13 Weeks in…..Bored

Confidence seems to be an issue for me right now, that and the two week gap between physio appointments.

The good news:

Exercises are doing great, walking is doing great (okay I still limp if I don’t focus, but it’s great if I shorten my stride :) ), I can walk up stairs on the balls of my feet (ATR leg starts on ball on lowers to flat though) and walking downstairs is not perfect but when I forget my injury I can canter down them quite easily….my atr leg now has more DF than my good leg (physio was worried it may heal long if I stretch more) so I am doing physio on the good one to stretch that one too :)

I do have a concern that the pain at the front of my foot comes and goes and is more apparent walking down stairs than any other exercise.

The physio and the timing (13wks)
My physio tells me to lay off doing standing calf raises and the exercise bike, treadmill etc and I am reminded by Sheena’s unfortunate re-rupture that I am still in the danger zone.

However, yesterday when I had to reach for something on top of the Kitchen cupboards, without thinking, I performed a standing calf raise on both feet to get what I wanted, there was more weight on the good one but it was only when I was fully extended that I realised what I was doing. The fear that it could POP even doing this hit me and gave me a bit of stress after the event - the lack of thought for just one moment at this point could of caused that undesireable consequence.

When I read other people’s blogs and they’re doing more at this stage, so in my mind I keep asking should I continue to be restrained or should I push through it - but also (it may just be my perception) it seems more of the surgical repair patients are doing more at this time period than the non-surgical.

So this is a kind of limbo post - It feels as though time has stopped, things I am doing now feel easy nor am I doing new things (which makes these exercises repetitive), the concern of the dangerzone ever present I probably should continue with what I have been instructed to do for this week and physio next Tuesday will be 14weeks hopefully they will test me abd allow me to push more to my limits rather than their own perceptions of what an ATR should be doing I’d like to include the bike, treadmill and possibly the cross trainer.

NOTE: By the time some people get to 15 weeks (2wks time), they’re able and allowed to do what this guy is doing in the video below (surgery 9th May 2009, video dated 22ng Aug 2009), jimminyc was cycling an 11mile round trip to work (surgical repair again 15weeks), Skutr was kickboxing!! I’ve not done any real strength/endurance exercises yet I am sure other ATR’s were also doing more but I can’t date things on most blogs without following the timeline and working it out so apologies if I missed any other capable rehabs

Bye bye Ortho center….Why hello there Physio!!

Well it’s a moment of relief and happiness with a new set of challenges ahead.

Having walked into the ortho center prepared for a challenging discussion, wearing my trainers and boot in hand, the guy just smiled at me, assessed the ankle, did a thompson test and stated they can do no more for me, everything looks great, I am now discharged and moved to physio…..so pleased and relieved.

The day started well - I only waited 20mins to get in and 10mins to get out (opposed to the 2.5hrs previously)

Then it got better - The physio was available to assess my status, I got in there in less than 5minutes from walking through the door and after some discussion and foot wiggling she was pleased with my progress (although we did discover that both of my feet invert well but not so good range the opposite way) - all that plus a physio therapy rehab appointment was available in less than a weeks time.

I was instructed to get me a tennis ball to roll around under my foot, to activate the balance sensors in my foot, I decided to get the marbles too.

Keeping the boot at the ready for those off-road/uneven surface walks was also mentioned at least for the next 4weeks.

Some advice I got about driving at the early stages - after a long motorway drive (1hr or more) don’t get out the car and go for long walks…..apparently the driving is a good workout for the right foot and a 30mins plus walk after would be putting the achilles at risk….don’t know how true this is with the modern protocols??

It’s not like winning the lottery but with this injury, things like this for me feel like massive wins….bring on the rehab :)

11 weeks in and finally in 2 Shoes….all the time :)

It’s that milestone…so pleased - two shoes, that’s normal shoes, slippers, barefoot, trainers no wedges :)

I drove a 140 mile roundtrip on Friday in my work shoes for a customer visit - the foot was sore when I got home and although I started off the day walking okay, there was a limp at the end of it, no additional swelling though and 1hr 30mins behind the wheel the shoes started to feel really uncomfortable (I may keep a pair of trainers in the car to drive).

I feel myself getting cocky a few times - stood up on the bed to change a lightbulb this morning and the foot sank into the big mattress - the ankle tightened up as I maintained my balance, I felt it and was able to shift my weight and breathe a sigh of relief - not out of danger yet must be vigilant.

Going down stairs - every ATR’s nemesis, at home, I can go down them okay, not quite fluent and adjusting my descent as per norms advice but normal…. I push myself to keep exercising though, the gains are less noticeable but still coming and now is not a time to consider easing up.

Still airing on the side of caution, the boot follows me wherever I go, on hand just in case I am going off-road (uneven surfaces etc) the boot is set to a cautious 15degs dorsi my ankle has more flex than that in it though :)

I am definitely and defiantly going into the hospital without my boot on for my review tomorrow (give me the physio!!!) and I may even go to the gym tonight and try some treadmill, cross trainer and stationary cycling….not sure about rowing though, any advice? :)

Happy healing all :)

Foot pain while dorsi flexing

While I am exercising and trying to gain more dorsi flexion I reach my max point, feel I can go beyond it and then get hit with some local pain at the front of the foot ankle area - the attached photo of a generic foot which I have marked for ease of explanation….. anyone have similar experiences or know why that is?

Foot Pain

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.

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