FHL Tendon Transfer - Rehab 2


It has been exactly ten weeks since my surgery.  I’m done with the boot two weeks ahead of schedule.

Recap> As you may recall, I am 62 years old, I wrote-off my Achilles tendon, so I had an FHL Tendon transfer to repair the rupture.  The FHL tendon connects your big toe to the FHL muscle in the calf.  The doctor snips the tendon, drills a hole in your heal bone,  stuffs the tendon in there, and uses a screw to anchor it.  I climbed for six months with the rupture and adapted my FHL tendon and muscle to stabilize my foot. Since I was already using it, the tendon relocation simply gave me a better lever arm and the use of the rest of my calf muscle.

The doctor said 2 weeks in the boot progressing from 20% to 100% weight bearing.  Then 2 weeks no boot, progressing from 20% to 100% weight bearing.  My flexibility and strength were excellent so he said not to bother with a heal wedge.

I was full weight bearing in the boot in a day.  All too easy.  Then I experimented with no boot. Also easy, no problem, but limited stability, so I went for a hybrid. No boot in the house and a boot out in the world where there was more risk.  After a week of that, walking without the boot was easier that walking with the boot, so I parked the boot.

I am still on twice a day rehab.  Bands, massage and ice.  I’ve added partial weight bearing raise on toes, and then full weight bearing isometric foot extensions, holding my body weight up on my toes.  I’ve had some muscle soreness in my calf and some mild tingling on the surface of my inner heal.  While walking I feel tightness in my calf just below the knee when I try to extend my stride.  I’m still avoiding doing any direct stretching of my new AT/FHL hybrid. I’ve had no problems with my gate, other than a slightly shorter stride length. I’m quickly re-adapting to having use of my calf muscle again and can roll forward onto the ball of my left foot as I walk.

Anything involving putting full body weight on the ball of my left foot it still totally out of the question. The strength and stability isn’t there.  But its just been 10 weeks and I am way, way ahead of schedule.

How does my foot look?  Almost normal. Swelling is almost gone. My AT/FHL hybrid is fatter that the original and I still have a slight indentation where the original AT resided.  My scar is almost invisible.  Swelling during extended periods of sitting has subsided dramatically.  Its all good.

I’ll do my next post after the doctor takes a look in two weeks.  I plan on asking for a PT appointment so I can have my progress evaluated.

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