It’s been a while – the site was down for about a month due to me not getting around to troubleshooting a database error – which is too bad, cause I had some posts queued up in my brain that will now never make it to digital paper. However, I thought I should do an update on how things have gone for my Achilles tendon, which is now almost 5 months to the day post-surgery.
The first month or so was actually not the hardest. You just happen to be handicapped. You can’t bear any weight, you have to sleep with the thing propped up and iced, you are constantly worried about knocking it on things, or getting pushed onto it, or your other Achilles tendon breaking from the strain of hobbling around. Going up and down stairs is a real pain in the ass, and it’s sometimes terrifying for a crutch to slip or your momentum to get ahead of you on your way down the stairs. This also means you just don’t get around very much, and simple things, like grocery shopping or laundry take an enormous amount of time. At this point, though, I could completely accept that; I was injured, and I didn’t expect much more than this.
By mid January, I had started to partially weight bear with the crutches, and was limping around in the boot. Instead of the black monstrosity that the surgeon had given me, I had went out and found the best boot I could find. It cost a pretty penny – over $300 – but given that I was in it for almost 3 months, it was totally worth it. In case you are wondering it was a VacoCast Pro, which allows for hinged motion in the ankle, as well as interchangeable treads on the bottom, as well as washable liners. This made a huge difference – the black boot was effectively unwashable, and even after only a few days, it was disgusting. I can’t imagine wearing that thing for long. The VacoCast also was quite comfortable to sleep in, and has the added benefit of looking like the boot of a robotic suit of armor. If you are some random reader looking for advice on Achilles tendon rehabilitation, I wouldn’t recommend this being your highest priority purchase – get a cryo cuff; it’s really useful all the way through your rehab and beyond – but I’d rank the VacoCast pretty high up.
I started rehab at a local PT clinic at the end of January that was not only recommended to me by a friend’s fiancee, who is a trainer for Cirque du Soliel, but was also very well reviewed on Yelp. I have to give them a shout out here: Tru Physical Therapy, for readers in Vegas/Henderson, is one of the best PTs I’ve been to. For those of you who know me, I’ve had a lot of physical therapy from a lot of very good physical therapists, but few have provided the kind of personal attention and support that Tru has, and none have produced such a familial environment. It probably helps that I go there 3 times a week. To start, we were mostly focused on range of motion and simple flexibility and balance exercises. These were startlingly challenging. This was probably the hardest time for me; realizing how long a road I had to walk to get back to normal was discouraging, and going home 3 times a week in pain – lasting pain that would eat at you throughout the rest of the evening and into the next day – was really difficult. Around this time, I ditched the crutches permanently.
After a few weeks of this, I graduated to stationary bike, as well as exercises to strengthening leg muscles (though not immediately my calf). I was grateful for this, because I had effectively been sedentary for 3 months, was putting on weight like crazy, and was going out of my mind with boredom. It was around this time that I transitioned out of the boot full time, and into shoes. Invest in some good shoes, and look for at least a couple pairs that hit at different points of your Achilles. The abrasion between the back of your shoe and your scar will be a consistent point of pain. Get some quarter length socks and some heavy moisturizer.
We did modified squats and lunges, squats on a Pilates reformer, steps, and, after a few weeks, started on calf raises. Man, this was hard and painful. Part of it is the fact that your calf muscles haven’t been used in a long time, and they are atrophied like crazy. Part of it is that you got sliced open, and the muscles are still healing. The rest of it is mental; you don’t trust the fact that your newly sewed together tendon is going to support this movement, and every minute pain seems like the unwinding of tendon tissue, or the sutures tearing away from the frayed ends of your Achilles. Fun!
At this point, some of the consistent pain started to subside, and most of the pain is reserved for times when you accidentally put your weight on the ball of your injured foot or during and after therapy. For this reason, I’ve stayed away from crowded places, where I might need to maneuver around people or other obstacles, or could possibly be pushed onto that foot. This has been a difficult change to deal with – you don’t realize that this means any kind of public event; no concerts, no sporting events, no happy hours, etc. This is probably the hardest thing for others to understand; unlike a knee or ankle ligament, which can be braced and still take weight fairly well, your Achilles is the only thing that takes the weight as it moves towards your toes. There are few other supporting structures to help it out. As such, you may be coerced into going to places that make you feel really uncomfortable and laughed at (by your family!) for being uncomfortable about it. Just accept that they have no idea what it’s like, and move on.
I never took any pain meds, other than a few ibuprofen on doctor’s orders post surgery, throughout this whole ordeal, by the way – I’ve learned that pain is an important indicator that you need to use during an injury. Would they have helped? I don’t know. I’m confident that I’ve done everything I could from a therapy perspective so far, and pain (especially what type of pain you feel) is a useful tool to know when to back off and when to ramp up effort.
In the last few weeks, it has seemed like I take 2 steps forwards, and 1 step back. Some days/hours, I feel pretty good, with pain only when I try to put more weight through the ball of my foot, and others it’s pretty rough, and I limp pretty badly. I’ve worn a calf sock that helps to keep the swelling down and supposedly helps blood flow since January. Two months ago, if I didn’t wear the calf sock, my ankle would be a balloon by the end of the day. Now, I just get minor swelling if I don’t wear it. Keeping the scar moisturized to keep it from cracking is a constant battle. Sometimes, some scar tissue will break up, and my ankle will crack. It’s liberating and terrifying all at the same time. A few times, it’s done this while at PT, and I’m scared I’ve torn it again. Again, FUN!
I’ve yet to start any real activities. No golf yet, though I think I’m getting close to being able to do that. Hockey is still a long ways off. I’m looking forward to the 6th month mark, when, supposedly, normal things, like walking, should be comfortable. Am I ahead or behind schedule? Well, my therapist would say that everyone’s schedule is different, and that it’s so variable. I’d probably say I’m a bit behind schedule, but there are definitely days where I feel much better than others; it’s just a case of increasing the number of those days. Until next time!