Coming up on 10 Weeks Non-Op
September 30, 2012 by carissa321
@californiaguy - my DF is getting there .. I’ve never had it measured .. but I’d say it’s just above half of what my good foot can do 
@starshep - yup, I was thinking the pain in my calf was just because it was being used now .. thanks
Now .. where am I now … well, about 3 days ago I ditched the boot at night time. I just felt it was time and it has been absolute HEAVEN! My doctor wanted me sleeping in it until week 12 .. um, not going to happen. I’ve also started shuffling around the house without the boot! just a few days of that as well. I can feel when my body has had enough of that and then I put the boot back on.
I have PT this coming Wednesday for the 3rd time. Am looking forward to that.
The only thing that is slightly worrying me is the indent where the break was. It’s only there when I PF .. but it’s definitely there. I was so worried about it yesterday that we did the Thompson test on it and …. there was TONS of movement thanks goodness! so I guess that indent is normal? will go away with time? I don’t have any more doctor’s appointments … but can make one if I feel that I need to .. right now, I don’t think I do.
A question about re-rupture … i know I haven’t done that BUT what does it feel like when you do? does it feel like the initial injury? is it painful? swelling? bruising? Just curious
Happy Healing!!
Sounds like you’re doing well.
When I do the thompson test, I get about 80% movement in my bad foot compared to my good leg. That worries me a bit, thinking it’s healing a bit long. But hey, the world isn’t perfect. I suppose.
I have that little indent too, and a little bump or knot right beneath the indent point. Not real sure what that is, but it’s not functionally bothering me. But, it’s certainly visible to the eye. I don’t worry that much about that.
I’m at 11 weeks and sounds like I have less DF than you. Probably around 10 degrees. I’m not stretching that much, because I’m so worried about healing long. I read another person’s comment on here that said their doctor told them not to actively stretch until week 12-16. The idea made sense so I’m just trying to loosen it up by walking, which seems to work throughout the day. I may start doing more stretching starting next week.
Hi there
I re ruptured at 13 weeks non op. I knew straight away and I think you would too. A pop and I felt it snap like an elastic band. Take it easy until 18weeks. I have a dent since my re rupture and surgery.
Carissa -
You’ll know if you re-rupture. There’s a loud pop and you feel a snap. It wasn’t as painful for me as the initial tear, but I knew right away. My incision also popped open at one point, just a little bit, and there was a decent amount of bleeding. Also bruising on both sides of the ankle. I still had full range of movement after my re-rupture, but that went away the next day, and it was painful to bear weight.
The indent seems normal - a lot of people mention it. Just depends on how your body heals, it seems. Good luck with your recovery, and don’t rush it. Honestly, it’s not worth it.
@californiaguy - I’m probably healing a bit long then .. but hopefully not. I’ll have to ask my PT if he can tell or something. Glad to hear that you have the ident too *lol*
@sheena - I can definitely see how someone can feel overconfident at 10 weeks … I have no pain, minimal swelling and am feeling more and more confident. I am still reminding myself to be careful though and wouldn’t dream of leaving the house without the boot on. I did start doing stairs yesterday, without the boot, but it’s a slow process … one stair at a time … so I kinda do prefer to have the boot on there as well. I’ve read your progress! sounds like you are doing great
@hoody711 - Oh no .. I’m not rushing at all .. I’m a wuss when it comes to pain *lol* thanks for the info on the re-rupture .. it’s funny how scary everything is and then you ask other people and find out things are completely normal. VERY glad to have this forum to connect with others
Looks like you are progressing well, Carissa. I’m 5 days behind you and was wondering how you transitioned to walking around the house without the boot? I have been walking without crutches for the past week but have not yet had the courage to take a step without the boot. I’m trying to stand on both legs without the the boot on and without holding on to anything but am not quite there yet. Funny how we are following different treatments and yet we are both living in the same city. I started physio treatment about 3 weeks ago (per the Ortho surgeon’s prescription) and have already been to 6 sessions. I’ve also got an appointment with the Ortho surgeon near the 12 week mark but it sounds like you are done with yours. Does that mean it is up to your Physiotherapist to officially move you in to 2 shoes?
@chrisq - Transitioning out of the boot … well, I just felt it was time and took 3 or 4 steps holding on to the counter the first time … later that day I tried again .. and a few days later and I’m not wearing the boot 80% of the time at home but I’m wearing it 100% of the time outside. I’d say, if your foot hurts to walk in the boot, you’re not ready to walk without it. Treatment differences .. yeah, it is weird. But I don’t think any two doctors do it the same. My doctor sent a note with me to PT at 8 weeks that said 2 weeks ROM then at 10 weeks I could start strengthening .. and at 12 weeks transition out of the boot. I’m just going a bit faster … trying to follow the UWO protocol which says week 8 - 12 transition out of the boot. I know that most people think that the doctors know best … but I don’t really think that that is the case all of the time .. you need to listen to your body .. it will tell you when you’re ready and when to slow down
@chrisq
My method of transitioning off the boot was to practice walking with only my bad foot forward. So when I move forward, I would lead with my bad side every step in a sort of shuffle. My back foot would never move past the heel of my bad foot. That way my dorsiflexion never moves past neutral. I started off doing this with a heel lift in my shoe and eventually went to doing the same thing bare foot.
I think this help build back some of the stabilizing muscles in my foot and around the ankle that have gotten weak over time. I practiced this up and down my hallway that has a rail to hold on to.
Ya, Californiaguy’s “shuffle” is the standard way of surviving when first moving to 2 shoes or barefoot. The scary part is stepping past the injured foot, which combines FWB and dorsiflexion, which challenges the healing AT. So that’s the part to minimize and control. Obviously, there are a lot of balance-losing scenarios that could get you there, so you’ve got to Watch Your Step, even as you get more comfortable and confident.
Calgary is now home of at least one of the authors of the UWO study, and one or two related ATR studies have come from there — one on hospitalization costs pops to mind. But rehab protocols are semi-random and hugely variable everywhere — probably even in London, Ontario, the home of UWO!! There are lots of reasons why ATR treatment is so inconsistent, though few if any of them are GOOD reasons! Like:
1) It’s a “boring” injury, and nobody dies from it. To the surgeons who operate on ATRs, the repair is sometimes called “the tonsillectomy of the leg”, because the OSs think they can do it in their sleep, and don’t need no stinkin’ evidence!
2) It’s “intuitively obvious to the most casual observer” that keeping a patient immobilized in casts or a boot and NWB on crutches for LONGER, will keep them SAFER. “After all, you don’t want to have to start over again from scratch and do this twice, right?” Unfortunately, that “obvious” relationship is pretty clearly BACKWARDS, based on the evidence, but it’s still pretty obvious, to patients and even to Doctors.
Don’t get me started — oh, wait, you did!
Californiaguy, I’m a huge fan of the Thompson test as a test of AT integrity or “connectedness”. But you’re the first person I’ve noticed who’s focused on using it as a quantitative test of AT length, rather than a “binary” or “qualitative” test of connectedness. What you say is logical, and may be right, but I wouldn’t be shocked if it isn’t, either. E.g., just the simple presence of inflammation (like some swelling) in the leg can compromise flexibility very significantly, which would decrease the flexion you’d get from a calf contraction. I tell the story on my blog of the symptoms I felt post-ATR#2, when I got a bone bruise on my “good” shin. The inflammation (swelling and discoloration) slid down my leg with gravity, and when it got to my ankle, it REALLY felt like I was recovering from an ATR!! I could have sworn. . . This was only a couple of months after I really WAS recovering from an ATR, but on the OTHER leg, so I remembered it pretty clearly, and this had zero to do with it — in fact, I hadn’t even bruised anything near this ankle or AT!! But it felt just like it.
normofthenorth,
Yeah, I didn’t really think too much about the comparison of the thompson test from my bad leg with the good leg. I just noticed that the foot didn’t pull up as firmly as the good leg. Would be willing to bet, however, that this is common for most ATR recoveries at this point. I also thought, as you suggested, that it may be the result of other stiffness related to the injury caused by swelling or maybe scar tissue? In any case, I’m not too worried about it.
To be honest, when I first was able to do the thompson test successfully a few weeks ago, I was so happy, I would do it like 5 times throughout the day. I couldn’t believe that my foot was actually moving! I guess it was some type of positive feedback that I could give to myself.
FWIW, I found that re-learning how to walk in the pool was very helpful with my transition out of the boot. Buoyancy kept the forces low; I started out with the water all the way up to my neck. If ever something felt wrong, I could just lift my foot up without fear of falling. The gentle slope of the pool bottom let me work uphill, downhill, and cross-hills.
When I actually took the boot off, and put my shoes on, I had a lot more confidence, and knew what to expect.
The pool was also a great place to work on single leg heel raises.
Thanks everybody for the advice on how to transition to 2 shoes. Initially, I had thought that using the crutches again would be necessary to transition out of the boot but I now see the better way of doing it.
I was very happy to find myself being able to stand on both legs without the boot and without holding on to anything this evening. I even managed to do a little shuffle, much like the way californiaguy and normofthenorth described. I’ll definitely be working on this over the next few days.
ryanb - the pool is a great idea.