Wayne’s Achilles Blog

It’s been a while since I’ve posted an update to my blog. My recovery has been moving along and I’m able to almost walk normally (just the slightest gimp at the end of my gait). I’m now going to physical therapy once every two weeks with the goal of returning to running. However I learned a valuable lesson today from my physical therapist who provided me with some good advice about my recovery.

I seem to have recently hit a plateau with my recovery doing exercises consisting primarily of doing several sets of two-legged and single-leg toe raises off of a step (focusing on the downward motion). Not only did I experience a plateau, I just may have pushed myself too hard and compromised my recovery schedule.

Essentially I was doing too much, too soon. I’d go to the gym, workout my upper body, then finish my workout by doing my PT exercises. I noticed that after doing my exercises that my Achilles felt inflamed (swollen, redness, and warm to the touch). The next morning my Achilles would be in so much pain. It took 2-3 days for the pain and swelling to go down before I could resume my PT exercises again. I even iced my AT and took Ibuprofen to bring the swelling down.

When I told my physical therapist about this she just gave me that look, “Hey stupid, slow it down and listen to your body!” She explained to me that with ATR recovery exercises its not a “no pain, no gain” situation. Because the tissue is still healing, I need to balance between too much stress (equals overload and tissue breakdown) and not enough stress (equals tissue atrophy and break down). The right balance of stress equals improved strength and hypertrophy.

According to an article that my physical therapist printed out for me – Return to Running Program by Steven L. Cole, it’s important to use the following principles to gauge whether you are overloading your tissues during PT recovery exercises:

1. Pain
2. Swelling, redness, and/or warmth. Apparently chronic swelling impedes the body’s ability to heal and may actually weaken surrounding tissues.
3. If after performing an activity you find that later your function is limited then you did too much.
4. Pain that occurs earlier on in a program that you performed previously.

My physical therapist refers to exercising to the point of my “tissue’s threshold” without exceeding (overloading) that threshold. Once you hit that threshold then its time to ease back a little and give your tissues a rest for the day.

Today my physical therapist introduced some new exercises involving weights – seated toe raises (two-legged using 45 lbs; single-leg using 25 lbs; 3 sets of 10 reps alternating between two- and single-leg seated toe raises).

For my Return to Running Program, I start with the Phase 1: Walking Program. In Phase 1 I must be able to walk, pain free, aggressively (roughly 4.2 to 5.2 miles per hour), preferably on a treadmill, before beginning the plyometric and walk/job program.