The journey begins

I’m 7.5 months post surgery, PT has been over for a while and I’m getting back to that normal state though I haven’t done any explosive activities and haven’t jogged too much because I prefer to fast walk farther and longer than if I was just jogging. My self rehab consists of walking, some heel lifts, some calf stretching and a ton of stairs.

I’ve been getting shin splints on my affected side, I used to get them when jogging, now I get them when walking and its pretty much just my recovering leg. I’m hoping this is due with the rebuilding of that leg and they’ll just go away the more I get out and about.

Not painful but my un-scientific observation shows that my plantar flexion on my recovoring leg is not close to my “good” leg. Dorsi flexion seems the same on both, I’m not sure why the plantar flexion has not come back. My thought was that plantar flexion would have come back before dorsi flexion but I guess I’m wrong

Anyone have issues with plantar flexion and ways to improve it this far into recovery? Any issues with shin splints and stretches or ways to get them to go away? 

I had my 5 month follow up yesterday, surgeon asked me to do a single heel-lift just as he did 6 weeks ago, I said “I haven’t been doing these so its probably not going to happen” I was wrong, to my amazement I was doing single leg heel lifts, sure they weren’t really high but I was suprised just the same. My surgeon declared me healed and said he didn’t need to see me again.

While that is an accomplishment the biggest thing on my mind is that my wife just had heart valve replacement surgery (been looking for Norm’s blog site for this) And while its only been a week for her I’m amazed at how the body recovers with a little help from the doctors. I’ve seen my achilles repair and how I have recovered and I know many heart surgery recipients that recover and resume their activities. 

I have another couple of PT sessions to attend but I’m basically at the point where I’ll be finishing the recovery on my own. As the weather warms up and I get back outside I’ll be looking to increase the jogging (now I only jog the last few minutes of a walk). I’m looking forward to rehabbing with my wife as we both bounce back, can’t wait until we run our first race again.  

** Update

16 week post op visit with the surgeon: Not much from the surgeon during this vist, he did give me the OK to start slow jogging, no more than 1/4 of a mile every other day. Try that for a week and if its OK then increase by 1/4 of a mile each week. Likes the way the achilles feels and how the scar looks. No quick burst activities and I could ditch the Dr Scholls gel heel pads I had been using in place of the quarter inch heel lifts he initially gacve me…. see him again in 6 weeks

Physical Therapy status: Have had 4 straight weeks of twice a week visits, no real change in PT tasks other than I walk on the treadmill with an incline and ride a recumbant bike, the same excersise are being done, just added to the reps. Decided with my PT that I don’t have to start jogging today, I need to get a new pair of running shoes (I run in Asics but wear Nike for everydaywear, I just like the look of Nike better but I can’t stand running in them) Also factoring in is that my PT schedule for next week was shifted around a bit and I’ll be there without my Physical Therapist and I’ll be seeing one of the other PTs those two days. So I have decided to wait ten extra days before I jog, I will start the jogging when I meet back up with my normal therapist. I will go twice a week that week that I jog for the first time and after that I will drop to once a week (That will put me at 6 straight weeks of two a week) Once I get the jogging on track and make sure all is progressing I will stop PT and rehab on my own.

Good responses to my original post, surgeons thumbs up to jog and daily improvement lead me to believe I’m not dumb for eyeballing a date to stop paid PT in the near future… Thats my update at week 16

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I’m at 15 weeks, been doing real PT as I call it twice a week for the last 3 weeks and the progress has been really good, I’m walking limp free and spending most of my PT time (and an hour a day at home doing the basics… heel raises, balance, stretches, dips on stairs, bosu ball and other strength building exercises. I follow Kevin’s (kkirk) updates because we are on about the same schedule, I must admit Kevin your PT sessions sound like they are a bit more strength building intensive, I’m not using any additional weight just my body weight. I take the dog out on his mile walk everyday with no issues and started treadmill walking with an incline. Progress is definitely happening and though maybe its a little slower I don’t mind, its winter and since I don’t normally partake in snowboarding, skiing or too many other outdoor winter activities I’m going with the flow because I know come spring I’ll be able to get out and do more.

I see the surgeon next week at the 16 week mark. Not sure what the normal 16 week surgeon visit protocol is, since I normally don’t get too much info from him anyway At some point I’m sure he will tell me good bye and good luck but he never told me the duration that I’ll be in his care. 6 weeks ago when he told me to put the boot in the closet and start PT that I can do the bike etc. but no running. I asked my PT at what point she thought I could jog and she thinks it will be another 6 weeks (the 22 week mark) anyone have input on that? I ask because at somepoint I’ll stop PT but before I do I want to be able to jog on the treadmill under the PTs supervision just to make sure gait and all is good….and I don’t see myself doing PT twice a week for a total of 12 weeks. I think at some point I’ll taper to once a week or once every other week.

Some general PT thoughts: The first day I went in for PT at the 10 week mark I sat and watched others walk back and forth doing simple stretches and excercises often with no PT with them, they just know their routine and they do it. I said to myself then that PT was a racket and if I do that I’ll stop going and stop paying a copay for things I can do on my own at home…….well here I am a few weeks later and I often find myself in that position, doing my excercises and then filling the PTA in to what I have done so they can chart it. So far I can do everything at PT on my own at home with the exception of the bosu ball and massage and joint manipulation the PT does (and I think helps) it use to hurt, now not so much but I think as I continue to progress it is part of the reason. My PT has added something new the last two visits, and I’m happy about that but in my mind I think that I should either commit to another 4 weeks of 2 a week visits or tell my PT that I’d like to start coming once a week and whatever my plan is I will do those on my own at home the rest of the week. If I go that route I could probably go once a week for another month or two. Not sure, maybe my surgeon will provide some answers when I see him next week, but the track record says he’ll tell me to stop when I have met my goals…..

so in closing this very long post I want to offer a word encouragement to those just starting the journey, it wasn’t that long ago that I was sitting on the sofa 3 days post op watching news reports about Hurricane Sandy and reading AchillesBlogs posts wondering what PWB, FWB and 2 shoes will be like and reading the blogs of others at various points of their recovery looking forward to the day I would be there… It does begin to go by quick. I find myself now reading the posts of others (like Eva’s 36 week update) and knowing that by the time I start hitting the beach this summer that I will probably be back in my normal jogging routine and looking at a calendar to see when I can make a return to the soccer field.

Secondly I wouldn’t mind hearing the gambit of feedback on the timeframe for jogging, the PT schedule that folks were on as I try to figure out how to proceed, and at what point does your surgeon shake your hand and tell you good luck……I guess the ?s don’t stop, they just change depending on your point in recovery!!

I’m 13 weeks post op, been two shoes since New Years Day. My doc has a different PT plan, I didn’t get PT orders until I went 2 shoes at 10 weeks. I went to two PT sessions where I got some scar massage done, was given some ROM excercise and did 4 theraband excercises. I had to go out of town after those two sessions so I had a 10 day window where I repeated those initial excercises plus some balance on my own. The limp has been improving and I thought I was making some progress. I went back to PT last night, confirmed with her what I had been doing on my own and her response was for me to continue that at home so we could work on tougher stuff at PT, sounded great to me. It started with some good work on my scar and some joint manipulation….more intense than the first two visits and it progressed to other strengthening excercises. I could feel it during the visit last night and I can definitely feel it today, that PT session was on a completely different level than the first two.  I started PT late and got a late start on ROM excercises following my doctors orders but I think the real work and the real benefit of PT is about to kick in. I wanted a therapist that I felt would work like this, I picked the clinic’s director who has experience with a few of the DC area’s pro sports teams and I think I made the right call. I have 2 sessions a week on the books for four weeks (I’m not going to count those first two sessions as PT, more introductory) I’m looking forward to seeing where I’m at a month from now, when I ruptured playing soccer I planned to stop playing but now my thought process is changing, I’m looking forward to get back on the field.

Had my 10 week follow up today, was told to put the boot in the closet, add a 1/2 inch heel lift in each shoe and start physical therapy…. So just like that the next phase starts, have had no PT up to this point, just some ROM stretches and the extras I added off kkirk’s printout. I’m self imposing one more night in the boot, probably wise to stick with the boot for New Years Eve and start two shoes transition tomorrow. Was told no running for 6 more weeks but that I could swim, eliptical and bike so those things will be starting this week. I’m hoping that having no PT to this point but doing ROM on my own that once I start up PT that I’ll get right into the good stuff. PT orders are pretty generic, 2-3 times a week, set goals with my PT and be done with PT as soon as those goals are met, doc figures 4-6 weeks of PT. With those generic orders I need to make sure I pick a good physical therapist so I have narrowed my search to a practice with several therapists on staff that have worked with some of the local professional sports teams, so hopefully that leads to a good therapist.

Just like that the boot and shower chair are retired(plan on keeping the boot handy for any potential sticky situations). This is finally the point where I have to put in some real effort and how much effort I put in will dictate how soon I’m able to get back to “normal” I have that 4 month danger zone in my mind so between now and March I’m going work hard but work smart. The next phase begins….

So I’m 7 weeks post op, FWB in my boot and walking pretty good with a minor limp that I’m blaming on my boot being a little taller than my shoe…… I thought I saw on the site suggestions to remedy this and nearly eliminate the limp while in the boot, but that was back in my early post surgery days and I can’t remember what set of posts or comments I saw it in. I’ve seen a product called “even up” for $30+ that seems to snap onto the bottom of your good shoe giving it a lift and Norm has made the comment to fix the uneveness so I know a solution is out there and with hoping only another few weeks in this boot I’d rather not buy a $30+ product.

I know the solution is going to be easy but I’m just not sure what it is, since I’m not going to go out and buy a righ-foot cowboy boot or wear my snowboard boot around the office I’m looking for the simple answer…. just add some kind of thick Dr Scholls insert into my good shoe?

Had my 6 week follow up this morning, all looks good, par for the course not a lot of info coming my way and I fully believe I’m on the conservative plan.

Was given the OK to sleep without the boot, not sure how I feel about that really.

Was given a couple of ROM excercises to do a couple times a day

Was given a follow up in 3 1/2 weeks which will put me in the 10 week post op zone

Was NOT given PT orders

To this point I have followed doctors orders as given but I think after I do a week of the given excercises I’m going to stray a little bit and add the ones KKirk posted. If I’m not going to be starting PT until the 10 week mark I need to get the ROM back on my own.

I plan to be as cautious as I have been all along, not going to get complacent or too ballsy and do something stupid, honestly by the time I take this boot off and go 2 shoes its going to be after the holidays and new years and since we’ll heading into winter there is no real rush to try and push things, by spring I should be well along and that works for me. I will say that for safety reasons I am kind of glad to be in the boot for upcoming holiday parties and New Years Eve! 

Started the move to FWB 4 weeks to the day after surgery (Last Wednesday) and I’m at FWB today. Probably took longer than I needed (9 days) to get there. Pain wasn’t a real issue, any discomfort that I had or still have is in the ankle joint. PWB with two crutches was a breeze and I had great form with the heel to toe movement and fluidity of movement. When I made the move to one crutch I kind of lost that and found myself leaning akwardly on the single crutch, one crutch PWB stinks and that prompted me to buy a cane. The cane was much easier than a crutch and I think it got me to FWB quicker than if I had stayed on a single crutch.

Here is my asterisk: I’ve watched Ryan’s video, took the advice of he and Norm to make sure you drive the knee and feel it in the shin. I think about that with every step, works great on two crutches, so far my FWB and even with the cane has been a bit choppy. I know (or hope) that the more I walk with this boot that the form and the speed will pick up. I brought the cane with me to work and will probably leave it in the car just in case, I can see it being useful at other times as well. So like everyone else on the blogs has stated, life got a little easier today, but I know that I have a ways to go. If I could just get my doc to give me some ROM instructions or order me up some PT I’d be even closer!

Just want to throw a couple questions out to the group, especially those who are at FWB and beyond. My doc doesn’t offer a lot of details when she gives me instructions so I rely on the experts from here to get my info!!

Question 1:

I’ve been given the OK to begin PWB on Monday (3 and half weeks after surgery). I was told the standard, start with 2 crutches, move to 1 and then FWB as tolerated which I get, but then she mentioned “most people get to FWB in just a few days”  after I left the office I started questioning the speed of that progression because I have seen a lot of the posts and protocols that make it sound like that pregression is done over a week or two, not a couple of days. Does that seem right assuming I can tolerate it? canI really set aside my crutches after 3 days?

Question 2:

As far as the walking boot goes I know it has the rocker bottom and that you land heel first but just how much do you roll off the toes? When I was in the boot prior to surgery I remember a couple of times where I must have rolled off the toe to far and it hurt a little bit, and that was with no Achilles!! so I’m just wondering how close to the toe you go or do I just use the heel and go peg leg style?

Thanks for any advice

Just left two week follow up, stitches looked good and were removed, steri strips on now. No swelling, tendon looked and felt good and responded well to the Thompson test.

I can take the boot off for showers and have 2 more NWB weeks. I was told to start PWB The Monday of Thanksgiving week (would be 3 1/2 weeks post op). Was told the standard start with two crutches to one and then to FWB when comfortable, she figured by Thanksgiving day I’d be FWB, so thats just three days of PWB, I’ll go with her plan.

I tried to attach a photo of the stitches but not sure how to do that, it shows up in my “media” as attached to this post but I don’t see it.