The End

Once again, I planned to keep better track of my progress.

And once again, I've found myself with very little progress to track.

My therapist went ahead and discharged me at the end of last year. Although I was still nowhere near where I needed to be to start dancing again, I could walk mostly without pain. I had good range of motion and enough strength to perform daily living activities. And my insurance company decided that was good enough.

Even today, I still can't do a full single-leg heel raise or jump on one leg. My left calf muscle has stopped growing and I can’t run farther than a mile or two without pain in my tendon and heel.

My surgeon retired last summer, but I went back to see a different doctor in the same practice over winter break. It was my one-year check-up in December—my final scheduled appointment. She reviewed my history and I updated her on my current abilities.

I can’t say I was really surprised to hear her prognosis—I guess I’d been expecting it. But it still came as a huge blow when she told me I’d have to learn to live with my new limitations. She told me that the chances of regaining my strength beyond one year post-op were very low and that I would likely never dance again.

I was crushed. Almost four years of surgeries and therapy had amounted to nothing. I cried on the way home from the appointment and a few days later almost published a bitter post about the ineffectiveness of surgeries and how I regretted having all three of them. 

But I’m glad I didn’t post that. I started this blog because I wanted to document my progress in a way that might help others get through their own recoveries, and impulsive hostility doesn’t help anyone.

Although I had almost totally given up on the idea of returning to dance, in recent weeks I’ve become re-inspired. I attend Alma College and am a part of the Alma College Kiltie Dancers, but since I can’t dance I usually end up watching jealously from the sidelines. But one week as I was “filling in” (mostly just place-holding in a group choreography) for a dancer who couldn’t attend class, I decided to push myself. 

I was watching some of the other dancers do these huge 180 degree leaps and I was dying to try one. I hadn’t done a leap in almost four years, and I realized in that moment how much I missed them. I’d always been pretty good at leaps, and I loved the feeling, the explosiveness of them.

So I decided to try it. The first one I attempted was sort of half-hearted—I didn’t really believe I could do it and wanted to play it safe. But I realized that I could keep going, and I pushed myself further. By the end of the class I had done four leaps, and they kept getting better.

Please ignore my arms and the look of pain on my face, but the picture below was my final leap that night.

My hope was restored, despite the fact that I couldn't control my landings and my left heel was sore for the following few days. Although I realized that most of the power had come from my right leg, I started to wonder if maybe I’d been too hard on myself. I’ve always been the type of person to strive for perfection, and this definitely limits me. Sometimes I don’t even try things if I don’t already know I’ll be able to do it correctly the first time. 

It’s stupid, I know.

My achilles tendon and calf will never be the same. I’ll probably never be as good of a dancer as I once was, but maybe my dance career doesn’t have to end completely. Recently I’ve started practicing some of the easier national dances, and although I still can’t stop my left heel from dropping down to the floor, I can still do a lot of other things quite nicely. I can turn out and point my feet, even if my left-sided hops don’t quite make the cut. 

I’m not saying I’m back, but I’m trying.

Thanks to everyone who has followed along with me throughout this lengthy process. And thanks especially to my family and my dance teachers who have continued hoping even when I haven't.

This will be my last Achilles Blog post. I'm going to keep it online, but if you have any questions please feel free to email me. You can use one of the email forms either on this page or in my About section. I'd love to hear from you.

I’m Back

Part I - Positivity

It’s been so long since I’ve updated this blog that I hardly know where to start.

In the past six months, I’ve progressed from knee-scooter races to jogging a mile around the track. I transitioned from a walking boot into regular shoes with three heel inserts, and eventually I removed those too. I went from extremely restricted lower-body movements to heel raises and 135 lb. squats.

Looking back, it all seems to have happened so fast, but there were times I felt like I’d never get back to where I am today.

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Recently, I’ve been struggling to stay positive about my recovery and current limitations. Over the course of this three-year long process, I’ve often found myself thinking how unfair it is that dancers almost ten years older than me are still competing (and winning) year after year, while I haven’t set foot on stage since I was barely nineteen. I can’t even walk to the bathroom consistently without pain. My leg is useless. Oh, woe is me.

I’m embarrassingly well-practiced at throwing myself a good pity party, if you couldn’t tell.

I fell into a bit of a slump after the USIR (United States Inter Regionals—the national championship of Scottish dancing) a few weekends ago. I was thrilled to attend another USIR, but it was my first time attending as a non-competitive participant. I knew it was going to be hard for me, but I wasn't prepared for the unbelievable amount of jealousy I felt after watching all those dancers happily bound across the stage. It was great taking pictures of the dancers, seeing old friends, and running the social media page, but I'd have given anything to be dancing alongside them.

You could say I got a little mopey.

But I’m trying not to do that anymore.

If there’s one thing I learned from my competitive dancing days, it’s that attitude really does affect outcome. Of course, this idea didn’t resonate with me until long after I ruptured my Achilles tendon and packed up my ghillies. Over my competitive years, I spent countless dance practices, lessons, and competitions bringing myself down with negative self-talk, and my dancing suffered as a result.

One of my teachers, Bill, recently reminded me of a time my inner-critic got out of control during a dance lesson. Although I never danced poorly on purpose, Bill told me he could always tell the exact moment I gave up on a dance. At this particular lesson, it happened during the first step of the Sword.

I danced the step once, and it quickly turned into a disaster. He told me to dance it again, but it was even worse the second time. I don’t remember all the particulars as well as Bill seems to, but he stopped the lesson right there and basically told me to get my act together or we were done working with each other.

I cried when he told me that. I was so frustrated, but not with him—with myself.

The problem with my dancing wasn’t disinterest or laziness—the problem was that I cared so deeply and wanted to be so good that anything I did was never good enough. My split high cuts were too small and my right foot always slid down the back of my leg. My half points were wobbly and my pas de bas too weak. As soon as I started dwelling on those things, I gave up. It always felt and looked terrible to me, and when you think you dance like a sack of potatoes, you inevitably start to dance like a sack of potatoes. I was a self-fulfilling prophecy.

I wasted a lot of good years harboring this negative attitude. I sometimes wonder what kind of dancer I could have been if I hadn’t lacked the necessary grit and positivity—if I wasn’t such a self-defeatist. A positive attitude alone isn’t going to win you any championships, but when combined with just a little bit of talent and a lot of hard work, it can be the difference between not placing in the Sword and a 3rd place in the Seann Triubhas.

I think a little positivity could benefit my recovery, too. When I was writing this blog more frequently, I had to make a conscious effort to notice not only the times when my ankle was stiff and sore, but also the little victories, however infrequent they might have been. It was good for morale because I wasn’t just dwelling on the droopy right high cuts—I was noting my good turnout and pointed feet, too, if you know what I mean.

I honestly thought I’d be ending this blog with a successful 12-month post-op report after my second surgery. Signing off with a “to be continued” was draining—I never planned on writing about a bit of tissue in my left leg for quite this long. But for the sake of making progress, I'm going to try to start noticing the small things again.

Part II - A Brief Recap of Months 1-6

 At the beginning of the year (about six weeks post-op) I started working with a therapist in Mt. Pleasant, MI. I was bearing full weight at six weeks post-op and had removed all three heel lifts by fifteen weeks. I visited my doctor for a check-up at the end of March and was given a prescription for more physical therapy, this time with no restrictions.

Since then, I worked on my exercises largely unsupervised. Although I utilized the prescription initially, I spent a few weeks traveling in April/May and my appointments became sporadic. Now that I’m settled in Alma again for the summer, I’m working with a new therapist in Alma and getting back to a regular routine.

At my first appointment with the new therapist, I used an anti-gravity treadmill to practice walking and doing heel raises. It allowed me to walk at just 60% of my bodyweight, which will help me improve my gait/lose the limp. I also performed a few sets of single-leg heel raises while strapped in to the treadmill, although I could only do these at 40% bodyweight. My therapist told me it will likely take at least eight weeks to see any improvement in strength.

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At one of my last appointments with him, my doctor told me a single-leg heel raise (with full bodyweight) would not be achievable until one year post-op, assuming the surgery is a success. At this point I am still unable to do even part of a single-leg heel raise without the aid of an anti-gravity treadmill, but I'm doing a variety of exercises to work up to it. These include weighted calf extensions on two legs, seated calf extensions with weight, toe-walking, and biking. I am also starting to get back into jogging, but my gait is still abnormal.

In the past few months I have noticed some small gains. In April, I was finally able to perform a single-leg calf extension with the 35 lb plate on the leg press machine. I was never able to achieve this after my first or second surgery, and yet I accomplished it after only three months this time around. Needless to say I was thrilled—I even took a video of it on my phone. However, I have yet to increase this weight.

In addition, the bulk of my calf has improved slightly. When my therapist took my calf measurements in April, the largest part of my left calf measured 31.5 centimeters while my right was 34.5. My left calf now measures 32.5 centimeters.

As far as resting tension (pictured above), the tension on my surgical left side still does not perfectly match my right. However, I do think it has improved. By not stretching my repaired Achilles tendon I hope that the existing tension will be enough to enable my return to dancing. Keep your fingers crossed!

As usual, please feel free to contact me with any questions. Also, I want to give a shout out to Dave who recently re-ruptured his surgically repaired Achilles tendon. You got this! :)

Adventures of Scooter Girl: Weeks 1-3

I am officially three weeks post-op and so far all is well. My doctor said the surgery went smoothly enough, and while there were a few minor obstacles, the complications were minimal in comparison to my 2014 ordeal.

 Incisions at one week post-op and my lovely walking boot

 Incisions at one week post-op and my lovely walking boot

My surgeon performed what he refers to as a hamstring allograft procedure. After making the incision, my doctor removed a section of my Achilles allograft and replaced it with a hamstring tendon, which he looped through a hole drilled into my calcaneus and tightened to what is hopefully optimal resting tension. He then used a special type of stitching known as fiber tape to help prevent excessive stretching. He also removed the titanium screws in my heel from my previous surgery, as they are no longer necessary.

When my doctor began the surgery he discovered that not only was my Achilles allograft too long, but it was adhered to the other tissue in my leg. Perhaps the lengthy resting period at the beginning of my last rehabilitation is to blame, so I was instructed to perform plantar flexion exercises without resistance beginning at one week post-op this time around. Ideally, this will prevent any unnecessary tissue adherence while also lightly activating my muscles.

As is becoming customary, the first few days after surgery were the most unpleasant. I can’t seem to take Oxycodone without experiencing at least half of the listed side effects, and consequently ended up dialing the physician on-call at 3 a.m. the day after my surgery, worried that my breathing was becoming too shallow. I ended up reaching my own doctor, who advised that I take only 1 of the 1-3 tablets I was prescribed (I had taken 2) and also mentioned that another side effect was increased anxiety. So while I do believe my respiratory distress was a real concern, perhaps my fear was slightly exacerbated by the drug as well. Sorry, Mom…

I started easing off prescription pain medications two days after surgery and became aware of discomfort in my calf muscle. It felt as if I'd spent an entire workout performing weighted calf extensions, and yet my leg was encased in a bulky dressing, completely immobile. When I brought this to the attention of my doctor at my one-week checkup, he seemed pleased. This strain indicated newfound tension on my calf; perhaps optimal resting tension has finally been achieved.

I am completely non weight-bearing for the first four weeks of this rehabilitation. After returning to school in Michigan with my trusty pair of crutches, I realized I was not going to survive winter if I didn’t find a better alternative. If you’ve never tried crutching on ice before, it kind of feels like you're a newborn baby giraffe. Because we all know what that feels like.

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My mom and I tracked down an equipment rental facility in town where I picked up this bad boy. Riding it feels about as ridiculous as it looks, so I decided to go all out and install all the bells and whistles/horns and streamers. It’s been pretty good for morale.

I’m stuck in a nasty walking boot for another three weeks or so, but I only have to sleep with it on for three more days! There are currently three heel lifts in my boot and I’m not sure I’ll be taking those out any time soon, but we’ll see. Also, this week I am allowed to start performing plantar flexion exercises with the lightest resistance band. I just have to be careful not to dorsiflex my foot beyond the position it rests in the boot, as this could damage the repair. So far, so good!

Lastly, I just want to thank my parents for putting up with me during that first week after surgery. You two really do deserve some sort of award after all that nonsense. ;)

Incision at three weeks post-op, dissolvable stitches beginning to fall out

Incision at three weeks post-op, dissolvable stitches beginning to fall out

The Power of Three

I ruptured my Achilles tendon in 2013 and had an unsuccessful surgical repair. In 2014, I had an Achilles tendon replacement. Tomorrow, I will have it removed, and either a hamstring or peroneal tendon will take its place. If you’re wondering why, please see my previous post linked here.

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It’s been almost three years since I last danced competitively, and some have questioned why I don’t just move on with my life at this point. After telling me nothing could be done, my second opinion doctor commented that “a lot of people are perfectly happy not doing Scottish dancing.” It kind of stung. I have no doubt I can and will find happiness in other aspects of my life, but I felt like he was suggesting that because my lifelong dedication means nothing to millions of other people, I should just go quietly, take up knitting, and adopt a few cats.

I was lucky enough to grow up in a household with an abundance of opportunity. Over the years I participated in gymnastics, figure skating, track, theatre, and ballet. And I quit every single one of them—except for highland dancing. (Just kidding, I quit that too, but only for a few months.) A lot of people don’t know that I first started dancing because I needed physical therapy. I had a brain injury at birth that led to both cognitive and physical limitations, and highland dancing was recommended to my parents as a good supplement because it requires an equal use of both sides of the body. Not only did it challenge me physically, but it demanded social interaction, of which I was especially avoidant as a young child. It might sound cheesy, but highland dancing made me who I am today, and it’s hard to give up on something that has had such a monumental impact on my life.

That being said, making the decision to go through with this surgery wasn’t easy. I don’t think I’ve ever been 100% sure of anything in my entire life, and this is no different. I’m the grandmaster of “maybes” and my brother lovingly nicknamed me “Sits on fence,” after one of my lengthier selection processes. But it’s a difficult decision for even the most decisive person because, as could be expected, this surgery does come with risks.

There’s the possibility that my calf muscles won’t recover from another operation, or that the optimal resting tension won’t be achieved. I could develop an infection and my strength could even get worse, but I’ve decided the potential gains are worth all these risks. If I don’t at least attempt to fix this, I might always wonder what I could have accomplished. Living without regrets seems to be a trending perspective in my generation, but I'm just not that type of person. Whether it be backing down or going for it, I might regret whatever option I choose. I may as well regret the one that gave me a chance.

Anyway, long story long, I’m having surgery tomorrow. I’ll explain more about what this procedure entails at a later date.

One Year Later

In the early stages of my recovery, I was told that an Achilles allograft surgery would require more time to heal than a typical Achilles repair. My doctor anticipated a single-leg heel raise would be achievable around 9-months post-op and advised me not to expect a full recovery until the one-year mark. As of November 14th, I am officially 12-months post-op, and both of these goals are still unattainable.

Progress at this point is either imperceptibly slow or totally nonexistent; sometimes I wonder if the improvements I am seeing are simply wishful thinking. While I can execute single-leg jumps on my surgical (left) side, I must bend my knee more to compensate for a shortage of calf strength. This allows me to use my quadriceps more than my calf, and makes my jumping appear labored and awkward. I have to use my arms to propel myself upwards, and even then I just barely lift off the ground.

My heel raise continues to plateau about halfway up, and I have seen no improvements there. I’ve been using the leg press machine at my school’s gym to perform calf extensions, but after three months, I am still unable to press 35 lbs (the lowest plate) without the assistance of my right calf. I go to the gym 4-5 days a week and include these in every workout.

I have to focus on pressing through the ball of my foot when walking, which still doesn’t come naturally. I also experience regular soreness and stiffness in my tendon and heel, though I thought this would’ve faded completely after an entire year. In general, I feel like this surgery has left my leg in worse condition than before. I have video recordings of myself jumping the week before my surgery in November 2014, and it looked significantly less strained than it does today.

The Achilles tendon acts much like a rubber band and anchors the heel to the calf muscle. To function correctly, the Achilles tendon must be short enough that there is tension at every angle of flexion, but not so tight that the tendon restricts range of motion. This sweet spot is considered optimal resting tension. If the tendon is too long, it cannot effectively activate the calf muscle. This results in a loss of strength in end-range plantar flexion (pointing the toe) and explains why I am still unable to perform a full single-leg heel raise.

Coming to this realization has been extremely frustrating. Back in January I became aware of the fact that the resting tension on my left side was dissimilar from that of my right. However, when I brought up this fact with my doctor, he was unconcerned. At this time I was still wearing a walking boot with three heel lifts, so it seems unlikely that I accidentally overstretched the tendon myself. This makes me question if my Achilles tendon was properly sized upon insertion, or if all this work has been pointless from the very start.

My next doctor appointment is on December 21st. I’m not sure if surgery will even be an option or, if it is, if I’ll be prepared for a third procedure and rehabilitation. I was promised before my last surgery that my strength wouldn’t get any worse, but I feel that it has. I definitely wouldn’t want it to decrease further. I will also be talking to my doctor about the potential for regaining strength without any further surgeries.