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4 weeks: Starting Weight Bearing

Four weeks in, and a couple changes: I get to start placing weight on my leg, in the boot, at 20% (3 wedges) flexion, with the goal of putting full weight onto the repaired leg at 6 weeks. The instructions are to start with 25% of my weight, then move to 50%, 75% and 100%, backing off if it hurts. If that goes well, the wedges come out between weeks 6 and 8, and the boot goes at week 8.

But for now: adding weight on the bad leg. This is more confusing than it might look. I’m playing with a scale at home to get a sense of what 40 lbs. of pressure feels like on the booted leg (which would be a bit more than 1/4 of my weight) — basically pressing down and watching the numbers go up on the bathroom scale. But when walking, I’m not likely to be able to duplicate that precisely. And “backing off if it hurts,” without doing damage — hm. But at least this is progress.

(On previously noted PT problems: I’ve found someone better, albeit at some out-of-pocket expense. She’s following the protocol, and has given me a few hip- and core-stability exercises. These may be busywork, but I’m grateful for busywork. Still going to the insurance-provided therapist, still finding him unsatisfactory, but it’ll be a couple weeks before I can get in with a different in-network PT. In the meantime, these guys have an upper body ergometer which allows me to break a sweat without using my legs.).

2 Weeks Post-Op: First Therapy Appointment

A report from my first physical therapy appointment yesterday.

The therapist was a minor disappointment; he hadn’t reviewed the surgeon’s rehab protocol, and seemed to be relying on an old-school, year-long protocol with much more prolonged immobility and inactivity than suggested by the surgeon. I’ll have to see if I can find someone else.

With that caveat, after reading the protocol, he moved me two small steps forward. First, I’m to perform “heel-toe touchdowns” — basically mimicking a more normal gait, without weighting my left leg. Second, I’m to ‘actively dorsiflex’ to 90 degrees — meaning I pump my forefoot upwards (but not push down), to a right angle with my shin, then relax (for a couple minutes, a few times a day) (the therapist suggested more icing and elevation to reduce residual inflammation too).

According to the protocol, there’s more that should be happening between weeks two and six: inversion/eversion range of motion work, joint mobilization, knee/hip strengthening (how that happens on one leg, I don’t know), and ┬ástationary bike with the boot (I’m guessing this happens a little later). I may have to find a different therapist to move those items along.

First Post-Op Review

Saw the surgeon today. Sounds like the surgery went well. Suture is out. I can take the boot off for showers (but no immersion allowed), and to air my foot out (a relief, after 10 days locked into the boot). First Physical Therapy appointment in 4 days, next Tuesday.

Ouch, Aftermath, and Goals

I’ll keep the background brief, since I plan to use this to document the recovery process. But here it is:

The injury: I tore my achilles playing light, non-competitive ultimate on May 18, 2014. (Though I played competitive ‘club’ ultimate in my twenties and thirties, I stopped around my 40th birthday, in large part for fear of just such an injury). Ultimate being what it is, there were two emergency-room doctors on the field, as well a player who had experienced an achilles rupture. So (aside from the classic symptoms — I even looked back to see who kicked me), I had a relatively firm diagnosis, and good advice as to how to proceed.

The surgery & immediate post-op: I had surgery the afternoon of May 20th. It was a complete rupture, but the surgeon reports that the surgery proceeded well enough. I needed the Vicodin during the first night after the operation, but otherwise, I’ve been getting by with ibuprofen. So now I’m just keeping the boot elevated as much as possible, and waiting for this first, unpleasant “no weight bearing” period to pass. My first post-op appointment with the surgeon is May 30th, and my first physical therapy appointment is June 3d.

Finally, a note as to goals, both for my recovery and for this blog: I’m a relatively serious recreational athlete, and this injury ranks high on the ‘worst nightmare’ list. Fortunately, I’d trimmed my pursuits to accommodate middle age: surfing once or twice a week, weightlifting/conditioning (’Crossfit’ though that name encompasses so many different programs that I’m not sure it has informative value) as background workouts, and a week or so of telemark-skiing in the winter. While I’m past competing at any of that — I’m happily intermediate, at best — I’m hoping to get back it all in a meaningful way.

I’m guessing that at some point, this blog will focus on rehab specific to surfing. But for the next few months, like everyone else, it’ll be walking, doing my share of the household chores, and suchlike. For now, just sitting it bed trying to keep the cast over my heart (difficult!), and trying to keep the darkest thoughts at bay.