Update - Phase 2

Went back to the hospital for my scheduled appointment. The doctor says I’m coming along fine. They decreased the height of the wedge in my walking boot by half, so its a little less awkward to “walk”. I started doing FWB with my walking boot at about 4 weeks (i.e. last week) and will continue to do so until I am able to get rid of the boot.

I have about 5 more weeks of walking with the smaller wedge before I go back to 90 degrees. The doctor initially said to come back in four weeks but I had some scheduling conflicts so I had to push it a week back. My doctor says the extra week will not make a big difference.

The real challenge for me is seeing how I adjust once I head back to university next week. I guess I will have to be an even more disciplined student to ensure I’m not late for classes.

5 Responses to “Update - Phase 2”

  1. I don’t know how big your wedges are, but I wouldn’t rush to go below 2cm heel lift before 6 wks (= UWO). But do something to straighten your body, by lifting up your “good” foot when you walk. I don’t think you have to equalize the heel-left angles, just the overall elevation so your body is straight and balanced.

    Especially if your boot is a fixed non-hinging AirCast-type, I’d start walking around the house in Crocs or barefoot sooner than 10 weeks, again like UWO. Nobody knows what’s best for reruptures, but the old assumption that slower is safer seems to be Just Plain Wrong in general, and especially for non-op patients like us.

    I often think (and sometimes write) that the MAIN reason why the older studies showed high re-rupture rates for non-op was non-random, biased, streaming of patients — “jocks” got surgery and “crocks” got casted. But many of the studies that were summarized in the 2005 meta-study WERE randomized, so the difference between those bad non-op results and the excellent non-op results from the 4 post-2007 studies is NOT (mostly) in the non-random streaming of patients. So it must have been the different rehab protocols — the fact that the non-op patients got your grandfather’s “conservative casting” — that made the difference.

    All of that makes me conclude (in the absence of any solid proof) that getting to wiggling/exercise and PT and WB earlier, is probably better for your leg than waiting longer.

    If you’ve got a boot that can hinge, I’d start letting it hinge — from maybe neutral to way plantarflexed — at around 7 weeks post-non-op. As long as you avoid scary moves (like walking backwards!), that should also get you progressing back toward normal.

    Good luck, and good healing!

  2. I can’t remember how big my heellifts were but I have a feeling that the original one was larger than 2cm (may have been 3cm?). I’ve been walking around with the boot and with a running shoe on my good foot to keep my body relatively level. You do make a good point about having more movement before 10 weeks and I’ll definitely shoot my doctor an e-mail to see what he thinks. I’m not entirely sure about walking around my house in crocs/barefoot though.

  3. So I talked to my doctor and he said it would be fine for me to take my foot out of my boot and move it around. Obviously I will not be putting any weight on the leg without the boot . 3 more weeks and my heel lifts come out and therapy starts once again.

  4. There are many suggestions here for good ways to wiggle! The UWO Protocol I’ve posted at bit.ly/UWOProtocol has some basic (though techy) notes. Others have suggested spelling the alphabet in the air with your big toe. Staying below a neutral angle, at least at first, is common to all of them. And staying “active” rather than “passive”, at least at first — i.e., just using your foot and leg muscles to wiggle your foot, rather than pushing or pulling it around with Therabands or towels, etc. All those other things will come, but not at first.

  5. thanks for the info!

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