No Physical Therapy!?

I was one of the lucky ones, my injury never hurt.  I had full range of motion at one month despite never going to physical therapy and not walking on it until after that doctor visit.  It seems odd that my doctor did not know I was not seeing a physical therapist (the NP I had been seeing said the doctor would decide if I needed PT).  The doctor asked how PT had been going and if the therapist was happy with my progress.  The doctor decided that I could walk, as tolerated, in my boot.  He also said that the need for PT would be determined at the 4/22/16 visit.

April arrived and walking was going well.  ‘The Hole’ (1.5cm section of the incision never closed) was continually leaking and looked disgusting despite being cleaned twice a day with alcohol.  At one point a hair was sitting on top of the leakage so I tried to lift it off with tweezers.  I actually grabbed the little dark spot on accident–my incision was on the back and just to the outside so it is very difficult to access.  The dark thing lifted away with no issues so I thought it was the fuzz.  Nope.  It was a purple knot of thread.  All three ends were cut cleanly and it was the nub of the knot that was darkening ‘The Hole’.  So, there was a hole within a hole.  It is still there, the two holes, over a month after the knot came out.  The doctor said that I “spit a stitch” and was not concerned.  He was also not concerned about the hole and said it would close up now that the stitch came out.

At the appointment on 4/22, the doctor said my physical therapist must be excited about my progress.  I still had full range of motion and good strength.  Again, I told him that I did not have PT and he said it would probably not be needed.  He gave me permission to wear shoes and I showed him the options I brought with.  He chose the heels and said to try to wear shoes with an incline as it is easier on the tendon.

The progression seems so odd to me.  I never had physical therapy, I have a hole on my ankle that gave birth to a purple stitch, and I am still numb from the outside ankle bone down to the sole of my foot and back to the middle of my heel.

2/19 Rupture at Pickle Ball

2/20 Misdiagnosis at convenience clinic as ankle pain

2/22 Saw Nurse Practitioner associated with the Orthopedic Surgeon on-call on 2/20, put in boot with lifts

2/23 MRI

2/24 Blood work

2/25 Surgery in AM with spinal block, finally met doctor, splint and ace wrap

2/29 Back to work

3/03 Out of splint, in boot with lifts, still NWB

3/10 Staples removed, steri-strips, boot with no lifts, still NWB

3/25 Saw doctor, full weight bearing in boot

4/21 Ankle gave birth to stitch

4/22 Saw doctor, full weight bearing in shoes

6/23 Next dr. appointment

4 Responses to “No Physical Therapy!?”

  1. Everything about this is a bit concerning. You should seek an alternate opinion and also have your PCP take a look at the incision hole. The fact that your surgeon said PT would not be needed is really quite appalling. This injury requires it, if even just finding your own regimen to build back the strength and stamina you lost with the injury. If you do not actively try to rehabilitate the tendon, calf, and leg, there is a good chance you will not go back to how things were before the injury. Being diligent about PT is key to getting over an ATR.

  2. AwBalls I agree with Mibball, I think that PT is very important. You can do it alone, there is lots of information on this site and the internet that will inform you of what exercises you should be doing. But a PT is able to watch you move and correct you and give you specific exercises to help any problems you might have. You don’t need to go a crazy amount - once every two weeks for two months is probably enough as long as you do the exercises that you’re given every day.

    About the open incision - this is going to sound strange but there is some evidence that pharmaceutical grade Manuka Honey is extremely effective for helping wounds to heal. Manuka Honey has antibiotic properties and apparently also helps the formation of granulation tissue which is the tissue that will close your wound. You can google it and decide. I didn’t have a wound issue but I have read quite a few blogs where people had issues and Manuka Honey solved the problem for them.

    All the best and good luck!

  3. I tore mine about a month before you, very similar schedule and have never gone to PT, hell, I haven’t been back to the doc since he told me it was ok to get out of the boot. I feel pretty good and am moving well, including running. The key is being active. Some people need the PT to motivate them to work the injury, others can do it on their own. If not going to PT is working for you, don’t fix it.

    As for your hole within a hole, are you sure the “purple stitch” you pulled out wasn’t actually a spider that had just laid eggs?

  4. Thank you guys. This is encouraging. I was following the different rehab protocols on here since I was in the splint following surgery. Beanie, a coworker mentioned the honey as well. ‘The Hole’ is now healing–smaller and not as deep.

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