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Months Five and Six: Summary

Summary of months 5 and 6, in which life has been relatively normal, but sports aren’t quite available yet.

Rehab: By month five, the mobility had mostly returned, and balance was well on its way. The challenges, over these months, has been calf strength. There appears to be a lot of variability on this, but I spent most of these two months rebuilding enough calf strength to begin harder, plyometric exercises that might enable running and jumping. The good news is that most of this can be done at home; I’ve managed with seeing the therapist every other week, and otherwise doing the exercises on my own. Pool sessions helped, as de-weighted exercises helped the muscles start firing again, a necessary prelude to bringing them back to adequate strength. And at six months, I began the hopping/jumping/plyometric exercises that should allow a full return to sports, perhaps by month 8 or so.

Life: Very close to normal throughout. A little soreness after long, steep walks, but nothing that really affects my day-to-day life.

Sports: As with the earlier months, no running or jumping (for want of calf strength), so these months just saw a bit of weightlifting, biking and similarly stable fare. But at just about the six month mark, I started surfing again, after spending some time practicing my pop-ups to make sure the leg could handle it (repeated burpees, basically). I’ve also restarted modified Crossfit workouts, with substitutions for all the running and jumping, at about the six-month mark. So more or less as hoped, perhaps a few weeks behind the schedule I’d desired.

26 Weeks: Back in the Water

At twenty-six weeks, headed back in for a surf amidst smaller (knee-waist high) surf. The leg is functional enough for surf purposes; it’s my front foot, I might have noticed it more otherwise. I’ve felt capable of surfing for a few weeks, but the PT wanted me to hold off until I gained a bit more strength. My conditioning is off — I tired quickly — and I was rusty, but overall it went better than I expected. I even caught a few.

Speaking of which, I’ve very gradually gained back a bit of calf strength; I can manage to sort of walk on my toes. The next piece of the physical-therapy progression is a variety of little hops, jumps, and skips. That’ll occupy the next month, at least — with something resembling normal functionality on the horizon, I’m told.

I’m also planning to give a few of the regular Crossfit workouts a shot in the upcoming two weeks, modified to remove all the running and jumping, and anything that might involve landing from a height (rope climbs, e.g.).

Five Months: Stalled

Five months, and after relatively smooth progress through the initial stage, I’m now stuck. I haven’t recovered enough calf strength to move to the next stage of physical therapy (hops, jumps and so forth towards running). It’s not clear how long this will take to return, or if it will. So nothing much to report, nor is there likely to be until that resolves itself (if it does). (And yes, I’m doing the prescribed lifts, silly walks, and all that — the calf just isn’t responding. Frustrating, but there it is). Anyway, if anything changes, I’ll continue updates but for the time being looks like I won’t be returning to sport any time soon (certainly not at the six month mark).

Months Three and Four: Summary

A brief recap of the third and fourth months, during which life has assumed its normal shape in most ways, but I’m not yet back to sports.

Rehab: For most of this, it’s been a combination of regaining mobility, trying to build strength, and working to get my balance back in the bad leg. The pool was a substantial boon; walking, running, calf raises, all doable in water, even before I could come close on dry land (and I’m quite light, I’d imagine the benefits would be more significant if I were larger). Physical therapy about once a week, give or take. The mobility came back quickly; I chose to continue sleeping in the boot, so as to avoid having my toe pointed all night, and that really helped. At some point that got old, and I invested in a sock that basically does the same thing (designed for plantar fasciatis). Strength has taken much, much longer. Still waiting on a one-legged calf-raise at four months.

Life: Month three remained awkward. Walking long distances (more than a mile at a time, or more than 4 miles in a day) was uncomfortable, my gait was uneven, stairs were slow. The fourth month, though, saw things move relatively rapidly towards pre-injury normal. I could drive a stick comfortably by the end of week 12 (using my injured leg on the clutch), and started biking again (both alone and on a large cargo-bike with my daughter, groceries etc. on the back) in week 15 (that could have happened earlier, but I chose to be cautious with the possibility of a weighted fall). By week 16, most everything in terms of house and work and so forth were more or less normal.

Sports: Essentially, I can neither run nor jump — so sports, not happening in any meaningful fashion. Because I can’t pop-up with much strength (that is, I can only slowly step to my feet), I’m still not surfing. And because box-jumps, burpees, running, and any sort of split-lift won’t work, I haven’t rejoined Crossfit workouts. Basic strength-training is fine, though, at least so long as I’m flat-footed. Squats, strict presses, bench presses, deadlifts, pull-ups, pushups, sit-ups — all fine. And I’m swimming for conditioning. My hope is that the next two months will — finally — allow me to move back into a normal routine of Crossfit (modified to avoid double-unders and box-jumps, for a while at least) and surfing.

14 Weeks: Recovery Part I

At this point, progress seems fairly linear. Range of motion and strength continue to improve, with some distance yet to go. I’ve been able to walk up to 4 miles in a day, with only minor discomfort. Driving a manual transmission (operating the clutch with my recovering leg) has been going fine for a week now, and my gait is relatively even. Still not enough strength to lift my body on my repaired calf, though the two legged lifts are coming along nicely. I wonder a bit if I’ve suffered some permanent loss of function, but it’s possible that I’m just recovering more slowly than some others.

Sports-wise, I’m running in the pool, but not on land. I’ve started swimming to improve conditioning, while adding light lower-body work at the gym, including:

Rowing (light resistance)
Squats (no weight)
Lunges (no weight)
Deadlifts (light weight)
Kettlebell Swings (light weight)
Push presses (light weight)

12 weeks: Starting Recovery Towards Activity

Two more weeks down. A visit to the surgeon confirmed that things are more or less on track. I’m essentially free to — very gradually — get back to regular activities, with the warning that the tendon won’t be 100% healed for another 9 months. I’m walking about a mile with minimal discomfort, though I’m still slow and a bit stiff-legged in the evenings.

A few observations as to the last two weeks: as have others, I found pool-walking massively helpful. I’ve also continued to use the boot while sleeping — that’s avoided morning stiffness (as my foot remains in neutral overnight rather than plantar-flexed) at the cost of some continued discomfort (but I’m pretty much used to sleeping with the boot).

Life-wise, things are approaching normal. I can walk to and from the train station (albeit not at great speed) and should be able to drive our manual transmission relatively soon. Walking barefoot in the house feels fine, as does most any kind of footwear. I haven’t gotten back on my bicycle, mostly because it seems like a terrible time to risk even a minor fall, but reckon I’ll probably give that a go soon.

Sport-wise, I’m still a long way off. My PT is focusing on getting some flexion back, strengthening my calf, and balance. Meanwhile, I’m slowly introducing a little more at the gym: deadlifts, strict presses, and kettlebell swings — all of which I can do standing on two feet, without flexing my ankles or pushing off on my feet. I’m hoping to start swimming in the next 10 days, too, so as to start getting back into surfing shape.

10 Weeks: Learning to Walk

This will be brief, as there is little to tell. My boot use is now restricted to crowded and/or unbalanced situations (the train, sporting venues and suchlike), and sleeping (so that my foot stays in neutral while I sleep — until my range of motion is a bit better, I don’t want to leave my toe pointed for six hours overnight).

Functionally, this has left me more limited than FWB: I could hobble a half mile or more in the boot, but can only walk about two blocks in shoes before it starts to stiffen up. Over this stretch, though, the PT has me focused on regaining my gait rather than building up to greater distances. And that’s going slowly, for now — I can sort of walk, but the limited flexion and push-off strength are quite visible. Pool-walking has helped a bit with both — but until I’m cleared to build strength and range of motion more forcefully (at least two weeks off), it’s hard to see how I’m going to get there.

Fitness wise, for this initial period I’ve settled on what amounts to a damage-control regime: a couple sessions of exercise-bike intervals for conditioning; and several rounds of mixed weightlifting (based on the exercises in my previous post) for upper body and core strength. With any luck it’ll give me a reasonable base to get back into (surfing, skiing, running, and biking) shape when the restrictions start to come off my lower body.

Week 8: Boot Transition and Upper Body Exercises

I’ve started walking about a bit without the boot. There’s a heel-raise in my left (injured) shoe, and the PT has me using a crutch to normalize my gait a bit. In crowded and uncertain areas (the train to work, e.g.), I’ll still be using the boot. Technically, this is progress; but the length of the recovery is much more obvious now that I can feel exactly how weak and stiff the repaired leg is.

Recovery-wise, I’m starting to think about getting some fitness back so that I can start surfing and so forth when the leg is up for it. With the help of the trainers at my gym, I’ve worked out an upper-body program to start working myself back into fitness. This is a Crossfit gym, so not equipped with a bunch of machines. Here’s a quick list of the things that seem do-able without one leg, using the stuff one might find at a basic Crossfit facility:

Bench-press (at low enough weights to leave the legs mostly idle)
Strict pull-ups (on a bar that can be reached standing up, with legs tucked)
Ring-Dips (same set-up, rings dropped down so that one can enter or exit standing up, legs curled to dip).
Push-ups (with bad leg crossed over the good one)
Planks (same thing — legs crossed)
Seated or kneeling dumb-bell exercises (press, fly, row, lateral and front shoulder-raises, e.g.)
Russian twists w/ kettle bell
Banded tricep extensions, face pulls

That stuff can be stitched together into little sets of a few minutes. I’m doing them with the boot on for now, as much as a reminder not to be stupid as anything else. Not nearly as rewarding as a regular workout, but better than nothing. Doing a bit of interval training on the stationary bikes for conditioning. Hardly fun, but at least it’s a start on the road back.

First Two Months: Summary

Given how much use I got from others’ experiences here, I thought I’d post a functional look back at my first couple months post-surgery before it (mercifully) fades from memory. All advice comes with a heavy caveat — everyone’s experience seems to vary, so this may not apply at all:

Work: The first four weeks went from almost completely helpless, to only moderately helpless. But no-weight-bearing isn’t easy. Public spaces are a little nerve-wracking, and carrying anything that requires more than two fingers requires a shoulder bag and substantial tactical planning. I was fortunate to be able to work mostly from home (I ride the train to work, usually standing-room-only. This did not appeal), and I’d recommend pursuing that option if you have it. It also makes it easier to keep the leg elevated and so forth. As my left leg was the non-functional one, driving an automatic was do-able after the first few days, so I drove into work once a week after week 2. At week 4 (and partial weight-bearing) life got easier, but it wasn’t until week 6 (full weight bearing) that things like public transit became fully feasible; at that point I managed to return to a relatively normal work schedule.

Life: Inside the house, the first two-ish weeks were unpleasant. Bathing was difficult (I went with sponge-baths), and carrying, say, a plate of food across the kitchen wasn’t really possible (the crutches required both hands). The remainder of full-weight-bearing and partial-weight-bearing was better, but quite restricted, mostly because I couldn’t walk and carry anything. I used a rolling desk-chair as a makeshift scooter over short distances (the kitchen, e.g.). Here, again, the first six weeks were the most difficult; once I could walk without crutches, life returned to something resembling normal; walking is slow, the boot is uncomfortable, and showers require a chair, but I can more or less follow the normal patterns as far as grocery shopping, cooking, and other domestic basics.

Fitness/exercise: I chose to use this as rest break. I haven’t taken more than 10 days off for several years, and since I can’t do anything fun for several months anyway, I figured some de-conditioning now was fine. After week 2 I started doing a little seated upper work with resistance bands (that can be anchored in a closet or room door), and at week 3 I started spending time on an exercise bike and upper-body-ergometer (an arm cycle, basically) before my physical therapy appointments (1-2x per week). But mostly, the first 8 weeks have been idle. From here on out I’ll be working to get back into decent recreational shape, and will try to post a bit about that. For those who want to get back sooner: the upper-body-ergometer seemed the best bet for conditioning, and I’d recommend trying to find one. Most upper-body-related machines seemed fully accessible too (but I have no taste for those things).

Bottom line: The first two weeks seemed like near incapacity. The next four weeks were difficult, but less so. After that, there’s the frustration of being hobbled, but with a little extra time, most of the basics seemed accessible with a bit of extra effort.

Next up: I’m meant to move out of the boot tomorrow-ish, at least in controlled conditions. My foot will barely flex, so I’m not expecting much (aside from the relief of not lugging this thing around).

6 Weeks: Full Weight Bearing (with Boot)

The progression to full weight bearing in the boot went well enough, so I’ve set the crutches aside. That’s let me spend significantly more time on my feet, without much in the way of adverse effects (touch wood). I’ve got a cane, but haven’t needed it much (aside from signaling disability on the train).

The next two weeks will, I hope, see the removal of the heel wedges to put me at neutral. The first one is out and I barely noticed. Guessing I’ll notice the last one, though, because I can’t flex my foot to neutral unassisted.

And I had my second post-op visit last week. The surgeon seemed pleased enough. He confirmed the trajectory from here, more or less: at 8 weeks, the boot comes off (aside from uncontrolled or crowded environments). At 12 weeks, most of the restrictions should be off — and I can start working to regain strength, mobility and balance in earnest. So half-way to that.

It seems at least feasible, now that I’m without crutches, to resume some non-trivial physical activity. The therapist (new and improved) seems to want me to restrict my lower body work to the exercise bike and light theraband work. But I’m going to talk to the folks at my gym about figuring out something more strenuous with the stuff above my waist (it’s a Crossfit affiliate, and there isn’t much I could do there without being able to carry weights about — something I should be able to do now, at least in minimal fashion).