Full Achilles Rupture

Running again; April 18, 2011; 10 Months Post-Surgery

Andrew Tucker — Tue, 19 Apr 2011 15:05:01 +0000

After 10 months of being cautious about a possible rerupture, I can finally get on a treadmill and run at a decent speed again with confidence. Here’s my exact workout 10 months out and my goal workout 12 months out:

10 months:

Duration: 45 minutes

Stretch/warm up = 5 minutes; Walk treadmill at 4.0 = 2 minutes; Run treadmill at 6.0 = 5 minutes; Repeat walk/run intervals same speeds until I get to 30 minute total treadmill workout.

Boxing = 10 minutes; I hit the bag for 2 minutes at a time going hard with short breaks to get that feeling of breathing heavy again

Lifting = Limited on cardio days, typically work in pullups, push ups, sit ups and step ups

12 month goal:

Duration: 1 hour

Stretch/warm up = 5 minutes; Run treadmill for 30 minutes straight at 8.0

Boxing = 20 minutes

Light Lifting = Pullups, push ups, sit ups and step ups

* Heavy Lifting = Sub for boxing with bench, squat, clean, box jump (the workout pre-surgery)

Week 12: Walking again, another visit to the surgeon

Andrew Tucker — Wed, 04 Aug 2010 02:26:30 +0000

It’s August 3rd, I’m 3 months out from surgery, and I’m walking 3/4 of a mile and stationary biking up to 25 minutes.

Despite the increase in strength, my scar is still sticking to my tendon about 4 inches up from my heel. If the scar does not fully separate from the tendon I’ll have to get another surgery in 3 months.

Week 7: Down to One Crutch, Neutral Dorsiflexion

Andrew Tucker — Mon, 21 Jun 2010 04:17:51 +0000

Finish Line PT is getting the job done. I can bike for 20 minutes now – last week I could only do 10. Biking with the boot is awkward because you can’t fit the pedal strap over the boot, so you basically just have to push with the heel of the boot and then strap in the other foot normally. Either way, just moving the legs again for the first time in 2 months is a great feeling.

I’m now able to walk with one crutch, and getting up and down stairs much easier. People at work don’t have to carry my stuff to meetings which is uplifting. I’m hoping that the next PT session Tuesday shows more results. This week my trainer wants to see my dorsiflexion go past neutral (image below). If you were to point your toes to the ground and then lift your foot, your foot will be perpendicular to the ground in a dorsiflexion neutral position. Going past neutral requires the strength in the achilles to pull the foot closer to the ankle…that’s the goal.

Dorsiflexion neutral

Week 6: Finish Line Physical Therapy, New York, NY

Andrew Tucker — Thu, 17 Jun 2010 01:31:45 +0000

With state of the art equipment, young trainers, and a list of patients that range from rec warriors to triathletes, Finish Line (located on West 23rd between 6th and 7th ave) gives you the feeling that you’re in the right place. On June 10th, I hobbled in and was greeted by Andy, who took my insurance and showed me the facility. The first thing I noticed was that it was clean and the machines were new, a great first impression. Check out the website below:

http://fle.wcds.net/index.html

My trainer Brynn knows what she’s doing. I know this because I’m seeing results. By my second session on June 15th, she had me on the stationary bike going faster and using more force than ever before. We worked on isometrics, where she applied more force to my foot than had been applied in previous weeks by my first trainer, and I was able to push back against that force with greater strength and mobility.

Most importantly, by the end of the second session I started full weight bearing in my boot, meaning that I could put all my weight down through my right heel as I walked, while still using crutches for balance. This is exactly where I’m supposed to be according to the protocol my surgeon issued. Some people will disagree with me, saying this is too conservative (see comments to the right), but I don’t think I’d feel comfortable going any faster. We’re on a good pace.

FIFA WORLD CUP SCHEDULE

Andrew Tucker — Fri, 11 Jun 2010 13:49:05 +0000

http://www.fifa.com/worldcup/matches/index.html?cid=google_onebox

Also, check out these notable sports injuries that will be preventing star players from playing in World Cup 2010. Ironically, one of them is a full achilles rupture – David Beckham.

http://blogs.reuters.com/soccer/2010/06/10/the-missing-world-cup-xi/

Week 5: Second PT Session, June 1

Andrew Tucker — Sat, 05 Jun 2010 16:04:45 +0000

While Steph (physical therapist) wasn’t looking, I took a picture of my progress chart. The chart is loaded with symbols and acronyms and I am waiting on a response from Steph with a full translation. This cryptic PT jargon has my head spinning.

The rest of the session was the same as my first – scar mobilization, ankle stretches, ice -except for two major differences. (1) I began PWB (partial weight bearing) at 30 percent of my body weight (56 lbs of pressure) in my walking boot. Putting weight down was a humbling feeling. (2) I began isometric exercises using applied force from a second party (in this case Steph) in four directions – pushing down with my foot against force, pulling up with my foot against force (hardest, because it requires most tension on the tendon), inversion and eversion.

Week 4: First PT session, May 28th

Andrew Tucker — Sat, 05 Jun 2010 01:47:47 +0000

My fist PT session was at a small clinic in Cranford, NJ. After a $30 co-pay and finding out that I get 50 sessions per year under my insurance plan (Not nearly enough, I’ll likely pay out of pocket to complete the PT), I met Stephanie, my physical therapist. She was not interested in being filmed for the blog, so I took a bunch of photos from the office. The first day was very basic. Stephanie took measurements to see what kind of progress I had made in my exercises at home. I still had some catching up to do.

Protocol May 28th

1) Wet Heat Wrap, 10 Minutes

2) Gentle scar mobilization, Ankle Pump, Inversion / Eversion exercises (video to come), Ankle Curl Circumduction, Measurements for range of motion taken with force applied

3) Ice Wrap, 5 Minutes (This helped, as ankle was swollen that day)

Week 3 – Exercises at home before formal PT begins

Andrew Tucker — Wed, 02 Jun 2010 20:11:41 +0000

There was a one week lag between when I got my splint off / sutures out and when I saw the Physical Therapist for the first time. During Week 3: May 17 – May 23, I started my Rehab Protocol on my own. See the photos below:

Exercise 1: Ankle Pump (avoid bringing ankle past 10 deg of neutral)

Repeat 20 times per set, 4-5 session per day

Exercise 2: Range of Motion: Inversion/Eversion

Repeat 20 times per set, 1 set per session, 4-5 sessision per day

Exercise 3: Ankle Curl (Circumduction)

Circle foot clock and countclockwise 10 times, 4-5 times per day

Rehab Protocol – Exercises and Benchmarks Set

Andrew Tucker — Wed, 02 Jun 2010 19:05:39 +0000

The is the Achilles Injury Rehabilitation Protocol that was given to me by my surgeon and passed along to the Physical Therapist for implementation. You can view the “Rehab Protocol” at any time by viewing the Rehab Protocol Page in the main menu at the top:

Week 1 (May 3 – May 9)

In splint
NWB (Non Weight Bearing)

Week 2 (May 10 – May 16)

Sutures remain
Placed in boot with heel lifts
ROM (Range of Motion) full PF to 10 degrees PF
NWB

Week 3 (May 17 – May 23)

Sutures removed
Inversion/eversion/circumduction
Still limited to 10 degrees PF
Isometrics
Gentle scar manipulation
Continue NWB in boot with heel lifts

Week 4-6 (May 24 – June 6)

Begin PWB FWB in boot with heel lift 33% Body weight per week to FWB Week 6
Isometric
Theraband exercises
Gentle exercises bicycle with pedal under heel
Active ROM with knee flexed to neutral
Scar mobilization

Week 7-8 (June 7 – June 20)

Continue FWB in boot removing 2 wedges each week until using none
Balance board and proprioceptive exercises
Stationary bike
Continue scar mobilization and stretching to neutral

Week 9-10

FWB in clogs (shoe with higher heel)
Begin double legged toe raises
Balance board and proprioceptive exercises
Stationary bike
Continue scar mobilization and stretching to neutral

Week 11-12

Progress to regular shoes
Treadmill
Continue double legged toe raises
Balance board and proprioceptive exercises
Stationary bike
Continue scar mobilization and stretching to neutral

Week 12 plus

Begin single legged toe raises as tolerated
Stretching past neutral
Treadmill walk jog program
Add cutting exercises 4-5 months
Running allowed at 5-6 months
No explosive jumping, tennis, racquetball, and squash etc. until 1 year out

Weeks 2 and 3: Post-op pain, seeing my new leg

Andrew Tucker — Tue, 01 Jun 2010 02:21:52 +0000

The “Injury Photos” page above tells the story of Weeks 2 and 3. Warning: if you have a weak stomach you may not want to see post-operative pictures of the wound and leg area in 7a) and 7b). It does serve as a good example of what to expect if you’re going through the surgery.