4 Weeks Post Op
Saw my surgeon 5/28 for my third follow-up appointment. I was told everything looks great. There was a small issue with my boot (some bending), but they fixed it and changed it to 5 degrees plantar flexion (I think).
I was told I can put as much weight on it as I can bear and when I feel comfortable, I can stop using crutches all together. Great news as I hate crutches!
I was told at my next appointment (6 weeks post op), that I’d be moved back into a normal tennis shoes with heel lifts. I was told I’ll start PT after my next follow-up (so start it week 6/7). Based on reading other comments and recovery stories, this seems pretty fast. It might just be the idea of being in a tennis shoe with no protection for the achilles that makes me nervous. However, it seems like he’s following closely with this protocol: http://www.uwhealth.org/files/uwhealth/docs/sportsmed/SM-27399_AchillesTendonProtocol.pdf
So far so good. It was nice to be able to make dinner and not worry about putting too much weight on the foot. I still have swelling at night and keep it raised when I sleep.
Any thoughts on the timing of the recovery and my doctor’s protocol? Does this seem overly aggressive or is this following some of the more recent literature on getting back to normal as quickly as possible?
I still need to figure out these widgets.
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Starting PT at 6-7 weeks is late, hitting 2 shoes at 6 weeks is early, compared to my (current) fave protocols - i.e., the ones with the best published results. That doesn’t prove it’s suboptimal, but it does suggest the possibility, at least the way I think. For sure, add some EXTRA Watch Your Step when you first get into the tennis shoes. (Most of us found it scary enough at 8 weeks.)
Norm - Can I bring you to all my follow-up appointments?
Thanks for the info.
You will find a new hightened awarness of everything around you once you are free of the boot. The bigger problem is that others around you will not see much wrong with you so you may have to be careful of those careless in your personal space. Your freinds and colleagues will think you are healed and you can just get on with life as before and you will soon get sick of telling them the long road to recovery has just begun. The wedges in the shoe will take pressure off the tendon as you walk but it is important for you to manage your stride length and pace to avoid limping. It is also good to even up the shoes with wedges in both and avoid uneven ground until you are more confident. I think you are very fortunate to have such a progressive doctor but it comes down to you doing the right thing and being careful. Most re-ruptures occur by accident such as tripping or people doing the wrong thing too soon. A friend of mine went surfing at 12 weeks and put himself back to the start. I don’t think you are going too fast but you are up there with the quicker. My reading of the research tells me the faster protocols get you back to a normal routine sooner but over 2 years the results tend to pan out very similar with regard to strength.
6 weeks into shoes does sound a little on the speedy side of things, but not completely unheard of. For reference, Kobe Bryant had his ATR surgery on April 13 and on May 30th tweeted a picture of himself walking 2 shoed on an alter-g treadmill (reduces impact by lowering bodyweight similar to walking in water).
Might it be possible that your doctor will tell you “shoes at home / on grav treadmill at PT / boot outside” starting week 6?
Just shows what can be achieved by someone as fit as Bryant and with the level of attention that he would have had from a team of medics, physios and bag carriers.
I tore mine and had surgery just over 2 weeks ago. I started PT this week and my PT mentioned that he had worked for an NBA team that would be treating a player with similar injury twice daily from the 2 week period on.
Norm or anyone, is there any consensus on what amount of PT per week is recommended for most people? I am trying to follow the accelerated rehab with Vacocast protocol which seems somewhat similar to what Joe is following.
youngrfpc - how often should you go to PT? How much can you afford? My PT told me that she was there to provide the information but in reality it was up to me to do it so I did PT every day but only saw her once a week which became once a fortnight then once a month. She would check my progress and guide me through the stages of rehab. There are some machines and devices PT’s have access to which can be of benefit but most of it can be done at home. I had a fantastic result and very quick without any fancy machines. Just hard work and follow the advice.
Professional sports teams have a full staff of PT’s who are paid to provide these services daily or twice daily to help get the team’s assets back on the field ASAP. For those of us who have insurance which provides for anywhere between 20-40 PT sessions for an injury such as this, or those without insurance at all need to figure out a good schedule with your OS or in my opinion, the PT’s themselves, that work for you and your benefit allotment. For example, I started PT twice weekly at 3 weeks and found tremendous benefit from it.
I think as a general rule you can’t really go wrong attending as many PT sessions as your time/finances allow for, particularly in the early weeks. While it might be a case of diminishing returns in terms of impact on long-term recovery, having access to things like massage and other anti-swelling modalities that you don’t have at home will at a minimum increase your comfort level, so it certainly won’t hurt to go.
If you’re constrained as most non-pro-athletes are, then it becomes a question of bang for your buck. As others have mentioned, a lot of the strengthening work for this injury can be done at home without any supervision beyond the initial instruction phase. It’s unlikely that you’ll need to supplement this instruction at intervals under one week, so you’ll be covered on that front by making weekly visits (and even longer, in the later stages). If you can maintain that schedule and squeeze in a few more sessions in the early weeks to help with the initial swelling / restricted movement, your leg will probably appreciate it!