Gymnopodal Therapy

It’s now been 10 weeks since the surgery to repair my ruptured Achilles tendon. Maybe it’s time for an update.

I spent 6 weeks with my foot pretty-much immobilized. At the end of that period, my calf muscle on that side looked like an empty bag of skin (and that actually fairly accurate). The tendon itself was definitely healing (according to my surgeon) but it was still at the stage where I had to be very careful about re-ripping it.

By the way, if you don’t know how these things go, when the Achilles tendon ruptures, it’s rather like ripping apart spaghetti (or, for that matter, cutting a metal cable under tension). The ends of the strands that make up the tendon just go all over the place.

Here’s a picture. (Yeah, I know it’s gross.) On the left you can see the two ends of the tendon that are at either ends of those stitches, before they’ve been drawn back together. Just blobs.

Pulling the Ends Together

Then on the right they’ve tightened the stitches up to pull the two ends together, where, as far as I can tell, they just butt them together. (Somehow, I thought they might connect strand to strand? Nope. That would take forever and a day.)

But the body is smart enough to start reaching out to the other side and making connections.

So, at 6 weeks I started physical therapy.

My surgeon was already concerned about how I was messing up his standard protocol. It said, at week five, that I could even try wearing cowboy boots (something with a lift). He knew that wasn’t going to happen. In fact, the protocol has a lot with elevated heels.

So he had me wear a weird strap-on surgical shoe that had lifts inside. I have to admit I didn’t use it much. With my physics background I had a pretty good idea what sort of positions would put stress on the still-healing Achilles, so I was really careful in that regard. And once I started physical therapy, I pretty much discarded it.

Early on, physical therapy was a lot of range-of-motion and simple isometric exercises.

(BTW, I have nothing but good words to say about physical therapists. They really know their stuff, and of course are used to working with people without shoes on. That’s how you get your range of motion and exercise everything.)

But after a bit, I was putting weight on my foot standing flat. (OK, at first for only 5 seconds, but 10 times of that.) At 8 weeks, I was ready for some gymnopodal therapy.

Gymno: naked. Podal: of the foot.

I went on a hike. I figured that would use the foot in a way that was much more “natural” than the physical therapy. I figured that was some of what I needed. It was also a bit of mental therapy, just to get out, and just to be able to feel like I was progressing.

So, on that hike I did a total of about a third of a mile. With crutches. I used the crutches (as I did for walking in general) to keep the weight off the ball of my foot (which is what puts stress on the Achilles). I even hiked a bit of that not using the crutches, but just being very careful to keep most of the weight on my heel.

Oh, and it was on gravel. (Fine gravel, but gravel nonetheless.) You can see where I was (and the gravel) here.

My sole hasn’t peeled yet, and I wanted to remind it that I’d really prefer if it didn’t. I have noticed that the skin that used to be well-keratinized has turned spongy. (The equivalent on my other foot is still mostly fine.)

The following week for a hike I went to Shallenberger State Nature Preserve. That’s a place that’s part of my Southeast Ohio Hiking Areas. I had not been there for quite a while, since when I was going out hiking I usually wanted to hike a farther distance. Right now that is no longer the case.

So, I got there and took a quick glance at the kiosk.

The Shallenberger Kiosk

Ah, I noticed, they have a new, topo-based map of the place (bottom row, third from the left). Let’s take a look at it.

Their “New” Topo Map

Hmmmm. That really looks kind of familiar. Where have I seen that before?

When I got home, I checked to make sure.

My Shallenberger Map

Yup, they borrowed from my website the map I had made. Yes, they changed the colors, but it was the same map. (I’m sure because when making one of these maps, I use the terrain and changes in elevation to estimate my position. If I were to do it again, I would have different estimates. There map tracks mine way too closely for them to have done their estimates of trail location.)

Oh, well. I guess I’m glad for the use. (Though I wish they’d given me credit.)

Here I am hiking along.

Gymnopodal Therapy

It really was nice just to get direct sole to dirt. It also gave my feet a strengthening challenge beyond physical therapy. There was uphill; there was downhill. (Not much, though.) My feet had to deal with side-to-side angles, and my toes had to grasp what I was walking on. And I really exercised my proprioception. You just don’t get that with shoes on!

In addition to dirt, I also navigated roots.

Sticks and Stones are Good for Bones (and Tendons)

And sticks and stones. Again, I had to be careful not to exceed what my tendon was capable of. That meant no exclusive weight on the ball of my foot (or even much bending of the angle upwards with weight on it).

But, oh, it was so nice to fell like I was back in the game.

At my physical therapy this past Tuesday (3 days ago), I walked in with minimal use of my crutches (see, things are improving!) and the physical therapist noticed me doing so. He was quite supportive (of course, in carefully protective situations). And I’d already done some standing on just my rehabbing for for 30-second stretches. So, he officially took me down to just ONE crutch. Progress.

I celebrated by heading back to Shallenberger. And I figured a hiking stick was just like a crutch, right?

At Shallenberger I did the full loop around Allen Knob. That was a total of 3/4 mile. It had a lot more up and down (and in locations I had to be particularly careful, because there was mud, and it was steeper than I’d done before).

Pretending I’m Normal

But I made it around. Took me an hour and twenty minutes (average speed: 0.56 mph), but hey!

You know, there may be something to gymnopodal therapy on top of physical therapy. At this point, I’m up to 2.65 miles of it. (Yes, I’ve been telling my physical therapist about the hikes—he’s fully supportive.)