The discussion about exercise has come up a number of times on achillesblog over the last several weeks. So, I thought I would take a minute to reflect on some of the things that I was able to do during the first 10 weeks of my recovery. Keep in mind that this is only my experience, and you should consult with your doctor and/or therapist about what exercises are appropriate for you.
I had been in very good physical condition prior to my injury. About 4 years ago I started to get into long distance running and since then I’ve completed a couple of marathons and numerous half-marathons. I also do a fair amount of biking to supplement my running. So, my cardio level has been pretty good. Following the rupture I was able to quickly accept the fact that I would lose most of the cardio I had built up for the last several year. I’m okay with this, because I know it will provide motivation once I’m able to start running again.
With that being said, I still wanted to try and keep some level of fitness while I was in casts and the boot. I really didn’t do much the first two weeks following surgery as my focus was on getting back to work and a level of normalcy. My exercising consisted mainly of propelling myself around on crutches. This actually provided a pretty good workout.
At my 2 week post op appointment I transferred from a splint into a cast and briefly spoke with my surgeon about things I could do to stay in shape. I was still non-weightbearing (NWB) at this point, so there wasn’t much I could do that involved the injured leg. My surgeon suggest to keep moving my toes around (up and down) and to do leg lifts. I could also weight lift with other parts of my body, as long as I remained NWB. I’ve never been much of a weightlifter, so I stuck mainly to the leg lifts. I was still getting a pretty good workout from the crutches.
I had another post op visit at week 4 when I was recasted with my foot back in a neutral position. I was also given the okay to start partial weightbearing and my doctor allowed me to start riding an exercise bike, if it felt comfortable. Well, my bike was sitting in a trainer in my basement since winter set in, just waiting to be ridden. So, that night I carefully hopped back into the saddle and went for a ride, albeit relatively short.
I rode my bike about 4 times a week for the next two weeks, slowly increasing my rpm and resistance. I also continued to do some leg lifts during these two weeks. I went back to the doctor at week 6 post op and moved into the boot. My doctor encouraged me to keep riding the bike and told me I could even ride the bike without the boot if I felt comfortable. He also encouraged pool exercises now that the incisions had healed. He said to start in shoulder depth water trying to walk slowly and trying to do heel lifts. Unfortunately, I let my gym membership lapse several months back, so I didn’t have access to a pool. I also wasn’t driving at this point and I didn’t want to be a burden on my family, asking them to take me to the pool. In hindsight, it may have been good to renew my membership and at least make a couple of trips to the pool.
Wearing the boot also allowed me to start some range of motion exercises. These exercises were pretty basic and can be seen on the first page of this exercise guide. I was also given the okay to start full weightbearing while wearing the boot. Just walking around in the boot provided some great exercise. The injury has given me more respect for walking as a good form of exercise.
I’m now beginning week 11 post op and I continue to ride on my bike trainer. I’m almost back to the same resistance and rpm I was at prior to the surgery. Biking works well because it doesn’t put a lot of strain on the tendon. I’ve done some work with therabands as well over the last few weeks to improve range of motion and start the slow process of rebuilding the calf muscle. I’m also in physical therapy now where the focus will be on rebuilding strength and getting back to my pre-injury level of fitness.
I’m sure my level of fitness has dropped quite a bit since the injury occurred, but I still feel pretty good. I’ve lost a lot of strength, but I feel good about my cardio level at this point. I also don’t think I’ve gained any weight, which is good. Most importantly, exercising has helped me mentally. Every little thing that I can do to get back to a level of normalcy allows me to accept that the injury happened and that I can now move on and focus on walking normally again.