SAM’S SUMMER OF FUN!

…and still slow but steady progress.

Had physio yesterday and had a go on the wobble board (bit scary!), step, bike and using gym ball, plus some painful tendon massage. Quite positive in the improvement in my walking and physio said I could drop to one crutch except when speed-walking in a hurry. Unfortunately she confirmed I’d developed some tendonitis in my good leg but recommended the rest, ice & elevation I’ve been doing plus some of the same stretches without weight-bearing that I’m doing for the injured side. She also gave me some Blue-Point gel heel cups to help absorb the shock in the heels, which are still painful after an hour on my feet.

She seems to think the hitch in my walk is due mainly to muscle atrophy in the glutes (!) and my knee still tending to lock, so have various different types of squats, glute exercises and knee squeezes to try. When I’m doing the step I’m also lifting the injured leg higher than I need to to get on, obviously some spacial awareness adjustments needed by my brain still!

I was feeling a bit low at work yesterday seeing things pile up and not being physcially capable of doing it all, but will just have to ignore it - have asked for some help. Today at Uni was easier as there is obviously less walking around and I’m sitting down for the lectures.

The first song to come on my iPod on the train this morning to cheer me up immensely was this…..happy weekend all.

Actually 13 weeks and 1 day post-op and it’s been a busy week.

I went back to work in the mixed FE/HE college library on Monday, but on lighter duties with some seated work rather than walking around all the time. I found after about an hour on my feet I needed to sit down for a while and had some swelling around the malleoli but that was all. I’m still using 2 crutches with some limping unaided for very short distances but my boss was right, I was still faster on 2 crutches than some of the students on 2 legs!

My part-time Uni course recommenced on Friday involving more walking and the train into central London - much easier to get a seat with crutches. Slight delay getting to the afternoon lecture when I realised it was on the 3rd floor up 6 flights of stairs (!) and the lift only worked for student cards configured to allow access, so I had to call security to get me up and down and will sort my card out for next week.

I only took 20 minutes to get back to the train station (about twice as long as normal) so I was home in time to go out for a meal and to the cinema with some friends. Quite a late night resulting in more swelling than normal.

Feeling a bit achey today and am concerned about my good ankle. Developing some tendonitis there through overuse/favouring that side? It feels a little sore, hard and lumpier than normal so will have a more restful weekend and check it with my physio next week.

At physio this week I had some very painful massage of the heel and plantar fascia which are causing me pain after being on my feet for any length of time, and restricting my dorsiflexion. I’m continuing with toe-tapping and seated heel raises to increase the strength through the toes, and doing more holding and squeezing of knee muscles to strengthen the knee.

Physio confirmed it was ok to walk short distances indoors without crutches (which I confessed I was already doing) and confirmed which Wii Fit exercises would help with strengthening and regaining balanced weight-bearing. She said I was nearly ready to go to one crutch but would have to slow down again then. And very scarily I tried standing on ONE LEG (ie. the bad one) which I am to practice more at home, obviously always with support nearby. That was very wobbly but the tendon felt strong.

So small improvements all the time, but still feels very slow. Happy weekend to everyone.

Husband tells me he can see improvements in my walking every day and I know it is true: more weight-bearing and improving strength but it’s still very slow and tiring. I’m hobbling around at home a lot without the crutches but always with my trainers on for support, and although I’m getting more confident my walking is still very hop-along.

I’m quite pleased with the appearance of the scar at this point thoug there’s still that little bit of thread/stitich sticking out near the bottom. The tendon is a little thicker on the injured side but not too bad. The swelling is usually only around the malleoli/ankle area and not too severe for the amount of walking I’ve been trying. The tendon is still quite tight expecially in the morning or if I’ve been inactive for a little while, but some ROM/stretching and marching on the spot usually help.

So here are some pictures to mark the occasion:

My feet at 12 weeks post-op.

My calves/scar at 12 weeks post-op.

It’s back to work for me on Monday and back to my one day a week Uni course on Friday, so it’s going to be a long challenging week.

Later addition to this post : Have just WALKED WITHOUT CRUTCHES to the postbox ’round the corner. It took me 10 minutes there and back which is slower than last time with crutches and much slower than the normal 2 minutes, but I did it FWB if with a bit of a lopsided gait. Physio would probably tell me off for that, but just wanted to see if I could do it. YES!!!

Happy weekend everyone!

….which means I did the hill at the end of my road. YES!

Ok it was very slowly and gingerly done with crutches, especially coming back down afterwards with some goodies in my rucksack. I had to actually hold on to the handrail provided at the top ‘cos it’s so steep.

But I did it. Little triumphs. And it only took 12 minutes to get to the Co-Op (with necessary cashpoint machine) instead of the usual 4-5.

Tired now so little foot massage is in order I think.

Best wishes to all.

Just had to write a bit of waffle about the exciting morning I’ve had - exciting for me by recent standards anyway!

Becuase it’s sunny again today I thought I’d try a bit to build up the distance I can go with the crutches and my confidence.

Started off with a little walk up and down the railway footbridge nearby, fair incline but not as steep as the hill at the end of the road or the one I’ll have to do on Monday if I catch the train to work. When I’m more confident I will try with the hiking poles as Dylan suggested.

Then I walked to the bus stop to catch the bus to the supermarket. Saw the bus leaving as I neared the corner of the road but not really in a position to run at the moment…so sat down to wait for the next one. Local black cab driver I know drove past and kindly dropped me at Tesco for no charge except a bit of a chat.

At Tesco, I put my crutches in one of their small trollies and walked around holding on for grim death, but gradually getting more blase about letting go and hobbling along pushing it. Once I’d got a few bits and pieces I found they have installed some self -service scanning machines since I was last in so amused myself there. Packed my little rucksack and proceeded to push the trolley out of the door only to have the security alarm go off TWICE, once for my printer cartridges and then again for my toothbrush heads. Oops, maybe the self-service wasn’t such a great idea afterall.

Walked the long way back to the bus stop, caught the bus home and got off the further stop again - still too chicken to tackle the big hill.

Not sure if it’s my imagination, but think people are staring at me more now I’m out and about on crutches without the cast. Guess it’s not so obvious what’s wrong with me now. Very tempted to start dribbling and talking to myself, but realise that is rather sick and insensitive!

Had my fifth physio session today with some painful (again) work on the tendon itself, and the tight spots in the sole of my foot and calf muscles. But it all feels much more relaxed afterwards. She got me to put my injured foot on the wobble board to see how well I could move it back and forth prior to perhaps actually standing on it next time!

So now in addition to all the other bits I am to concentrate on putting more weight through the injured leg: marching on the spot, moving each leg forward and back and to each side. And I am to start trying some calf raises but using as much support as I need from a stable surface such as the kitchen worktop. Certainly feels like progress today.

I got the cab to drop me at the local shops after the session ‘cos I was feeling so good and it’s so sunny today. I pootled around a bit picking up a couple of things I needed, only as much as I could fit in my backpack, then caught the bus home - woohoo, near independence! Would normally have walked to and from the shops, only 15 minutes each way, but it still took me 10 minutes to walk from the bus-stop ‘cos I chickened out of the one at the top of the hill and got off further away for a flatter walk. All still with both crutches, I hasten to add.

Physio said not to do too much barefoot walking yet until there’s more strength in the ankle and knee so am doing that very cautiously for a few minutes each day.

It’s now 11weeks and 4days since surgery and I’m beginning to feel more confident about things again. It will also be my birthday on Thursday which will be exactly 3 months from the rupture and things feel like they’re VERY slowly getting back to normal. Still frustratingly slow at getting around and doing just about anything but, hey, a few weeks back I couldn’t even do this much.

Well, I can see these posts are going to get progressively more boring from now on so will try not to waffle for too long.

Was feeling a bit disheartened the last day or two that progress isn’t quicker, and I’ve caught my daughter’s cold, but this morning I walked (still with 2 crutches) to the postbox and back in 6 minutes - half the time from a week ago so there has been progress, just not mindblowingly obvious.

More exciting, for me anyway, is the fact that I managed to walk barefoot (with crutches) across the living room floor very slowly, with not much weight on the injured leg but with the HEEL TO THE FLOOR! Woohoo!!!!

My physiotherpist was quite pleased with the improved performance and as a reward didn’t hurt me so much this time - actually what she said was the soleus needed a few more days rest before she had another go at it, as it is still a bit sore from Monday’s session.

 So she had a go at the bottom of the foot, the heel, a bit around the tendon and those knobbly ankle bits (malleoli? - sounds like a flower). Still working on dorsiflexion but just about at 90 degrees by the end of the session, after a little frustration trying to get my heel to do as it was being told!

I have to work on my confidence to put more weight through the injured leg and she gave me some exercises to help strengthen the knee and other leg muscles after their weeks of NWB:

lying on back with knees bent and feet flat to floor, squeeze buttocks together and lift bottom off floor for 30 seconds,

standing up and sitting down slowly on a chair, changing the height of the chair to make it easier or harder as necessary, (can also try some half squats here),

with a pillow under the knees, slightly bend knees, bring toes up towards me, straighten knee and squeeze knee muscles,

and what she called a clam : lying on side with pelvis square and hips and knees bent, keeping heels together lift the top knee by turning the hip out without twisting the back or pelvis, only move as far as a stable back and pelvis allow, then return to start slowly and keeping control the whole time.

NB For anyone reading this further back in their recovery, she said this last exercise would actually have been useful to start in the cast to keep some of the upper leg/bottom muscles working.

So it’s 11 weeks post-op tomorrow and although not as far along as some people at the same stage (particularly those with more aggressive regimes) I don’t feel too bad about things right now. My life of work and study is supposed to start again at the end of September so that’s a good goal for me to be getting up a bit more speed and weight-bearing.

I can see it won’t be easy for a while but I’ll get there, so today’s song is “You can get it if you really want“.

Not in the achilles tendon but the soleus muscle. It’s seems for me this muscle is very tight and preventing the motion my physio thinks I should have. I really could’ve done with a stick to bite on today! But otherwise the session was good..and I have to admit even the painful massage was worth it as I can feel the muscle moving a bit better.

I am to continue with my ROM exercises, massage, and rolling pin/water bottle rolling which has improved the tightness underfoot, plus the following:

some seated toe-tapping and heel-raises,

GENTLE calf stretch leaning forwards against the wall,

good leg on the floor and bad leg on the first step of the stairs, lean into the bad leg for further stretch,

side to side and forwards and backwards rocking to get used to shifting weight from foot to foot.

Physio thinks the achilles is quite ready to be stretched a bit more but the soleus muscle is preventing some stretching and dorsiflexion. So that’s all good positive progress, if quite slow still.

I’m walking a bit better on the two crutches, ie (slightly!) more normal leg action, but it’s still very slow and varies throughout the day as to how much weight I feel I can put through the bad leg. My physio is very insistent on trying to use the right movements and keeping the rest of the body in the right position, so wants me to continue with 2 crutches. I have tried a little bit of 1 crutch walking (and even a bit of shuffling without crutches - ooh, naughty!), but find I am favouring my good leg so much it is throwing the balance of the body. Don’t want to end with any hip or back problems too.

Anyway feeling a bit more positive after the session though all today’s plans to go to work for a team meeting and catch up fell through when my daughter was ill overnight. Friend fortunately stepped in to look after her this afternoon so I could still go to physio - thank you!!!

Went to another friend’s 40th birthday party on Saturday night and had a great time - did take over a small part of the dance floor for short periods but don’t think I was my normal cool (??!) mover with the crutches in tow! I was just sensible enough with the wine and very sensible with my shoes. As shoe pictures seem to be popular at the moment I thought I’d join in. These are the shoes I didn’t wear, but really wanted to, followed by the ones I did wear:

My sparkly shoes!

My "running" shoes

Just back from my second physio session and thought I’d post something straight away, not least so I can remember what the physiotherapist said!

Again it was great if a little more painful than the first one.

My lady was impressed with how much the swelling had gone down and that I was managing to put a little weight through the bad leg when walking, especially bearing in mind I only came out of the cast 2 days ago. The only real bit of swelling now is around those pointy ankle bits I mentioned somewhere else, which she said haven’t been squished but are covered by some swelling - so a bit more massage to carry on there. I showed her the finger walking I was doing in that area which she said was fine.

The dorsiflexion is still quite limited and my ankle is very juddery going through to the plantar flexion, so she did lots of massage and manipulation of the foot and ankle. The ligament under my foot is very tight, preventing some motion (obviously shortened from pointy toes in cast) and contributing to the heel pain, and the actual ankle joint is not working smoothly yet.

She also did some massage of the tight spots up and down the achilles tendon - OUCH! She said to tell her when it was hurting but she might still carry on if it felt ok to her, a balance between pain and gain I suppose.

One side of the leg seems slightly tighter than the other which might be due to the positioning in the cast so the foot seems to flop slightly to one side - more massage up the calf to relieve the tighter side.

So I just have to continue with the same basic exercises as the previous session to continue working on the ROM and getting the foot flat. A couple of extras she said to try are:

use a rolling pin or frozen water bottle and roll it backwards and forwards under my bare foot to work and stretch that ligament,

sit on a chair with wood flooring underneath, put one sock on and slide the foot backwards trying to keep the heel on the floor,

and to massage the tightened calf, cross the bad leg over the good one and rub the calf up and down the knee of the good leg pressing and holding at any particularly sore/tight spots.

She said I might feel a bit sore later today ‘cos of the work she’d done but at the moment it feels really good. Obviously still not much strength but feels much looser and more comfortable, much closer to flat on the floor too.

She agreed with the consultant about using the recumbent exercise bike and swimming - will be more worried about slipping on the wet floor than anything else so might wait till I’m more confident to try that. And I can walk (slowly) as much as I want subject to pain and swelling. I actually walked to the postbox ’round the corner this morning, and it only took me 12 minutes there and back instead of the usual 2!!

Next session Monday.

We have a 40th birthday party to go to this weekend and I’ve decided to be sensible and wear trousers with my trainers rather than risk any mishaps with heels - won’t be doing that much boogieing anyway! But maybe I’ll be able to try a little (with the crutches of course) - that’ll clear the dance floor!

Wow, really enjoyed that. A nice firm foot massage and some manipulation of those poor cramped foot bones, plus some work on the rest of the soft tissue around the scar and up and down the leg…ah, could’ve lain there for hours!

My physio was great, really positive friendly lady. She didn’t seem to think it should take too long to get things working better. Hold that cheer for a while just in case…

So the exercises I have at the moment are mainly to start to increase the motion/flexibility:

pushing toes up then down from the heel;

turning foot and ankle inwards then outwards without twisting the knee;

stretching the tendon by pulling it back with something like a scarf or towel, ie non-stretchy at this point.

I’d say these are a few from Dennis’ week 7 list on the site.

She also showed me how to walk properly with the crutches but putting my bad leg down instead of holding it up (putting it flat on the floor at the moment but will progress to heel-toes movement) and how to go up and down stairs properly with the crutches (down = bad leg down+crutch+bannister, then good leg down; up = good leg up then bad+crutch+bannister). Does that make sense?

She said there was no point in having a boot at this stage when a couple of pads in my shoe are all I need; the boot would’ve been instead of one of the periods in the cast.

I can’t quite put my heel flat to the floor without my trainers on and the pads in. Physio did say I could wear things with a small heel, eg my sandals, but best to wear my “proper” running shoes with the  support they offer. As the foot is still swollen I won’t be able to squeeze any fancy shoes on for a while yet anyway. Oh, that’s what else we discussed - continued elevation and icing if necessary. She suggested having two buckets, one of warm/hot water and one of iced, and alternating the foot between each for up to 30 seconds at a time - this would help the circulation and draining of the fluid that causes the swelling which in turn would help the soft tissue become more flexible and less tight.

And the bit of white thread is apparently a bit of the internal stitches (!!!) but NOT to worry about it, just means they haven’t fully dissolved yet and that bit will fall off when they have.

Well it’s been such an exciting day, I feel quite worn out now, so will do my exercises again and probably get off up to bed for a rest. Next session on Thursday.

Sweet dreams everyone.