When do folks start PWB?

November 10th, 2009

Hi All,

My doctor may be a good surgeon, but his office is TERRIBLE about answering my questions so I thought I would ping all of you!  I have some confusion on my PT schedule.  It is unclear what the start date is for the schedule; Is it when I had the surgery? or when I got the boot?  (My PT thinks “Week 1″ refers to the first week after surgery so he already has me starting on “week 4″ which include PWB - but I thought “week 1″ was the first week I had on the boot which is when my dr. had me start flexing and pointing my foot)  Of course, my dr. and his worthless assistant will not answer my calls…

While I know none of you can answer this, what I thought you could tell me is when you started your PWB?  While I like the idea that I could start PWB already, I am super scared of re-rupturing and being misguided by folks who don’t seem too concerned with the post-surgical part of this experience.

Thanks in advance!!!


9 Responses to “When do folks start PWB?”

  1. mari on November 10, 2009 11:08 pm

    Ugh, that sucks!
    My Dr calls me when I have a question.

    I’m 2 weeks ahead of you, just entered my 2nd week of PWB with crutches.
    It differs so much from person to person.

    I’d would light a fire under his rear and get your answers, you are employing him and he should be there to answer questions.

  2. sam66 on November 11, 2009 9:12 am

    I was in cast for 9 weeks so my tendon should’ve been fairly well healed before I even attempted PWB. Many others on more aggressive regimes have tried PWB earlier successfuly, but do be careful. I remember reading somewhere that the tendon isn’t 90% healed till around the 6 week mark.
    I would’ve thought that PT weeks don’t start counting till you actually start physio and the dr says so rather than straightaway post-surgery. Give them another ring and insist on a proper answer!
    Good luck.

  3. Kath63 on November 11, 2009 9:37 am

    Aren’t surgeons frustrating?! I’ve posted (vented) at times about this same situation. When I went into the boot at 4 weeks post-op I had a consult with a PT. It wasn’t hard core therapy, just some massage and lessons on what is basically, toe-wiggling. He coached me on PWB… with 2 crutches always. With boot a sort of gentle rolling step (my boot has a sort of rocker sole that prevents a hard flat-footed impact)and if I am w/o boot, toe-touch WB only. Seems somewhat conservative compared to others, but I err on the side of caution (fear??) b/c after reading re-rupture stories, I am paranoid!! The flip side of that is that I feel like if I don’t step it up (!!) my ankle will further freeze up, my calf will get even skinnier and this will NEVER end! I see the Doc of few words today at noon, where once again, I will ask too many questions, and hope to get a couple of answers.

  4. doster79 on November 11, 2009 12:03 pm

    that’s horrible about your doctor. if i ever call the office with a question, he has always called me back within a reasonable amount of time. i was non weight bearing for six weeks, and after the cast was removed i was very nervous just moving my foot around a little bit in the office. i was pwb after six weeks, no boot for me. went right into a sneaker with an orthotic. started off @ 10% of my total body weight, and am increasing it a little bit each day. PT 3x a week, mostly just gently stretches to gain full range of motion back.

  5. hjg3 on November 11, 2009 1:01 pm

    i was in splint for 3weeks and then boot nwb for 3 more weeks. i think i wont have pt until 9 weeks. is that too long? i rather be safe than sorry i guess.

    my surgery was on oct 22. 13 hours after rupture

  6. 2ndtimer on November 11, 2009 1:10 pm

    There does not seem to be a standard, my experience was this: I got the boot nearly 5 weeks after surgery and it was set at 30 degrees, so there was no way to walk on it like that, just touch the ground at each step. At 6 weeks my boot was set to 0 degree and I was told to gradually start weight bearing, and managed to ditch the crutches 17 days later, more than 8 weeks post-op. (keep in mind this was a re-rupture, so they were cautious, and my foot was weaker than normal)

    When discussing things surgeons and PT seem to count weeks from the day of surgery, as that is the start of recovery. My PT does not start strength exercises before 8 weeks passed by. As you are young you may have a more aggressive physio plan.

  7. ultidad on November 11, 2009 10:26 pm

    Catherine- You’ll probably get as many opinions/experiences as there are bloggers. I think most of us count the weeks as your PT is doing. By that counting, I was splinted, NWB for weeks 1 & 2; in the boot, PWB for week 3, done with the crutches by week 4, and out of the boot after week 5. At the end of week 5, when my surgeon said I could ditch the boot in favor of above-ankle hiking boots, he also said that I could start PT. Once I started PT, further progress has been dictated by my PT - such as when I could go from hiking boots to running shoes. Frankly, I would suggest viewing surgeons as being good at operating and planning the immediate post-operative period and then relying on your PT’s advice thereafter (assuming a. your PT has ATR experience and b. you trust him). Good luck, Ron

  8. emily on November 13, 2009 2:51 pm

    Hi Catherine-
    How are doing today? I’ve been venturing out with friends the past few days on one crutch- just happy to get out of the house! I’ve been using my husband’s black socks under my boot since they go all the way up to my knee:) I don’t have much swelling but I can sure feel the scar tissue building up around my tendon…Not looking forward to the PT massaging that!! My doc told me at my 9 day post-op visit to weight bear “as tolerated” which I took to mean without pain. I read several articles and it seems that those that weight bear earlier still have a similar outcome as those that don’t but they are happier:) Also you lose less muscle mass which is good. I was horrified to see my bum calf is half the size of my other one- sheesh!
    Have a great weekend:)

  9. GerryR on November 23, 2009 9:11 am

    I don’t think it is so a matter of every one of us being different as it is each surgeon having a different approach. Your surgeon sounds like a jerk, BTW and I would talk to another who may be more willing to answer questions. The surgeon is generally the one who sets the schedule, aggressive, conservative or somewhere in between. My surgeon laid out an aggressive plan for me, even though I’m 65; sutures out, PWB and begin PT 2 weeks after surgery, FWB two weeks after that and 2 shoes as soon as I could get one on my injured foot. That all got hosed up by complications but that was the plan. Assuming your physical therapist has plenty of experience dealing with Achilles ruptures, I would go along with what he/she recommends.
    And, I would consider filing a complaint with whatever regulatory agency there is about your surgeon.

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