Hello all - I’ve had a bit of a setback unfortunately with my right (non-surgery) achilles.  As I described in my earlier posts, back in October I ‘tweaked’ it a bit while playing basketball and it was sore and tender for months afterwards, though I was able to continue with my normal activities, including basketball, after a period of resting for 2-3 weeks (but still walking, etc.).  My PT had looked at it afterwards and didn’t find any indication of acute injury so wasn’t too concerned.  The morning soreness never completely went away, but it did gradually improve, and I’d say as of a few weeks ago it was more or less behind me.  As I’ve said before, this is an injury that I have suffered maybe 6 times in my past over the years, and it never was bad enough to warrant a doctor’s visit, and always (eventually) completely went away, without having to limit my activity much.

Then I was playing basketball a few weeks ago, and towards the end of the game when I was rather tired and playing defense aggressively on an 18 yr. old kid about twice as quick as me, I felt a similar acute pain in the achilles, but maybe twice as intense.  I pulled myself out and was able to kind of ‘walk it off’ but it was definitely sore and caused me to walk with a slight limp.  I knew it wasn’t a full tear, but was concerned it could have been a partial.  I had a 5 day skiing trip planned for the next day, and so I iced it that night, woke up rather sore with a limp, and hoped for the best.  Luckily, by the time it came to put on my ski boot, though I couldn’t walk completely normal, I felt more or less normal with the ski boot on, and was able to get through the whole week skiing without much limitation.  I of course iced every night, and every day it got a little more normal - by the end of the week I was walking without any noticeable issue, except it would be sore and stiff each morning.  I had a week off from basketball after that, so basically took it easy that week, then decided to give basketball a go this Monday.  I got through the game okay, but was definitely playing 70% effort, and had a slight limp at the end.  Still, I could run and jump (at least at 70-80% effort) without any issue.

Today I got into the VA podiatry department after taking the rest of the week off, in the hopes that they would do an MRI.  As I sort of suspected, they wouldn’t be able to get me in for an MRI for another couple months, and as such advised me to stay off it and wear a boot for 3-4 weeks.  Thompson test showed no issues, and plantar flexion strength is good, so they aren’t sure exactly what the issue is, but indicated it could potentially be a partial tear and the best way for it to heal is to isolate it for 3 weeks in a boot.  I did convince them to do an ultrasound test, but they won’t be able to get me in for that until next week, or maybe later.

For those of you that have gotten this far, my questions are:

• Has anyone had a similar injury to what I’m describing, and if so have you ever had a diagnosis and treatment for it?
• For those of you that have had a diagnosed partial tear, what did it feel like when it happened, what could you do afterwards, and what was the diagnosis and treatment?  I realize that a 90% partial is different than a 10% partial, but that is the data I’m trying to get.  It’s a fact that I don’t have a 90% partial, but I could have a 10%, and also could have a 0.1% or 0%.
• Any general advice on whether to wear the boot or just do what I’m doing, and be careful, assuming it will heal on its own without completely shutting it down?  I’m motivated to not go the boot route by my desire to finish both the bball and ski season, as well as a surf trip I have planned in about 3 weeks.  If I knew for sure it was a partial tear, I’d hop in the boot right away, but I don’t want to do that if it’s just some minor injury that will heal without such drastic measures.  I’ll know more with the ultrasound, but that still leaves me a week or two to decide on boot or no boot.

Thanks so much for those of you that can weigh in on this!  The good news is that my left achilles feels great!

It’s been a hard road with plenty of highs and lows, but here I am a year out from surgery with one basketball league win injury free in the books!  As I said in my last post, I’m still not 100%, but I’m doing everything I did before and enjoying it twice as much.  It’s hard to believe that one year ago at this time I was laying miserably in bed unable to sleep with uncontrollable hiccups.  I still have a lot of work to do to get back to 100%, but my progress continues, and I’m confident that by next year I’ll be 100% on the left leg and overall more fit and stronger than ever.

My achievements since last month are:

• An amazing trip to San Diego with my wife where I surfed every day without any achilles-related limitations (but plenty of living in Colorado so horribly out of surf shape limitations).
• Jogging on the beach in San Diego.
• Back to back full days skiing challenging terrain.
• Several more days of cross country skiing.
• Able to do single calf raises a bit easier - the improvement is slow, but I’m still moving forward.
• Landmark accomplishment: Played my first men’s league game, and went 4-4 from three, got up and down the court without a problem, and even played some pretty solid D.  Most importantly, I had a blast and my team got the win.  We changed our name from ‘The Grumpy Old Men’ to ‘The Rocky Mountain Goats’ but the core of our team is intact and I’m looking forward to playing the full season and getting stronger every game.

I’m going to try to put together a full list of highlights and lowlights from the year in the next week or so, but I wanted to take the time today to reflect on how far I’ve come, and celebrate my ultimate goal of returning to the bball court to play with my team.  Thanks to everyone on here and to my friends and family for your continued support.  Most of all, thanks to my amazing wife for taking care of me, encouraging me, cheering me on, and lovingly helping me get through one of the most humbling and challenging experiences of my life.

I was hoping to be completely back to normal around this time, but I’m not quite there yet.  The good news is that I’m still slowly improving, and at this point have no limitations on the activities that I can do.  Also, though the periodic soreness is not completely gone, for the most part my issues with my right (good) achilles have gone away.

In terms of progress, it all comes down to calf strength, as my left calf is still around an inch less in circumference than my right.  It is getting more defined, and stronger, but the girth is only very slowly coming back (also my right has increased in girth over the last 6 months).  My routine hasn’t officially changed, but I wasn’t very good about doing my exercises over the last 4-6 weeks.  Even so, my strength has improved.  As cliche as it is, with the new year I’ve recommitted to my continued recovery and general fitness, and so far it’s going well.  For some personal reasons, I had to cancel some of the adventures I had planned (bike tour and surf trip), but things have now settled down and my wife and I have a beach and surf trip to San Diego coming up at the end of this week which I’m really looking forward to.  Also, the bball rec. league starts in two weeks!  The grumpy old men are beginning to assemble…

My achievements since my last check in are:

• Went for my first actual jog and felt great, though I did have some general ankle soreness afterwards.  I’ve done plenty of running while playing bball, but it’s kind of different.  I’ve since gone on one other jog, but will probably add it to my weekly routine, and maybe do it daily on the beach while in San Diego.
• Have gone downhill skiing a bunch, and am adjusting pretty well.  The first couple times I did have some extra fatigue in my calf, but nothing too noticeable, and my skiing does not seem to be affected in any way (other than general lack of ski conditioning from missing a full season).
• Have gone cross country skiing a bunch, and feel great with no limitations.
• Continue to play bball, and feel a bit better out there every time, most notably on defense.  I’m still not where I’d like to be, but watching Kobe who is 2.5 years removed from his injury and the same age as me, I have to say even at this stage I’m quite a bit closer to my pre-injury peak than he is.  My lateral quickness still needs to improve, as does my first step and ability to finish strong, but those are probably all about 70-80% right now, which when considering how much strength I still have to gain in my calf, is pretty reasonable.
• My ability to do a calf raise has continued to improve, despite a fairly neglectful recovery routine for the last 6 weeks.  I still can’t quite get that last 5-10% without assistance, but I can knock out 10-20 or so at 80-90% height, which is not too much different than my right.
• When I do my vertical jumping drills, I can jump about the same height on each side.  I still have a pretty noticeable difference when doing my one and three jump forward jump tests on each leg, but that seems to be slowly improving.

For those of you early in recovery, you’ll be out doing the activities you love before you know it!  Set small goals, and use the blog to track your progress to see how much you improve from month to month.  Each week or month, looking back on where you were before is so helpful with motivation.

I continue to have soreness in the morning in my right (non-surgery achilles) though I believe it is getting slightly better.  The good news is that it doesn’t bother me in the least bike riding, or even playing bball, once I get warmed up, and my left (surgical) achilles seems to be less sore in the morning than in the past.  I’m sticking with the dynamic warmup drills my PT gave me before I play bball, and I don’t notice anything once I get going.  The two main things I notice that are concerning are: 1.  Stiffness and soreness every morning (mostly stiffness) which goes away once I walk around a bit and do my heel drops.  2.  Tenderness when I walk for a long time in my shoes - it seems like it is a pressure on the achilles issue, rather than from walking itself, but still weird as I didn’t get this before tweaking it, and my left (surgical side) doesn’t have this issue at all.

For a number of reasons (a rather crazy few weeks), I actually have not been too good about doing strength work the last few weeks, so I don’t have a great sense of whether things are improving there, and this is a bit of a short time period update as my last one was mid-month, so I’ll skip the accomplishments for now.  Mostly just wanted to check in, as things have settled down a bit in my life, so I’m excited to re-focus my efforts on recovery and strength building going into this week.  My routine hasn’t changed since last month, so I’ll omit that as well.  I’m looking forward to checking in a month from now with some good accomplishments, and hopefully good news on improvements for both my right and left achilles.

It’s been a mixed bag the last 1+ month since my last update.  The good news is that I am definitely stronger in my calf, and can now more or less do a full heel raise.  I still can’t quite extend as high as on the right, but it’s close enough that I’ll call it a heel raise, and the more important news is that I continue to make slow but steady progress.  I can see quite clearly that my calf definition has increased since last month, but it still seems to be more or less the same in terms of girth (about 1.25" less than my right).  My PT says that I shouldn’t worry about it as long as I’m making functional and strength gains, and that the girth should come back in time.

The negative news for the last couple of weeks is that I did something to my right (non-recovering) achilles.  After a challenging and exhausting (but successful) 3 day backpacking trip, I decided it was a good idea to play in the local Monday night bball pickup game instead of resting.  This turned out to be ill-advised, as I was sluggish on the court, and ended up kind of tweaking my right achilles.  It is something I’ve done in the past maybe a half dozen times, and always eventually gets better, and doesn’t limit me too much (I’ve always just worked through it) but obviously I’m incredibly cautious now.  Immediately afterwards I got a horrible cold, so those two things sidelined me for the better part of 2 weeks, which was probably a good thing as it forced me to rest my body.  I actually didn’t do anything physical for a good two weeks during that time.

By the time I went to PT a couple weeks later, it had basically gone away, and she didn’t see any signs of serious injury, but said that I likely just strained it a bit, and gave me some dynamic warm-up exercises to do, along with daily heel drops and scraping for both achilles.  The specific heel drop exercise she is having me do for this is different than typical, in that it isn’t for strength, but for limberness I guess.  She is having me do 3 sets of 20 every morning where I start with both heels level hanging off a step, and then let them completely drop, then back up and repeat.  So for this exercise I am deliberately not controlling the downward motion and just letting my heels kind of free-fall.  I’m curious if anyone else has had their PT prescribe this exercise.  I’ve also been scraping, and have started getting back into my agility court drills and strengthening, but unfortunately once I did some of the symptoms have come back (mild tightness and soreness in that achilles).

I’m going to proceed with caution on the court drills for now, at least until I see my PT again on Wednesday.

My achievements since last time are:

• I can now do close to a full heel raise - I’d say maybe 3 at 80-90% of full height vs. the right, and am noticeably stronger for that exercise.
• I can see more calf definition on the left side.
• I completed a 3 day, 18 or so mile backpacking trip in Never Summer Wilderness (lots of elevation gain).  I was certainly tired and even a bit limpy at the end of each day, but 90% of each day I felt more or less 100%.
• I hiked a couple 14000′ peaks here in Colorado (Grays/Torreys - right next to one another) something I had never done before.
• I’ve started playing pickup bball again (just half court so far due to numbers) although have had to back off due to the issue with my right achilles.  Still, when I played, I wasn’t horribly limited.  The main things I noticed were less quickness on D, and on first steps to the basket.

I have a surf trip coming up in a few weeks, which will be an interesting test.  I was never a good surfer to begin with when I lived in CA, and now that I’m land locked, my rustiness combined with lack of skill will probably be a bigger factor than my achilles, but regardless it will be nice to get out in the water.  I also have a tentative Denver city bike tour planned with my wife, but we are a bit on the fence about it, so we’ll see.  The other big test coming up is skiing.  I’m actually less concerned about any ill-effect to my ability from the injury as much as how my boots will fit.

I’ll go ahead and post my current recovery schedule, which has changed a little bit since last month.

General:

• 2-3 days calf raises and balance (2x per day)
• 2-3 days bball, ladder drills, and jumping
• 2x per month add pool workout (haven’t been able to do yet)
• 1-3 days rest
• 2 days yoga/stretch
• Pre-bball dynamic warmup routine

*not as important

Weekly Schedule:
Mon: BBall - pickup
Tue: Rest, stretch
Wed: Calf raises/balance #1, bike/hike (about 1 hr), yoga
Thu: bball/ladder/jumps #2
Fri: Rest OR Calf raises/balance #2, bike/hike (1 hr)
Sat: bike/hike, and/or bball/ladder/jumps #2 or #3
Sun: bike/hike, and/or Calf raises/balance #3

Calf Raises (2x/day 2-3 days/ wk):

• 1-3 sets x20, 2 footed standing (last 10 lowered 1 footed assisted)
• 1 set 1 footed non-assisted standing (goal: 25 reps of 50-75% each side)
• 1-3 sets x6-8, 1 footed assisted standing
• 2 sets x20, 2 footed standing toes in/toes out
• 3 sets x5, 2 footed standing to bent knee 5 second hold (use weights), try wide legged
• *4 sets x8, 1 footed sitting (50lbs)

Balance:

• *10-20x walking forward leaning lunges (use weights and/or crouch)
• 1 set ea. way x 5 ft balls of feet side walk
• 1 set x10 balance board 1 foot f/b
• 1 set x10 balance board 2 foot s/s
• balance board foot roll
• *4-6 various standing exercises, 1 foot with weight shifts

Ladder Drills/Jumps:

• runners drill - step up to platform (3×10)
• *cross stepping 2 laps ~20ft (80ft total)
• *quick steps 2 laps ~20ft (80ft total)
• 1 foot single jump compare (11” diff 9/2)
• 1 foot triple jump compare (27.5” diff 9/2)
• 1-2x full court suicide (work up to full speed)
• 1x full court defense sliding (work up to full speed)
• diagonal 1 foot hops 4 laps ~20ft (80ft total)
• 10x two foot jumps with soft landing
• 5x one foot vertical jumps (each foot)
• 10x layup lines
• 2-3 x 30 seconds side-side hops

Bball: 30-60 mins w/jumping and moving, and running full court
Heel Drops: As described above, 3×20 each morning.
Other:  scraping/calf massage most nights, ice/elevation as needed, stretching (do knee towards wall), tennis ball under foot all day

For those of you in the early stages, please stay optimistic, and remember that long term you’ll be able to do everything that you love to do, it just takes time.  I looked at some pictures with my wife over the last 6 months or so, and it’s amazing how far I’ve come in that time, and even since posting only every month or so, it has been encouraging for me to read the previous month’s post and see that I am still moving forward.  Keep up the hard work everyone!

I’m nine days past my 7 month surgery anniversary, and am still making slow, but steady progress.  I still can’t do a full one legged calf raise, but am getting closer, and can at least get up on two and slowly lower (but not quite hold) on one.  My calf seems to have not gained any girth, which is frustrating because it’s still tiny in comparison, but my pt says I shouldn’t focus on that, and that it will come, and that the important thing is that I’m getting stronger.  She has me doing one foot single hop forward, and triple hop forward to measure progress.  My initial test was 11" behind for one hop, and 27.5" behind on the triple.

I’ve had some fun active adventures over the last month, including a two year anniversary trip to New Mexico with my wife last weekend.  I did a lot of walking and standing, which did tire out my calf by the end of the day, similar to how I feel on long hikes, which kind of surprised me but also makes me realize that site-seeing can be pretty good exercise! We also did an amazing bike ride in the Albuquerque foothills, which was where I started mountain biking over a decade ago.

I have a few big adventures coming up that I’m looking forward to, which will all challenge my calf, but I believe I’ll be ready for:

• 3 day  backpacking trip with some friends in the Never Summer Wilderness two weekends from now.  We’ll be keeping the daily mileage to camp at 5-6 miles, which will likely be the end of my day, but we’ll also have the option for some peak bagging without packs if I feel up for it.
• Weekend bike tour of Denver with my wife in late October - we’ll likely ride 30-40 miles or so each day.
• 4 day surf trip to Oregon in early November.  I’m not a very good surfer to start with, so it will be interesting to see how my balance is affected by my lack of strength.  It will be nice to be out in the water in any case.

My major achievements since last month are:

• I can get my heel further off the ground unassisted and need less support to do a full raise.  I’d say 50% of the way unassisted, 75% with minimal assistance (more balance than anything), and 100% of the way there with some, but not intense assistance.  I can also now go up on two, and come down with one, as I mentioned above.  I still can’t quite hold it there, but I can control the descent.  So while I’m still lacking significant strength, I am moving forward.
• I have been jumping off one foot with full intensity as part of my agility and bball drills, and there is no pain or discomfort.  With a couple steps (taking a layup), I am definitely not jumping as well as pre-op, but when I take one step and jump straight up under the basket, I can get up about as high as off my right (touch the net, woo-hoo - couldn’t do that in 7th grade!).
• I’ve increased the intensity of my bball and agility drills, and now include full court ’suicide’ drills - at this point not full speed, but pretty good speed while dribbling, and also layup lines.  I don’t feel quite 100% doing it, but pretty close, and my PT has cleared me to play a little bit competitively, as long as I’m careful!  I plan on playing in the weekly pickup tomorrow afternoon - probably just one game for now, but I’m pretty excited about it!
• I did an overnight backpacking trip with my brother at high elevation and proved that I can carry a pack over challenging terrain.  It wasn’t super long (about 3 miles in, 3 miles out) and I did feel fatigue towards the end on my left calf on the way out, but that was also after an additional 3-4 miles of hiking without the pack that morning.
• Yesterday I climbed to the top of Searle pass on my mountain bike, which was an over 9 mile climb (18.5 total) and over 3000′ on fairly challenging terrain.  I will admit that I was struggling towards the top, but I made it, and after a good 30+ minute rest on the pass, was fresh enough to be able to enjoy the descent.  By the end I was definitely exhausted, but as has been the case throughout for mountain biking during recovery, there wasn’t noticeably more fatigue on my left vs. my right while riding.  I actually think at the end I felt a bit better than I did last year after a similar ride (Kenosha pass), so that is a a good sign, and this morning I’m surprisingly not that sore.  I was definitely more sore after my bball/agility drills last week.
• I’ve been doing yoga each week, and trying to stretch more - not sure my flexibility has improved much yet, but it does feel good, and I’m sure if I continue, it will have lasting benefits in flexibility and hopefully injury prevention.
• My pt indicates my scar and thickening on the tendon has improved.  It’s hard for me to tell, but I’ve been scraping it 3-4x per week to reduce the scarring.

My recovery program hasn’t changed much since last month, but I’ll post it here again for reference:

2-3x per week strength/balance (2x per day):

*items that I don’t worry too much about fitting in if time doesn’t allow

• 2-3 sets x20 two foot heel raises lowering one foot on last 10
• 2-3 sets x6-8 one foot heel raises assisted
• 20-25 1 legged heel raises to failure (about 50% height or so)
• 1 set each x20 two foot heel raise at angles (toes in, toes out)
• *4 sets x8 two foot seated heel raises (55lbs or so now)
• 3 sets x5 2 footed standing to bent knee 5 second hold
• *10-20x walking forward leaning lunges (use weights and/or crouch)
• 1 set ea. way x 5 ft balls of feet side walk on raised board
• 1 set x10 balance board one foot front to back
• 1 set x10 balance board two feet side to side
• balance board foot roll (for flexibility)
• 1-2 sets walk across stair sideways on balls of feel keeping heel level (3 back and forth per set)
• *4-6 various standing balance exercises with weight shifts

2-3x per week dynamic strength/agility:

• 1-2 sets x10 runners drill (stepping up on platform and then pushing up and forward)
• bball by myself for 30 mins
• cross stepping 1-2 laps ~20ft
• quick steps 1-2 laps ~20ft
• diagonal 1 foot hops (only on left foot) 4 laps ~20ft (80ft total)
• *hopscotch like steps 4 laps ~20ft (80ft total)
• 10x two foot high jumps with soft landing
• 5x one foot jump up with one step
• 1x one foot forward jump test
• 1x one foot triple forward jump test
• 1-2x full court suicide drill with ball (not full sprint, but close to full speed with ball)
• 1-2x full court defensive slide suicide drill (50-75% full speed)
• 1-2x 10 each side layup lines
• 2-3 x30 seconds quick side hops

I’m also making sure I get 1-3 days of full rest in there, and listening to my body.  Honestly, because I’ve also been riding and hiking a lot on the weekends, I usually only get 1 full day of the agility drills in each week, as it puts a pretty high stress load on my body at this stage.  I’ve also been doing yoga once a week as mentioned above.

Overall, still making progress, still working hard, and looking forward to some upcoming adventures and the ski season, which is shockingly just around the corner.  Better try on those ski boots to see what kind of adjustments might be needed in the achilles area!

Tomorrow will be 6 months and a week since surgery and I’m still making steady forward progress.  My strength is still not where I’d like to be in the calf, but it is getting stronger, slowly but surely.  Today I did my first real yoga class ever with my physical therapist who is also a yoga teacher.  I really liked it, and am hoping that if I stick with it I’ll become more limber and hopefully stave off future such injuries.  I also went for a pretty grueling 6.5 hour hike this weekend up to a 13,800′ peak that involved a lot of scrambling up and down the summit off trail.  I never was a hiking boot guy before, but wisely picked up a pair last week, and was happy to have them.  I think they’ll serve me well as I continue to build strength through the rest of the summer and fall.

My major achievements since last month are:

• I can get my heel further off the ground unassisted and need less support to do a full raise.  I’d say 25% of the way unassisted, 50% with minimal assistance (more balance than anything), and 75% of the way there with some, but not intense assistance.  The final 25% of the way still requires quite a bit of help pushing off the table with my hands, but I can tell it’s less than it was.  Sounds like this is behind a lot of people, but I suppose as long as I’m moving forward I can be happy.
• I’ve gained some girth to my calf, about a half an inch in circumference, and noticeable definition.  Unfortunately, I’ve also gained almost a half an inch on the good side during recovery, so I haven’t caught up much (still about an inch off in circumference), but it’s progress.
• I’ve been playing bball by myself 2-3 times per week for about 30 mins, and it honestly doesn’t feel too much different than before the injury in that context.  I feel like I’m jumping pretty good off both feet, and even can jump a bit off my bad foot, but haven’t pushed that much.  I feel like I can move laterally pretty good too.  I know my full quickness and explosiveness likely isn’t there yet, but at least just playing around by myself it’s not noticeable.
• I have been doing ladder agility drills 2-3 times per week and with full intensity, and feel pretty quick doing them.
• I have gone on increasingly long hikes, including a couple pretty epic ones, and the calf strength is only an issue towards the very end.  Most of the way I don’t feel much different than before.
• I’ve been able to mtn. bike with more intensity, not usually thinking about how rough the terrain is, or how intensely I attack a technical climb.
• Walking normal isn’t even a thought (a month ago I did it, but was sort of conscious of it).
• Swelling has recently improved quite a bit, to the point where often when I get up and look in the mirror in the morning, both ankles appear the same to me from the front.  The actual achilles area still seems to stay swollen, but it’s tough to say how much of that is just permanent thickening and scar tissue vs. swelling.
• The initial stiffness in the achilles in the morning is getting to be less, even after long hikes like I described.
• I’m feeling my overall fitness improving through riding, hiking, bball/drills, lifting, stretching, and now yoga.

As of last week, my PT still doesn’t want me jogging, mostly because she doesn’t see it as being hugely beneficial at this stage, and could lead to compensation injury until I get a bit stronger.  I’m going to transition to going to PT once per week or so vs. twice per week and have it act mostly as monitoring and adjusting my program.  My current program is the following:

2-3x per week strength/balance (2x per day):

• 2-3 sets x20 two foot heel raises lowering one foot on last 10
• 2-3 sets x6-8 one foot heel raises assisted
• 4 sets x8 two foot seated heel raises (55lbs or so now)
• 3 sets x5 2 footed standing to bent knee 5 second hold
• 10-20x walking forward leaning lunges (use weights and/or crouch)
• 2 sets x 10 stepping down stairs then up
• 1 set ea. way x 5 ft balls of feet side walk on raised board
• 1 set x10 balance board one foot front to back
• 1 set x10 balance board two feet side to side
• balance board foot roll (for flexibility)
• 4-6 various standing balance exercises with weight shifts

2-3x per week dynamic strength/agility:

• bball by myself for 30 mins
• cross stepping 4 laps ~20ft (80ft total)
• quick steps 4 laps ~20ft (80ft total)
• diagonal 1 foot hops 4 laps ~20ft (80ft total)
• hopscotch like steps 4 laps ~20ft (80ft total)
• 10x two foot high jumps with soft landing

I’m also making sure I get 1-3 days of full rest in there, and am biking or hiking about 4x per week and lifting with my upper body 2x per week.

For those of you in the early stages of recovery stuck in bed, it becomes a memory quickly, even though while you’re there it seems endless.  Still, I think those early stages were a strangely formative part of my life moving forward, and getting through those weeks made me stronger, more humble, and made me appreciate my wife and family more than ever.  Those are all very positive things, even though while in the moment it often seemed difficult to see the value in it.  I’m not anxious to get there soon, but I hope to be a more graceful and appreciative old man someday (if I’m lucky) as a result of this experience.  I also believe the experience has reminded me to take a bit better care of myself, so that I can hopefully go a little longer without needing assistance from loved ones again, whether from injury or old age.

Today I celebrated my 37th birthday as well as my 5 month post op mark (plus a few days).  I’m definitely making steady progress, but it is slow moving despite my hard work.  Looking back at my 4 month update is encouraging however, as I can see I am moving forward.

My major improvements since a month ago are:

• I can now get my heal off the ground without assistance, but I’d hardly call it a heal raise at this point.  Still, a month ago I couldn’t even slip a sheet of paper between my heal and the ground when trying a single leg calf raise, so that is definitely progress.
• I’m walking normally, for the most part.  I still have issues in the morning and other times when my heal is stiff, but the push off strength is there to walk normally.
• I’ve continued to mountain bike a ton, and have gone on technical and longer rides up to 14 miles.
• I’ve been able to hike without limping, up to 3-4 miles.
• My PT cleared me to play bball by myself for 30 mins - nothing too intense, but she said it will be good for me to move around laterally on my toes.
• Yesterday I started doing two foot jumps up to a 1 foot box.  I was kind of surprised my PT had me doing it, as I’m still not cleared to jog, but was even more surprised at how easy it was.  She had me incorporate the jumps into my regular exercise routine.
• Swelling has become less of an issue, and really doesn’t change much with activity.  The general area down there is still holding more fluid, but nothing my PT said wasn’t normal, and it is slowly moving towards normal.  I’ve been icing and elevating significantly less.

I’m anxious to get to the point where I am doing non-supported one legged calf raises and jogging, but I’m happy to be able to hit the court and do my jump drills, and am still grateful that I’ve been able to ride and hike more or less normally (just slower) and that I’m making forward progress, even if it isn’t as fast as I’d like.  I also planned a late September backpacking trip and an early November surfing trip, which will keep me motivated to work hard through recovery.  The goal is to be in overall better shape a year from now at 38 than I was a year ago at 36.

I’m a few days shy of 4 months since my surgery and am feeling kind of mixed about my progress. On one hand, I’ve been able to mountain bike the last couple of weeks without really any significant limitations. Mind you it’s been on fairly mellow trails in terms of technical challenge and climbing, but I’ve gone on rides of up to 7 miles or so on rolling singletrack and though I’m not cranking super hard, I am pedaling normally (leading with the ball of my foot) and don’t notice much until I stop, at which point I definitely have a bit of stiffness from the pedal position. Anyway, that’s been the huge highlight, as I had no expectation that I’d be mountain biking by this point already.

What has been a bit of a bummer is that I still can’t quite walk normal, mainly due to a lack of push off strength on my toes. My range of motion is pretty good at this point, but I just don’t have the strength to be able to get up on my toes on my left foot while stepping forward with my right, so I’m slightly cutting it short. It’s barely noticeable if you watch me, but you can see that my left foot is not fully flexing in the same way it does on the right. My PT indicated I’m a bit behind on this, and when I did some one legged calf raises with her (on the angled machine, fairly flat with minimal weight) I had a really hard time fully extending. I realized that with both seated and the two footed calf raises I had been doing, I wasn’t going up fully on the balls of my feet (really extending) and as such had very little strength there. It is actually kind of weird how dramatic it is - I have decent (relatively) strength up to a certain point, but then that extra 5 degrees or whatever extension way up on the balls of my feet is super weak. The last 4 days or so I’ve been really focusing on that quality vs. quantity, especially with the standing raises- really controlling the down motion and using a table to make sure that I am able to full extend and lower slowly. I think even in that short time I’ve gained some strength back in that upper range of extension. The PT at the VA had me doing tons of raises, but didn’t pay much attention to me to make sure I was doing them the right way. I’ve decided to stop going there and instead do a couple 2/wks with my local PT who seems to be much more in tune with where I’m at and what’s best for me.

She’s also been paying attention to my swelling, doing some ultrasound last week which seems to have helped break up the areas of scar tissue at either end of my achilles. She also has me doing plenty of balance exercises, walking lunges, stretching, etc. I’ve got a whole routine that takes about 45 mins that I’ve been doing 1-3x per day.

With calf raises, I’m curious what kind of reps/sets/days all of you are doing/did at around 4 months. My PT thinks I should do less reps, and take some days off, which I believe is wise, but just curious what other people have seen good results with in terms of times per day/ sets / reps / days/wk.

I went on a 1.4 mile hike today, which was also nice, and surprised myself with how well I did, although I moved fairly slow and am currently recovering with some ice and elevation.

I’ve been going down stairs fairly normal for maybe a week, and I feel that become more natural and less tricky each day. It actually seems weird to me that I’m able to do that, yet walking is still a little off.

I’m curious where other people are/were at 4 months post surgery with various activities. I realize we all have our own recovery schedule, but I’m a little disappointed that I’m still lacking strength such that I can’t walk normal, and one of the doctors (a resident, not the surgeon) indicated I’d be able to start jogging very lightly at 4 months. Admittedly I’d much rather be able to mountain bike than jog, but all the same it’s disappointing to be missing that expected milestone.

It’s been a while since my last update - I suppose I’ve been busy - spending more of my rehab actually doing things vs. writing about how I feel, which is good.  I’m about 13.5 weeks right now, and since I last wrote I’ve done a bunch.

One of the big highlights was an awesome week long trip to Miami/the Keys with my wife.  While I was there I:

• Walked a lot, some with a boot, but mostly without.  The walking and the heat/humidity caused a ton of swelling, so I did plenty of icing every night.  The worst swelling was by far the first day, but that included a red eye flight and then a full day out and about.  As the week went on the swelling became less of an issue.
• Swam a lot at the pool, and a little in the ocean (snorkeling).  Definitely good exercise for early rehab.
• Went kayaking in the everglades where we saw wild alligators and crocodiles - really fun, and another good way to get exercise without using my feet.
• Did my daily exercises twice a day: theraband, balance exercises (lunge pose with variations, right foot in front of left with variations) , seated calf raises, rolling out my calf on a foam roller, gentle two leg standing calf stretch, towel stretch.

Since that trip (3 weeks ago), I’ve added the following exercises:

• One leg leaning forward (against wall for safety).
• Balance on left leg and slide my right leg (good one) around on the floor on a towel.
• Balance with right foot forward fully (previously was kind of next to left foot).
• Working on moving up and down steps normally (just using phonebook for now).
• Most recently (last week), 2 foot standing heel raises - using a table for support, going up 25%left/75%right, down 50%.  After about 12 of these I’m done.
• Lots of exercise bike and upper body weight lifting.  Still leading with my midfoot on my left, but moving towards the ball of my foot.

My physical therapy situation is pretty good now - I’ve decided to go to the VA once per week, and the local PT once per week.  The guy at the VA isn’t ideal, but he is a former PT for a CBA team (level below NBA prior to the NBA d-league) and seems to generally know his stuff - he’s had me doing mostly heal raises, but also some balance board stuff.  My other PT focuses more on creative balance exercises and improving gait, and also does some massage to improve blood flow.  In a perfect world I’d probably go to her twice a week, but going once there and once to the VA gives me two different perspectives, which certainly isn’t a bad thing.

I also bought a new mountain bike a week ago, and have even ridden it around a couple of times, leading mostly with my heal.  There are a lot of mellow trails that I’m going to be riding this coming week once things dry out- just being careful not to hit anything technical.

I still have swelling, and my range of motion isn’t quite there, but it’s getting better.  Walking is still tough to do normally.  When I take smaller steps it’s fine, but normal steps are tough to get full extension.  I think it’s a combination of lack of ROM, balance, and lack of push off strength.  Getting a little better each day, but this is a little bit of a frustrating phase, as I’m getting really anxious for things to move faster, yet I’m just not there yet.