Snapped Hubris

At least I am much closer to normal now, the limp is getting much better, almost gone.  I am out on the bike often, in 2 shoes, and sometimes now 2 clipped in bike shoes, and seem to be getting better all the time.  This injury has been very trying at times with all the crawling, knee walking, one legged hopping, always fearing a fall and a rerupture, all the little physical things that make up normal life gone and very much missed.  Some isolation and much of a summer’s best missed and gone.  But in the bigger picture of life, we all know how that ends, so in that light, this injury is a temporary obstacle to overcome.  And perhaps something valuable to be learned along the way.

I’ve already had what is probably my last pt, ten sessions total.  I am certainly not yet fully recovered of course, but I’m not sure if I’ll miss it too much.  Not that it was bad, or hard and painful in any way, they were kind and helpful, and reassuring in encouraging the kind of exercises I’d been at and will continue on.  But they seemed to specialize in seniors, many suffering chronic endless type injuries and infirmities, needing lots of encouragement for even the slowest and weakest exertions imaginable, and minorly injured high school athletes.  Each time at pt was the same, warm up on the semi-recumbant bike, move to cat board (that is the round ankle wobble platform), a small amount of stretching, finished off with 20 min. of e-stim.  By the last few pt appoinments I was really wishing they’d mix it up with some work in the pool, or mini-trampoline, eliptical, treadmill, or any number of the devices that were right there in front of me and available.  But most of all I wish they’d done a wee bit of massage, especially to explain what can and should be done for massage.  Also would have liked to try ultrasound, which they also had around there somewhere.  The head pt guy there couldn’t seem to come up with a name or anything at all when I asked if he knew any good massage people.  Weird.

Anyway, I’m pretty well committed to full recovery and then some on my own.  But  right now here are a few things I can and cannot do.  

Can Do’s–walk, better each day, bike, beginning to ride clipped in again, carry increasingly heavy objects, often pass for a normal uninjured person.

Can Not Do’s — jumping, running, bunnyhopping the bike, big vertical ladders and steep, loose terrain, the sinlgle leg calf raise,  and saving the world from evil and environmental catastrophe.

I really look forward to moving more and more of the can not do stuff up to can do.  Lord please give us strength, and I pray that we can all laugh about this someday, like today.

I ruptured my right achilles tendon 5/16/08.  Skateboarding for the first time in, oh 20 years or so.  I’ve never really been injured before, way too much childlike faith that I’d never get hurt, etc.  Anyway, no nasty wreck to cause the injury to brag of, just moving along at a good clip, and kicking way too hard apparently.  Funny motion while kicking along on a board, it forces you to extend the muscles and tendon while you’re kicking and contracting.  I’m almost 40 now, and until this have been very fit and active, and unfortunately this is way too important in my life now.  I’m mostly a bike geek, and was really looking forward to a summer of long rides.  Now I don’t know if I’ll ever regain what I had, but I sure will try.  I’m now 26 days after open surgery with graft jacket.  Has anyone else had surgery with graft jacket, and does this change recovery times and protocols?

The injury happened much as reported by nearly all, pop, wtf?, oh my what did I just do to myself?  Within about 3 seconds I knew, and was able to confirm suspicions with the handy info available here. The pain was not too bad, a little shockey at first, but manageable.  A visit to the local ER the next day confirmed and referred me to my orthopedic surgeon, and I had the work done 5 days post rupture.  Post surgical pain wasn’t too bad with help from the drugs, home that day in a fiberglass below the knee cast with toes down 15-20 degrees.  The cast was removed 2 weeks post-op, staples pulled, and I was lucky enough to get the removable boot.  They gave me a set of 4 open celled foam pads to go under the heel, but being soft open celled foam they compress almost down to nothing, so my ankle is at about 90 degrees in the boot.  That first day, 90 was quite tight, but they didn’t seem worried, and it has held together fine so far.  From what I can tell the surgeon did a great job, the wound healing looks good, but like a typical good surgeon, I’ve received almost no good advice.  Probably just incurs liability.  Thank God for the internet.  Seriously, no advice at all.  I gather from reading here, I should probably wear this boot 24/7 (even in bed?), but around the house I’ve been fine without-knock on wood.  I know the consequences of one wrong step, and I am careful, and I’m mostly just sitting around on this computer anyway, so it’s not too risky I hope.  Anyway, I’m not scheduled for anything other than a return to the orthopedist’s office at 6 weeks post op.  Right now I’m almost 3 weeks p.o.  So  no pt advice yet.  But from what I’ve seen online for early mobility studies and a passing comment at the doctor’s about increasing flexibility and working on strength to minimize atrophy being a good thing, I decided to begin my own mobility & strength work.  Aware that muscle atrophy would probably be the biggest hurdle to full and timely recovery, and optimistic about the strength of the surgical repair, I can’t wait a month to possibly begin pt.

While still in the cast, rather soon after the surgery, I’d begun the toe wiggling and tentative downward plantar flexion (pushing the gas pedal), felt like it was attached, unlike before surgery, but of course very tender and weak.  Probably wouldn’t push more than maybe a half pound down at first.  But before the cast was off I’d given maybe 5 pounds briefly.  The day the cast was removed, 2 weeks p.o., I found I had good full range of motion down (plantar flexion) but discomfort beginning around 90 degrees or maybe 5 degrees dorsiflexed (toes up from the floor).  I could fairly comfortably do 3 sets of 20 through this range of motion against about 5 pounds resistance against plantar flexion.  I’ve gradually worked up to 10-20 lbs. resistance in the 12 days since.  Three sets of 15 to 20 with about 165 lbs. is my old routine.  I had not thought about that until now, just to put it in perspective, in regards to both my leg strength that I do understand that my injured leg is not as it was.  I am also doing some side to side and a little dorsiflexion, but plantar flexion is obviously the critically affected motion.  I’m also beginning light weightbearing, and that seems important to help reduce the nervy feeling in the bottom of the foot that I and so many others here seem to have after a time with no weight on the foot.   It all feels good so far, and I’m not pushing past any serious discomfort.  In fact it seems to make it feel much better, both getting stronger and able to bear weight. 

I do hope that I’m not messing this up.  But it seems good so far, and I can’t stand to see my leg waste away any more than it has already.  So I’ll try to let you all know how it’s going, and I certainly hope the best for all you fellow AT trauma suffering people.  Photo is 19 days post-op.

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