Rehab & Exercise
Rehab Equipments:
- http://www.fitter1.com (It looks like they have a good selection. I’ve never ordered from them, but I might get a balance board from them. Thanks Dr. Ross for the link!)
- https://plus37.safe-order.net/cgi-heelspurs/a/b.cgi?p=pro (Looks like a good place for finding products for foot related injuries. I’ve never ordered from them. Thanks Tom for the link!)
- Amerigel (Troy’s recommendation: http://achillesblog.com/dennis/general-comments/#comment-321)
- ProStretch from Amazon:
- Not sure if it’s the exact same product, but $19.95 from here:
ProStretch - Unilateral - AchilloTrain brace
- StrengthRite (Thanks Marianne for the link!)
Push-ups:
After the ATR, it’s been a bit difficult finding the right exercises to stay in shape. I don’t have a gym membership anymore, and I have no other exercise equipment at home. My primary exercise of choice used to be basketball and jogging. Well, I can’t do those things any more, so I’ve been doing primarily push-ups to stay in shape. It gets my heart rate up, and it’s simple.
The problem used to be that my wrists would get really sore from doing push-ups. I used to wear old rollerblading wrist guards to do push-ups.
I saw a TV commercial about the Perfect Push-up, and it looked promising. While I was out shopping a week ago, I happened to see a version of it. So I bought it and decided to give it a try. I bought this:
It’s been working great, and it cost only $19 so I’ve pretty happy with the purchase. It feels slightly flimsy though. I’ve read that Perfect Pushup - Original is better constructed, and it swivels smoother. So maybe the extra $20 would have been worth it. Here is what it looks like:
Perfect Pushup - Original
Update: I happened to walk past a shop that was selling Perfect Pushup - Original, and I actually went inside to take a closer look. It is better constructed and swivels better. The handle is designed differently than Zatorski’s Push Up Pro and seems a bit sturdier. It limits the way you hold onto the handle, so maybe it makes you have a more proper form. I think it’s overall a better product, but I am not sure if it’s worth twice as much.
If I had to buy one again, and I felt like spending $20 more at the time.. I’d probably buy the Perfect Pushup instead.
Update #2:My friend has the Perfect Pushup, and I gave it a try. In my opinion, it’s a better product. The handle is much more comfortable and is made of softer rubberish material, and it feels more sturdy.
Here’s awebsite that has some good home rehab equipment….not affiliated with it
talk with your PT/chiropractor/surgeon before buying or attempting any home exercise…..
Doc Ross
http://www.fitter1.com/Catalog/Category/63/Products.aspx
Dr. Ross - I’ve added http://www.fitter1.com to:
http://achillesblog.com/things-you-might-need/physical-therapy-and-rehab/
Tom - I’ve also added:
https://plus37.safe-order.net/cgi-heelspurs/a/b.cgi?p=pro
Let me know if you’d like me to add any descriptions to the links.. like if you found their service to be excellent, or they have really good prices/selection.)
I have been on cast for 53 days now…is this normal although my surgery was succeful? I see you guys started to walk and do excercises by the 4th week!
I also need your help guys on the boot you are using…how does it look like?
prince -
Everyone’s recovery protoco is different, but we can give you an average days figure as of April 16th. thanks to Brendan.
For 42 people,
28 - days immobile
28 - days to PWB
31 - days to FWB
49 - days to Shoe
42 - days to PT
You can find more information here. I hope this helps!
http://achillesblog.com/brendan/achillesblog-user-datainformation/
a warning! I ordered an Achillo Train and ordered a size 5….the largest listed. I wear a size 11.5 shoe and when I called Allegro Medical, the company that Amazon uses for this product, I was told the size 5 equalled a size 10.75 (never heard of that size!) foot. It did not fit and was very uncomfortable.
worse than this was Allegro does not allow you to return their product without a “RA number”, which I was told on my first call to their customer service dept that it would be emailed to me. after 5 calls to Allegro and 1 email I still do not have the RA number. I think a call to the BBB is in order….
I am at the 4 week mark and in a boot. Does any1 recommend and type of heel lift for the other foot to even it out. I start theropy Thursday so maybe they will give me something, but I would like to be even when I walk.
Hi MIke,
I was given my AirCast/Boot at 6 weeks post-op and was given two heels/wedges one for the AirCast/Boot and the other for my good leg shoe to balance things out.
Hi, would like to do lots of walking this summer (will be 12 weeks post op) and was told by my PT that the strength of the tendon won’t be a problem but the swelling might be if I’m walking all day. I saw a compression sock on amazon for about 50 dollars that claims to support the achillies. Anyone ever used one? Does it help with comfort when your walking all day?
Thanks in advance.
Heather
During one of my followup visits with my (non-operating) surgeon, I was having a “bad day” and my leg was swollen. Ordinarily, it stayed “down” pretty well as long as I had time to elevate it during the day, but it was puffy when he saw it. (Since he only saw me maybe once a month, he probably thought it had been like that a lot, which wasn’t true.)
He recommended that I buy a compression-type ankle support from the drugstore, or Walmart, etc. More like $10 or less than $50. He said the fabric kind were better than the Spandex kind, though I wasn’t sure I found any that WEREN’T Spandex in the stores.
I wore it a couple of times, but I didn’t love it, compared to simple elevation. I think I’m in the majority here, on that one. Others here have gotten great relief from icing (I never did much), and a few (Doug53 for one) relied primarily on compression, maybe mostly with an Ace bandage.
Everybody seems to be different in how long the swelling-and-elevation thing persists. I posted a blog a while ago saying that I was tired of it already! Even now, I’ve got my leg up as I type! Keeping it down all day isn’t a serious problem any more, but it still feels better up. . .
I’m really late to this blog - week 15 and I’m dying to run again. Surgeon won’t allow dorsiflex but will see him in 2 weeks. Heel pain from aircast has dissipated a lot with the strengthening of my calf and foot. Continue to work with my gait - getting it straightened. Recommend ameswalker.com for compression socks.
Alan, you’re still in a fixed boot at 14 or 15 weeks post-op? Sounds nuts, based on the studies available online. Watch out for GerryR when you say “Surgeon won’t allow. . .”, because he’ll remind you who’s the boss, who’s the patient, and whose LEG it is!!
Check out bit.ly/UWOProtocol for a good modern protocol that produced excellent results in 145 patients — probably much better than your surgeon’s so-called “conservative” approach. And definitely more convenient!
Walking straight throughout ATR rehab is very important for all of us — and even MORE important if your rehab lasts way (too) long!!
Hi, my name’s Megan. I tore my Achilles’ tendon for the second time in the summer. I’m in one of those dumb walking boots. It’s terrible, and I don’t have insurance, so I think my doctor is just saying I don’t need surgery. I’m a college student, and my parents aren’t around. I just want my leg to get better and am so stressed.
Megan, it is a stressful recovery for most of us, but there’s light at the end of the tunnel. Do your best, try to stay positive, and follow a good rehab approach, and your leg should be fine, though it does take a while. Is this a re-rupture of the same AT, or have you torn both sides? (I did that!)
The Good News is that 4 new studies have shown that “those dumb walking boots”, without surgery, can produce excellent results, just as good as surgery without the infections and other complications — and without the ~$15,000 expense, too.
Those studies all used similar modern protocols, and that seems to be the key for the most reliable good results. I’ve posted the one my surgeon gave me — from a new study at U. of Western Ontario — at bit.ly/UWOProtocol . If your doctor is planning something very different for you, or if he hasn’t given you a schedule at all, I’d print this out and discuss it with him. Going a lot slower is common, and it USUALLY works fine, too, but the overall statistics aren’t as good — and it’s a much bigger “pain”!
The authors of that study presented their results at the 2009 Annual conference of the AAOS, the Am. Ass. of Orthopedic Surgeons. It’s online, linked from reference #7 in the Wikipedia ATR article, bit.ly/Wiki-ATR . Almost all of their patients recovered very well, including the half (~75 patients) who skipped the surgery, like you.
There are quite a few ATR athletes blogging here who are doing well without surgery, including me, gunner, mikek753, johanna, and several others. Check out our blogs and Cheer Up! And Brock is doing well with a RE-rupture that’s being treated without surgery. (There are also a bunch here who’ve had ugly results with surgery, but that’s another matter.)
If you start a blog and share the details and ask some questions, you’ll probably get lots of comments.
Good luck, good spirits, and good healing!
Hi there!
New studies shows that the achillestendon is containing layers that are moving differently depending on the foot position.
That should be the same as that the muscles are attached to different parts of the tendon and are causing a shear force between the different layers in the tendon.
- Is this causing the “inflammation” (it is no inflammation as recent studies show Link:http://umu.diva-portal.org/smash/record.jsf?pid=diva2:349953 )
To treat these tensions the achilles and Gastrocnemius/Soleus muscle need to be stretched in different angles to find the tensed part and to relive the irritation.
There are a new invention that can do this http://www.stretchpower.eu
Use this with a wedge to find the tensed part of the muscle to relieve the shear force in the tendon!
Good luck!
Hi everyone, im in a tough situation. I have no insurance and I ruptured my achilles tendom by 40%. Its been 5 weeks since I have done so but I was wonderibg if you all knew of any rehab exercises I can do or of any equipment thats fairly cheap to help recover because I cannot afford another doctors visit. Thank you!
Hey Everybody! I hope you all doing fabulously well in your recoveries! I need some rehab advice if anybody has some suggestions.
I completely ruptured my AT on 5/31/11 and had surgery to repair on 6/7/11. I am now in the Aircast boot and walking without crutches in it. I am overdue on starting rehab due to an insurance hiccup which has been incredibly frustrating and now looks like it won’t be sorted for another 2-3 weeks. Quite demoralizing in its way. SIGH.
Anyway, I’m very anxious that this delay will impair a full recovery (I’m a ballet teacher and choreographer so being able to move reasonably well really helps!) and wonder if any of you have rehab exercises appropriate for my stage in the healing process that you might advise doing.
I downloaded the rehab protocols on this site and read those. I have been doing some simple range of motion exercises on my own and have been feeling that the tendon — while still stiff — is beginning to come around. I guess I want some advice on whether I should try things like the theraband on my own while waiting for the insurance people to refer me to the right PT.
Thanks to everyone here! This site really has been a godsend!
This is a tough one Daisy. Your doctor has you following a different path but you should have been given a protocol to give to your physio. That would indicate what exercises the doctor feels is appropriate. Range of motion exercises are good and so is some massage (tendon and surrounding joints). Patience is the anti spam word for this post and I would urge that. A physio will show you the right way to do exercises as the wrong way can be detrimental. Apart from the injury, you can do exercises that strengthen the glutes, quads and hamstrings that will help you walk properly again. Standing in your aircast, drop one hip. Put your finger around where you panty line would be and suck in the muscles around there and hold it. Take a step forward on the uninjured side. A couple of weeks wait is not critical in the recovery so take it easy. The other alternative is just go to one visit and pay for it. You would get a fair bit out of the way and it may be worth the out of pocket expense. Your insurance may re-imburse you later. We pay around $60-80 AU dollars for a visit but I am not sure how it is for you. My insurance only covers half the amount and I get about 9 visits a year. After that I can go to the public system which is free and staffed with children straight out of training.
Thank you, Stuart! Your advice is always so balanced and sensible. You have an excellent point about coughing up for some physio on my own. There’s an excellent facility not too far from where I teach — maybe I will call them Monday and see if they can fit me in. I’m yearning for a proper evaluation from a PT so I know where I … well, stand. (grin) By the way, the exercise you detail sounds great! Will start that today.
I’m pretty good on body stuff — given some instruction, I could do a lot on my own. Just want to know where the NO! boundary is! But you are right — patience is key. I’m really relieved that you think being a little late to physio won’t be the end of the world.
Thank you for always having great information so articulately presented! Really really helps.
Bicycles ……. At what week can one expect to get on one of these puppies? :}
No simple answer to that question Brian. It depends on your treatment and protocol. Some people ride their bike - in a boot (or even a cast) - very early. Are you talking indoors, or outdoors? On a road, or on a trail? In a boot, in a tennis shoe, or clipped in? Are you looking to use the bike for transport, cardio workout, or as Achilles Rehab?
Personally, I can tell you that I started riding a spin bike (indoors), clipped in, with very low resistance (no cardio workout), for Achilles Rehab, starting just before the 4 week (post traditional/open surgery) mark.
I first rode a bike outside at about 7 weeks. I used a mountain bike, so as to be able to keep in a low gear, reducing pedal forces (low resistance).
I am now (just over 8 weeks) trail riding in the mountains. I still use reduced gears (vs. pre injury), but can ride hard enough to hit my cardio red line on the hill climbs. Sadly, that probably says more about my current lack of cardio fitness than the strength in my legs
Great information here. I had a complete tear on Sept. 15, 2011, surgery on Oct. 7. NWB and crutches until Nov. 10. Cast came off 34 days post surgery, and I am back in “the boot.” I look like Frankenstein walking down the street!
My surgeon is a former Army doctor, wants me to start PT on Dec. 1. It is driving me crazy, not being able to get a good workout every day. I have been walking without crutches, full weight bearing for 10 days. I have been doing lots of upper body with weights (nothing involving legs or lower extremities).
My doctor wants to use the William Beaumont Army Medical Center (El Paso) PT Protocol for AT repair. That protocol says: “Weeks 4-6: Stationary bike in cam walker with heel on the pedal.”
Question: how much bike is too much? I went 30 minutes yesterday while wearing the boot. Had no problems and not much pain, but I really want to go two hours. Anybody see a problem with that?
I am glad to stop by as liked reading the blog. Thank you so much for providing the worthy information.
About 9 mo out of surgery.
My therapy was only good for 13 visits, didn’t do much besides stretch, light lifting, and balance back then. Definitely helped but it wasn’t enough.
Had some problems with the incision healing for awhile, saw a couple of different people. My primary doctor was the only one who helped and shot me up with some minor antibiotic to help clear the redness. I was worried it was infected for the longest time. My incision site still looks terrible.
I’ve had some pain in my right foot and knee for some time. Subconsciously I feel I’m overusing my right side to walk etc. Been seeing a “medical masseuse”, which doesn’t seem to be helping too much but does alleviate some stress/pain…
Started back at the gym doing free weights, and focusing on legs to strengthen about 2 mo ago. Still cannot do a single leg calf raise on my left side yet. Anyone else have this problem? I feel like the muscles in my foot aren’t strong enough yet or something. Anyone else having this problem. I can lift a little weight with both feet together on some calf machines but the single leg calf is so frustrating.
garettcox,
The calf muscle atrophies quickly and is one of the toughest muscles to get back. I’m at 5 months and can’t do a single leg calf raise yet either. I’ve been working my injured leg only on a seated calf raise machine for about a month now and see some progress but is it certainly slow. You have to do low weights/high reps or else you risk straining your calf muscle. That also reduces the risk of a re-rupture. All seated calf raise machines are different in terms of length of the arm and initial weight with no plates so I shoot for a weight where I can do at least 20 reps.
Starshep - keep in mind that the seated calf raise is going to work your soleus, and really won’t (*can’t*) do much to build the Gastrocnemius. The Gastrocnemius attaches to the back of the femur, above the knee. When your leg is bent - like on a seated calf raise machine - it is relaxed, and really can’t exert any force. Conversely, when your leg is straight, it is the muscle responsible for most of your calf power - it’s your gastroc that will eventually push up that single standing heel raise.
There is nothing bad whatsoever about building up your soleus (which ties in below the knee) - keep that up for sure. But don’t neglect the gastroc; be sure to do a good portion (I’d say at least 50%) of your calf building work with straight legs.
ryanb:
Thanks for the tip. I didn’t know that. I just looked at a “calf” muscle chart. There sure is a boat load of muscles that make up the calf. Fortunately I have been doing assisted single-leg calf raises too. Until I can do a single-leg calf raise, I can’t think of a way to isolate the Gastrcnemius and quantify my progress. I tried your idea of holding on to a lat raise bar and found myself twisting too much.
Maybe try seated, straight leg, single leg, calf press, on a leg-press machine (use your good leg to help get it started, and to provide assistance - ie, a self spot - when necessary).
ryanb,
Thanks. That should work. I just started going back to a gym and they do have a leg-press machine. Prior to that I was using my home gym and don’t have the space for one.
So when seated it’s working the sides of the calves isn’t it? I should be doing straight leg calf raised on the machines or leg press machine?
Appreciate the feeback by the way.
garettcoc,
Looks like you need 2 different exercises to work the 2 main muscles in the calf, seated calf raises and standing calf raises or leg extended calf raises in a leg press machine.
I am 12 weeks post-op. I am 67 and reptured my achilles tendon in Nov. of 2012. First Dr. tried boot for 11 weeks then basically said live with it. Second Dr. had me do 8 weeks of physical therapy. Third Dr. said because of time that had passed surgery was not a good idea. He made me a plastic AFO horrible. I could walk but when I removed it the pain was terrible. I finally was refered to my wonderful Dr. I have now. . He could not believe I had walked on it all that time. I had an Achellolvableies Tendon transfer on May 21 becuse of the fact I have psoriatic arthritis I spent 24 hr in hospital with IV antibiotics. I still ended up with an infection. On antibiotic when I pinched a nerve in my back I now had 2 feet I could put no weight on. I spent 6 days in the hospital and as long as I was there they gave me antibiotic and when I went home no infection. I spent 8 weeks in a boot in a wheelchair with out ever once putting weight on my foot. THen I went to physical therapy I was doing so great. Week 11 I ended up with a dissolvable stitch that did not diissolve. I ended up with another infection and 2 open sores. It is now week 12 1/2 and tomorrow I head back to PT. I still have 7 more days on antibiotics. I have no strength in my legs and I want to be out and going. This has been a long road to recovery. I pray that there will be no more set backs.
Marlton - what a terrible journey you have endured thus far, This injury is horrble even when things go well.
I extend my sincere wishes for continued recovery and hopes that this time it’s a full one
Blood flow stimulators will reduce the recovery time and help to build a stronger tendon by getting more oxygen and nutrients to the tissues during the rebuild stage. This is by far the best one I’ve come across, I don’t know that I’d ever have been able to run again without it.
http://www.kingbrand.com/Achillies_Tendonitis_Treatment.php?REF=52PV24