1 week on at the 2-shoes stage
I have been under the guidance of my PT for one week now. My progress is apparently excellent and she is pleased that I am getting more and more comfortable walking around without crutches in my shiny new 2-shoes (see below, these shoes are great because their adjustable straps allow swelling). She only took my boot away last week for the first time in 8.5 weeks, so lots has happened in the last 7 days. It only took me 2 days or so to completely ditch the crutches. I have a funny limp as I walk, but apparently developing normal gait is going to take some time yet. My ROM is fine, though still a few degrees off the normal range. Calf is weak, as expected. So more playing with elastic bands for me, and more balancing practice too (I could almost do 15 seconds on the bad leg).
One thing she got me to do is to balance on a wobble board. I don’t know if others have experienced this but it looked super dangerous and difficult to me and I was scared stiff of it. The point of this board was to see where I place most of my weight, and as expected, I tend to put it all on the back heel. Apparently, I am supposed to try to consciously shift it more towards the front of the foot, so it is more evenly spread over the leg. I don’t like this wobble thing and hope to never see it again. Anyone else met the scary wobble board?
Apart from balancing and fun with elastic bands, she is also getting me to try and very very gently lift the heel of my legs (including the bad one!) off the ground, while using my fingers to lean on something. This feels dangerous and early and I am too scared to do it. Has anyone else been told anything to do this quite this quickly in their treatment? She said it will gradually help to stretch and strengthen the tendon.
Things are good otherwise, not much swelling to report and I managed to walk 35 min (at my snail pace) without any break stops into town the other day, so I am happy enough with that. No stationary cycle for me yet (my PT does not seem to think it is quite the messiah that other PTs appear to believe it is, so she is not reccomending it. I will apparently join some gym circuit group at some point in the next few weeks though, so maybe then!?! not sure yet).
Happy healing everyone!
August 19th, 2010 at 11:25 am
Sounds like great progress to me.
I have used wobble boards BEFORE i ruptured my tendon. i can see how they strengthen but it seems a bit ‘violent’ for a still repairing tendon.
i’m in cast #1 with my toes down, so any kinda walking sounds good to me!
brad
August 19th, 2010 at 11:34 am
Hi Andreea,
That wobble board does sound scary. At your stage, falling forward awkwardly and pulling your tendon too hard is a real danger. If it were me, I would say, “Thank you, no.” I had a faster rehab than most, but I found that balance itself wasn’t really the problem, it was just not having enough calf strength to catch my weight if I started falling forward that limited my “balance” progress.
Your mild limp will be around until your calf is much stronger, and can lift your heel off the ground before the other foot touches the ground in front and takes some of your body weight, especially with longer strides.
Regarding your other comment about going up and down stairs, a slower but safer way is to turn sideways, with your hands on the railing behind your back, and go up and down the stairs with sideways steps. I did this when my flexibility was not there yet, and I had to keep my injured foot farther forward.
Good luck,
Doug
August 19th, 2010 at 11:36 am
Brad,
I can’t resist asking, what is your link to Ann Arbor? I was born there, and come from a family full of UM grads.
Doug
August 19th, 2010 at 12:08 pm
I also uses an wobble board when im at my PT, but i always uses my hands to hold on to something too. So im just using it for controlled movements back and forward, and sideways. So no balancing excersise, but just controlled strengning movements. I would not try standing on it without something to hold on to. I really doubt that i could do that before my ATR
Know i think my best rehab is walking with shoes again, as im experiencing my movements is getting better, and i feel stronger every day.
So keep up the good work Andreea, but its your AT, not your PTs
August 19th, 2010 at 12:11 pm
Thanks everyone for your comments. It’s, nice to know that I am not the only paranoid wuss around here re: the wobble board. I think Ronny is using it in the same way as I am supposed to: to help strengthen rather than help with balance, and I was also allowed to hang on to something too while on it. It’s still scary people, sc-aaa-ry! I think the PT has realised I am not keen on it so I doubt she will bring it out of the toy-cupboard again (though my partner was terribly sad he didn’t get a go on it).
Daoug: thanks for the stairs tip, will have to try it out!
Ronny: Good luck with the recovery and happy walking, great to hear your progress!
August 19th, 2010 at 3:01 pm
Andreea: is this the round board with a half sphere under it or the smaller one that only rocks back and forth. I can see the latter being good for controlled stretching, with arms on a wall or weight machine just in case.
Doug: I work for Pfizer (was Warner Lambert). I work from home as they closed the Plymouth Road site in 2007-2008.
My softball team is “Pfazed-outs”, with lost of ex and current pfizer people (softball is how is did my rupture)
Football Saturdays are right around the corner!
August 19th, 2010 at 5:54 pm
PTs aren’t any closer to perfect — having gotten 100% at school and now getting 100% at work — than surgeons or any of the rest of us! After my first ATR, my PT bullied me into doing as many 1-leg heel raises as I could, WAY too soon, and I lost exactly a month because of it! On another Achilles blog (Marfell Family Achilles Forum, IIRC), they surveyed their bloggers who re-ruptured, and summarized how it happened. One of the biggest reasons was “Physio”!
It’s your leg when you’re dealing with a PT, just as it is when you’re dealing with a Doc, so don’t turn off your judgment. 8 years ago, I told my PT that I wasn’t ready to do 1-leg heel raises, because (as I told her) I knew I could never do 8 of them. That’s when she said “so just do as many as you can”, and I was dumb enough to take the bait! Do as I say, not as I did!
BTW, my fave way to walk down stairs in (early) 2 shoes is the same as my fave way to walk down stairs in a boot: Step down onto your “good” foot normally, and roll over it normally.
When you step onto your healing foot (one more step down), carefully place it on the edge of the step, so 1/2 - 2/3 of your foot is hanging over air. Then you should be able to roll over that foot SORT OF normally, without putting any strain on your healing calf-and-AT.
It’s a very subtle cheat, and your appearance and your speed will be remarkably “normal”, while the forces on your healing parts will be way gentle. Do NOT talk on the phone (or maybe even in person!!) while doing this, though, because each step is IMPORTANT!
This rehab gives new meaning to “Watch Your Step!”
August 20th, 2010 at 4:45 am
This board is the latter, the one that only rolls backwards and forwards (no round thing underneath it).
August 20th, 2010 at 4:49 am
Thanks normofthenorth. I guess it is tricky because if I was all that knowledgeable, I would not go to the physio in the first place. There is a certain amount of trust I am putting in her to ask me to guide me along. When she first took my boot away, I was scared to be without it and somewhat reluctant, so I am prob. naturally more cautious than average. It’s good to hear your experience though, and I will try to trust my gut instinct. My instinct tell me I am not ready to do much heel lifting off the floor yet perhaps. So might not do that for now.
August 20th, 2010 at 1:53 pm
The other thing that my professionals were keener on than I was — and where I quietly ignored some of my PT’s instructions — was in stretching my calf and AT.
Fairly early on, I could dorsiflex just about as far with the healing ankle as I could with the other one (long-healed from an earlier ATR & surgery). My PT still prescribed a bunch of fairly aggressive stretches, which I mostly “mailed in”, i.e., I didn’t do ‘em.
Heck, if you end up with a very slightly tighter-shorter AT than before — as I actually did the first time, after surgery — it doesn’t seem to do any noticeable harm, even in aggressive high-risk competitive sports. But if it’s OVER-stretched, and heals too long, it can easily create a serious functional deficit, and even require surgery to fix it.
My two ankles are now indistinguishable from each other in ROM in both directions, so I think I did OK.
BTW, when I told my first surgeon that I had a very slightly tighter-shorter AT than before, he said “Good! That’s what I was aiming for.”
And finally, there ARE good reasons for knowledgeable people to go to a PT! I think it’s very hard to give yourself a good deep massage, and most of us don’t have the fancy lasers and ultrasounds and electro-stim devices (and Biodex strength measurers) that most PTs come with, either.