doing daily calf strenghtening with both double leg and single leg heel lifts, and my ankle movement range is pretty much back to normal. My achilles attachment is still a bit sore and slightly swollen but feels stronger as each week goes by. Closed shoes are still a bit uncomfortable although running shoes are fine. Thank goodness it’s late summer weather here and I live in sandals or thongs most of the time.

I saw the surgeon 4 weeks ago and he said I can progress to shallow water running.  I’ve been deep water running for several weeks now with no problems, but running with my feet in contact with the bottom of the pool is another thing altogether. After the first run in a 1.1m pool the DOMS in my calf was so bad I could hardly touch my leg for three days - hmm, maybe 10 minutes was too long for the first session!

Once I can cope OK with water running I can try very short runs on land. I’ve been a bit nervous to try it so far as I still have some slight swelling and a noticeable lump on my heel. I also find that if I am on my feet a lot it gets quite sore by the end of the day, especially going up and down stairs. I see the surgeon again next week so I’ll try a couple of very short land runs before I see him, so I can report on progress. All things considered I think I am on track - just nervous of every twinge!

It’s now more than 10 weeks since my surgery and although I am able to walk normally my foot is still pretty sore, and I’m still quite swollen around the achilles attachment.  It doesn’t take long standing or walking around to start it really hurting like it did before the surgery. Of course this really freaks me out because I’m wondering if the surgery actually hasn’t made any difference. My next post-op appointment with the surgeon is more than two weeks away but in the meantime I’ve started having some physio on the foot once a week which is really helping to get a bit more mobility back in my ankle. The physio also massages my calf - painful but necessary.

I tried a bike ride last weekend but was really really sore afterwards so I decided it was still too early and haven’t been back on the bike since. Swimming and water running are great though and my ice pack is now my best friend.

After nearly 2 weeks in plaster of paris, followed by another almost 2 weeks in a plastic cast, the cast was finally removed. This was a nerve wracking experience in itself as the trembling young assistant attacked the cast with an electric cutting wheel, which looked like it could easily slice into my shin bone with one careless slip of the hand.

My surgeon was away and no-one seemed to know if I should go into an Achilles boot or not. It didn’t inspire confidence but I gratefully hobbled out of the consulting rooms with no boot and with the imprint of the plastic cast lining still clearly visible on my now quite hairy right leg. I also still had the black arrow down the back of my calf that the hospital had asked me to draw with a felt pen on the day of surgery - just to make the 100% sure the surgeon actually operated on the correct foot!!!

The next two weeks were spent getting used to (something resembling) walking again.  Although I didn’t have a boot, I could really only walk with help of a crutch. For me this stage was a lot more painful than the days immediately after surgery. In fact I had very little pain after the surgery and while cast was on, but once I was walking around around on my affected leg,  it took very little time before my heel would get sore and I’d need to take the weight off my foot (all 45kg of me…).

I remember coming round in the recovery room and was amazed that I’d only been in surgery for half an hour.  My right leg was in plaster from the knee down, and with my foot slightly plantar-flexed (toes pointing down). The surgery involved making a vertical incision about 3 cms long along the inner side of my heel and cutting the excess bone away from behind the Achilles tendon but above where it attaches to the heel bone, so there was no need to detach the tendon itself.

The next 10 days or so I was in the plaster cast and had to learn to get around on crutches. Even simple tasks were suddenly hard work and getting around was pretty exhausting. I have a tiled floor at home and live in a typical single story Australian house, so I was able to whizz around on a wheeled office chair, which was particularly useful when trying to prepare a meal or move from one end of the house to the other. I missed the usual Aussie Christmas day on the beach and spent the holiday period watching movies on the TV.

After the first 10 days my stitches were removed and the plaster cast was replaced with a much lighter plastic cast.  Although this was still rigid, the lighter weight made it a little easier to get around and I went back to work.

I didn’t actually rupture my achilles.  I probably should make it clear. But it would have ruptured if I had carried on. It started  about three years ago as a mild soreness around the back of my heel in the first 5 minutes or so of a run. It gradually got worse until I developed a lump at the back of my right heel, which was sore most of the time and made running for more than a few minutes impossible.  In 2011 I spent more time NOT running and trying conservative treatments that I hoped would fix the problem - eccentric calf raises, cortisone, autologous blood injections - none of which made much difference. Eventually I saw an orthopaedic surgeon who agreed that I had an ‘impingement’ of my right achilles tendon caused by a Haglund’s deformity - basically a bony spur at the back of the heel bone that shouldn’t be there. Was it caused by running? Who knows, but my high arched feet and weak glutes certainly contributed to the problem.

I saw the specialist on 28 November 2011 and the surgery date was booked for 22 December. It was actually a relief, that at last there was a chance I might be able to resolve this chronic injury. By this time even walking or being on my feet for a couple of hours would make it sore and I was aware of it all the time.