Moving forward or back

Yesterday was the first time I was in physical therapy back to back. I was doing a lot of weight bearing outside of the boot. And I have had the boot since the 23rd. I have two different physical therapist, a woman who is more aggressive and a guy who wants slow recovery. I had the guy this Tuesday and the woman Monday. The woman likes me to do everything out of the boot and gives deep tissue massages. The guy doesn’t want to give one since he says the wound is new and wants me in the boot to do weight bearing. I have no complaints with the woman therapist, but with the guy I feel like he moves too slow. So he called my bluff of not wanting the boot and had me do 30 % plus weight bearing on the foot no boot. I was doing side stepping, back and forth stepping, and moving forward with the crutches. Now since the therapy my foot feels heavy, the rom is a little sloppy, more pressure around the heel, and my Achilles tendon when flexing up or down feels very tense. Is this normal when you try to start weight bearing early, or did I do damage. I am no expert, so I am asking the community for input, I can’t get in touch with my doctor to ask, and my next appointment is the 16th. My other question is should I lay off the weight bearing outside of boot regardless of the discomfort in it?

6 Responses to “Moving forward or back”

  1. I don’t think you’ve done damage. Probably muscles being stiff. When I do a lot of walking it feels tight but when I do some inflection with my good food, it wasn’t any worse. Just felt stiff. I’ve been out of boot for almost a week now. Actually liking it a lot. I also scheduled my pt with the same guy every time and he knew my progress and he’s recommendations have been spot on.

  2. I can’t offer you any advice but I love hearing how your recovery is going as we had surgery on the same day. While you were in the cast longer than me, you have moved to boot walking faster. All so fascinating. Just listen to your body and give it some rest in between. The soreness may be because you did PT two days in a row and both days were rather intense. Keep up the great progress.

  3. PTs and OSs are all humans, just like us patients. And PTs have been known to do harm and advise ATR patients to do bad things, too much too soon. (See my blog for a painful example, when I REALLY knew better than to follow my PTs stupid advice!) Others are too slow. Get into a peeing match with one of your health professionals while you’re recovering and it’s probably not the pro who will limp away. ‘Nuff said. . .

  4. Norm you couldn’t be any more right, I come home sore and hurt from pt, but when the pain goes away I can do a little more each day. Last week I could not bend my knees while on two feet, this week I can. I am skating on very thin ice, I just want to be able to move, my living situation, and love life is suffering from not being able to walk. I will try to wear the boot my next pt, I don’t want to re injure, but I also don’t want to be part of the group that doesn’t early weight bear and re rupture later.

    Anna, you may have been right, the soreness went away and my foot is less stiff, with the day off. This is truly a learning experience, and if you learn anything don’t follow too much of what I do, I think I am wolverine and heal quick, while in real life it is a very slow recovery.

  5. I am not sure if you have ready my blog, but I am an orthopedic physical therapist who is also currently going through therapy S/P ATR.

    The 1st thing I would suggest is that you stop seeing two different therapist. One of the biggest things I push with my patients is that they need continuity of care. It ensures the best outcomes and allows for better communication between your therapist and you. I also find it very odd that (2) therapists in the same practice have such different views on what you should and should not be doing. They should absolutely be communicating with each other about your plan of care so that there is no confusion or discrepancy. Every once in a while, no big deal. But 90% of your sessions should be with the same person.

    As a general rule, your repair is healed in 6-8 weeks (meaning fully scarred down and low risk for rupture; assuming you had a typical repair done). Simple weight bearing without your boot will not tear your repair. Your heel is getting sore since you have not really put weight into it for a long time. You start you lose your callouses and your fat pad at the bottom of your calcaneous when you are casted/booted for a long time. I had the same reaction when going out of the boot where I felt tension in the back where the surgical site was, but my biggest complaint was pain at the bottom of my heel. Felt almost like a bone bruise. It will take a little while for your body to adjust and get used to accepting weight into that foot.

    At 7-8 weeks, your main concern is scar tissue mobilization, ankle ROM, intrinsic muscle strength, and starting to work on weight acceptance and gait training. Sounds like you are right on track.

  6. Dmbfan. You couldn’t be anymore right. The feeling of walking is something, that feels weird, and at the moment my gait is horrible heavy limp. I appreciate the comment. Yeah I prefer the female since the male is a little slow, but I will tell him to check the chart the next therapy session.

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