Week 4: First Physical Therapy Appointment

Hi everyone, happy FriYay!

This is the first post I’ve ever done on time! As I said last post, I was cleared to start some passive physical therapy this week until I transition into more active treatment when I’m out of NWB in 2 weeks. I found a small PT office close to my house with great reviews about really personal and hands-on treatment and also education about the injuries, rehab, and future prevention. After I jumped through a million and one hoops with my insurance, I showed up to my appointment in the afternoon.

The exact instructions on the PT referral were “PWB 25%, for passive and AAROM”. This means I am allowed to put up to 25% of my body weight onto my left achilles and I’m only focusing on passive and Active Assisted Range of Motion (AAROM) exercises.

Today’s appointment was more of an evaluation of my leg post-op and an introduction into what I’ll be doing starting next week until my 3rd post-op at the end of the week. My PT first measured my left ankle’s mobility in all directions using my right leg as the control for comparison and wrote down all the degree measurements. She said that the swelling actually looks really good and there don’t seem to be any concerns about the joint or the current state of my flexibility. After, she manually worked on the foot and spent time stretching my foot in dorsiflexion. My achilles–the wound specifically–was feeling a little tight throughout the stretching but it wasn’t anything severe. I have been incredibly careful with my boot the last few weeks so I think that it was just my ankle and achilles’ first chance to move in a long time and test the healing/scabbing of the incision. Next, I rolled over onto my stomach and my PT massaged my lower calf and the area around the incision which felt like it released a lot of tension I didn’t know was there. The tightness in my wound was completely gone by the end of the session. Finally, she showed me a couple of my exercises for the next week: the heel sliding on the ground (3×10reps once a day) and a strap-assisted ankle inversion/eversion (3×10 once a day, assisted because only passive and AAROM movement right now).

Overall, today turned out great! My PT was super nice, informative, and great with answering any questions I had. I felt very comfortable in the PT office and we were able to talk about our lives, last night’s US Open matches *sigh Serena*, and gender balance in the workplace! I have a long road to recovery ahead of me but my PT assured me that healing is slow but possible and I feel that I’m in good hands. Looking ahead, I’ll have to stay really diligent if I go through with my big holiday travel plans and I’ll probably have to find another physical therapist when I move out to LA in 2021 but I’m willing to do whatever it takes to get back to my old life so I’m here for it!

Thanks!

Vicky

P.S. I think I figured out a way to wash my boot (thank god)

Week 3: 2nd Post-Op

Hi Everyone!

I don’t have that much to update from Week 2. My constant googling has contributed to my ever growing list of pro athlete ATRs (and their comebacks, if any) and I recently added John Wall (Go Wizards!) and Misty May-Treanor, who went on to win gold at the 2012 London Olympics after her 2008 injury! My 2nd week post-op was me getting back into the swing of things around the house and getting used to sleeping in my boot again. It’s not that bad but sometimes it feels too tight or too loose, especially since I naturally have tiny ankles and calves:/ The tingling along the outside of my foot is still present, along with the numbness, but I saw that nerve damage from surgery can take anywhere up to 6-12 months after surgery to heal so I’m not too concerned. My days consist of me meandering around my house and stretching my Achilles to try to get to that 90º (or 0º if you’re in a hinged boot) flexion. I stretched 2-4 times a day with hopes of having my foot flat in my boot by my 2nd post-op.

At Week 3 second post-op was even quicker than the first. My foot was able to get to that 90º stretch which my doctor was happy about. The tape over the incision hadn’t fallen off so my doctor said I could go ahead and take it off after my next shower. He told me he wants to be proactive with my recovery so he cleared me to start physical therapy next week! I am to be NWB for the full 6 weeks so my physical therapy will initially be focused on stretching, mobility, and range of motion and I’m allowed to put up to 20% of my body weight onto my leg in some PT exercises. I’m super excited because this gives me something to look forward to and to focus on in the meantime since quarantine life is pretty boring! I’m a little scared of how hard and long this recovery is but I’m also determined to come back in equal, if not better, shape than before! If Misty May can do it, why can’t I? I’ll write back after my first appointment to explain how it went and what my treatment is going to look like.

Thanks!

Vicky

P.S. My doctor is super thorough but once I get home from my appointments, I think of so many non-urgent questions I meant to ask him but forgot that aren’t important enough to call his office about so if anyone is reading this and has any answers or advice I’d appreciate it!

Random Questions

  • When did you stop elevating your foot whenever you were lying down and during sleep?
  • When did you stop wearing your boot to sleep? *Bear in mind, I am an extremely active sleeper*
  • I have gauze and an ACE bandage on under my foot but the incision doesn’t bleed anymore, do I still need the ACE bandage?
  • Is there any easy way to wash my boot???

P.P.S. I’m not as consistent a blogger as I’d like so I’m just catching up with my old posts

Week 1: First Post-Op Appointment

It’s been one week since my surgery and I’ll be switching from the splint they put on after surgery, back into my boot at this first post-op. I’ll be honest and say my showers this last week were…infrequent to say the least. I used a trash bag, a shower chair, and some tape to protect my splint and switched to bucket bathing in my tub. I highly recommend this instead of a regular shower for this injury, it offers so much more control and you don’t feel like you’re getting drowned by the shower stream with the chair sitting directly in its path. I wish I had figured this out before my first shower in the chair.

With surgery last Thursday, by Monday, my pain was down to a 2 or 3/10 and Tuesday, it was basically down to 0. I was back to moving around normally with my crutches and my parents decided to buy me this knee scooter to use around the kitchen downstairs (I was driving my mom crazy dragging our chairs across the floor to take some weight off). A couple friends came to visit me (physically distanced on the porch of course) so I haven’t been completely out of contact with the outside world. With my combination of crutches, scooter, and strategic hopping, I’ve figured out a “normal” routine that will get me through the next couple weeks of NWB.

My post-op appointment was brief and anti-climactic but it gave me a better sense of what to expect in the upcoming weeks. My doctor said that the surgery was smooth with no complications and there was very little bleeding in the dressings under the splint. He didn’t specify but I’m assuming he used dissolvable stitches because there was nothing visible and nothing to remove. There are a couple small translucent strips of dressing covering the incisions which my doctor said will fall off on their own during my next showers and I’m free to let water run over my incision and even lather if I want (I don’t think I will for my first real shower). He put some gauze over the incision and an Ace bandage around my ankle to wear under the boot. He told me I’d be NWB for the next 6 weeks but he wanted me to *lightly* stretch my achilles just by sliding it along the floor with the hopes of reaching 90º by the time I see him again in 2 weeks. I am a stickler for instructions so I followed his directions to a tee.

Thanks,

Vicky

Week 0: Surgery + Recovery

Hi everyone!

Sorry about the unintentional hiatus, I’ve been keeping notes together but have neglected writing my full posts until now. Going back to describe surgery that happened Aug. 13.

My surgery was exactly 2 weeks after my ATR due to schedule conflicts (my orthro surgeon said 2 weeks is the longest anyone should wait after the injury) so I got to the hospital around 8:30 that morning. Getting checked in was a smooth process. I was put into pre-op room where I had to repeatedly confirm personal info and details of the surgery, get hooked to an IV drip, and do a COVID test. Around 9:30, the anesthesiologist came in to meet me and go over my health background and the CRNA came in to explain that I’d be going under general anesthesia administered through the IV and I’d be out within 5-10 minutes. Once it was go time, I was wheeled into the OR and the last thing I remember was moving from the bed to the operating table…

I woke up groggily in a general recovery ward before I was moved into my own post-op room (my memory of that move is pretty foggy), I realised that I was back in another splint with much more dressing than the ER one. I was in and out of it for a while in the post-op room before I was finally discharged and wheeled out to be driven home. I wasn’t in too much pain, I just put elevated my leg on pillows and slept for hours. When I woke up that evening, my mum told me that my doctor said the surgery was smooth and complication-free and he administered a nerve block that I would be feeling the effects of for the rest of the day. I was prescribed oxycodone but I didn’t take anything when I got home because I had taken Percocet (Oxycodone + Acetaminophen) in the recovery room. I had dinner in bed but felt nauseous and didn’t eat much (anesthesia side effect). My leg really didn’t feel too bad, I just felt pressure and a dull ache so after dinner, I slept again. I woke up around 1AM with a really strong, aching pain so I took one of my prescribed oxy pills and eventually went back to bed.

The first three days after surgery were definitely the hardest, but still not as bad as I was expecting. I normally avoid taking painkillers unless absolutely necessary so I was really trying to limit my use of the Oxy as much as possible. The night after surgery, I woke up around 6AM with burning, aching leg pain so I took another Oxy. When I woke up, did some googling and found out that I could take Tylenol (Acetaminophen) at the same time as Oxy and when my doctor called later that day to follow up after surgery, he confirmed that I could take Tylenol and Advil (Ibuprofen/NSAID) along with, or instead of, the Oxy. I decided that I’d alternate one Tylenol and Advil pill (with the rare Oxy) during the day as needed and I’d make sure to take Oxy at night to try to help me sleep through the night.

My leg felt heavy and had the dull (but strong) aching pain throughout most of the day. I made sure to wiggle and flex my toes in the splint often to make sure I could. My pinky toe and the outside of my foot had been tingling since the surgery and though it initially felt like I had some gauze or something stuck between my pinky toe and my fourth toe, I looked and realised that there was nothing there. To the touch, there was still that weird feeling of tingling and some numbness, but I was still able to feel everything. I mentioned it to my doctor during the follow up call and he wasn’t concerned and suggested that it might be from the retraction (pulling the skin open) during the surgery which stretched some nerves. He told me to keep an eye on it and said it should get better over time.

I spent the first two days in bed, sleeping and watching tv, only getting up to go to the bathroom. My family brought me everything I needed throughout the day which was super nice. I didn’t feel too much pressure or blood rushing to my foot when I would get up which was lucky. I didn’t succeed in sleeping through the night until the fourth night but by the third day, the pain was largely better and I made the big trip out of my bed to the couch downstairs! I made sure to elevate with all my couch pillows down there too and I had my lunch on the couch. I eventually got tired again and crawled back upstairs to get into bed. I stopped taking any pills by that night.

Thanks,

Vicky

Injury + Pre-Op

Hi everyone!

I’m Vicky and ever since I ruptured my achilles a couple weeks ago, I’ve been reading through this website for info, advice, reassurance before I finally decided to start my own! I’m extremely talkative and overly-detailed so I hope my oversharing and long posts don’t overwhelm or tragically bore whoever comes across this.

About Me

I’m 22 years old from the DC area and I have lived an incredibly active lifestyle since I was a kid. I just graduated college where I was a 2-sport athlete (VB/T&F) and an All-American (saying this just to emphasize that I really do a lot of high-level athletics). I’ve dealt with normal wear and tear throughout my athletic career–sprained ankles, pulled hamstrings, shin splits etc.–but I was lucky enough to never have any serious injuries so this ATR is especially scary for me. I did experience bad Achilles tendinitis in my last two seasons of volleyball, especially in my left Achilles so now I’m wondering if that had an effect or made me more susceptible to the tear. I’m grateful to have made it through college before having this injury but I want to stay extremely active in the gym and play competitive volleyball for as long as possible. I’m really trying to stay diligent with my recovery so that I’ll be able to come back with the confidence to continue my life, especially since this happened so young.

Injury: Thurs. July 30, 2020

My injury story sounds pretty typical after reading through people’s experiences. This summer quarantine, I had been biking, walking, body-weight lifting intermittently but that day was my first time playing volleyball in about 7 months. I didn’t warm up because I absolutely hate warming up (believe me, I am a changed woman now) and about 45 minutes into playing, we were doing a pass to attack drill when I made a great pass and I was excited for the chance to hit. I took a quick, small step back to start an aggressive approach and I immediately slipped and fell. At first, I thought I had slipped back and my foot bumped into the next girl in line but I asked my coach if anyone was around me and looked around to see that the closest person was about 6 feet away. I immediately realised that the sound I heard wasn’t me hitting someone else’s shoe but rather my Achilles popping. When I stood up, it felt like I suddenly had a bunch of heel inserts or that my shoe’s heel had grown a couple inches and I wasn’t able to walk or put any weight on it. My coaches carried me to the side where I kept my shoes and ankle brace on and laid on the floor with my foot elevated on a chair and a couple ice bags around my ankle. For a torn tendon, it honesstly wasn’t that painful of an injury, though I did take some Advil.

I made the trip to the ER to see what to do next since I was pretty certain it was an AT tear. They did an X-ray to make sure there were no chipped or broken bones and performed the Thompson Test to confirm that it was my Achilles. They put me in a splint and gave me crutches and told me to go an orthopedic doctor as soon as possible to move forward with treatment. I slept with my leg elevated and called the ortho Friday morning, the next available appointment was the following Tuesday.

Pre-Op

I’ll be honest, I knew the injury wasn’t great but I really didn’t understand the severity of it until I was googling up a storm later. After I got injured, my first thought was “thank god it wasn’t my ACL”, but that relief was quickly gone. I kept seeing articles of pro athletes never coming back from an ATR and random forums of people saying that it’s actually worse than an ACL injury. All of a sudden, I was really scared what my next few months would look like. I never really considered that I would be having surgery.

Quick research informed me that operative and non-operative treatment options were possible for ATR and I was determined to avoid surgery as much as possible. The more research I did, however, the more likely it seemed that I would need surgery as a young woman with an extremely active lifestyle.

My appointment was a little more casual than I expected but nothing negative. I assumed I’d have an MRI to visualize fully visualize the damage but my ortho made it clear that it was a complete rupture and didn’t even hint at any need for an MRI. I had come with my own mental list of questions to ask regarding treatment options, outcome, length of recovery, etc. but my ortho was very thorough and informative on his own. He discussed his thoughts regarding operative vs. non-op and addressed recent literature, although he said he wasn’t quite convinced about non-op on younger patients. He made it clear that this is a pretty routine surgery for him. Although risks exist, he told me I was more likely to have an accident on the Beltway than have major complications with surgery and he completely expected me to make a full recovery which made me feel better. He put me into a walking boot like this with NWB and we scheduled the surgery for the following Thursday since I was going out of town that weekend. Overall, I felt like I was in a much better place to accept what was coming and returned to the internet, and this blog to keep reading. I spent the next week crutching around my house and climbing up and down the stairs. I wasn’t in too much pain, just felt some throbbing and pressure every now and then. Getting used to sleeping in the boot

Sorry for the long winded description if anyone is out there! I’m not quite sure if any of them will really get any shorter but hopefully this helps someone else (especially younger ATR patients).

Thanks!

Vicky

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