breaking ankles again by 2016

Long Hikes and Yoga: 6 Month Update

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.

August 10th, 2015 at 10:56 pm

5 Responses to “Long Hikes and Yoga: 6 Month Update”

  1. Stuart Says:

    Good to hear from you again and all sounds like it is going to plan. You wrote, ‘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 was reading something yesterday funny enough about compensation injuries after this injury because of running. This is an important lesson for all of those runners who are intent on getting back to the distance as soon as they can. I know it is like an addictive drug taken away and in some ways it is your identitiy (how you are known to others) but Skelona’s PT has a good point. What I read had to do with gait retraining before running and the pressure put on other parts of the body by running when you gait is not correct. It could be favouring the injured leg that causes the gait problem or the leg itself is not ready. The dorsi-flexion angle required for running is much greater than that for walking. This is running and not your casual jog but jogging has similar stress to a lesser degree. Relying on poor push off strength could mean you push harder with the other leg to compensate and your running could resemble a fast limp (something like a hitch i the gait). I remember wanting to just start jogging so much as it was a key indicator of my healing (for me anyway) but I was not cleared to until my flexion was right and I has sufficient push off strength. I hear it so much here. ‘Listen to your body’ or ‘I know my body’ but the forces that drive you are sometimes without reason or sound knowledge of the bigger picture so this is when you should listen to the person treating you. Thanks Skel. I am happy to read of the strength improvements you have since your last post.

  2. skelonas Says:

    Thanks for the comment Stuart - I do think my pt has a really good sense of what can go wrong if things are pushed too far to early. I also have a bball friend who I was talking to the other day that suffered some left hip problems after jumping back into bball too soon after a right hip replacement. Every time I look down at my left calf and see how much smaller it is than my right I’m reminded that I have to take things incrementally. I guess I’m just lucky that running isn’t something I miss that much, and that I’ve been able to mtn. bike without any issue for a number of months now.

  3. oscillot Says:

    Sounds like a good routine you’ve got there. I’m going mountain bike shopping this weekend, and am contemplating retiring from marathons. How long rides do you go on, and how long were you going early in your rehab?

  4. skelonas Says:

    I started riding at about 13 weeks, and initially was just peddling with my heel on the good side on mellow, fairly flat singletrack for a mile or two. At that point I was still limping significantly while walking.

    I worked up to peddling normally and riding further with more effort over the next month, to the point where I was riding fairly normally (but not at all aggressive) up to 7 miles at 4 months (still rolling singletrack). Still not quite walking normal at that point due to lack of push of strength. I didn’t notice any discomfort during rides at that point, but my achilles/ankle area would be quite stiff after the ride due to holding the pedal position - it would subside quickly though after walking it out.

    Over the next month I worked my way up to longer and slightly more technical rides, up to 14 miles with plenty of climbing and downhill. At that point I was still riding somewhat conservatively (not attacking technical sections, and just spinning in a low gear on uphills).

    Now at 6 months I’ve actually been hiking more and riding less, because I was away for 2.5 weeks, it’s probably better strength building than riding, and it’s beautiful here now in Colorado up at the high elevations where bikes can’t get to.

    That being said, I don’t feel any limitation to my biking at this point - last weekend I rode some moderately technical stuff about as hard as ever. I haven’t felt that stiffness at the end of the ride for a while now. I wouldn’t be afraid to go on 20+ mile rides at this point, and plan to be doing some of those longer rides over the next 2-3 months.

    Just with anything else, I’d say start very slow, stretch plenty afterwards, and pay close attention to your body to moderate progression. And have fun!

  5. donna Says:

    Glad to hear from you, yoga is great! Good for you. I’ve also done some hiking (I’m south of you in Colorado). I’m doing easy hikes of 3 - 5 miles, small elevation gains on different terrain, I try to avoid loose rocky trails because I still can’t wear proper shoes and that’s part of it. The first time I was able to wear shoes with a back was a few days ago. I found that I can’t “scramble” over boulders like I used to. I’m also very cautious and tend to baby the tendon. I’m pretty sore after, but with rest it dissipates. It’s well worth it and I feel I’m exactly where I need to be at 9 months. I am not 100% but I am the best I have since the repair. My only PT right now is a walking program. I’m walking on avg. 25 miles a week…and of course Yoga stretching! Big smile for you.

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