univofpittbull’s AchillesBlog

Hey everyone,

It’s really interesting to return here after a long time and see a completely new set of names going through the recovery process. It’s also a bit sad to see some old names who are still having some struggles with recovery. Nonetheless, I thought I’d give everyone at least one more update regarding where I am with my recovery.

Cliff Notes on Injury:
I’m a former NCAA athlete (track and field)
Tore Right Achilles Playing Soccer
Surgically Repaired
Back to sports in around 5 months. Back to full effort (I say this because i wasn’t really “full speed” yet) in 6 months.

I thought I should use this time to give a bit more info on the final phase of recovery. I got back into sports pretty quickly after my injury. 6 months post op I was a full participant on my teams and going after it. But I did make several mistakes that begun to have negative effects on me.

I think i jumped to full speed to fast and the rest of my body wasn’t ready for it. During recovery we spend so much time only focusing on the afflicted Achilles and calf that we forget that we haven’t used the other half of our body to it’s full potential either. So, after a month or two of playing hard my left side started to rebel. First, my calf became extra tight. I mean it was so tight that I was afraid my other achilles would snap just walking around some days. Lots of stretching helped loosen it up but I NEVER STOPPED PLAYING. This wasn’t an end of the world mistake by any means but it definitely wasn’t too smart.

With the tight calf and compensating for the achilles I really started to screw my body up. Soon, i was getting pains behind my left knee where my hamstring inserted into the calf. My tight calf was causing my hamstring to literally *click* while i was running. Again, I kept going at it without really stopping. At this point I was at about the 9-10 month mark. For good measure, I decided to throw in training for a half marathon to go along with my two soccer teams.

Tightness in left calf + clicking hamstring + right achilles recovery = peroneal insertional tendinitis in right foot.

I don’t know exactly how that math adds up but I assure you it was a painful equation. That is when I finally shut it down for a couple of weeks. No running at all.

This brings to 11-12 months. With spring comes outdoor soccer and softball. Feeling pretty good after my brief rest period I jumped into the deep end again. Two soccer games a week and 1 softball game. Following the theme of the story, it took only a couple of more weeks before stuff started to ache again. My tendinitis stayed away but the tightness and hamstring issues came back with a vengence. I did everything I could to keep those in check when the next on the string of injuries decided to give me a reality check. Rounding first during a softball game, my left groin decided it had had enough and I pulled it. This was by far the worst of all the injuries. This one put me down for a month.

That’s when I decided to get smart. I realized that the 6 months I took off because of the ATR was the longest stretch of time I was inactive since I was 10 years old. During that time I lost some of the strength, durability, and flexibility that I built and maintained over my constantly active lifestyle. So, after my groin was all healed up, I started back at ground level trying to rebuild my body. Any high intensity athlete will tell you the best place to start is always the Gym.

At 13 months I got back into weight training in a big way. I threw myself at plates, dumbbells, and medicine balls 2-3 times a week. A few weeks and a bunch of protein shakes later, I felt like a new man. The marvelous machines that our bodies are only need a little kick in the pants to jump start themselves. The tightness in my calf and hamstring went away within a couple of weeks of going back to the gym. My tendinitis and groin injuries weren’t even on my radar anymore. That’s when I re-inserted myself into sports. And now I feel every bit of the athlete i was before the injury. There’s a small chance that I’m even a bit faster.

I guess the moral of the story is to not forget the rest of your body during your recovery. I treated the rest of me like red headed stepchild (no offense gingers!) while I focused on my injured AT. It obviously came back to bite me a bit. However, I still say that once you hit your safe milestones to push your rehab as much as possible. If you want to get back to full speed in a reasonable amount of time, you have to believe your docs when they say your AT is healed and ready for action.

Happy Healing Everyone. I’ll try no to be so much of a stranger.

PittBull

Well, I am now in the "wow I can’t believe it’s been X weeks" club. The last few weeks have seemed like nothing more than a blink of the eye. I’ve found myself in a weird in-between phase of recovery where I feel like I’m as good as I will be for while.

I’ve played 2 games of soccer in the last two weeks. I really started to speed up a bit in the second one. However, I still find myself sort of locking my ankle in a dorsi flexed position while running. I’m still a bit tentative to really be explosive on the hurt AT. Nonetheless, my wife told me I was moving too fast for my first few games back so I guess that’s a good sign. Maybe the feeling of being stuck in quicksand is just a mental thing.

Most likely, I will try to speed up a bit with my running this week. Hopefully, I can get another video posted to show everyone my progression. I am a bit scared that there won’t be too much to show because I haven’t been working as hard on rehab the last few weeks. After the games I was pretty sore, so I just shut it down for a few days. By the time I felt better again, it was time for the next game =) I did reel off 20 single heel raises with 1 finger on my bathroom sink for balance last night. I believe now my issue is ankle strength as I feel wobbly once I’m at the top of the heel raises.

I’m making an effort to keep posting through these last few weeks through the 26 weeks milestone. When i first joined the site, I noticed that bloggers tend to fall off from posting after 5 months or so. I’ll try to keep at it to build the 20+ week knowledge base up some more.

I hope everyone is progressing well.

Quick Video:

As promised, here’s a short video I made jogging on the track.  I took the video after I ran a quick mile and did some stretching.  There’s definitely still a bit of a hitch in my stride but I think it’s mostly from me being a bit gun shy.  There’s no pain at all during or after jogging;  My calf does get a little sore though.  You’ll notice I started off kind of fast and strong on the first one just from pure habit.  It scared me a little so I walked into the next three.  I have to admit, it’s a bit bitter sweet to watch the video of me running.  While on the track I felt like I was really moving but the videos clearly show otherwise.  I have a bunch of videos of me running track and this is just pitiful compared to how I used to run.  I guess I have a lot of work to do and hopefully I can regain most of my speed….

Also, I’ve just been given the old Heave-Ho out of rehab.  On my final day, my PT took some ROM measurements and than had me do some single legged heel raises.  Once I got to 10 she told me to stop but I think I could have gotten another 5 done pretty easy.  The only number I remember from my ROM is I had 24 degrees of dorsi flexion.  The rest of the session went well with some plyos and then I said my good-byes.  Off to brave the world on my own.

Please excuse the shoddy editing but without further ado:

Just thought I’d pop in and give a quick update on my progress.  Today I am 17 weeks removed from surgery and am feeling pretty awesome.  I’ve fallen into a weekly routine and am feeling better and better each day.  Like I was telling Nickokie on his page, I do 3 sets of 12-15 single legged heel raises twice a day.  The first 7 or so of each set are on my own but then i help myself using a counter for the last few in each set.  I’ve also started walking on my toes quite a bit.  Feels like I’m on stilts at first but my ankles are finally adjusting to bearing the weight again.

I’ve also been doing a lot of jogging and biking.  My rides are usually about 10 miles long and have really helped build my leg strength back up.  My jogs usually top out at about 1.5 miles but that limit is mostly because I’ve started to speed up a bit.  Last night my last 1/2 a mile was at a 7 minute mile pace.

I’ve re-entered the soccer world with some easy ball drills and kicking around.  Nothing serious but fun nonetheless.

I’m setting a goal to return to my indoor soccer team within the next two weeks.  I don’t need to sprint while playing indoor and can work myself back into condition.  I’m eyeing a return to outdoor a week or two after that when I know i can stride out at 3/4 speed. 

Finally, I’m planning on putting together a short video showing me doing the single heel raises and jogging a bit.  I know how much elsurfer’s videos helped me get confidence so I want to do my part for everyone too. 

Love this community.  Love being so close to being strong again.

Regards

PittBull

It’s been a while since my last post because I’ve been running around like a maniac these last few weeks.  I’ll give a short and sweet engineers version of an update:

Married - Walk down aisle was flawless.  Dancing not so flawless.

Honeymoon - Went to Costa Rica. ATV riding, Snorkeling, Zip Lines, Hiking, all good.  Change in cabin pressure in plane and getting AT hit with luggage cart, all bad.

In general, I think i’m progressing quite well.  I missed three sessions of PT because of the wedding and honeymoon and just got back in with the therapist today.  Totally different mentality now that I’ve surpassed 12 weeks.  Session consisted of:

• 3 minute Bosu Ball March
• 15 yard Drills - Shuffling, Karaoke, skipping, high skipping, two footed hops (forward and backward)
• Ladder Drills - quick feet in and outs, sideways two footed hops, forward two footed hops
• Standing on Versadisc and sliding foot forward, sideways, and backward on slide board
• 4 way theraband hip exercises on balance pad
• 90 degree jumps and turns on bosu ball
• 30 heel raises with shins on some weird ball thing against wall

For the first time during therapy, I was actually winded.  Also for the first time, I feel like I am on my back to normal.  The plyos really got the blood flowing and I’m still riding a high of sorts because I can hop, skip, and jump again.  My PT also said it shouldn’t be a problem if I start kicking a soccer ball around again.  She said since my ROM is completely back I’m not in much danger of re-injurying myself.

That’s all i have for the moment.  Hope everyone else is progressing well also.

I’ve finally had my second post-op check up with my surgeon this week.  I didn’t have any expectations of a long conversation about my progress with the guy so i was not disappointed when he ran in grabbed my ankle and then ran out.  I guess I’m on my own still.

My PT says starting with my next appointment, we will be “turning it up a notch” to begin getting my calf back into shape.  Little does she know, I’ve had the notch turned up for 2 weeks now.  Daily, two footed heel raises and some workouts in the pool.  I plan on beginning some light jogging next week as I feel my tendon is as strong as it can be.  Anyone have any stories about how their first jog came about?  I’m not sure how to begin really.

My limp is almost completely gone at this point.  However, it comes back with a vengence as soon as someone says “Hey, you’re limp is gone.”  I suppose there’s some kind of battle of wits going on between my brain and lower extremities at the moment.  Sometimes, the muscles win.  Sometimes, the brain dominates.

I seem to be having the opposite problem of everyone else when it comes to shoes.  I feel great in dress shoes.  The heel and low cut are very easy on the scar and AT.  My problem is running shoes.  When i put sneakers on, it presses on the outside of my AT while walking and causes the outside muscles to get really tight and hard.  I can work it out easy enough but it’s annoying nonetheless.

Well that’s my update for now.  Getting stronger every day but still have a long way to go.  I’ve set a mental goal to be back at soccer in some form in September.  That will only be 4 months but i’ve already began dribbling around my living room again =)  I just need my running back now.

Cheers

Week 7 can be summarized pretty quickly.  Exact same experience with rehab and I’m pushing to get into two shoes.  I pretty much only have the boot on while out in public.  I’m also supposed to get an AchilloTrain in the mail today.  Anyone have experience with one of these.  I figured it couldn’t hurt since i have very low swelling but haven’t been given heel wedges by my doc (bc i don’t see him again until July 29th). 

Anyway, I’ve been filling my time doing some research on some rehab methods.  Here’s my list of interests:

Hyperbaric Oxygen Chamber - getting massage and doing exercise in the chamber may speed recovery. Used by Donovan Bailey and Trace Armstrong.

Platelet-Rich Plasma Replacement Therapy - Uses your own blood and increases red blood cell count (so more oxygen).  Some NFL players have used this to recover from injuries

Graston Technique Deep Tissue Massage - targets scar tissue but may be too imbrasive for ruptured ATs

Active Release Massage - jam a finger on the scar tissue and then flex the afflicted area

I really wish i heard about the hyperbaric and PRP treatment options earlier.  I probably would have given my body up in the name of science.  Donovan Bailey supposedly returned to running striders on the track in just 10 weeks.  I guess returning was his only job though…and he had a big bank account.

Any thoughts?

I know it was fairly obvious to all that I was a bit jaded after my first rehab session.  I just didn’t feel like I was going to get enough attention at the facility I went to.  Luckily, the second rehab session went a lot better.  I got a lot a of one on one time with massage and stretching and had a very good conversation about my recovery with the PT.  The only problem was that it wasn’t my assigned PT, it was a different one because my PT was on vacation.  I hope that I have a similar experience next week when my PT returns.

The session started off with some soft massage to warm me up a bit.  I explained to the PT that my ankle was a bit stiff because i was in the car for a long period over the weekend and couldn’t elevate properly.  She went to work stretching, rotating, and rubbing the hell out of the effected areas.  At one point my ankle had a very satisfying “Pop” and felt as if the bones and tendons in there actually exhaled.  She explained that my calcaneous was a bit out of place from being restricted in the cast /boot and that the pop was it setting itself right.  This morning it still feels great and my swelling went down significantly.

After the massage, it was time to do the usual exercises.  Alphabet, circles and marble picking up.  She did throw in the a curve ball and started me on some theraband strengthening exercises.  She said my ROM in my ankle was really good so we could add in some strengthening too.  To close the session she wanted me on the stationary bike for 5 minutes. 

As I was about to put the boot on, an idea popped into my head.  “Can I walk over to the bike barefoot?”  her reply “Sure thing if you feel up to it…matter of fact, if you think you can handle it, you can bike without the boot.”  I was more than a little shocked but decided to go with it.  I whipped my other shoe out of my gym bag and asked if I could throw it on for the quick walk and bike ride and she laughed saying I came prepared. 

So, I laced up my right shoe for the first time in nearly two months and set out on my 10 yard journey to the bike.  It felt amazing!  I was wearing nike shox, so my heel was nicely elevated.  There was no pain in my walk at all and my gait felt way smother than with the clunky boot on.  I hopped on the bike and started a wobbly pedal focusing on keeping heel pressure on the pedal.  Five minues later I felt like a new man and strolled back over to my belongings strapped up the boot and headed out.

I’m not going to jump to conclusions and move to 2-shoes just yet but I can definitely see it on the horizon in the next couple of weeks.  In the meantime, I’ve opened my boot up to allow dorsiflexion to 10 degrees which I hit with every stride without any pain or discomfort.  Next, I plan on unlimiting the plantar flexion instead of limiting it to Zero like it is now. 

I am a little sore this morning after all the work yesterday but it is a good sore.  My background helps me recognize the difference between pain and soreness.  I think it’s a good idea for all ATR sufferers to try to do the same so that you can maximize your recovery efforts without putting yourself in danger.

That’s all for now.  I think I’ll put together a Driving post between now and my next PT session.  I’ve been driving since week 2 Post Op!

5- Weeks Post Op

So, I went to my first PT session yesterday afternoon with a beaming smile on my face.  I was expecting to get a nice plan laid out for me which would make my road to final recovery a bit clearer.  What I got instead wasn’t much at all.

I walked in, filled out the usual forms, and anxiously awaited in the lobby.  I couldn’t help to notice the place had about 5 workers (It was later determined that 3 were PTs and 2 were “aides”) but had 7 or 8 patients.  For the most part, patients were hustling and bustling on their own while the PTs and aides ran back and forth setting timers and handing off dumbbells.  Not a good sign.

I got called back a few minutes later by a lady who introduced herself as the Manager there.  I popped off my shoe and she asked a few questions about the injury.  She also told me that she sees way more ACL injuries than achilles injuries while playing soccer on turf.  Next, she broke out a plastic protractor type thing to check my ROM. ”Okay…Good…Mmmm Hmmm….Alright.  Your range of motion is pretty good.” 

She told me to flip over on my stomach with my foot hanging off the table.  I complied and before I could ask whats next she grabbed my heel and pulled it down putting me into a nice stretch.  She then ran her fingers down the sides of the tendon while squeezing.  I don’t know if you guys ever got a good sports massage on your hammies or calves before but they hurt sooooo good.  This was no exception.  Just as I thought “This is what I was waiting for.”  She stopped. 

She jumped up, said the scar looks good and told me to put some vitamin E on it .  She then told me that we’ll be dropping PT from twice a week to once a week until I can walk in 2 shoes.  Huh? Really? After that, she left.  What the?  About 5 minutes later an aide came in with a print out of home exercises that had the exact same images that are referenced in the Rehab section of this blog.  Like, exactly the same.  The aide walked me through the highly complicated exercises one by one and the told me to put my boot on and go home.

I spent a grand total of 5 minutes with the PT.   I know this was an evaluation period of sorts but I was expecting more.  More massage.  More instruction.  More attention.  Instead, I feel like I just got a real life version of an intructional email.

Before leaving I tracked down the PT and asked if there was anything else we’d be doing today or in the near future.  “Massage? E-Stim?”  Her replies were they’d work in massage in future sessions and she doesn’t believe in stim.  “Strength test?”  Answer was that there was no need since I have no strength.  A little frustrated I politely said thank you and left.

I was a bit steamed but have decided I’ll give it another week to see if the lack of intimacy and information was solely because it was the first visit.  In the meantime I’ve talked to a friend who is a PT and who’s husband does PT for a MLB team.  She said massage is a must and I should be getting it 2 or 3 times a week.  She also said it may be worth it to check into other rehab facilities which are more focused on athletes and will have full sessions with PTs instead of aides.  We are paying for an hours of a PTs time afterall.

On a side note.  I set my boot to 10 degrees dorsi this morning after I got work.  I’m limiting the plantar flexion to 0 degrees while i sit in my office chair and stretch for a while.  I found the boot is the best stretching aid I have since i can tell exactly how far I am going.  I’ll lock it back into 0 degrees before walking until i know i can get to 10 with no problem.

Cheers everyone.

I had my follow up on Thursday June 2^nd.  It was actually with a different doc because mine was on vacation.   They cut my cast off and checked out the incision.  My tech snapped a pic for me.  I looked back at my leg and realized that I had staples not stitches.  I suppose I should have known that at some point before then during this process.  No big deal though. Those bad boys came out and the doc said he was putting me in another neutral cast.  I lobbied weakly for a boot but he said they never let anyone out of the cast before 4 weeks.  “It’s just not worth it.”  So, we scheduled a follow up with my original doctor for Exactly four weeks post op (June 22).

By week 3 post op I was fed up with having the cast on.  My leg shrunk a ton and didn’t really swell much anymore and the cast was bouncing around as I crutched (I’m using this like a verb now). So, I called the docs office and rescheduled my appointment to 5 days earlier.  She didn’t even check with the doctor and made the changes for me.  For the next few days I felt like I really pulled a fast one on them.

June 17^th -  I couldn’t contain my happiness to the prospect of finally getting the cast off.  I took the entire day off from work and prepared myself.  I had a huge breakfast.  Got a haircut and then headed to the doc.  The bottom of my crutches could have caught fire from how fast I was moving through the hospital center’s lobby.  When I got to the waiting room, there was a young girl of around 8 years of age who also was getting a cast removed.  Hers was on her arm and extended above her elbow.  She was all smiles when she asked if was getting mine cut off too and I replied ‘yes’.  Heck, I was all smiles too.  We both sat there grinning like…well, like little girls.

A tech took me back and went to work cutting off my cast.  It swear when it finally broke apart it was like one of those cryo-sleep pods in sci-fi movies opening.  Dust shot out the sides as the two halves opened up slowly revealing my now infant looking leg.  Despite its emaciated appearance, I was ecstatic to see my old friend again.  “I missed you leg.  Let’s never fight again.”

My doc came in and went to work checking out the Achilles. I was surprised at how rough he was.  He grabbed my leg.  He Dorsi-flexed my foot which scared the bajeezus out of me.  My Achilles was super tight and I could feel the scabs on the incision ripping a little bit.  But this also showed me that I don’t have to be too gentle with it.  The doc gave me a CAM Walker boot and set it to stop at -10 degrees.  The boot allowed me to point my toes (plantar flex) as much as i wanted.  It just limited my dorsi-flexion to -10 degrees (I think others may refer to this as 100 degrees).  He told me to immediately put as much weight on it as I can bear, and to adjust it to 0 degrees after a week.  At first I was pumped because he was being aggressive.  Then I tried to get my foot in the boot set and flex to -10 degrees and I was thinking “there’s no F-ing way I can even get to -10. 0 in a week would be impossible.”

So off I went still crutching in the boot.  When I got home I started experimenting.  I stood up on my feet with no crutch.  Besides the pins and needles in my heel it felt okay.  I then started to stretch the tendon in the boot trying to hit the -10 degree limits.  A few hours later I hit the limits and nearly jumped out my seat with excitement.  The rest of the week has been enjoying the simple things.

It was absolute pleasure to be able to stand on two feet while going to the bathroom. 

My first shower without the cast was amazing.  The feeling of water running down my leg had me giggling like school girl and washing my foot had me singing in the rain.  All was well until I got out of the shower and starting toweling off.  Skin was coming off of my league and foot in layers.  Completely gross.  It was like scraping mayonnaise off of a burger’s bun when the 14 year old behind the counter ruins your order.  Luckily, this only lasted for a few days. 

About a week later, I’m alternating between walking with one crutch and with no crutches.  It’s been a bit akward as the boot setting makes me lock my knee a bit.  Hopefully, this will be remedied when I go to 0 degrees but I imagine I’ll have to go through the pains of stretching the tendon again.  No big deal though.  I’m also excited because I start PT next Tuesday (June 28^th).  Can’t wait to get my calf back.

Until next time.

After some conversations with nickokie, I have to ask this.  How was everyone’s boot set up after you guys came out of your casts? 

I’m really beginning to feel I may have been given some bad instruction/set up by the tech.  Kind of scary since I am still in the danger zone for re-rupture.