vmack’s AchillesBlog

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Training at the GYM with DAS BOOT

So its 10 pm on May 21, 2011 POST RAPTURE RUPTURE update…..HA ha.. someone had to make that joke…Lame as it is here is post 2.  I promise to blog more often.

Anyways so its been 7 weeks post op and 5 weeks since walking boot nwb

For the past 5 weeks I have been working, working out, and carrying on a regular life - minus strenuous exercises.

Fortunately I work at a desk and aside from having 2 weeks of sick time being on crutches it hasn’t affected work.  Each day after work I ‘crutch’ down to my gym (just a few blocks from work) and spend a few hours moving around.

At first I was driven to not get fat, but now I am working to minimize atrophy and reduce the rehab timeline expected for my return to sports or racing again.

My first few workouts were very slow as I was testing the limits of what the boot can handle as far as the ability to sustain my weight as I transferred on and off a spin bike.  I started off on an upright spin cycle and only peddled with my ‘good’ leg while I planted the right leg/boot on the bike frame or wrapped behind the seat as to be clear of the moving pedals.  This was just to develop a sweat as I mentioned my first few trips back to the gym were to shake the rust off my body from laying around my house for two weeks playing COD, however with discussion with a physio therapist it was noted biking with both legs is fine as long as the foot stays below neutral.

First double leg bike trial:

I performed this at home as I have a recumbent bike.   I placed the pedal under my heel as to exert the biking force through my leg as opposed to leveraging my foot to transfer force through the pedals.  It helps to have it on the lowest gear to start and to have your ‘good’ foot strapped in.  As I have learned in a bike class that to bike efficiently for longer periods it is not a proper technique to pump your legs down through the stroke, but to push down on the stroke and to pull up on the upward and as this is occurring on one side the opposite complementing the motion.  This generates more power and is easier on the knees and quads as it incorporates your hamstrings, hip flexors, core.

So at 3 weeks post op my incision spot was extremely tight and any jerking motion would cause discomfort, and biking produced a few moments of :/ so I continued to single leg bike at the gym until the 4th week post op I brought both shoes and decided to try it again.

I started by strapping in my left foot and testing the waters with the boot on the bottom side of the pedal (so straps facing downward) and I started pedalling….Eureka!!!! (solved the dilemma of obtaining my cardio at a certain level) needless to say I haven’t attempted biking without the boot since.

I have 2 workout plans for cardio maintenance:

Interval training.

The first is I cycle at a (60-70%) resistance (subjective) for 8-9 mins and then cycle at 40-50% for the next minute (9 and 1’s).  Repeat for 30-50 minutes depending on day.

Hill Climb.

The second mimics a hill climb I start off at a very low resistant and every 5 minutes I turn the dial up working my way up to 50 mins.

Pros and Cons about a Spin bike over a Upright bike.

Pro.

Usually the pedals are metal so the underside of the one supporting the ATR will have ‘teeth’ to grip the boot’s rubber bottom - providing a base for you ATR leg to leverage and generate force to cycle through.

Usually very narrow so it is quite easy to wrap you leg around the back seat

Proven tool for maintaining fitness/training of long distance racers

Con.

The metal teeth have totally started eating away my boot’s rubber bottom (degree of care here - very low)

Because most spin bikes are not electronic resistance adjustment is very touchy depending on the resistance mechanism so the electronic uprights have an advantage over the spin bikes.

Maintaining my metabolism and diet was the next hurdle to address:

First I cut my portions and frequency down from Race/Game ready (4-5 meals + 2-3 snacks min) to (3-4 meals +1-2 snacks max).  Before you comment on this item know this I love food and I am the first to say that starving the body of calories was not my intentions, but merely I changed the quants and the quality of the food I took in.  Before two servings of pasta was not an issue when you ran upwards of 20-35km a week on top of gym and sports, so when the basic need for fuel is taken away so should the supply for it too.  I followed the food guide needless to say.

Next I amped up the amount of upper body and core workouts I did.  With the crutches I developed an increased amount of arm stamina in fact my bench has shot up probably 30 lbs.  I sometimes run out of energy before I max out.

I was lifting before the rupture and there was no reason to stop.  So I kept up the upper body routine, however I did have to stop the lower body workouts/deadlift and squats for obvious reasons of course. Around the 5th post op week I started doing one legged lunges by placing the boot on a bench and performing the exercise this way.  Also I have been doing strength training on my left leg with the various machines by keeping the boot out of the way.

My core training was unaffected at all - in fact it complimented my physio therapy training requiring leg movements like clam shells or leg raises etc.  The importance of the first round of physio therapy (assessment stage) was to minimize atrophy of the entire right leg.  It is quite apparent the drop in mass in the calf, but I have noticed the atrophy in my glute and quad so anything to engage these muscles I do.

For a crazy training routine try youtubing Lebron James Team USA core workout. His routine really focuses on core strength and it extends into the hip flex region.

Stretching is vital and very important as working out everyday and bearing the weight of Das Boot have really taken its toll on my lower back - in fact it has never been this tight in my life unfortunately I have not gone to see my massage therapist yet, but instead have been using my foam roller to alleviate for the short time any tightness/knots.  Its doing its job for the time being.

So basically if you are reading this blog and have the ambition to head back to the gym - its doable - I’ve been doing it for the past 5 weeks, and every few days I up the degree and intensity of my workouts.

In fact its where I feel the most comfortable - odd right? Entering the gym on crutches? Well here is the self reflective part of my entry so most technical knowledge has been summed up to this point.

Take a look around at the gym - and I mean a real gym - not one that is populated with pre-teens who are there to socialize and gawk at others as they workout but its filled with individuals who are there to improve their health and well being - usually.  I have met some really interesting people many of who have a close friend or relative or personally who has been on crutches or ATR.  You pick up the best advice, and the biggest motivation in the gym to carry on and not succumb to couch time.

One dude mentioned how his friend tore his in friendly basketball game and has since returned to playing, and how it has not resulted in any loss of step, and another said his brother kept the atrophy down by working out the opposite leg - FYI I did not research it I prefer to live in denial and believe it hahah.

The third dude was a crazy story he broke his ankle and was on crutches and shortly after healing required surgery on his shoulder and his self reflections made the most connection.  That being the worse feeling isn’t the actual injury, but the feeling you get when you enter a room or an elevator and everyone looks your way, or when they make conversation with you but stare at the boot.  I know its that they are just curious, but somewhere along the way people have transitioned from generic get wells to straight out arrogant remarks.  I know it sucks I don’t need to be reminded each time you see me.  Also I will never use the word GIMP again .. although I never used that really.  Its really odd I sometimes have to really bite my tongue when I am out as people think its funny to comment on the ’sticks’ or my Gimp state.  I do a few mental *face palms* in the day - but not many and I am trying not to care… or secretly wish they fall on their face.. What I never said I was pure of heart haha :P.

So I conclude by saying thanks to those who commented on my last post I did perform the recommended exercises, and I would like to say thank you to all friends and family who have helped me out in the last 7 weeks I know it hasn’t been easy and  I appreciate everything.

On a last note those in plaster casts waiting for their walking boot - it is pretty sweet as far as looking like  Captain Morgan and if you have an air cast felt liner you will be blown away ha ha.

Oh that reminds me of my next blog item - stay tuned to "How to prevent your boot from turning into a rancid 24/7 gym shoe"

-vince

PS. Sorry if I B*tched in this last post but some people need to be slapped in the face - not even for this but just for the hell of it.

PPS. Sorry for swearing.

New User - Freak Accident

Hi all, :)

I apologize in advance if I violate a blogger code of conduct as this is the first time I have ever been on this side of a forum, but something is compelling me to blog about my experience as of late, and possibly aid any future ATR’ recoveries.

A little about me before I detail my experience.

I am a 24 male and quite active.  I have been training again to run my first half marathon since 2008 and possibly a 30km race this summer as well.  Aside from ultimate (which I am so/so in) I also am an avid biker, and an amateur yogi.

I ruptured my right achilles on April 1, 2011 in an ultimate frisbee game… couldn’t have been more than 3 shifts in for me.  I was back peddling and about to make a cut forward when something caught the back of my cleat keeping my foot flush to the turf and as I took the step forward my achilles popped (actual sound).   I can summarize how it felt… it was like a shopping cart had run into the back of my heel x’s 10.

Now being an all season runner in Canada I have had my share of twists and bends on running on snow/ice/ice chunks/slush puddles… often without stopping after a twist I’d just continue to run and any sensation quickly passes (no swelling ever) so I can conclude with reasonable assurance that my foot and leg strength was not a factor. It was just a freak accident.  Luckily I played with 2 doctors who were able to provide an on field assessment.  I recall the moment when I rolled on the turf and the sensation of numbness hit as I literally lifted my right leg with my arms and tapped/banged it onto the turf and I just felt a throbbing sensation.  Thats when I knew something was wrong - still optimistic that it was just a minor tweak similar to those experienced on a winter run, however I have never been brought to the ground before.  I recall the night where I was comparing the rigidity of my left and right achilles… a healthy one was firm as I placed my thumb on the heel, however my thumb would collapse the skin on my right heel (swelling hadnt set in yet).  I apologize if this is quite graphic. I should have placed a disclaimer at the top… My bad.

Leaving promptly to the emergency room and returning the next morning (Saturday April 2, 2011) for surgery ( a total 13mins).

Fast forward to present day.

I took 2 weeks off work to rest and to ensure as much elevation as possible.  The first few mornings I would wake up not fully comprehending the situation and it would slowly get to me..but 2 weeks later it has fully sunk in.  So I probably have experienced one of those stages of grief from denial to depression/anger to acceptance.. and back and forth from depression/anger to acceptance.  Not quite sequential - I would definitely say it was very circular or cyclical.  I would be a psychology major’s best friend :P.

People have said the sympathy from others must be nice… yes and no as I can bet some bloggers or readers of achilles blog can agree we would trade the sympathy for an undo or a fast forward from nwb (non weight bearing) to rehab.  I am 50/50 pumped for rehab.. but also really angry too that I have to take things slow when in the past I haven’t.  Being young I am still under the illusion of invincibility or that nothing can go wrong this has been a big wake up call…but by no means do I regret being active nor have future plans of taking it easy.  I’ll just rehab stronger, and I am sure if it was not for that coincidental moment I would have never experienced this.

So far I have purchased a groupon (mass online coupon company) for future 10 pass yoga drop ins at a local studio, and have made contact with a friend of family member who will be opening his own physio clinic in preparation for rehab.

As soon as I am able I will be ‘jumping’ into both.  I have been told sports would be out for a year.  I can take that I don’t play anything other than ultimate, and I have quickly made the decision to sub in disc golf for the summer.

This marks the end of the cast and the beginning (fingers crossed) the beginning of the walking boot (as of Monday April 18, 2011).

I have experienced greater motion in my foot as I have gone from no range of motion to full toe wiggle and span out - spreading the toes apart. I call this the p90x of foot workouts. Currently my leg is in a cast with my foot pointed forward, but I have experimented with calf flexes and my foot moves a bit :).

Periodically though I experience poor circulation and feeling of blood pooling in the heel depending on the angle i am sitting. I am looking forward to the walking boot this Monday.

I will conclude with a question for the blog.

What are some of the exercises you can perform within the first month of post surgery?

Happy Healing

-vmack

P.s Stairs suck - alot.  Makes me sympathize with individuals who are permanently immobilized.

P.p.s With the amount of COD (Call of Duty) these past 2 weeks I more than likely will not buy the next one hahaha.