Cast off, boot on. What to expect from physio?
My cast was taken off last Tuesday, seven weeks and six days after my ATR. I’ve now got an Aircast boot with one wedge in it.
Just after the cast came off the consultant did the Thompson test and my toes moved, which was quite a relief. He asked me to push my foot down on his hand, and I was able to put some pressure on. Likewise lifting it was fine too. So that was all excellent news, and seemed to show things are going to plan.
My calf muscle is much smaller but there’s still quite a bit of mass there, even if I can’t tense it fully at the moment.
So, I was given an Aircast boot, and told everything looked fine and I was discharged. I had my physio assessment booked for the next day.
It all felt like great progress, but I left the first physio session feeling confused. The chap I saw was fine in that he checked the tendon again and was reasonably upbeat about how things were going. But he wouldn’t give me a good idea on how things might develop from here.
He said the Aircast boot was not totally necessary as I could be doing my PWB in shoes. This was surprising, but he said I should keep using it until my next appointment, which is on 6th January. I have a maximum of six sessions on the NHS, but I might only need 2 or 3.
Does that sound right? I have a sheet with some exercises I can do at home, but I get the feeling from other blogs that some physio is very hands on and more frequent.
Anyway, I am taking it as an indication that things are going well. But, I’d really like to spend a decent session with a physio who’ll take me through the exercises, and give me strong indication of how much I can push the tendon. Hopefully that will happen in the new year.
I don’t want to sound like I’m moaning, but some more answers from consultants and physios who are treating me would be very, very welcome. Thank goodness for this website! Happy Christmas!
I definitely hear what you are saying. I was told there was no need for PT because my foot was progressing normally. However, I want to play in a charity softball tournament in May, so I really want to know how much I can ‘push’ myself without pushing too hard.
Deanne (aka DREAMS)
Sounds about right. I got my boot sooner than you did but was walking in two shoes around week 6-7. It’s a slow process and you’ll see improvement on a weekly basis.
Hi Alex,
Sounds like solid progress to me. I was in my Aircast boot after six and a bit weeks and after a couple of tricky days was really pleased with it. Bit surprised to hear your physio say it’s not totally necessary: I was shaky when I got mine and very apprehensive but the boot allowed to build up confidence and start walking pretty well. I’ve just been given the nod to come out of it and the progress I made in the three and a half weeks with it on was very pleasing - swelling right down, foot looking ‘normal’, etc.
As for physio, I’ve arranged mine through my insurance and had three so far. None planned through the NHS. I’ll be having quite a lot - been told once the AT is ‘fixed’ they’ll be looking in to finding out why I had the injury and looking to remedy whatever problem caused it.
So far, my sessions have comprised mostly of some basic range of motion exercises, massage (not the tendon itself, but the calf muscle, which has been painful), and ultrasound treatment. Last week I was given a theraband and have been doing some gentle stretching with that.
This is about right as I have had a re-rupture. I’m post op +2weeks now and come out my cast in 3 weeks and start physio the next day where before I was out my air boot near on a month and never got to get to physio as the tendon went pop again. Looking forward to hearing what they have to say. And yes no info from doctors at all not happy about that at all.