Finishing up week 5 of PT

We subtracted the kettlebell-up-on-toes walk from the program due to the sharp pains I am having on the outside of my heel, when going up/pushing off on my toe.To sub in for that, I am doing heel raises. Can’t initiate one with the op foot yet, but what I do is go up on both toes, then take my weight off  I can get a fraction of an inch off the ground on the op foot by itself. It’s a start. 

I have been massaging the area on both sides where I’ve had those zings of pain – the ones on both sides directly below my ankle bone on both sides, where the bottom of the foot meets the side. It seems to start on the bottom and radiate up. If I keep going, it eventually numbs out and remains there, only dull. The PT massaged the one on the lateral area pretty thoroughly the other day. I have been massaging it myself and noticed that it feels a little … crunchy? Snappy? Clicky? … in one certain spot where the pain seems to originate. So I will ask him tomorrow if he noticed that when he was massaging. Makes me wonder if it’s remnants of bursae that need to break up. Definitely feels better and freer today after massaging last night. 

I don’t know how much longer I’ll be in PT. He hasn’t told me we are wrapping up in x number of weeks. I have an ortho followup in a week, which will be 14 weeks and 1 day post op. I am pretty confident I’ll be released back to work full duty – I’d better be, because I put myself on the schedule covering open shifts!

 

That familiar Zing…

… It reared its ugly head again. Outside of foot on the heel, directly below my ankle, starting from the bottom of my foot and shooting up. I have been trying to get 10,000 steps per day in and I’m cleared to do anything I want except jumping/plyo. I was walking the dog on the same flat, paved park path we’ve been using and all of a sudden… Zing. 

I limped for a good 1/4 mile after that then the spot sort of numbed out. I finished my 3ish mile walk, went about my day, and when I got to a place where I was going to be sitting awhile, iced my foot. It feels ok now so I guess it’s just more scar tissue breaking up. 

94 days post op, end of week 4 physical therapy

This has been a good week of building strength and endurance. The dog is happy to report we’re going for lots of walks. New things this week:

• my physical therapist massaged the incision and tendon, and showed me how to have my husband do it. It was a little uncomfortable, but felt great and flexible afterward.
• I realized I’m going to be a much pickier shoe ho. I’ve already gotten rid of a beloved pair of Merrell low hikers and my Brooks runners, and a few other randoms I frankly never wore, because they rub my heel the wrong way now. This is a first: I tried 3 pairs of shoes the other day, and realized none of them would work with my incision. Maybe it’ll get easier after it’s desensitized, but for now I’m more than a little bummed.
• 3mph!! on the treadmill. That’s a moderately fast walk for my short little stumps.
• I put myself on a 90 day challenge of sorts, hoping that I forget after 90 days that said challenge ever existed and it just becomes my life. Part of that is 10,000 steps a day. I’ve been getting that most days, pretty easily. I love comparing pre op and post op after a 10,000 step day. What a difference. After a 10k day pre op, I would be out of commission for anything but painful waddling for the next several days. Now, I still have a stiff first several steps, but once I get moving it feels great.
• Day 107 post op I have an ortho followup. My physical therapist led me to believe I’ll be released back to full duty after that. I’m ready. The only movement I should avoid at this point, I have been told, are plyometric jumping types of moves. Everything else is GO!

I guess it’s time to get used to waking up for work again…

PT Week 4 – focus on strengthening

What a difference this week. Most of the pain on movement is gone. If there is any discomfort now, I’d call it stiffness. Feels like I need a good calf/achilles stretch (but not sure how much of that I’m allowed to do, so I just stretch it out by walking). Also feeling a faint occasional sensation of adhesion at the incision site. Feels like someone left a strip of double sided tape inside there. I watched YouTube videos demonstrating how to massage that area, but they made me cringe. I should note I’m not a squeamish person at all. The massage technique was just that rough. 

The week 4 routine is geared toward building strength.

• Treadmill at speed and time tolerated with emphasis on good heel to toe gait. Today’s new speed record – 2:8mph. Almost normal! (I’m short)

• Squat press 130lbs with balls of feet/toes – sets of 10, at least 50 – at extension weighted plantarflexion for 5 count then dorsiflexion/stretch for 5 count

• BAPS on setting 4, clockwise x100, counterclockwise x100

• Balance board (finally able to use the taller one for everything!) plantarflexion/dorsiflexion x100, inversion/eversion x100

• Balance on op foot on balance cushion, Karate Kid style – non op leg bent at knee up high and arms out to side – x15 for as long as I can stand

• 10 laps walking lunges. 

• Sumo squats with 25lb kettlebell, up on toes at end of rep – 50
• New – weighted with 25lb kettlebell on each side, walk across room, going up on toe with each push off. This was hard and damn near impossible on my op foot. If it’s like everything else that I’ve done, though, I will see results in  how I handle stairs or other routine movements, and by next session I’ll be better at the actual exercise. 

Having read about many others’ post op experiences, I have to say, I am really grateful for being a best case scenario case at this point. It’s great to have a physical therapist I trust, that knew my abilities pre op. 

 

 

12 weeks out. Another milestone!

 

Those arrows indicate where I have been having the most discomfort when walking or doing physical therapy since my surgery 11/20/13.

Initially, the bottom of my heel felt crunchy and achey, but that subsided in the first couple weeks of full weight bearing. Rolling the bottom of the heel on a frozen water bottle, then blasting it with a hot tub jet later in the night, really helped to break up whatever that was – my physical therapist thought it was probably early bursitis. 

So anyway, I started PT today with my usual treadmill walk. It was pulling on the right (lateral) side more so than the left side. It usually does when I’m warming up. At some point while on the BAPs board or balance board, I distinctly noticed that I didn’t notice that pain anymore. Doing the seated weighted squat press/plantarflex/dorsiflex, I felt it minimally. Usually by the end of that set of exercises I’m really sore. Today, I moved on to walking lunges feeling like a million bucks. 

Added something new today: sumo squats with a 25lb kettlebell, finishing the move with a calf raise (both sides) and hold for 2 seconds. It felt great! Obviously I could tell my non-op side was bearing the brunt of the weight. However, during the lunges I was to go up on my toe on the forward leg. I noticed a huge improvement on the right side just since last week, and it has translated to stairs becoming much easier. I’m getting my push-off back. 

PT Week 3

Much the same as week 2:

• Treadmill at speed and time tolerated with emphasis on good heel to toe gait. I got up to 2.6mph today!
• Squat press 130lbs with balls of feet/toes – sets of 10, at least 50 – at extension weighted plantarflexion for 5 count then dorsiflexion/stretch for 5 count
• BAPS now on setting 4! clockwise x100, counterclockwise x100
• Balance board (finally able to use the taller one for everything!) plantarflexion/dorsiflexion x100 ,inversion/eversion x100
• Balance on op foot on balance cushion, Karate Kid style – non op leg bent at knee up high and arms out to side – x15 for as long as I can stand
• 10 laps walking lunges. Therapist threatened to weight me this week for lunges, but after my glute on the non-op side seized up on the first lunge, he had mercy on me. I had to stop everything and stretch for about 5 minutes. It’s still really touchy. Thank goodness for the hot tub on the back deck.

Something I took notice of the last several days: Sore today = feels great tomorrow. Feels great today = will be very stiff tomorrow. So, that’s good incentive to stay active.

 

Ending the week on a good note

PT went really well today. No change to the routine, but I was hurting less, feeling stronger, and my form was so much better in all of the exercises. Especially the lunges at the end. I had really been dreading them, but ended up doing 5 more reps than I was supposed to do because I was feeling so good. Even made it up onto my op foot toe when lunging the other foot forward – couldn’t do that Wednesday. 

Next week, I don’t know what else he’s adding, but he said I’d be doing the lunges weighted, with a medicine ball or something. Yikes!

78 days / 2 miles

The dog and I did 2 slow miles on the paved walkway in the park. By the end of it, as expected, I was doing the ol’ Haglund’s Hop – my name for the short limpy stride my right leg takes on when it’s tiring. 

I will go home and rest and ice a bit, though I haven’t really had swelling for weeks. I think I may do some tendon massage and some balancing on the op foot just for fun later. Back to PT tomorrow. 

No pain, no gain

It really is true. PT continues, Monday/Wednesday/Friday. Yesterday I did all of the Monday stuff, and also added walking lunges. The purpose of those is general balance and functionality for work. I was  hurting when I left there yesterday. Both sides of my heel under the ankle bones and the Achilles itself. Came home, iced for 45 minutes, then hit the hot tub for a couple rounds. That definitely helped, though I was still stiff and sore. 

Today… woke up feeling great. There is some expected muscle soreness from the lunges and weight work, otherwise the Achilles and the whole foot feels great. 

PT Week 2

Added more activity this week with some weight work. This week’s routine:

• Treadmill at speed and time tolerated with emphasis on good heel to toe gait
• Squat press with balls of feet/toes – sets of 10, at least 50 – at extension weighted plantarflexion for 5 count then dorsiflexion/stretch for 5 count
• BAPS on setting 3, clockwise x100, counterclockwise x100
• Balance board (moved up to taller one this week) plantarflexion/dorsiflexion x100 – (still on smaller one) inversion/eversion x100
• Balance on op foot on balance cushion, Karate Kid style – non op leg bent at knee up high and arms out to side – x15 for as long as I can stand

I did something on the treadmill at the beginning that tweaked something in my foot the wrong way. Maybe I should lay off the music. A good song came up in my shuffle and I decided I was going to walk “fast” (2.5mph) to it. The zing of pain was in the medial aspect of the heel, nowhere near where anything was cut or anchored. I’ve heard it’s pretty common and it did get better with activity. My PT attributes it to scar tissue breaking up. Anyway, that continued to zing me throughout therapy and during the passive stretches the therapist did after. My frozen water bottle works great for the bottom of my foot, but is too shocking for the sides,so I purchased a freezeable/heatable neoprene and Velcro wrap. It helped quite a bit, then I hit the hot tub and jetted the heck out of the bottom of my heel. Woke up this morning no worse for the wear, and was happy about that.

I think I’ll take the dog for a quick (ha!) walk around the block. I’ve been doing enough pf/df that I think I should be able to handle the hilly streets.