Tatyana’s AchillesBlog

I haven’t written here for a few months. It was actually a doctor’s order! He felt that reading the blog every day, comparing my progress to the ones of others, etc.. made me too anxious about the recovery. I think it is probably only natural to worry about the outcome of the AT repair (especially considering that it was my first ever surgery!)

But I always meant to come back to the blog and share my development for the benefit of others who may be just starting the recovery process. Right now, I am approaching my 7 month mark and doing great. For me, the things have changed significantly at 5 month (20-21 weeks.) It was the point when swelling, pain, and limping just went away and never came back. The fear of other people accidentally stepping/bumping on the back of my leg went away as well. Currently, I do feel just like my normal healthy self, just like before the injury. Yes, I do have a scar/bump on my ankle, but the back of my leg looks and feels like a tendon, not like some post op mess it was. When I go about my everyday business, I am not continuously aware of it as I used to be.

I still do wear pants, not only to protect the scar from the sun, but also to hide my asymmetrical calves. My injured gastroc is about half way back and I wonder whether it will ever come back completely. No, I cannot do a full unaided heel raise on an injured leg — only about half way – but I am not worried about it. I have half a muscle, I raise half way. Once I get the whole muscle back, I am sure I will be able to raise my heel all the way and higher.

In terms of physical activity in general, I do not feel any restrictions at all – I walk any distance, run, jump, squat, lunge, use all possible machines, and can perform all sorts of exercises – I can do everything I was doing before the injury (except a single heel raise.) At the moment, my favorite exercise for getting back my calf is stepping on the Stair Master. I feel it just does what I need — works my gastroc and AT to the point of exhaustion, plus offers some serious cardio as a bonus. But on the other hand, it exercises the other leg to the same degree and the danger is that with this workout my calves will never catch up! But this is a different story… I wish everyone smooth and speedy recovery!

I have been very skeptical about the Kinesio tape (KT.) I tried it once, right after I dropped the boot, and didn’t feel any difference. But then I cannot say I was really walking at that point, and by walking I mean not just stepping on the injured leg, but actually using the calf muscle to lift the heel and push off with each step. Once I started doing that, I developed soreness in the calf area and various little aches here and there, all of which were longed for, as they indicated that my muscles were still in place and functioning just alright. What bothered me was a terrible stiffness, painful and unpleasant, which I experienced every single morning. All I wanted was to stretch my AT before taking my first step of the day. I know it is common and yes, it does go away as I start walking. But it comes right back later! Every time I sit down and then get up, AT gets all tight and has to be stretched all over again.

My PT convinced me to give KT another try and I am glad I did. With the tape, I feel free of all this stiffness, tightness, little aches, and other annoying things. I just get up and go! I can walk longer distances without getting as tired as I would have been if I had not used the tape. In fact, I’ve had an experiment (inadvertently) this past weekend when I took KT off and performed all my regular weekend activities. I wear FitBit all the time and can tell that I haven’t done anything outrageous, but I felt absolutely exhausted. So I think I am a KT believer now.

I did a quick research on the tape in PubMed and none of the studies confirms any therapeutic effect associated with KT. Only one study cited increased ROM immediately after taping. But the thing is that none of these studies (at least the ones I went through) look at the “injured” individuals. They deal just with healthy athletes. Pretty much all KT research is focused on the effort to enhance athletic performance, not to treat a certain condition. Well, I can tell that I do feel the difference in ways I go through the days taped vs. un-taped and if all I have is only a “placebo” effect, then it is pretty powerful and I’ll take it, I like it, and I welcome it.

For people interested, here is a video showing the taping technique (and it is actually my PT) https://www.youtube.com/watch?v=vC7-eiy3M_U But she tapes me a little differently though.

I haven’t posted for a while. Things are progressing as expected, I guess.

I am almost at 14 weeks now. Physical therapy is still going wonderfully and working very well. My walking is acceptable, but a slight limp remains (due to lack of strength.) After about two weeks of walking in 2 shoes, with a progressively increasing distance, every day I was happy to feel some soreness in my calf (took it as a confirmation that I still had some muscles there that worked, or at least tried to), but then I noticed some pain that was located strangely on the top of my foot, not in the AT area, and was persistent. I thought of it as a part of awakening of my leg as a whole to daily activities and emerging of all those tiny muscles and connections that were doomed to passivity while hidden in the boot. But once I mentioned that to my PT, she performed some intolerably painful move (a few times!) and it felt as if she released something in my ankle area. My walking immediately became unrestricted and painless, I could not believe it! She said it was a problem that was clearly caused by prolonged immobility – the ligaments that connect the leg and the foot became “rusty” and had trouble moving/stretching normally. She demonstrated the process on the skeletal model – all makes sense. Right away I thought that if I started PT sooner, I wouldn’t have developed such rustiness. But the PT didn’t agree with that and just said that a body response to trauma is highly individual and this was the way my body chose to deal with my ATR.

With this problem out of the way, I am progressing nicely on the anti gravity treadmill, walking briskly 70% of my weight, doing 30 single heel raises also with 70% weight (still holding on the sides of the machine for support.) Double heel raises are easy now, with regular gravity, equal weight distribution between the injured/uninjured sides, and no support. I find single heel raises more challenging mentally than physically. It is difficult for me to wrap my mind around the idea that I am not able to control a part of my own body. I stand facing the wall, give the command to my injured leg to rise up… up… up? and it doesn’t obey! I quickly test the healthy side and yes, everything works perfectly, but then why didn’t it work on the ATR side? I try again, still nothing. I can’t get over this weird feeling that I am not in control, what is wrong with me? Therefore, every free minute I can find is spent on attempting single heel raises, but so far I can manage only a few millimeters… PT is happy though and she still calls it a progress and promises that by week 16 it won’t be an issue at all. We’ll see.

In addition to two PT sessions per week, I do Pilates once a week (never tried before, but like it now), tried yoga once a week (which I always disliked and still could not tolerate), so I skip yoga and work out in the gym instead. PT gave me a clearance for using almost all machines. I was planning to wear a boot to walk to the gym for extra protection, but actually wore it just once. I am not completely paranoid about watching my step anymore and can handle the distance (0.7 miles one way) with ease. Swelling by the end of the day is minor, but I continue icing for 15 minutes each day.

I am giving a second chance to Kinesio tape. First time around, I haven’t  detected any difference. These days, I am more active, so decided to see whether it would really help me walk. I will certainly report later.

Happy healing everyone!

Lots of news!

My 10 weeks appointment with OS went well. I told him that I take the boot off only at home, but actually I dropped it completely at 9 weeks and never looked back. He suggested I start weaning off the boot in the course of the following two weeks. But of course, I am not putting it back on just to wean off it! There is no return to it for me. I am done with this ugly heavy thing! I keep it at work now and only use twice a week to walk to/from my exercise (Yoga and Pilates) classes (0.7 miles each way) just because it is faster and I am guaranteed not to hurt myself. But I do consider stopping this next week. It feels awkward to wear it these days. The doc also said that I do not need to wear my light ankle brace to bed anymore, which means I am free of all restraints when I sleep. Finally! He said I should be able to start jogging in October, which puts me at 7 months post op. Is it right? Do I really have to wait that long to start running and jumping again?

But the main thing I wanted to report is my physical therapy. It is a pure pleasure and I love every minute of it. I am at 11 weeks right now and unfortunately, my strength is just not there yet, not at all. Today at PT I was in the anti gravity machine (Alter G) and even with only 20% of the weight I was only able to do a little over a half of a single heel raise (actually 30 of them) while still holding onto the sides of the machine. How pathetic is that? PT doesn’t seem to be concerned though and thinks that I am doing alright for 11 weeks. On the other hand, my brain was delighted today to have me walk absolutely normally, taking long strides and pushing off, but with only 25% of the weight… Still, I loved the experience and the fact that I didn’t forget how to walk like a normal human being! In addition to defying gravity, we normally do all the standard exercises – stationary bike, various bridges, side steps with resistance band, stability ball, etc. My favorite part is a manual massage of Achilles and the ultra sound massage of the scar (apparently it helps to break down the scar tissue.) It feels so very good and only now, at 11 weeks post op, I am actually beginning to believe that I can be normal again. Up to this point, I was really doubtful that my active life will ever be the same. Now I see the light in this tunnel. Happy! 

I am not supposed to even think about 2 shoes yet. My next appointment with my OS is only next week (10 weeks) but…  It is hard to sit in my boot and read in this blog about everyone else walking bootless by the 8 weeks mark. I think my doc would not mind that first (8 weeks) I started walking barefoot at home and then (9 weeks) tried a pair of athletic shoes. Yes, I am limping (not much though) and yes, I am slow, but I do feel how my tendon gets progressively stronger. I literally feel the difference from day to day! As someone on this blog said, going to 2 shoes is both thrilling and terrifying! I cannot agree more! I am continuously thinking that while wearing shoes I would simply forget that I am still imperfect and take a wrong step or bend too far or something else silly. And yet, all this thinking is not enough to drive me back to the boot! Today I attempted stairs and climbed up perfectly, but I still felt too tight to go down, which I think is fine at this point.

Now a quick report on my physical activities. I stick to my regular exercise routine (push ups, curl ups, free weights, etc) almost every day. I pedal a stationary bike for 20 minutes every day, in the boot. I stop at 20 min not because I can’t do any more, but just because I find it very very boring! Being stuck in one spot doesn’t feel like a workout to me, although I do break a sweat. Also, since I am not going to be able to continue my bootcamp class for a while, I have signed up for Pilates (which I’ve never taken before) and Yoga (which I strongly dislike) twice a week. These classes seem somewhat calmer and less intense than my favorite bootcamp, but I just cannot wait and feel I have to do at least something! So I figured that by engaging in less desirable activities I may move faster toward the activities I would love to engage in. Plus, I am finally starting my “official” PT and will report later on what I do and how it works for me.

Wishing everyone smooth healing!

The boot I got after surgery is worn out! The tech nurse told me it was the first in her practice. I don’t know if anyone else experienced that, but the boot (Bledsoe) was literally falling apart, the Velcro strips didn’t stick securely, the foot lining kept sliding out every which way, forcing me to step on the hard plastic wedge. So I was given a new, so called Regular CAM walker, meaning that it doesn’t have any heel lift. None whatsoever. I still had the very last wedge in my old boot, but now I abruptly went way too low and it feels like way too fast. By the end of the day, I felt exactly how I did after switching from the cast to the boot for the first time, pretty much unable to walk, hurting, and feeling frustrated. Today is already a second day, but I still cannot make the new boot work! It sure is much cozier, softer, and nicer, but the tendon hurts so much, that I give up walking! Plus, the regular rolling walking style no longer works. There is not much rolling capacity and I just have to stretch my AT with every step. Maybe it is the whole point, but should it hurt sooo much?

Saw the doctor today because I didn’t like the look of my scar. He said the scar does look a bit redder than he would like it to, but it is not infected. Just some irritation from where the boot is touching it. I cannot stand the boot anymore, I am really and truly sick of it… So I mentioned it to the doc and he had some mercy on me! I got a break — he gave me an ankle brace for the night only. I don’t have to sleep with that awful anchor anymore. Oh joy! How little do I need these days to feel happy!

I also scheduled my future PT visits, so as soon as I get my OS’ prescription/referral, I would not have to wait for the next available appointment, I am all set.

Oh, and I went back to work this week. It feels terrible. I was not swollen at all before, but once I started at my desk, my ankle is getting big and painful by the end of the day. Good thing I have a handicapped parking permit now,  so it takes me only a few seconds to jump to my car, zip home, and put my leg on ice and All the way up.

I am dropping another wedge this weekend. We’ll see how it goes…

And I do exercise pretty hard at home, mostly upper body, free weights, crunches, push ups using both feet, etc. Plus, my unofficial PT — Theraband AT stretches, alphabet spelling, bumpy ball rolling. Very disappointed with my non-existent calf, but there is not much I can do about it right now. I am literally all itching to get back to my regular exercise routine!!!

Finally, the first wedge is gone! By today, I was seriously FWB, was walking like a pro, going upstairs absolutely normally, and could stand on my injured leg for about a minute. But once the wedge was out, I was back to square one. Painful, uncomfortable, very tight in the tendon area… But the OS said that by the end of the day I would feel the same as with three wedges. Well, I do feel much better, but not 100% comfortable yet. I certainly won’t be able to stand on my ATR leg even for a moment.

As of today, the plan is to take out one wedge every two weeks and when I run out of them, I will see my doc again. Will I be allowed to lose the boot at that point? And when we say 2 shoes, do we mean just any shoes? I think I remember my OS mentioned that in the beginning I will have to wear some sort of “worker’s boots” that offer ankle support. Is it true? Those are ugly, how can I wear them in the summer in California?

I am so eager to start walking on my own that I kept bugging my doc about PT. According to my hospital protocol, the PT starts 10-12 weeks post op. According to me, it is way to late! So I was given a resistance band TODAY to stretch my calf at home. I should also do ankle rotations and general ROM exercises. My doc called it “unofficial PT.” I like it!

Also, I am allowed now to remove my boot while at home and just enjoy the freedom. I can massage my calf, move my toes, and let my leg breathe! Oh, how much I missed this!

I have been feeling pretty well recently. Started taking a few steps in my boot without crutches, mostly around the house. Once out, for speed reason, I was still on crutches. Instead of sliding on my bottom, I started going down the stairs step by step, with my good leg forward, and my hands glued to the railings. But for going up I still have scoot backwards.

With all this progress, my OS still found me not ready to move forward and did not remove even the first wedge from my boot. I still have all three of them. It felt very discouraging! I am so anxious to lose all those wedges and the boot itself!

He told me to put the crutches away for good and walk on my own. What I cannot manage yet is to take a full step. I take sort of a half step. I step with my ATR leg and then just bring my good leg to the same level. But what I should learn to do is to step with my ATR leg and then with a good one step further forward, leaving the ATR leg behind and making it closer to the full step. For some reason, it is a challenge for me. My hips get totally out of balance because of the huge heel lift difference. The doc actually advised to wear a shoe with a matching heel size on my healthy leg as it may feel more natural. So this is what I have been doing since. I know it looks pretty strange, nice high heel on one foot and an ugly boot on the other, but I think I am making some progress with my stride.

Another unpleasant discovery I made during this check up is that my gastrocnemius muscle is just not there. I mean, of course, it is there, but it looks like nothing. It was so shocking! All these years of intense workouts and only one month of rest. Where did all this strength go so fast?!

LET ME START BY SAYING THANK YOU TO EVERYONE WHO LEFT SUCH KIND COMMENTS OF SUPPORT AND  ENCOURAGEMENT!

I VERY VERY VERY MUCH APPRECIATE THAT!

I  have read them all, but couldn’t possibly write back. In fact, I could hardly breathe before I met my OS this morning.

All your comments were right! I didn’t re-rupture my tendon! The doc was happy with the way my leg looked and felt — he didn’t find any problem with me. He even removed my stitches and put me in the boot 2 days ahead of the schedule. So instead of going for a surgery 2nd time, I was promoted to PWB, still with crutches though.

I was prepared to the fact that the boot would be clumsy and awkward, but I didn’t expect it would be soooo heavy! I am to keep it on at all times. The nurse suggested to put a pillow case on it when I take it from street to bed. I will definitely try that.

Aaah, I feel so much happier today!!!