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.