A few days ago, I met with both my physical therapist and my doctor. I am learning that having a “care team” means that you have many appointments with people who disagree.
Heel lifts: Yes! Mountaineering: No!
My PT thinks my leg length discrepancy is about 2 mm, so she pulled off two of the layers from the adjustable heel lifts she recommended, had me put them in my right shoe, and walk around. The change in my gait was pretty immediate. I have a bunion on the same foot as my Achilles injury, and my gait is weird on that foot. With the heel lift in my right shoe, I walked pretty close to normal. Amazing!!!
We developed a plan for slowly increasing the amount of time I spend wearing the lift. Then I did one-legged squats while my PT told me she thought it was pretty unlikely I’d be ready for mountaineering season. 🙁
Heel lifts: eh? Mountaineering: Sure!
Later that day I had a video visit with my doctor. He didn’t think I would do additional damage to the tendon by hiking through the pain, although it would impair recovery. So we came up with a plan. If it’s still hurting in a couple of months, I can probably just power through mountaineering season like I have for the past 4 years and have another procedure on my Achilles at the end of the season.
The doc was less stoked on the heel lifts. He was concerned that I was now changing my biomechanics and could overload muscles that haven’t seen much use. I pointed out that existing biomechanics aren’t exactly working for me. The doc seemed comforted by the small amount of the discrepancy and the plan for easing into wearing the lift.
Urban Hiking (aka walking around town with a Camelbak)
Part of the plan was that I go on a longer walk/hike on rolling hills for an hour or more with the heel lift. And while I love my bike trainer, it’s not very transferable to mountaineering. I wanted to see if just walking would help get my heart rate in a similar zone without causing the pain that straight uphill hiking does.
So I mapped out a hilly walk in my area that was 6.64 miles with 755 feet of total elevation gain. I only had to wait for 2 stoplights, and got to walk around on some nature trails and next to Lake Washington. Not spectacular scenery, but not bad. The walk took me 2 hours … and my Achilles did not hurt! I was able to keep my heart rate in zones 1 and 2 for about 2/3 of the hike, so I got a decent training effect.
While it will probably still be awhile before I can get back to uphill training hikes, this is a positive development.