11 weeks and in the pool…
Am now at week 11 non-op and have used the pool at the gym for physio today and last Friday. For about 45 mins I walked up and down the length of the pool, doing 10 heel raises at each end. The walking wasn’t too bad (although had a tendency to move away from the edge so had to keep holding on) and I really concentrated on my gait and having an equal amount of time on each foot. On Friday it was noticeable that I am not pushing off on the bad foot, so I tried to roll through on that more, definitely lifting up my heel and trying to put weight on the toes before lifting it off the ground, and today it was much better.
Heel raises were a little disappointing on Friday as I tried to do more with the bad foot and that’s when it became obvious how much (almost all) of the work is being done by the good foot :( So at each end I tried to put more of my body weight on the bad side. Could really feel it in my calf. Today it was still hard raising myself up using mostly my bad leg, but coming down on was a little slower/more controlled… Calf still feels painful when I do it - where have all my muscles gone!?!?
(Could do with a bit more reading material on the walls, as there are only so many times you can read about ‘showering before using the pool’ and ‘being careful not to slip’ before that gets a bit boring!)
Have been trying to walk more in 2 shoes every day, and am still doing the strengthening exercises at home (using towel/resistance band, and double heel raises) but am trying to decide whether to increase my physio visits - will see what he says when I go next week - but am still going privately as NHS physio dept has not been in touch and having tried several times to call and no-one has answered I am almost giving up on them!
Friends are still being very helpful driving me to the shops and gym etc, but I would love to be able to drive myself… I haven’t needed to rush it so far, and as its a right ATR I want to be sure that I will be safe on the road, but I feel like I now have enough strength/confidence to use the accelerator/brake and do an emergency stop. But, I had a letter from the hospital, detailing the checkup I went to two weeks ago, which at the end said “patient can return to driving when she is able to tiptoe”! This seems (to me) a little excessive as I don’t drive normally putting the weight through my toes but through the ball of my foot, and I can do that now! Have rung up to query this (especially as the doctor only saw me for about 5 minutes) and will talk to my physio too. I am also not sure if I need to talk to my insurers about the injury - has anyone else in the UK done this before driving again?
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My NHS clinic told me that I could drive when I could do an emergency stop. Mine was a right leg injury too and I started to drive at about week 9 or 10, when I was comfortable in 2 shoes.
As for physio, it varies enormously all over the UK, all over the world judging by the posts here. I was on a fast protocol but still only saw the OS for diagnosis (and went non-op), after which I was in the hands of the physio with fortnightly visits to the specialist AT clinic.
When these visits ended after 10 weeks I saw another, very good, NHS physio for about 6 weeks, after which I had a number of sessions with a sports physio to guide my further recovery.
Heel raises - you’re doing ok. It is very early yet - some to succeed at this stage but not many. I was at about 18 weeks when I could do it on only my injured leg but many struggle to do it ever.
Interesting that you were able to use the pool. I asked for this, using the hospital hydro pool, but was dissuaded on the basis of having a boot that allowed for early, and increasing ROM, which gave my moving parts the early exercise that they needed. This worked fine but I was a little disappointed at the time.
An emergency stop can put a lot of force on the ball of your foot, maybe comparable to walking tiptoe. If you’re good at hitting the brake with your heel, you could be safe sooner.
Love the writing, Annie! Don’t forget that choosing a different depth changes the challenge to your leg.
hillie: thank you for that - very informative - and when I say I did physio in the pool it was on my own, but because my private physio had said it was something I could start to do now I’m in 2 shoes!
I only saw an OS at the end of week 1 when I went from cast to boot, and then at the end of week 9 when I was given official permission to wean off the boot - and that was a different OS who really spent very little time with me. But the NHS physio who came in after I’m sure said that driving would be ok when I could do an emergency stop!
I still find it weird how much protocol and advice varies from place to place… as it sounds like you had a good NHS physio experience!
But do you remember if you contacted your insurance at all before you started driving? (As I’ve been googling it but can’t find anything that says you have to for this type of injury.)
norm: thank you too - and you could be right about the force of an emergency stop… unfortunately my gym pool is all one depth - which is not quite as deep as I’d like for my height - but the support that the water does give makes it easier to do the gait and raises so I will continue
Had a call back from the doctors who now says the benchmark for being able to drive again is to be able to comfortably / safely do an emergency stop. So, although mentally and physically I think I am ready to try, for my own peace of mind I will continue to build up strength and flexibility (for the swivel between brake and accelerator) this week, then try a short drive round the block next week…
Anniel - Be careful raising your body completely on your bad leg. In the pool there is less force on the tendon but out you could find the force too much. It is early days as Hillie said.
Re driving - I was cleared to drive as soon as I was able to wear 2 shoes but the important thing is being cleared to drive and being confident you are able. You have the words from the doc and I suggest you make a note of them in a diary. Modern cars do not require a significant amount of force to stop (assuming you have a modern car) and it is only our brains that force our foot on the pedal so hard in an emergency. When you start driving again I suggest you drive like everyone else on the road is an idiot just waiting to test you out. That is good advice to all drivers anyway. Extend the distance from you to the car in front to at least 4 seconds. Drop your speed below the speed limit and don’t worry about what others will think. When your foot is not on the accelerator then cover the brake (foot over the brake but not pushing on it) so you reaction time is halved. If you need to push hard to avoid a collision and you damage the tendon again then it is better than a collision. Practise first in a quiet place and build your confidence. As far as your insurance company goes I would leave them out. They do not need to know anything once you have clearance. I would never recommend driving without clearance.
Stuart - very sound advice - thanks… I see my physio next week so will see what he says re clearance to drive - and have made a note of the doctors update today. I think if I don’t have to be able to tiptoe then it will take the pressure off me trying to get those heel raises too soon (and I think anyway that most of the raise is still being done by my good leg - no matter how much I’d like to believe the bad leg is more involved!)…