Oct 19 2008
7 months and back on the court
Well….its been 7.5 months, feeling great, running, no pain so……..Back to the racquetball court. Went slow, had some fun showing off the scar and then it was back to normal. No after affects just an overall achiness but felt great the next day.
Have been pushing myself with exercises. The only thing I can report is that the medial gastroc really lags behind with respect to strength gains and therefore definition. I have been following the “maximum calves” exercise protocol for 6 weeks and although stronger, able to do a calf raise I’m not seeing as much bulk there.
Overall I’m happy, back to real life, the ankle is not holding me back from doing anything although I’m cautious. I know the tendon still has a few more months before completely healing but its still nice to be out and about.
So to those behind me…keep on exercising, pushing and don’t let the bads get you down for time heals both physically as well as mentally.
We are one day closer to the end.
Doc Ross
Doc Ross - Glad to hear that you are progress nicely. Looks like you’ve made it to manhattan on your marathon tracker as well. Congrats on getting back out on the court, and looking forward to reading more about your progress.
Hey Doc…nice work. It’s been good to recover along with you. It’s good to hear that both you and Dennis are back on your respective courts. I passed a kidney stone and had a little prostatitis a few weeks ago and they wanted to hit me with 4-6 weeks of levaquin/cipro to make sure nothing lingered. Given the stuff I’ve been reading, I passed. I’m enjoying my tendon’s connected and healing. Hope you are doing well and look me up if you’re ever in Colorado.
Cheers!
Nice goin Doc!
My Ortho said structurally at 6 months the AT is 100%. The nerve endings and strength come back to near normal levels at the 12-month mark.
The quickest a MLB player made it back was 8 months (Gabe Kapler)…according to your widget you beat him by 4 days!
Great progress…something to shoot for!
Wow, Doc. If I remember correctly, you were hoping to be on the court by the first of the year. Congrats on the progress and exceeding expectations!
And not to be a downer, but Kevin Fransden of the SF Giants suffered an ATR in March and got an at-bat in their final game of the season. Meaning he was right at 6 months from rupture to back in the bigs.
Doc - Great job! As Craig mentioned, you smashed your goal of returning to the court by the first of the year. Sounds like you’re doing great. I share your struggle with the medial gastroc. My calf strength is slowly coming back, but the medial head is lagging behind. Just need to stay patience and keep working at it.
To All,
Thanks for the comments. I have been practicing what I preach to patients, Just do it and you will see the benefits. I recently have had a run of achille tendon injury patients, spurs, tendonitis, plantar fascitis and tell everyone I know this injury and condition intimately. I recently did another lit search and have purchased “The Achilles Tendon” by Maffulli. I should receive it soon and will make it available to Dennis. Good info, rehab, orthotic specification, etc.
Do your exercises, be diligent and we’ll all be ready for the ATR Open.
Doc Ross
Hi Doc, I’d be interested in what you think of “The Achilles Tendon”. Since my injury, it’s amazing how many people I’ve run across with injuries ranging from tendonitis to outright ruptures. More info on healing and prevention would be great to pass along.
Craig
Craig,
Read a few excerpts, looked at the chapter titles and figured it would be a great asset to me as well as my practice. Once I read and review it I will post my thoughts and offer any advice from it.
How is your progress??
Doc Ross
Good Purchase Doc! Dr Guyton, at Union Memorial who did my surgery wrote the chapter in there on “FHL Transfer” for Achilles Tendonitis with Debridement…..sorry if I am repeating myself here. I asked him last week if he ever had to remove the “anchors” and he hasn’t yet….mine was “tunnelled” in the bone but it still hurts a bit. I am only 8 weeks and he said he expects it.
The pain is NO where post op that it was pre-op.
MarilynRD,
8 weeks post op….must feel great to be getting around. I have had several patients with the anchors, some have them removed later on some don’t. Hard to know what the guidelines are for something like that. Hopefullly the book will enlighten me on protocol.
Let me know if you need any information and I’ll pass it on.
Doc Ross
Doc Ross,
Would you do me the favor of reading my latest post and giving me your opinion? I sure would appreciate it!
Thanking you in advance,
Marianne
Hi Doc,
Thanks, I’ll check out the book.
I hit the 6th month mark last week, and have wanted to post, but don’t really have much to say. Other than lack of strength, I feel great. A little stiff in the morning, but that usually goes away after a minute or two of stretching and walking. I’m shooting for January 1 return to basketball.
Craig
Doc Ross,
Thanks so much for your advice….getting a second PT opinion is a good idea. This was the protocal at PT for the past 12 weeks..Weeks 1-6 went 3x’s/week and the routine consisted of 10 min. of moist heat, marbles, towell scrunches, ultrasound w/stim, rocker board while sitting, stationary bike 5 min., pro-stretch, massage and stretch, then ice 10 min. At home, all of the above and stretch with tubing and towell, except no ultrasound or rocker board 2x’s/day. So, I spent 2 hrs. everyday, at home doing my exercises.
Weeks 6-12: Started with same routine for first couple weeks…added standing wedge for stretching. Went 2x’s/week for weeks 6-12….. Asked if I could add some more activities to the routine at week 9 since I felt I should be doing more. Bike for 10 min., ultrasound with no stim, standing rocker-board using doorframe for support, total gym 30 rep at level 6, stair stepper for 3 min., squat machine at 20 lbs./20 reps, one legged stand for 10 for 10 sec. each, using fingertips for support on table. At home, added standing wall stretch trying to get heel to touch the baseboard of the wall….very painful ;( for 10 min. 2x’s a day. Still am riding bike at home for 20 min., theraband stretch, pro-stretch, use wedge for stretching, soak in hot epsom salts before exercises.
My husband has been working on massaging the ankle on the days I haven’t had therapy….he is also helping with the stretching.
I will check tommorrow for another PT’s opinion, and will also talk to ortho, on Tues., about removable cast/boot.
I really appreciate your input….if you think of any other ideas, pls let me know!!! I am sooooo wanting this to turn out right.
Marianne
Does anyone know of a good brace to protect a tendon that was ruptured and repaird? I am 7 months post op and am playing tennis again and would like to know if there is such a brace. thanks!! awesome site!
Tony
Tony,
The one I use is called Physioroom.com - have a look.
Richard
http://www.unionmemorial.org/body.cfm?id=556112
Here is a link to someone who did need more than one surgery, for whatever it is worth. Obviously every situation is unique. I am glad that I did the lengthening surgery after fooling around with two different boots, PT, ect for several years without relief of pain.
Good Luck Maryanne, keep up the fight and let us know how you make out. You will be a good resource for someone else I am sure and at least you can say that you tried another PT if you do end up with another surgery (but hopefully you won’t need it and this will be it for you!)
To All,
Just received “The Achilles Tendon” Book and have all ready learned a few things.
First the soleus and the gastroc tendons insert on different parts of the calcaneus and actually spiral to promote better movement and stability. Obviously with surgery there is NO way to duplicate this and therefore we are never 100%. crap
Second…the AT actually sends fibers to the plantar fascia for support but again post surgery this change in mechanics can lead to plantar fascitis down the road. Thus make sure you get fitted for orthotics!!!!
…..and I’m only on page 8.
As I come across more info I will pass it along.
Go forth and heal….
Doc Ross
Doc Ross,
Thanks for meticulously archiving your experience. Your information has definitely helped me as I am about 10 weeks post-op. During your healing, have you had any experience with skin adhesion of the repair spot on the tendon to the skin? My PT said that I have scar tissue that is causing some adhesion (I can see it as a small rice grain size spot on the skin as I try to massage along the scar). Right now, I get good ROM, but can’t dorsiflex fully like my good leg (I’m only at 8 degrees). Was you tendon shorter to begin with and did it stretch out over time (hoping my lack of full dorsiflexion isn’t due to the adhesion)? My therapist said that PT should hopefully help with the adhesion. I’m thinking that as I become more flexible, the adhesion will dissipate as I dorsiflex more?
Thanks,
Steve
Steve,
Adhesions are to be expected, if you don’t get them thats a blessing. Most important thing is to heat it for 10 minutes than stretch and massage vigorously. Try to schedule an appt with a massage therapist. I know you and the PT are doing some but a full 30-60 minute lower extremity massage will make your legs feel great. As for the dorsiflexion keep on stretching….are you using a belt wrapped around your foot and pulling?? The more you do the better it will be. It will stretch over time but only if you work it.
Will be posting my 8 month ATR pictures and update this weekend.
Let me know if you have any other questions.
Doc Ross
Hi All,
Its been one year and 7.5 months since my injury. Have not posted in a long time as you just want to move on….literally. Update…have been able to do everything…run, golf, racquetball, etc that I could do prior to the ATR. On the one year mark got a tattoo above the incision.
No matter how much rehab I have done the medial gastroc is still noticeably atrophied. Did some research and this is common and more than likely will not return.
Just had a patient walk into my office with it yesterday which
prompted me to look back at the site.
To All- I know you are frustrated and pissed off…keep on doing the rehab faithfully, read the blogs, do the work and you will get there.
If you have any questions feel free to contact me.
See you on the court.
Doc Ross
Hi Doc Ross!
I’ve read and reread your blog for the last couple of weeks, while dealing with this ATR that I so luckily acquired on Dec. 9th. I had to wait 2 weeks for surgery, which I had on Dec. 23rd. Yesterday, 7 days post-op, my crutches slipped and I fell, and, of course, put some weight on my toes of my ATR foot, which killed my AT for about 2 minutes. I hobbled to the couch, wrapped an ice pack on it, popped 800mg of Ibuprofin, and elevated it. The pain subsided, but now I’m wondering if I did any damage. My husband checked using the Thompson test, and he said my foot does move, not as much as the unaffected one. I wish I had done this before I fell.
Do you have any insight as to how responsive one’s calf muscle is after surgical reattachment to toe flexing and pointing? Mine is barely firing when I flex my toes up, or point them down. Of course, I didn’t do this either before my little accident, so I have nothing to compare it to. It seems to me that if the tendon is correctly attached, even with the calf muscle atrophy, that my calf would react to toe exercises. What do you think? None of this hurts, btw, and my doc told me to move my toes around post-op.
I see the doc for my first post-op on Monday (in 4 days), so I just figured that I’d wait till then for him to check it out, rather than go now, because if it’s re-ruptured, or partially re-torn, I don’t necessarily see how 4 days is going to change anything.
Thanks so much for your blog and your thoughtful responses to everyone here-it truly helps! Btw, I’m amazed you did that Grand Canyon hike at 10.5 weeks!!!
Btw, I’m a 43 yr. old ex-Olympian, fire fighter, competitive surfer, fanatic for exercise and the outdoors.
Peace!
Betsy
Betsy,
I lost balance and fell on my big toe of the injured foot 2 weeks post-op. To make matters worse I had just gotten the cast off and the only protection I had at the time was the ACE wrap. I read all the re-rupture posts on this website trying to figure out what I actually did. Finally, I convinced the doc to prescribe me an MRI which showed swelling, fluid, etc. So I did do some damage, but did not actually re-rupture. That was the point when I was able to mentally go back to my recovery. Actually, I think if I did not fall then I would have surely re-ruptured because I was being to eger to start doing things and to be independent again. So everything happens for the best (or at least I tell myself so)
Good luck and I hope it turns out to just be a little scare
Marina
Betsy, Try not to worry! This community is FULL of people (including me!) who fell—usually at around 2 weeks when we start venturing forth a little, usually landing on the big toe, usually smarting like crazy and so far NONE that I have seen has re-ruptured because of it. Take heart and take care!
Betsy,
I agree with Mary and Mshap, nothing to worry about. Muscles atrophy at an alarming rate post rupture. The firing will increase daily, BTW make sure you are firing the good leg exercise wise, it willhelp. It takes longer than you think it should to come around with rehab. Once you start noticing improvement it comes back quickly. I am almost 2 years post rupture and with as much rehab as I did and am still doing my medial gastroc has 3/4 to 1 inch less girth than my non-ATR leg.
Based on your loving to exercise this is just one more challenge to add to your list of accomplishments, albeit one you did not want.
Ex-Olympian…..do tell….when, where, what sport, etc.
Good luck and if you have questions feel free to contact me.
Doc Ross
Oh phew!!!
Thank you Marina, Mary K., and Doc Ross. That makes me feel way better!!! I talked to a PT friend of mine today, who also said that there is no way my calf would be “firing” even with intact reattachment due to the atrophy and other highly complicated anatomical reasons. She basically said that until I’m weight bearing, I won’t notice much firing at all.
Oh, and yes, Doc Ross, I was already in our garage gym on Day 3 (post op) working the rest of my body.
I actually feel pretty good, so as long as all is well, I think my recovery will go well.
So…..just because you asked…..I was on the 1992 team in Barcelona for rowing. I was an alternate (due to a last minute lawsuit by a disgruntled rower) for the sculling team. It was the best time of my life!
I wish you all a Happy New Year!!!!
I’ll post an update after my check-up next week.
Cheerz!!!!
Hi All,
Quick update: went to doc 12 days post op and everything looked fine. Not much swelling even. They put me in a boot and told me to start PT! They said change only the dorsi flexion angle on the boot once a week, or per pain. The current setup is that I can move from 40 deg. plantar to 30 deg. dorsi. Once that gets easy, I go to 20 deg. dorsi, etc..
The PT (I’ve been twice already) is being very careful since it’s only 2 weeks post op, but we do easy band work (no plantar), circles, alphabet, light massage, then ice and stim.
I sleep with the boot off, which is nice, and I can shower, but no soaking of it yet because the incision isn’t totally healed.
It’s very stiff and feels like it’s going to take forever to get it feeling normal.
Oh, and there is no way that I will be in 2 shoes in 4 weeks like some of you out there! I just can’t imagine it.
So, luckily my little fall didn’t cause any damage and I’m on my way!
Cheers to you all!
Betsy