Tag Archives: physical therapy

2 Year Since Achilles Rupture

2016-09-11-13-05-53It has been two years since my Achilles rupture and I thought I post an update. No update is a good thing right? I’ve pretty much been going on about life as if I have never had the injury. There is no tightness when I walk or run. I have no reservation when I exercise. I don’t need to take any medication or supplement. For my wedding anniversary, my wife and I scaled a 1000 ft hike and I had no issues. Here is the picture from that hike!

The only slight inconvenience is some tightness when I squat and some muscle atrophy. The atrophy is not noticeable but I am reminded of my injury when I explode my calf muscles to jump or kick a soccer ball. I cramp often when that happens. To be honest, I haven’t kept up with all of the exercises. Daily life and busy-ness got the better of me. It’s just a matter of commitment. I do occasional calf raisers during shower and try to tire it as much as possible.

All in all, I am doing well. Very happy with my surgery. Treatment was very good. My scar is very smooth as well as the skin. Aside from the incision marking, you can’t tell from the texture of my skin that I had surgery. After the surgery, my Achilles was extremely thick due to the scar tissue.

My left Achilles that ruptured compared with my right one. (Sorry for the bad angle).

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Below is my batte scar. You can’t tell from the picture but it is very smooth. All the therapy worked!

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At this time, I want to thank you for reading all the posts and joining me in this journey. I see each and every one of your visits and can see this blog brings value to your journey whether you are going through this yourself or someone you care for. Keep it up. There is life after this surgery which is an active one. Feel free to email or contact me for any questions. I’ll be glad to elaborate.

5 month post surgery and last physical therapy

This week I had two milestones. It has been 5 months since my surgery to repair my Achilles and yesterday I went through my last physical therapy session. I don’t know if it was a mental thing but I also felt very comfortable walking without any pain and only minor tightness. When I wake up, my Achilles is tight but slowly becomes more loose. I can feel strength and barely limp especially when I have shoes on. When I am on my bare feet, there is still some struggle when lifting my heel off the ground when I take a step.

All in all, I am happy with my progress. I was hoping to be able to get into full activity including sports by month 6 but that looks like it will have to be pushed out. I still cannot jog or jump. I can somewhat manage a job but its really oblique and doesn’t look or feel like a job. It is best not to push it and slowly stay with the strengthening regimen of strengthening my calf and muscles around my foot.

I decided to end my physical therapy due to two reasons. The primary one being the cost. On April first, my deductible will reset and  I will need to pay the full amount out of pocket. Second reason is that I am already set with my exercise routine. As long as I am disciplined, I should be good to go. The physical therapy office I went was a godsend. They were very helpful and diligently worked with me to ensure I did my exercises correctly and pushed my reps just the right amount. I left them with some cream puffs so I hope they enjoyed it! I would highly recommend them if you are looking for a place near Pasadena.

Achilles physical therapy – 75% weight bearing

gamereadyNov. 24th. I’ve been to physical therapy several times now and know what to expect and am very comfortable. Due to improvements to my condition, I am now able to go 75% weight bearing which means I can use only one crutch on the opposite side of my foot with the Achilles rupture and walk. This is much more natural as I am able to swing my arms the way I would when walking. I always start with scar tissue treatment using the Granston method and deep tissue massage on my calf. Here is a list of exercises I do regularly at physical therapy and at home.

1) Ankle pumps to loosen up the Achilles – 20 times
2) Rotate my ankle – 20 times each direction
3) Write out the alphabet with my toe from A to Z – 2 times
4) Band exercises – various
-dorsiflexion and plantarflexion – 3 x 15
-45 degree plantarflexion inner and outer  3 x 15
-90 degree plantarflexion inner and outer 3 x 15
-clams to work on hip both sides – 3 x 15
5) Picking up marbles with my toes onto a plastic jar
6) Seated calf raisers

I end each session icing my foot to decrease swelling. The physical therapy center uses a GameReady compression machine which really helps. It circulates ice water while compressing on your injury.

Introduction and Timeline

On Oct 13, 2014, I ruptured my left Achilles. At the time of the rupture, I was a healthy 35 year old male, 6′ 2″ and about 210lbs. My physical fitness was semi-active. I work from home but try to manage cycling 1-2 times a week and play full court basketball at least once a week. So I wasn’t completely out of shape but I wasn’t in super great shape either.

In hindsight, I don’t think you can pinpoint the cause of the rupture. I played competitive sports throughout high school and lettered in volleyball, basketball, and soccer all 4 years. I put my body during those years very hard. I was young so I thought. Much of my problems came from my knees but never any foot or ankle problems.

About a year before the rupture, I did see the doctor to have my left Achilles checked out. I often would wake up in the morning with a very stiff left foot. The doctor indicated it there was some swelling on my Achilles and was diagnosed with tendonosis. I was given a few leg strengthening exercises and off I went. One more checkup and the pain went away. Laziness got the better of me and I stopped doing the exercises. At no point did the doctor say there was going to be a risk of a rupture. Thinking back, it was likely precursor to the full rupture.

Here is a timeline view of my blog posts of my recovery.

Oct 13 2014 – The Rupture
Oct 14 2014 – visit chiropractor, MRI
Oct 15 2014 – MRI confirm full rupture
Oct 16 2014 – Dr. L. No surgery date. Soft cast taken off
Oct 17 2014 – iwalk arrives
Oct 18 2014 – First Weekend
Oct 21 2014 – Dr. J. Surgery confirmed for Tuesday Oct 23
Oct 23 2014 – Surgery
Oct 23 2014 – Immense Pain Post Surgery
Oct 25 2014 – Side effects
Oct 29 2014 – Pain in Calf / Cast Removed
Oct 31 2014 – Nutrition post Achilles surgery
Nov 4 2014 – Post Op appt, stitches removed, limited exercises
Nov 14 2014 – physical therapy
Nov 18 2014 – Post Op appt – 50% weight bearing
Nov 21 2014 – physical therapy
Nov 24 2014 – physical therapy – 75% weight bearing
Dec 1 2014 – physical therapy
Dec 3 2014 – physical therapy
Dec 8 2014- physical therapy
Dec 10 2014 – physical therapy
Dec 15 2014 – physical therapy
Dec 16 2014 – Post Op appt – No crutches!
Dec 17 2014 – physical therapy – 50-50 Boots
Dec 22 2014 – physical therapy –
Dec 29 2014 – physical therapy – no boots
Jan 13 2015 – Post Op appt
Jan 21 2015 – physical therapy
Jan 23 2015 – 3 months post op update!
Jan 28 2015 – physical therapy
Feb 4 2015 – physical therapy
Feb 12 2015 – Legoland Trip!
Mar 11 2015 – 4 months post op
March 26 2015 – 5 months post op and end of physical therapy
May 2 2015 – Business Trip
June 29 2015 – 8 months post op
Oct 2 2015 – Jogging
Dec 18 2015 – one year and 2 months post op
Jan 4 2016 – Back to basketball!
March 25, 2016 – Visiting New York City after Achilles Rupture
Nov13, 2016- Two years update

Nov 21 Achilles Physical Therapy

Just shy of one month since surgery to repair my Achilles, I had my 2nd physical therapy session. I’m still in the boot most of the time but it is nice that I can now take a bath without any concern. Being that this was the 2nd session, I was less nervous. The session started with more observation of the scar and swelling. It still swells especially if I move it a lot of put it down. I have occasional throbbing pain but not as bad as when the first two weeks out of surgery. Steve worked with me using the grastron technique to settle the swelling and scraping the scar tissue. He also helped massage my calf which is actually more painful then my Achilles and worked on my actual surgery scar. He encouraged me to use my fingers to break the tissue around the scar so it won’t heal firm.

Now finally to some exercises. This is the menu I was given which has a list of exercises, movement, and icing.

  • foot pumps x 30
  • Write alphabet with my toes x 2
  • Seated toe raisers
  • Band exercises
  • Clam (for my hip)
  • Ice

I’ll upload a video that is probably easier to explain.

Update:
I couldn’t find the video that was taken at this time so I just made a new one. Disclaimer, I am not 11 months removed from my surgery so the range of motion will be much more than someone who just had surgery a month back.

 

Nov 14 – physical therapy

Physical therapy for my Achilles tendon rupture couldn’t come fast enough. I know this would probably be the most difficult part of my recovery, even more difficult than the surgery. I’m not a very patient person. When I want to get things done, I want it done in the fastest and efficient way as possible. This is the exact opposite. Achilles tendon rehab is going to be a long and will require a lot of patience as it heals extremely slow. Slow than bone and muscle.

I was a bit nervous at first but the people at this clinic made it very easy to get acclimated. People were very friendly and every chatted with each other. People of all walks of life were here. You see high school athletes who had an injury playing pep sports to the retired fireman who tore an ACL while mountain biking. Everyone had their war story and how they get there.

I worked with Stephen, an intern who graduated from USC, and was toward the end of his 3 month turn. Stephen was very attentive and worked with a seasoned PT to ensure I was on the right track. As I just had the stitches taken out, there was very little I could do in terms of exercise and how they could work on me. The did spend a lot of time deep tissue massage my calf as it was in pain. They used a scraping tool to help the scar tissue. I believe it is the Graston technique. They scrap the tissue to help the soft tissue align. It also helps with increased blood flow and helps alleviate swelling.

They measured how far back I could pull back my toe without discomfort and measured it for record. There were very little exercise I could do. As for actual exercise, I were to move my toes to stimulate blood flow and push my foot against the boot or the arm of my sofa. That’s it. My physical therapy indicated that the following week I can try some band exercises.

After I was done, I iced my foot and hobbled back on my iWalk2.0.

This will be a long journey.

Post Op appt, stitches removed, limited exercises

Nov 4 – Day 11 post Achilles operation first appointment. This was the day I was originally supposed to have my cast removed but I had it removed earlier in the week as I thought it was causing my calf pain. I have been in my boot have been zero weight bearing. To get around, I have been using my iWalk 2.0 but for the most part I stay at home hunkered on my couch with my leg elevated. I cleaned myself by submerging myself in my bathtub which is more like a soaker. I elevate my left foot and tie a garbage bag over it to ensure I do not get it wet. I continued to take both the morphine and the oxycodone. Good news is that I was getting sensation back to my foot and toes. I can actually feel them when I move.

2014-11-03 10.51.39The dr. appointment went smooth. It was a challenge to make my way to the doctor’s office but I just took my time. I initially thought that the stitches would melt away but apparently it had to be removed. Just a nip on one end and tweezers on the other end to pry out the sutures did the trick. It did hurt. Surprisingly, there were two total which had to be removed. I thought there were several but that was it. He then used surgical tape to seal the wound just in case.

Next, the doctor cleared me to begin physical therapy. He asked if I had a place in mind and 2014-11-06 16.47.27that they had one right next door which I can try out. I honestly didn’t and it was convenient to be able to check out a place right next door so I went ahead and made an appointment. My first physical therapy session was going to be Nov. 14th. One month after the rupture and 20 days post op. Meanwhile, I continue to move my toes to encourage blood circulation and elevate my foot above my heart to minimize swelling.