23 Weeks - Getting better but Heel Pain and Bump

My strength continues to increase. Flexibility so so but in proving. The PT tendonitis subsiding a little.

Question though. I have for the most part since trying to start walking had pain in my heel at the insertion point of my achilles. There is a visible bump there. I do not know for how long I have had this bump on my heel but that is definitely the isolation of where the pain is. And I know for sure it hurt at week 16 when looking at my past posts.

The bump is a little spongy and then hard after that. I can’t tell where the spongy stops and bone starts. I don’t remember it being like that before. The scar runs next to it so not sure if the spongy part is scar tissue or not.

I did some internet searching and it comes back with all sorts of possibilities among them a heel spur which it looks like lots of people have surgically removed. I HOPE THAT IS NOT IT! I don’t want to have to go through this again. I see my doctor in a few weeks and I will ask him then. In the mean time has anyone else have this bump?

20 Weeks - Curve Ball

I have developed some tendonitis/tendonosis on what my Posterior Tibial tendon. My PT and doctor did not seem too concerned and were not too shocked either. They gave me PPT Langer Shoe Insoles for my shoes and said keep going in the non-pain range. Easier said than done. When you think you are on the path to recovering you get a a curve ball like this. Only silver lining I can find in this storm cloud is it limits me slightly from pushing on too fast but I hope it does not stick around too long.

Other than that I am a far ways off from pre injury BUT my strength and flexibility is slowly but surely returning. I can walk pretty much normal now in shoes. Bear foot is rough with the tendonitis. My jogging is pretty pathetic still largely because my strength and dorsiflection is still pretty bad.

Many people posting here seem to have gained most of their DF back by 20 weeks. I stretch daily but would say my DF is still 20 degrees off from my good leg. I really hope it continues to return otherwise I don’t think I could ever run again. The restriction seems to be largely my soleus muscle which kind of makes sense since that is near my rupture. When I hang off stairs my feet match so my calf is fine. The second I bend my knee to do DF then I get the restriction.

16 Weeks: Benchmark Achieved but more Heal Pain

So this week I have been able to consistently get my knee to touch the wall when doing DF. I am also gaining great progress in dual heal raises to where they are pretty easy except for that last bit to get on my very tip toes. I contribute that to going to the pool 2 times a week and doing my therapy in the water where I can burn out my calf muscles more easily without putting too much strain on my achilles. Progress, woot! I am now turning to another concern which I have noticed.

When walking I get a pain in what feels like the bone of my ankle where my achilles attaches. It is not a constant pain but comes and goes randomly with different levels of walking. Sometimes pretty painful other times just letting me know it is there. What I find odd is it occurs more when not engaging my calf muscles. If I limp around it hurts more than if I force my calf to engage. Also, this area is always warm to the touch and can get swollen. I figured that would have gone away by now. Any one else experience this?

Another is I have a lump half the size of a golf ball right above where my tendon attaches to the ankle bone. It does not hurt but right below it does where the bone is. I do not remember if it was there before or not. It probably was but was less of a concern early on and I just assumed it would go away. Anyways, compared to my other ankle which is smooth and not lumpy it concerns me. I am worried it could cause the tendon not to slide as well or something? For anyone who has gone through this, do you still have lumps at 6 months or a year out?

14 Weeks Gaining DF and Strength

I posted last time that I was concerned about my DF. The gage I am using is put my toes against the wall and bend my knee. I then measure the distance from my knee to the wall. It was at 8 cm from the wall two weeks ago. With daily rehab plus some stretching where I go until I feel a little pain has gotten me some good return. Below is the progress I am seeing by daily measurements. It is slow but surly getting better. I asked my surgeon who agrees with my PT that as long as I continue to stretch I will be able to gain all my DF back (not quickly but over a few months). He went on to explain that the lengthening/stretching that is occurring is in the muscle, not the repair. The repair should not stretch/lengthen, tendons should NEVER do that.

I also have a pre planned trip to a water park (made before my injury) coming up in a month which I am super excited and at the same time little sad about what I will be able to do. I asked both my PT and surgeon about how safe it is to do the rides and such which they both gave me caution on. The lazy river and wave pool should be no problem. As for the tube rides, as long as I can avoid jamming my foot against a wall or landing on my foot to cause forced DF I should be fine.

Why I am sad is the water park has a flow rider which simulates a wave which you can do body boarding or surfing on. Last year, while surfing, I was able to work my way up to staying on a whole minute before falling and want to see if I still had it this year. The surfing ride is probably the biggest risk of me falling and re-injuring my foot since I will be in the least control when falling off.

The part of me that really wants to do it is thinking back on all the times I fell last year, each time it is into a rushing stream of water where you really have no change to plant your feet. Its more your body hits the water and it pushes you back onto a platform where you make sure your swim trunks didn’t get ripped off and you get back to your feet there. We will see where I am in a month but I probably will not risk that ride to my great disappointment.

Progress of DF:
DATE Distance from wall (centimeters)
11/21/12 — 8.5
11/26/12 — 8
11/28/12 — 7
11/30/12 — 5
12/01/12 — 5
12/02/12 — 5
12/03/12 — 4.5
12/04/12 — 4.5
12/05/12 — 4.5
12/06/12 — 4
12/07/12 — 4

12 weeks Dorsiflexion?

I have been working my way to two shoes slowly. I wear two shoes for short distance walking and the boot for the longer distance at the moment. I can still get pains in my leg when walking if I try to walk too fast still and I cannot walk very well at all without wedges in my shoe.

My ROM has gotten better but am a little concerned about my dorsiflexion. While my planterflection is 90% back compared to my good leg the dorsiflexion has a very far way to go. By last measurement, my dorsiflexion is only at 3 degrees past neutral and really giving me trouble getting a natural gate when walking without wedges in my shoe. For a comparison of how much different they are I do this rough measurement: Facing the wall, touch my toes to the wall and bend my knees. I can touch the wall no problem with good leg knee while my bad leg is 3.5 inches away. How long does that take to come back? I do not expected it to come 100% back but even 75% would be nice.

10 weeks, rehab pains

Still trucking alone. Went to my father in law’s retirement party this past Friday. Had a lot of fun and I was on my feet for maybe 4-5 hours. This has been the longest I have been on my feet since the injury. Everything felt fine BUT my ankle was huge when I got home. Put it on ice and slept on the couch so I could elevate my foot against the back so my foot was way above my heart all night. Returned to normal in the morning.

The other thing I have been dealing with is the bottom of my foot, my “heal pad” has been hurting when putting full weight on it just standing or limping around the house.

Has anyone else had the swelling and/or foot hurting and how long did it take for those issues to go away?

9 weeks and counting

I have been having very isolated a 1 out of 10 scale of throbbing / aching on one side of my achilles. Not painful but noticeable and was concerning me. It started maybe three weeks ago and became more noticeable once I began weight bearing. It would do it a random times of day resting the leg or moving it. The feeling has dropped off in the last week or so. I thought it weird that it was not uniform since I ripped it all the way through the tendon. You would think the feeling would go all the way across the tendon and not be isolated to a single side.

I saw my doctor again today. I told him my concern and he did not seem concerned, examined my leg, and said it all looked good. I pressed him on the issue a few more times, he examined my leg a little more throughly, and he really did not seem concerned which I am taking as a good sign. He mentioned he looks for a few things, all of which I was exhibiting. He checked the following by asking me to lay on my stomach and flex and unflex my foot as he felt the tendon. They all basically look for good tension:

  • The continuity of the tendon from the heal up towards the calf muscle. It it was loose of mushy that would be a sign of rupture.
  • Good definition of what little calf muscle I have left. If it was ruptured it would be ‘mushy’
  • Is my food resting in a good position. A ruptured tendon will leave your foot floppy.

I asked him about the Thompsons test which he explained is pretty inconclusive this early post op as the foot is resting where the test ends. He did how ever show if me if I relax my foot, press my foot more towards neutral with one hand and squeezed your calf you can feel the movement that way (not easy to balance and achieve by yourself though).

I am FWB now which is is awesome with the drawback of really throwing my knees / hits / back well just about everything out of alignment with the bulking 2 inches taller boot. Progress I guess. My ROM has improved to just about 0 degrees on a good day. Now it is time to buckle down on the rehab.

Life at 7 weeks

These past two weeks have I resumed ROM and worked my way down to 2 heel lifts (starting from 3). I think I could move to 1 lift but it would be a tight fit dont want to push it too fast. I have been going to the park and sitting by the creek. It is no mountain biking but it is better than nothing. Speaking of that I have read some people start biking again around 5 weeks That is crazy and I am jealous! I am going to ask they feel its safe enough to do that next time I go to the doctor.

I had my first PT visit. My PT doctor massaged my leg and gave me some stretches and workouts to keep the muscles I still have. While at my PT session it was explained to me the concept of adhesions. Which I now understand and have. It is basically when you get cut through multiple layers of “stuff” like skin, muscle, tendon it will heal together as one. The massaging and ROM help break that up. I now notice when I move my ankle/tendon my whole skin moves with it. This does not happen on my good leg. I have noticed a dent in my incision has flattened out which I assume is the adhesions on either side breaking apart. I have also had a mild burning sensation in the surgery area once and a while. Not sure what that is about.

Until I am weight bearing my PT said there is really nothing more she could do that I could not do my self until I start weight bearing. In some better news my PT doctor mentioned my surgeon has noted in my chart possibly starting weight bearing next visit to him. I go to the doctor next wednesday and I dont want to get my hopes up but I would really like to ditch the crutches.

That is all for now!

Ruptured my Achilles First 5 weeks

This is my first post so I need to give the back story.  My future updates should be much smaller.

WARNING: Gross surgery pictures attached below…

I fully ruptured my left achilles tendon 8/26/2012 playing backyard kickball of all things. During the game leading up to this I started to notice my lower left calf/ankle feeling sore.  That should have been the sign to stop but I have been active all my life and what is a little soreness. Being left footed I figured it was partly from kicking a heavy rubber ball over and over.  It was maybe two hours into playing, I kicked the ball, planted my left foot to run, just as I did the entire game. As I pushed off my foot I felt ripping in my calf area.  I had no pain but my foot was not working right.   I could not push off my foot.   I was pretty calm up until the point I pinched the area of where I you normally feel the “hard cord rubber thing” behind the ankle and all I felt was mush.  I knew I did something major at this point.

It was confirmed at the ER that day I ruptured my achilles and I had surgery to repair it 8/30/2012.   In hind sight, aside from obviously stopping at a sore leg before I ruptured my achilles, I should have skipped the ER as it was a hefty bill to put me into a splint and tell me I need to go to another doctor.  Live and learn I guess.

Week 1 post op was not soo bad.  Just kept taking my Percocet which made me sleep most of of the week.

Week 2 was a little better.  Started to get a little better at the cruches.  Leg throbbing when it was below my heart started to go away.

Week 3 got my stitches out and put into a boot. YAY.  Was told could do some limited ROM.

Week 4:

All was going great, I was just put into a boot and started ROM. Sept 29th, around 4 weeks post op, and then I slipped on the stairs. To prevent falling I put full weight on my bad leg.  As the weight came down I felt tingling in my foot and as I came to a stop it shocklingy felt pretty good.  It was my first time on my leg in 4 weeks and nothing hurt. This was immediately followed by the feeling of something in the area of the tendon letting go.  It did not hurt but was just a small release of some kind.  I kinda wish it hurt a little so I could know if all was ok or not.  I did a self exam and it looked OK but that feeling I had could not have been good.  

Went to the doctor four days later who did a physical exam.  He said what ever it was I felt, my tendon still appears to be attached.  It is possible for a small tear to exist but felt it less likely.  He mentioned I have permanent stitches (which with the pictures I have look very well sewn in there) and it would be very difficult to re-rupture with them.  He followed that up with a however, anything is possible with the right amount of force.

The doctor said an MRI is not an option at this point as it will be inconclusive with too much mix of healing tendon + possible damaged tendon.  In feeling no gap in my tendon and still noticing my concern he gave me four options in ranking falling somewhere between super conservative to more extreme.   Do exploratory surgery to see if anything is wrong, go back in a cast for 2-3 weeks, rest it for a week including no ROM, continue as normal.  I chose the middle ground to rest for a week and take it from there.

Two things that still worry me is 1) What was it I felt that let go? and 2)  My calf muscle has begun to ache (maybe throb a little) when I first stand up after a long time of sitting or sleeping.  The longer I am not standing the more it hurts when I do.  It goes away after a few minutes.  The doctor said this is normal but what concerns me is it was not doing that until after I fell.  He guessed it might be a side affect from when I slipped causing my tendon to pull at my calf which has been unused for soo long.  He could not know for sure unless we did the exploratory surgery which I opted against.

That is all I have for now.

WARNING: Gross surgery pictures attached below…

Here is some photos of the surgery