Archive for July, 2012

9wk Ortho Visit - I find the outcome very disappointing

Okay, so 9wk review with the OS today and after a less than delightful 2hrs and 44minute wait I got just over 7minutes of my OS’s time….the outlook for the next two ( possibly 4) weeks is gloomy.

So the Ortho Doctor I got today, was just reading notes left by the Ortho director, move boot to 7.5degrees and come back in 2 weeks to set at neutral - but I adjusted the boot to 7.5degs myself 9days ago and was confident they’d be pleased and just go to neutral in the boot (neutral in the boot is actually past neutral in reality)…. he just stuck to the notes - leave at 7.5degrees for two more weeks….the guy never even looked at my ankle :(

During our brief discussion, I mentioned UWO, the reply I got was that a more recent study in Belfast showed that the protocol they are following (using the hinged boot and adjusting RoM every two weeks) was as effective.

I asked to review the ultrasound scans, where he mentioned that that my ‘rupture’ being right where the calf muscle meets the tendon ‘could not be any higher’ - I do get the distinct impression that the rupture being in a position that, should a re-rupture occur, surgery would be complicated/nasty……. if I can say anything about these doctors, they do have this calmness about them that does install confidence in how they want you to proceed…. were it not for what I have read here about being more agressive in the recovery protocols, I don’t think I’d feel bad about what they suggest.

I am confused/conflicted now - because I am not wearing the boot around the house (when they say I should), I am doing light physio (when they won’t book me in or recommend it), I can walk up and down stairs reasonably comfortably, my dorsiflex is improving every day and I am compelled but confused about manually adjusting the boot…. I’ve been at this setting for over 9 days and again the leg dorsi flex beyond the boot setting.

It just goes to show how little I know and how broad the ideas are on rehab protocols, forget globally, even in the UK alone.

I’d love to hear what you guys and gals think :)

Feeling so capable and yet so delicate…

I am forever testing myself during this healing process (it’s better than being bored I guess) and today I feel I’m progressing beyond the boot in terms of ability, at the same time I feel so fragile……examples:

1) My RoM is well beyond neutral now, if I take a position like in the kimjax pics - my knee is touching the frame
2) I can walk in trainers and go up and down the stairs barefoot, tendon/calf is a bit tighter going downstairs than up
3) I walked from my car to the house (30mtrs so nothing huge) in my trainers

But at 8 weeks POST ATR and conservative healing, I remind myself now of how delicate this freedom is right now - I feel very aware that I am in the zone of not having enough agility or muscle to react to the unexpected and potentially do more harm.

So after every test or exercise I do, I force myself back into the boot, mine is hinged so I get to walk and use my ankle in that controlled environment…….

7wks and 6 days, drove my car for the first time since the injury…..

Bouyed by some of the stories here and taking the right level of caution for the same reason, I gathered myself for a test today…….

Using my boot to get from the house to the drive, I got in the car, swapped hinged boot for trainer, simulated acceleration with control and hit the breaks hard for a simulated emergency stop……everything was okay, my heart was racing with some excitement, so I did it again and again and again, it felt good, I felt as though I was able to apply the right level of control for the accelerator and more than enough breaking pressure and after all this, I was able to drive my car today for first time since ‘that evening’ May28th 2012.

Today, my fellow ATR comrades, is a milestone and a particularly good day :)

Happy healing all :)

Considering adjusting your own boot?

Okay, so my flexibility is coming back to me and it’s beyond where the boot allows and I feel ready to progress after just 5 days from my previous adjustment - I know how to adjust the boot and my next speicalist appointment is not until 31st July (it’s at 15degs right now and 7.5 degs is the next step).

Should I adjust the boot so it allows me to be closer to my flex limit or should I remain in this current state for the next 10 days?

EDIT: I adjusted it and it feels like the right thing, the rolling motion of the boot is making the ball of my foot do some work as I walk with the boot on but you also become aware that there’s no muscle memory and I feel conscious of every step I am taking…..I am going to leave as it is for tonight and re-assess in the morning.

Disclaimer: I did this knowing my own limits, being fully aware of how to adjust the boot and the risk I was taking, I was very careful in how I did it and had crutches and a friend around me as I first put the boot on and walked…….if anyone else decides to try this they do so at their own risks.

Atrophy is cruel…….

Last night, just before I went to bed and for the first time - I looked in the mirror and compared my legs, my ATR leg is so much thinner than my left leg :(

It’s worse because I am Right footed for football (soccer) and since my cruciate ligament op on the left leg a few years back, I knew that I compensated for the left using the right more, eventually something had to give and it did….it’s been a few years, but I recall measuring both calfs with a tape measure and my right calf was about 2cm larger than my left, so to see that same calf looking so weak, it’s amazing how quickly muscles disappear when not used.

So now my right calf looks miserably thin…..I am not worried though, I can’t wait to start building it back up and I have visual goals to reach too….. I think I am gaining momentum to get back into a much more healthier/regular exercise regime and this is the unfortunate kick start to do it and do it right :)

I must be stretching my leg every night when I sleep, the tendon and calf feel tight for a few hours when I get out of bed….. it’s a dull ache rather than any pain, I’d scale it a 4 when it peaks and a 1 once it’s settled….. but I can flex more than the boot allows already…and I can go barefoot and hobble slowly and quite gingerly around the living room so we’re making good progress.

Happy healing all :)

7wks in……..

Had my appointment at the ortho center today all was well, was quite the wait, my appt was booked for 10:50 and I was seen at 12:45.

It was a swift 15min discussion finishing in my boot being adjusted from 22.5 degrees to 15degrees the plan being to be at 0 degrees in 4 weeks (11weeks from date recovery started).

So I am not neutral yet, the 15degrees tugs on my tendon, which I suspect is what it needs to do if I am to reach neutral and beyond?

I am also gaining more perspective as to why we need crutches when these things are first done and can understand why it’s good sense to use them when first going to two shoes, safer to ease into it over a few days.

I Asked about physio today and was told that my boot is the physio for now and that physio sessions start when I go to two shoes…. wierd, but okay, this sounds less agressive than I was expecting to be honest.

Am home now and the amount if movement in the boot is still tight on my tendon…. which of course makes me terribly nervous and being honest, a little scared in fact… I’d welcome some words from ‘the club’ here on this.

Overall I would say today was progressive, no major milestones reached, but we’re heading in the right direction.

Happy healing all.

Compression Sock are… FANTASTIC

Occasionally ordering on the web is not as fast as you want it to be, it’s taken nearly a week for my compression socks to land and to me thats longer than
I have come to expect from online ordering.

Now I have them I don’t want to let them go, I don’t know the level of compression I have, I just orders these

They are banded left and right, so the sections of compression must be tailored specifcially for each foot, but these things squeeze the swelling out of the ankle region a treat, they feel funny at first and after two hours I took them off for 15 mins, then I put them back on and forgot about them.

What this reduction in swelling does for me though, I can move my foot more freely now, things feel (and look) more natural and I sincerely feel as though these are now a ‘must have’ recovery aid.

So Just a small update, but compression socks are so important to me I thought it deserved it’s own section in my recovery blog :)

Crutches Free Walking!!

As the title suggests I am now walking (in a fashion) around the house and can go up and down stairs crutches free :)

I checked with the specialist and had my boot adjusted today to accomodate the range of motion I found after I worked off the stiffness gained whilst in the cast, the boot was re-set to accomodate this…..I was able to practice ‘walking’ on the new settings and I feel I am now in ‘the zone’. I also had it confirmed that I am PWBAT but not FWBAT so I am still walking around like a fencer with my AT foot leading and this is the way to go… for now. Pushing to walk normally (within the confines of the boot) is something we will work towards during the next full review……but if I feel ready I’ll probably give it a go before then.

Also the missus pointed out I was mistaken and I am not walking/standing evenly, with that in mind, today I ordered the “Evenup Limb Leveler” which will help me when I am ready to start walking properly.

It’s not the most comfortable style of walking, my AT heel aches a lot even after a short period of time - I can’t see me walking to the newsagents and back just yet, but as Sheena found out, just being able to walk and carry things around the house…….. feels chuffin fantastic!!

WK5…got the boot, but…..

Sooo, I got the boot, it’s a ROM walker too, yaaaaay :)

But my ROM was pretty limited and the boot was set based on my immediate capabilities out of the cast, now that I am home I have a bit more plantar flexions (toes pulled toward shin) so I am limited by the walker now, but out the boot things are limbering well and airing on the side of caution whilst walking around is all good for me.

By the way, I walk like I am a sword fencer now, slapping my ROM boot in front of me and have the trailing good leg play catch up lol :) 

I wish I could hold my foot neutral though, because I was told I could sleep with the boot off (great!!) but all the velcro tearing as I put it on for a bio break is bound to wake up the missus, who really dislikes being woken once asleep…. having a neutral foot position would of allowed me to use a bed brace…….open to suggestions though.

I was not prepared when I saw how swollen around the heel was still not looking great… I thought it’d be looking more regular by now.

Being able to choose if I should have a bath or get a boot cover and have a shower… little glimpses of freedom coming back, makes me feel much better about the situation.