Tatyana’s AchillesBlog

Glad to hear that things are going well. I am right behind you so will be looking to you for inspiration! I am steadily increasing my PWB, and will be starting the process of transitioning to FWB next Tuesday. I will get to go with the smaller sole on the Vacocast and plan to use one of my middle-weight hiking boots to even things up. Already wearing shorts to work - going to be pushing the limit with my hiking boot I figure this injury gives me a hall pass fow a bit more…..

Tatyana, it seems that the calf muscles (especially the Gastroc) is one of the fastest muscles to atrophy. (If only it were as fast to rebuild! But no.) Many ATR victims (especially sad for hot women and their admirers) have to learn to live with some residual asymmetry afterwards. Sad but true.

Balancing your two feet is vital to a good booted walk, but there’s more. Your boot has to be snug enough and stiff enough — the right size and with the right strap adjustments — to transfer your whole body weight from under the ball of your foot to the front of your shin. If it isn’t, fix it. If it is, trust it!
Trusting it means rolling over the boot sole, from heel to toe, while pushing “that” knee forward so your shin forces the top of the boot cuff forward, lifting your heel. Your calf and AT should be able to relax while this is happening, while the boot does the work. DON’T splay your toes out to the side, and DON’T use your booted leg as a “peg-leg”, or let your knee straighten or hyper-extend.
Once you get the hang of it, you’ll be flying.
I think RyanB’s blog has some good videos of good boot-walking, and I’m sure YouTube does, too. Ryan’s also got an amazing way to stair-walk on crutches, caught on video!
I’m pretty sure I could get you walking up and down stairs pretty normally pretty quick. I’ve written up a great trick for going down stairs “normally” FWB, on my blogs and many others. And some tips on how to crutch-walk up stairs, too. But once you can stand on your booted foot alone, you should be able to put your other foot one step up, no? Then you’re stair-walking. . .
For the heel wedges, 3.5 weeks is still early times. bit.ly/UWOProtocol kept them all in for 6 weeks, while other good protocols take them out sooner, and gradually. As long as you can get balanced, you can walk fine in equinus. (Horses do it, right?)

Norm,
I don’t know what I would do without this blog and especially without you! Before my check up I was doing exactly “peg-leg”, just what you said. Then OS showed me what he expects, I thought I got it and started doing it. But what was I doing? Hyper-extending, over straightening my knee, just what you said.
I am trying to walk your way now and eventually will make it work — it even feels more natural, but for some reason, it didn’t come naturally to me.
And you are so right about the boot! My first week I was struggling terribly, the boot simply didn’t cooperate in the least. I felt as if I had a snowboard permanently attached to me. I was frustrated and went back to hospital hoping to see the tech for adjustment or some help. I was seen by a nurse of a different OS (not mine) She immediately told me that the boot was way too big for me! She fitted me to a new one, size S, and only at that point I made my first attempt to walk. So you are right again, feeling that the boot is snug is awfully important. Thank you for all your contributions for all of us, ATR victims!
But I hate the thought of calf asymmetry, I need my gastroc back the way it was. And I want it ASAP!

I am so excited! I am walking and my stride is as close to normal as I can manage for today. My hips are completely balanced and I am not even limping! And this is with all three wedges! It will get only better from now! Thank you Norm!

Sounds great Tatyana - Love the attitude most importantly, staying positive brings tremendous value to this recovery! Thanks for sharing.

YAY!! You are so very welcome.
Some people escape with virtually no asymmetry, Tatiana, so just “wait for it” and keep staying with “the program” and hope for the best. AND be careful what you wish for, since some of us get more symmetrical by rupturing the OTHER AT!
And some women still have great legs even with some asymmetry — check out KellyGirl’s latest photos!

Stupid system won’t allow a post with TWO SMILEYS in it, without “awaiting moderation”!! Here it is with only one:
YAY!! You are so very welcome.
Some people escape with virtually no asymmetry, Tatiana, so just “wait for it” and keep staying with “the program” and hope for the best. AND be careful what you wish for, since some of us get more symmetrical by rupturing the OTHER AT! [wink!]
And some women still have great legs even with some asymmetry — check out KellyGirl’s latest photos!

Yes, I’ve looked at Kellygirl’s pictures. I had my first disappointment when I saw how her calves looked a year after ATR. Still, it is very kind of her to post such dramatic ATR evidence for the rest of us.
Very funny about the other leg ATR just for symmetry, but no thank you!:-)
Now I am concerned than my physical therapy will start only at week 10-12, according to my doc. Too late!!! I must start doing something for my gastroc sooner! I will strive for “no asymmetry” They talk about setting goals — this will be mine, equality for both calves, by all means.

You go, girl!

Doesn’t help that we’re all probably increasing muscle mass in the good leg due to being forced to do everything on it for such a long time. Makes the atrophy in the bad leg look even worse. Its not just in the calves, my hamstring/quad/glutes are all half the size of my good leg at around week 7.

Seated calf raises were the first exercises I could do that involved really flexing my gastroc on my bad leg around week 5.

To Roark,

Exactly! I was thinking about it too. The other side has to overcompensate for the loss of strength at the injured area. And it certainly doesn’t help the overall body appearance.
Are the calf raises part of your PT routine? My PT will only start at 10 weeks. By that time, everything on the affected side will atrophy! Panic!!!

Yeah, I started doing them around week 5, but they weren’t recommended by my Dr or PT. They’re the first type of closed kinetic chain exercise you can safely attempt. After that its 1-2lbs resistance bands. I’m only following the Dr and PT recommendations that make sense to me based on what I’ve researched. My Dr initially only wanted me to start PT at 10 weeks too. I told him I read differently and he admitted he was being conservative so I could do more if I felt ready. But he showed me an ultrasound so I could be aware of how healed up it actually was so I didn’t push it too far. Made sense to me.

I’m even getting some asymmetry in my core from overcompensation. I’ve been able to limit it a little bit in my legs since I found out I could still do squats and lunges while in the boot around week 3. There’s tons of stuff you can do to maintain overall strength while still in the boot. In week 7 now I’m back to doing 2 a day workouts in the boot. Just no running or extreme agility. I think some of it translates down to the gastroc and soleus isometrically without putting tension on the achilles.

But still, even with trying to limit the atrophy on the ATR side, its all making my other side look bigger =-P

Tatyana, I can relate to your concern about atrophy in your injured leg. After 4 weeks I was shocked/disgusted to see what was a muscular, well-abled calf a month prior look like just hanging skin (probably the best way I can describe it). As we advance and work through PT I know it will come back, it’s just if your as impatient as you and I it makes it that much more difficult. It sounds like you are walking in the boot much better than me at that stage so congrats on that! I finally feel ok not bringing crutches everywhere I go!