Achilles Rupture Recovery

Today is the official 3 month mark since my unfocussed sports injury.

FINALLY got outside in normal shoes (plus silicon heel insert) for the first time today – a cancelled meeting plus the last rays of the sun plus my super supportive partner = a swift drive to a nearby quiet village to ‘test walk’ myself. I was initially a bit disappointed with my gait: B couldn’t describe what wasn’t right, describing it as ‘nicht ganz rund’ (German ‘not completely round’ = ‘not quite right’); I was waddling a bit, my right droopy shoulder is so hideously droopy, my 4th toe/ball was screaming a 3-4/10 pain at every push-off and other small things I couldn’t quite put my finger on weren’t ‘quite right’:

Nevertheless, having asked a few people, including Achilles Chris, it seems I’m just being overly critical at this early stage. I mean, I have been saying myself that (approximately) 3 months of wearing the boot are followed by 3 months re-learning how to walk (wrt all aspects, including gait, length and pace of walk, increasing the metres of ascension, etc.). So I guess it’s another case of learning to be patient.

Still pulling my boot on first thing in the morning … I just figure, give the tendon a little while to warm up, me to shake off general morning grogginess and help to avoid a stupid mistake first thing leading to a <SNAP>.

After overthinking how to tackle the stretch to work, considering being driven to avoid the train, I realised all I really have to do is a) take both crutches so I can unload the affected foot-in-a-shoe (making the distance almost irrelevant), and b) avoid trains full of kids (so travelling well before or after the standard school-time trains). I’ll get myself a pair of light, wide running shoes, probably this afternoon; maybe use the boot once more on Friday to get to work, and then as of Monday, VACOped adé.

Sitting in the train, wondering about my droopy shoulder; couldn’t see it via laptop yesterday evening whilst sitting in my bed, thought I’d check again here in the train … and it’s there. Hmmm …

Oh well, Rome wasn’t built in the day, there are bigger fish to fry I guess.

Like replacing apparently way-more-worn-out-than-I-thought running shoes.

Because it turn’s out, I should have followed the good example of my fellow redditor and friend from the Netherlands and gone and bought new running shoes before I came out of the boot.

I, however, had thought, ahh … they’re still good enough! Turns out, not so much – the theoretical 6mm drop is probably half of that; the worn out soles (which are no longer waterproof any more) are so run down that they’re perhaps even part of the reason the ball of my toe is hurting … certainly taking steps in the new shoes hardly hurts at all – being stiffer, I guess they spread the load more.

Was a bit of a ‘duuuh!’ moment, tbh ^^. I guess one never stops (re-)learning 😅.

Oh yes: I also just stumbled across a possible danger: compression (socks): see Gemini research below if interested.

Positive Moment(s): thanks to a closing down sale of a neighbouring sports shop I now have a decent pair of ‘light running’ shoes as well as a pair of ‘proper’ running shoes (because by the time I can run again, the shop will be gone), all for just a third of the original price -> feeling chuffed 😎 !

For hopefully the last time, I wore the boot to this afternoon’s physio session; there’s still ice and snow abound, but it was time – this was w13 d4 and most protocols are pushing for weaning out of the boot between w9-10 or so, at the latest by w12, so I’m already ‘overdue’.

Still, this was a conscious decision based on risk minimisation at the possible cost of further atrophy, increased difficulty at combating any ‘bad habits’ developed whilst in the boot; it was not one of convenience, comfort, ‘simple’ fear or the like. I was and remain convinced that an extra week or two this way or that is not going to be decisive in the overall 12-18+ month long haul of recovery. I could be wrong, of course.

I mean, the affected foot sometimes lands a little ‘flat’ (i.e. work on heel strike due); additionaly, what I didn’t see straight off: the push-off was weak (Chris spotted this); I was also fairly unsteady still, occasionally needing to rest a finger or back of a hand on the side supports (at the beginning, I was still holding on the whole time to balance properly at the slow start speeds). Nevertheless, all-in-all, I am still seeing improvements every 1-3 days.

I do like travelling by train, particularly at this time of year (so long as they’re running properly) – it’s somehow kind of soothing, stepping into a warm train from significant sub-zero temperatures at the station; this 07:37 train is particularly good for me today – it’s too late to have any school kids in it 😎!

Now, the walk to the train station … well, it’s not like the ‘Street of Doom’, but ‘soothing’ is also not a word I’d use to describe it: the last few hundred metres are a fairly steep uphill climb (that’s the 1.25-1.50km stretch in the screenshot). And the tendon is not ready for that level of tension/dorsiflexion -> doubling down on weight bearing on the crutches, the affected foot not even trying to follow through – gait on pause. Hard work with that blimmin 15kg rucksack … buuut let’s not whine, it’s doable, just hard work – my sports app says I burned over 250 calories on the way (based on my body stats plus pulse) so there’s that 😅!

This, however, kind of underlines how dangerous this time is, I think, even if I’m statistically speaking out of the worst danger zone of weeks 9-13 – so understandable how you could just ‘forget’ for a moment, do something you shouldn’t, and re-rupture. Thus, the crutches will stay with me a for a while yet – they help to remind me (and everyone else) that I am definitely not healed yet; it’s still only kind of 1/4 of the way there (to 90-98%, not 100%!) at the one year mark … and that’s IF thing’s carry on going well.

So, I skipped today’s session at the climbing gym. On the one hand, it’s kind of gutting … but on the other hand, a bit more ‘legs up’ time will help get the swelling back under control; plus, I need some time to do my exercises, catch up on this lil’ole project, do my laundry, and a thousand other things which just don’t seem to get done during the week.

I also went ahead and paid for the next 7 months Achilles.Rebuild … it’s a month or more early, but I wanted to get this done well up front. In fact, Chris’s support is now booked exactly up to and including the day of my injury … I think this is actually also just a coincidence, but I’ll have to ask him!

Positive Moment(s): Today’s a good day … I mean, most of them have been, since my injury, but sometimes there are just lots of good moments to make one smile, like a short stretch of a walk where I really felt like I’ve nailed both push-off and heel strike, with an arm swing to match. Plus, I have gained back that little bit of time required to get in and out of the boot – the shoe is just so much quicker and easier to slip into 👏 💪 !

Ankle Mobility: Currently, this unit consists of a) scar massage (also non-ops), b) ankle pump, c) active inversion and eversion, d) seated ankle dance, e) seated heel slide, f) sit-on-heels (ankle plantarflexion stretch). Additionally, there are 3 gait drills: a) weight shift progression, b) march-in-place, and c) step through.

Ankle Strength: Starts with a) 8 x plantarflexion isometric, b) 12 x banded ankle eversion, c) inversion, d) and plantar flexion, e) seated weighted calf raise (20kg / 45lbs), f) double leg calf raise – bridge/supine, g) double leg calf raise – straight, h) single leg balance.

Lower Body Strength: 1 set comprises of heel elevated a) 10 x goblet squats / b) 10 x kettlebell RDLs (with 17kg / 37lbs, initially with 5kg / 12lbs weight); c) wall sit (75s – up from 30s), d) 10 x straight leg calf raise (non-affected only, unweighted, but that needs to change), e) 10 x bent knee side plank/leg raise (each side), f) glute bridges, g) 10 x supine resisted hip flexion (each side), h) 10 x bent knee calf raise (non-affected leg only, unweighted ok).

< NOTE: all exercises have been demonstrated via video snippet in earlier posts, will try and link later >

Walking: See Thursday’s entry for 25s on the treadmill (last bit of a 10min session); see Sunday’s entry for 10s walking outside near to home (last bit of a couple of mins).

Cycling: Currently, I’m working with my local physio practice (2 x 20min sessions a week) – there I also typically do cardio on the stationary bike 3-4 times a week (120W @ 30min) plus, in the meantime, a couple of 10-15 min treadmill sessions.

This week saw me ditching the boot as already noted; this meant doing a short ‘trial’ stationary bike session in shoes for the first time on Monday, with a more or less return to normal parameters on Thursday. There were no noticeable ill effects; next week I shall start ramping up slowly.

(Note: benefits of low load cycling for Achilles rehab)

Climbing: Whilst I’m aiming to return to at least a 3 session a week rhythm, I am not so fixated on this that I will ignore other ‘signs’. In this particular case, trying to get back to the Thursday morning session was just too much effort during a work week where I’m struggling anyway; the Sunday afternoon session I ditched because of the swelling from Friday, plus generally feeling slightly ‘over-exercised’.

Even the Tuesday this week went a bit short: no climbing & no gallery exercises. Instead, it was basically more of a social event plus a little light traversing. But it’s early days … no beating myself up for missing ‘scheduled training’, rather a more tolerant taking into account of where I’m physically at, doing some ‘second-guessing’ of my AT wrt what it’s up to and what it’s not.

Exercise sessions: < still not really sure if this is the best way to display these stats … 🤔 >