I am daily feeling gains in strength in my injured leg, both in terms of balancing in my boot and walking with more strength. The PT is getting more adventurous as I improve as well.
One aspect of that is scar tissue remobilization. I am just at the beginning of that process but for now it involves gentle massage of the incision site. Some spots feel good to have this treatment, but a couple of areas, especially near the top of the incision are less enjoyable. I have heard this gets more intense and less comfortable sometime in the future.
In general, I am progressing quickly and should be starting to do some work outside my boot in the next weeks. I sneaked standing on my injured leg without the boot a couple of times and found it to be strong and comfortable. Not trying to roll forward on it yet but I think that is coming soon. My therapist described the next weeks as a series of levels to reach and then I get to move to the next level. Everyone's timeline is different at this point, but once you can do something, then you can try the next. For example, I have been one-legged biking with a bike trainer I borrowed from a friend the last couple of days. Now that I can balance on my injured leg in the boot I can add the second pedal. I will still be biking in the boot, but can have a more natural biking experience. Once this gets comfortable, I think elliptical training will be next but will wait until later this week to find out about that.
I have tried two different massages in the last two weeks. Somehow our insurance is more in favor of massage than acupuncture so I wanted to see what benefits I could get from massage on top of my other treatments. Last week, I got more of a relaxing massage except for some deep tissue work on my shoulders. It probably was good because it helped me break some defenses down after the surgery but really wasn't terribly therapeutic in any way. This weekend, I went to see Katie Cook Massage and got an entirely different sort of treatment. Her thoughtfulness and methods were completely different from the previous weekend. She seemed to work on fixing function of parts of my body and my posture, and doing this by manipulating soft tissue. I can't say it was enjoyable (it actually was near my upper pain threshold frequently) but I can already feel some changes. My neck and shoulders are moving better. She tried to fix the alignment in my hips that has been messed up by walking in the boot - the difference in heights is somewhat unavoidable. This morning, I noticed that I was walking on my tip-toes on my right foot. Amazingly, my hips wanted to stay at the same height instead of twist to accommodate the differences. I'm sure I will reverse this with more walking in the boot, but it shows what she can do for me once I am out of the boot. It was such an interesting experience, I think I bored Teresa with stories from my treatment by telling so many but I was fascinated by what she did. There are stops that she pressed on that I didn't know could be sore. I think both Teresa and I will be using her services to keep us running smoothly as we escalate our exercise intensities into the future. I would recommend her even if she wasn't our neighbor and friend!
As I mentioned before, Teresa has been starting to run and enjoying it. Once I am free to go into the outdoors again, she will be running loops to get her cardio with me along. I don't mind but we are both preparing mentally for this role reversal. I think she is quite excited about leaving me in her dust...
Sunday, July 17, 2011
Wednesday, July 13, 2011
Starting PT
Now the fun really begins! I had my first and second PT sessions last week and started walking with a boot and crutches and now can walk without support. I am using a cane to try to level out the walking a little but am walking enough to make my shin sore while everything else is feeling great.
The main focus of the PT is on strengthening and not on range of motion at this point. I didn't quite understand the therapists explanation of the mechanisms behind this (I was trying to spell the alphabet with my foot and somehow it took all my mental focus to do that) but the main concern is over-stretching the tendon. If that happens, it will be really hard to have strength in the range of motion required to push forward. So for now, building strength is the key. I could start doing some riding of my bike on a borrowed trainer but wasn't strong enough to change the pedals over the weekend. I will try again soon.
Last Wednesday after PT, 4 hours at work, and learning to walk again in the boot, I had an acupuncture treatment. Ever since the surgery, I have been extremely sensitive to the needles - much more than before. Part of this is that she can't "confuse" my nerves in my ankle area by pressing on them prior to inserting the needles because it would hurt too much to press that hard. Part of it is that my system is still a mess and needs some time to get back to normal. And some if it is due to the slight swelling I am still working on below the injured area. She has been focusing on getting things in better alignment, healing, and reducing swelling. I am also continuing to take a suite of chinese herbs to help with the swelling and keep my calves relaxed. As far as I can tell, all this is helping me. My most recent treatment was my most "normal" yet. She thinks that the herbs and treatments have me doing better than I was before the injury (except for my achilles of course). But my pre-surgery status was related mainly to trying to rebuild my body after the stress of the tenure process.
The tenure process is an interesting experience. You put every fiber and thought into getting as much done as possible before you have to send your packet out for review. You barely see family and friends, take on too many projects, and are always looking for one more paper. I really enjoyed the lag between submitting an article to a journal and hearing back because it meant I could focus on another project. I was working at a rate of submitting or re-submitting an article every month for the last year and a half of the process and was right at the upper limit of my productivity during that time. And some projects fell to the wayside and some surprised me to get done quickly. One surprise was a paper just recently accepted to the electronic journal of applied statistics (for statisticians, the acronym EJASA is not a coincidence).
The story behind it is not really all that typical: I was working with some Arctic researchers on other projects and they brought me a side project looking at presence or absence of certain microbes in different layers of ice cores. The data set wasn't conducive to inference, really it just needed a nice description of the patterns observed. I did a standard hierarchical cluster analysis but the reviewers wanted some revisions on the paper. I ran into a different type of clustering more suited to the binary nature of the data set and showed the results to them. They thought it was nice but that the plot was hard to interpret. So I made it better. And that application paper got accepted. And then I used the same method on a data set from the Examining Mathematics Coaching (EMC) project that I am funded on and showed it to those collaborators and they thought it was interesting as well. So I wrote a paper describing the method being used and why the graph I developed was useful, and suggested some different areas of interest for its application. I think it took me a week to write the paper although it was built on my previous work and feedback from great collaborators. The first reviews wanted more of a contrast between methods and I added that to it shortly after the semester ended. I am happily surprised about its subsequent acceptance but it shows that small novel ideas can get you publications without years of work. And sometimes years of work on a project barely gets you a publication.
The main frustrations of last week have been hearing the recovery timeline re-iterated and some stiffness in my neck. My neck has improved, but I am still faced with the following. The surgeon says 6 months to fully unrestricted activity and the physical therapist said that I will struggle to recover my previous strength for up to around a year. So my week has included the excitement of walking, returning that awful scooter, starting my PT, getting an article accepted... and then thinking about a long time to getting back to where I was a month ago. But I feel like I have a good team around me - PT, acupuncturist, wife, and dog. And I will get to cross-country ski this winter so I can't wait for the snow.
The main focus of the PT is on strengthening and not on range of motion at this point. I didn't quite understand the therapists explanation of the mechanisms behind this (I was trying to spell the alphabet with my foot and somehow it took all my mental focus to do that) but the main concern is over-stretching the tendon. If that happens, it will be really hard to have strength in the range of motion required to push forward. So for now, building strength is the key. I could start doing some riding of my bike on a borrowed trainer but wasn't strong enough to change the pedals over the weekend. I will try again soon.
Last Wednesday after PT, 4 hours at work, and learning to walk again in the boot, I had an acupuncture treatment. Ever since the surgery, I have been extremely sensitive to the needles - much more than before. Part of this is that she can't "confuse" my nerves in my ankle area by pressing on them prior to inserting the needles because it would hurt too much to press that hard. Part of it is that my system is still a mess and needs some time to get back to normal. And some if it is due to the slight swelling I am still working on below the injured area. She has been focusing on getting things in better alignment, healing, and reducing swelling. I am also continuing to take a suite of chinese herbs to help with the swelling and keep my calves relaxed. As far as I can tell, all this is helping me. My most recent treatment was my most "normal" yet. She thinks that the herbs and treatments have me doing better than I was before the injury (except for my achilles of course). But my pre-surgery status was related mainly to trying to rebuild my body after the stress of the tenure process.
The tenure process is an interesting experience. You put every fiber and thought into getting as much done as possible before you have to send your packet out for review. You barely see family and friends, take on too many projects, and are always looking for one more paper. I really enjoyed the lag between submitting an article to a journal and hearing back because it meant I could focus on another project. I was working at a rate of submitting or re-submitting an article every month for the last year and a half of the process and was right at the upper limit of my productivity during that time. And some projects fell to the wayside and some surprised me to get done quickly. One surprise was a paper just recently accepted to the electronic journal of applied statistics (for statisticians, the acronym EJASA is not a coincidence).
The story behind it is not really all that typical: I was working with some Arctic researchers on other projects and they brought me a side project looking at presence or absence of certain microbes in different layers of ice cores. The data set wasn't conducive to inference, really it just needed a nice description of the patterns observed. I did a standard hierarchical cluster analysis but the reviewers wanted some revisions on the paper. I ran into a different type of clustering more suited to the binary nature of the data set and showed the results to them. They thought it was nice but that the plot was hard to interpret. So I made it better. And that application paper got accepted. And then I used the same method on a data set from the Examining Mathematics Coaching (EMC) project that I am funded on and showed it to those collaborators and they thought it was interesting as well. So I wrote a paper describing the method being used and why the graph I developed was useful, and suggested some different areas of interest for its application. I think it took me a week to write the paper although it was built on my previous work and feedback from great collaborators. The first reviews wanted more of a contrast between methods and I added that to it shortly after the semester ended. I am happily surprised about its subsequent acceptance but it shows that small novel ideas can get you publications without years of work. And sometimes years of work on a project barely gets you a publication.
The main frustrations of last week have been hearing the recovery timeline re-iterated and some stiffness in my neck. My neck has improved, but I am still faced with the following. The surgeon says 6 months to fully unrestricted activity and the physical therapist said that I will struggle to recover my previous strength for up to around a year. So my week has included the excitement of walking, returning that awful scooter, starting my PT, getting an article accepted... and then thinking about a long time to getting back to where I was a month ago. But I feel like I have a good team around me - PT, acupuncturist, wife, and dog. And I will get to cross-country ski this winter so I can't wait for the snow.
Tuesday, July 5, 2011
4 weeks post injury, 3 weeks post surgery
Happy 4th of July weekend!
Recovery continues to progress well. I had a bit a swelling and discomfort the last few days as I have gotten more active and started trying to move my ankle around but it is enjoyable to get things working again. I expected some pain as I start to break the scar tissue up and form better tissues in the area. Being able to directly ice my ankle has provided some nice relief and kept the swelling down. I took an opportunity to explore some of the literature related to achilles tendon ruptures (ATR). There seems to be studies indicating no evidence of a difference with and without surgery after 6 months. Those studies might have ignored looking at differences in trajectories over time as they all seem to use relatively simple statistical analyses to compare different outcomes at fixed time points. I wonder if they are missing differences in recovery at earlier time points... More on this later when or if I find some studies I want to use in my class in the fall and really dig through the details.
I have been enjoying watching Teresa get into running in the last couple of weeks. It is early days for her doing this, but she seems quite taken with it. Before my injury, we would go for bike rides and I would often ride ahead and then loop back to ride with her for a bit. Whenever I get back to doing fun stuff, I suspect she will be giving me the same treatment. It will be a while before I get to going ahead of her again.
We have been dealing with fireworks "season" here in Bozeman, MT. In 2004, non-flying, non-concussive fireworks were legalized for July 3, 4, and 5th (I guess). This has lead to Bozeman sounding like a war-zone for about a week around the 4th. We tend to hide in our basement a few weeks to try to get some sleep and let our dog keep from overloading in adrenaline. Our personal problems with this vary depending on how much our close neighbors choose to violate the law. This year was one of the worst in recent memory... I like to think people are generally clueless about the actual laws here (Bozeman ordinance), the impacts on pets, babies, wildlife, the environment, and people that actually try to work in the mornings during this time of year. An interesting article about pollution from fireworks and a potential method of reducing it for professional shows is here. I think Bozeman's "real" show had fewer loud concussive fireworks and was much less jarring than previous years. I appreciate that change and wish all of our neighbors would read and obey the regulations. I also wish the city would ban all fireworks because most people seem to have missed (or outright disobey) the nuances in the current law.
I really like Bozeman but I do think the city council has missed the boat in their regulation of fireworks and the police in terms of trying to enforce the laws. I don't really blame the police, because I think they have many difficult laws to enforce at this time of year.
I will stop ranting about fireworks as I am headed out to the doctor to get fitted into my boot. It will be interesting to see how hard it is to walk now. My calf muscles now can contract and I am only lacking a few degrees of flexibility in the injured foot. I will be really happy to be free of crutches and scooters in the near future...
Recovery continues to progress well. I had a bit a swelling and discomfort the last few days as I have gotten more active and started trying to move my ankle around but it is enjoyable to get things working again. I expected some pain as I start to break the scar tissue up and form better tissues in the area. Being able to directly ice my ankle has provided some nice relief and kept the swelling down. I took an opportunity to explore some of the literature related to achilles tendon ruptures (ATR). There seems to be studies indicating no evidence of a difference with and without surgery after 6 months. Those studies might have ignored looking at differences in trajectories over time as they all seem to use relatively simple statistical analyses to compare different outcomes at fixed time points. I wonder if they are missing differences in recovery at earlier time points... More on this later when or if I find some studies I want to use in my class in the fall and really dig through the details.
I have been enjoying watching Teresa get into running in the last couple of weeks. It is early days for her doing this, but she seems quite taken with it. Before my injury, we would go for bike rides and I would often ride ahead and then loop back to ride with her for a bit. Whenever I get back to doing fun stuff, I suspect she will be giving me the same treatment. It will be a while before I get to going ahead of her again.
We have been dealing with fireworks "season" here in Bozeman, MT. In 2004, non-flying, non-concussive fireworks were legalized for July 3, 4, and 5th (I guess). This has lead to Bozeman sounding like a war-zone for about a week around the 4th. We tend to hide in our basement a few weeks to try to get some sleep and let our dog keep from overloading in adrenaline. Our personal problems with this vary depending on how much our close neighbors choose to violate the law. This year was one of the worst in recent memory... I like to think people are generally clueless about the actual laws here (Bozeman ordinance), the impacts on pets, babies, wildlife, the environment, and people that actually try to work in the mornings during this time of year. An interesting article about pollution from fireworks and a potential method of reducing it for professional shows is here. I think Bozeman's "real" show had fewer loud concussive fireworks and was much less jarring than previous years. I appreciate that change and wish all of our neighbors would read and obey the regulations. I also wish the city would ban all fireworks because most people seem to have missed (or outright disobey) the nuances in the current law.
I really like Bozeman but I do think the city council has missed the boat in their regulation of fireworks and the police in terms of trying to enforce the laws. I don't really blame the police, because I think they have many difficult laws to enforce at this time of year.
I will stop ranting about fireworks as I am headed out to the doctor to get fitted into my boot. It will be interesting to see how hard it is to walk now. My calf muscles now can contract and I am only lacking a few degrees of flexibility in the injured foot. I will be really happy to be free of crutches and scooters in the near future...
Subscribe to:
Posts (Atom)