** UPDATED ** 15 weeks: Progress, PT thoughts and a few ?s

** 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

****

 

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!!

12 comments ↓

#1 kkirk on 02.08.13 at 7:34 pm

IT seems to me that strengthing the calf is what I need to do (for the most part). I have great flexibility (My operative foot has the same dorsi and plantar as my left leg) and balance and strength are my biggest deficits. My doctor has cleared me for any jogging or explosive exercise until 4/8! Although, I have an appointment in 2 weeks, so maybe that will change. I know for a fact that physically I not close to running…. yet.

#2 Darryn on 02.08.13 at 8:37 pm

I’m at similar stage in terms of having doc visit coming up and wondering about jogging. Also have questions about value of PT. Just dropped from twice to once a week, and feel better about. As you say, can do nearly everything at home.

#3 kkirk on 02.08.13 at 9:09 pm

I would do the same, but my WC is “paying in full” 3 PT sessions a week (90-100 min. sessions). I’m going to take advantage of those appointments as long as possible. Then, I’ll probably spend my time at the YMCA.

#4 kkirk on 02.08.13 at 9:10 pm

My main goal right now is to correct by gait and strengthen my calf. :)

#5 normofthenorth on 02.09.13 at 1:10 am

I reached a point in my PT where my physio thought he’d finished his work, and handed me off to a colleague who started me on more athletic exercises. The agility drills on the “flat rope ladder” and such. I wasn’t convinced that those exercises were different enough from what I’d do at home to justify the fees (which I was paying) or the travel time, so I stopped going. But what my first physio had been doing — checking flexion, manipulating, massaging, using high-tech gizmos, and assigning new home exercises and stretches each week — did seem worth the $ and the time (1x/week).

If I’d been going more or less often, I’m guessing that the “hand off” (and my quitting) would still have happened at about the same time, but that’s just a guess.

For jogging, I’m guessing that now that you’re emerging from the “window” where rerupture is a serious risk, you could job gently whenever it felt good. I did my first jogging in a hinged boot crossing a busy street (earlier than you are now), and it felt semi-scary, so I waited a bit before doing more.

The more serious decision is when to re-start “explosive” sports and exercises — and whether to try to start them early on a gentle basis, or whether to keep exercising and stretching until you’re ready to “go for it” 100%. I ended up waiting a fair while after both ATRs (10-11 months after ATR #1, even longer after ATR #2 for other reasons), then I “went for it” 100%. It worked fine both times. My first (ultra-conservative) OS said to hold off on the explosive sports until I could do a bunch of 1-leg heel raises without grunting. I violated that after ATR #2, because I still can’t do a bunch of 1-leg heel raises without grunting (and probably never will), but I’ve been back to competitive volleyball for well over a year!

#6 dfoss on 02.09.13 at 12:17 pm

Your post was good reading for me. I am in the middle of week 10 and was wondering about the value of twice a week PT myself since it is all out of my pocket (high deductible insurance). The exercises I am doing are the same as yours to increase flexibility and strength and can do them all at home except the bosu ball. Balancing on a towel or pillow simulates this well enough though. I can tell this will continue for several weeks before anything different can be added. I get a good massage on my tendon and calf but don’t think its worth the price by itself. If I’m missing something please let me know.

#7 Muriel on 02.11.13 at 9:29 pm

Hi. I’ve been told by PT NOT to run until 6 months post op which for me is the end of Feb :-). My rupture was quite bad so recovery has taken its time. Like you I keep up with my exercises, but I still limp if I try to walk fast. PT has given me lots of hip strengthening & balance exercises that sound similar to yours and less intensive than kkirk’s. In addition i cycle 20-25 min 2-3 times a week for cardio and to build resistance. My PT appointments are every 2 weeks. I recently stopped one 2 one physio, being assessed as physically able to attend the local “lower limb group”: approx 12 people in the hospital gym, working through their respective routines under supervision from 2 physios. It suits me, and while there i concentrate on exercises that require equipment i dont have at home (exercise balls, staircase with steps of varying heights, balance boards).
As for running, until recently i could not physically do that movement (and nearly got knocked over trying to cross a road quickly then realising half way through that i just couldnt run). But i feel increasingly close to it - but definitely something i want the physio to oversee first!
Maybe you can discuss running + frequency nexf time you see your PT?

#8 Darryn on 02.14.13 at 7:24 pm

That is great news about the jogging. I was told yesterday i will not likely to be running for 2 more months (which will be around 5 mths). I don’t think I can stick with PT that long.

#9 starshep on 02.24.13 at 11:05 pm

I detailed all my PT sessions in my blog. If you are interested, they start here achillesblog.com/starshep/page/3/

#10 moon on 11.04.13 at 7:06 pm

Hi all, I ruptured on 6 June this year and chose the non op route. Two weeks in fixed cast then i to the VacoPed Boot. I have been out of the boot for ten weeks now (approx), and am having PT once a week.
I saw my physio today and felt strong on the exercise bike, jogging on a small trampoline and little jumping. I then had jobs around the house to do. I sat down this evening and my achilies is sooooo sore and swollen. I iced it for twenty minutes, and kept it elevated for three hours, now though it is still the same. Is this normal? Is there a blog I can read somewhere about the PT journey someone has written who chose non op? When am I likely to be back on the tennis court (physio wont tell me)????
Going through this journey, you so find out who your friends are!

#11 kellygirl on 11.04.13 at 8:02 pm

I think it’s normal, Moon. I went through several weeks dealing with the “lump of pain” on my achilles. I felt great, it was healing well and then I started doing more and I had to back off because of the swelling and discomfort. It seems to be a lot of progression/regression with this injury. I don’t know about the tennis court but at six months, non-op I’m just starting to jog. I can’t do quick starts–or rather, I’m leery of trying just yet. I’ve been doing liners–side to side on the court but I don’t feel back to normal just yet. The bad leg still feels rather plank like at times.

#12 moon on 11.08.13 at 5:50 am

Thanks Kelly girl. Did you do yours on the tennis court? How are you doing?

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