Mountain Biking… but Still Limping: 4 Month Update

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.