Five weeks and its physio time

Maybe it is symptomaitc of health care professionals to tell you the worst and then let you be pleased if what actually happens is better, but everytime I go to an appointment the prognosis and information I get seems to improve.

Today was my first physio appointment. I released myself from the cast and then shuffled around the physio’s office and gym with a naked, if somewhat feeble, leg.

Having had a good feel of the tendon and murmured his satisfaction with the progress he then went on to tell me that there was no reason that I shouldn’t make a full recovery and get back to basketball at some point. That was pretty much what I have wanted to hear for the last five weeks so I could have packed up and gone home then, but he had more for me.

He asked what kind of sport I got up to normally and I listed out my usual list. ‘OK’ he said ‘do you fancy getting on a bike?’, at which he led me into another room and set me up on an exercise bike. He explained that I could cycle on very low resistance as long as I was pushing from the middle of my foot. The low resistance bit was a shame I thought as that pretty much meant no road work yet, but then he said that if I had a turbo trainer, that would be ideal, particularly if I had cycle shoes as they would keep me foot in a better position. We discussed the issuse of getting clips in and out on of pedals, but I think that if I leave the shoe on the pedal then all should be well. I don’t have a turbo trainer but had been thinking of getting one for the winter this year anyway, so any excuse to buy new toys was gratefully embraced. After a couple of demonstrations of other exercises and an assurance that swimming without vigorous kicking would be fine (I don’t kick hard anyway, and I would be swimming more for my upper body than my recovery), I strapped myself back into the boot, hopped (not quite so literally) into my automatic chariot and came home to plunder Amazon for a turbo trainer.

Couple of other bits of progress to report and maybe a word of caution. I took an executive decision to remove one of the remaining two heal lifts out of my cast on Friday. I went to work for the first time and walk-come-hobbled (wobbled?) from Waterloo Station to Fetter Lane in London - about two miles. No adverse affect on the Achilles but the heal of my foot was painful and bruised because the flat surface of the lift was small and there was no support under my arch. So I removed the top lift and now all is good.

The word of caution - I have seen a couple of folks comment that they are watching and following me. Some sage advice from the physio today about what to do and why I might be a little different to some recoveries. He noted that because my rupture is so high up it is not ‘tendon to tendon’ healing, but there is a fair portion of muscle that is healing there too. Muscle has a lot more blood in it and heals more quickly, so he suspects that might put me ahead of the curve a little. The sage advice, after I admitted to being an impatient patient, was ‘if you feel you want to go faster or try something new, you might be able to, but from now on you ask me first’. I would suggest that no matter how frustrating your protocol is, you all do the same. Every recovery pattern is different it seems, but they are different for good reasons. The last thing any of us want is a big step backward in the race to go forwards.

Heal well folks. More next week.

6 Responses to “Five weeks and its physio time”

  1. All good words Danair. I bought a turbo trainer and set up my old hard tail mountain bike. It has been excellent but still not as good as the real thing. It is a bit noisy but my rear tyre is chunky. I was interested in what your physio said about clips and I have had similar discussions with others about it. Yesterday was the first time I took my other bike out for a free ride. A bit nervous but fortunately everything went well. I didn’t clip in as I wanted to concentrate on stopping and getting my foot down. I thought putting my good foot down first would be the right thing to do but quickly found it was the other way round. Just like on crutches, bad down first and heel not toes. I am off to physio today with lots of questions. Regarding your boot and walking, I didn’t do it but heard someone else put an arch support from a running shoe inside and it seemed to help. The advice came from their physio and seemed quite logical. Can’t remember who it was but they may read this and offer a comment.

  2. I am also at 5 1/2 weeks. I am a non-op and the doctor is being a little conservative. She didn’t want me WB until about six weeks. I was walking in my cast at 3+ weeks and when I got the boot at 4 weeks I ditched the crutches. Now at 5+ weeks I walk around the house bare foot. I have also ridden my bike outside and in the trainer but only with the boot on. My foot doesn’t have a lot of strength yet but it feels good to feel the balance and move my ankle. I feel I can push down with a fare amount of force on the ball of my foot but when I try the Thompson test nothing seems to happen. I am not sure what is going on there. maybe my ankle is stiff. One more week until my PT apointment, and then another two weeks until I see my doctor again. I hope when I see my doctor I walk in with two shoes on.

  3. Soles and heels are almost always hyper-sensitive early in the rehab. Squishy gel-type footbeds or shoes (like Crocs) help a lot, as does rest, elevation, ice, etc. And time!

    Brian, there’s a difference between slow and “conservative”, since conservative meens doing what’s safe. The studies seem to show that safer results (e.g., lower re-rupture rates) come with faster protocols, not slower ones — especially without surgery. E.g., check out for the schedule used in one of the most successful studies.

    Did you squeeze your own calf for the Thompson test? For some reason, most of us can’t do that successfully. I don’t know why, maybe it’s related to our not being able to tickle ourselves. . . Get somebody else to squeeze your calf while you like down and relax, face down, with your legs hanging over the edge of whatever you’re on. (And NOT in the boot, either! ;-) )

  4. normofthenorth, Thanks for your help. I have been reading your blog since the beginning of my injury and found your information to be very influential. Funny you just wrote about sore soles and heals, that is what I have just been experiencing. I started walking barefoot but now am walking in my Crocs. Crocs are the best. As far as the Thompson test goes, yes I squeezed my own calf. I think my leg was not relaxed. when I squeeze my calf I can feel the tendon move down by my ankle, so I know that it is connected. This was my big early paranoia, That my tendon wasn’t completely attached, that part could be still up by my calf. I think because my doctor said that you can push down on your foot with other sets of muscles other than the calf got me worried in the beginning. Did anyone else non-op have worries about the tendon not fully attaching? On the positive side, I rode my trainer this morning in my crocks set very low resistance. It feels really good to get blood flow into my legs and stretch the tendon a little. Thanks for your help and encouragement.

  5. Brian, thanks for the kind words, and I’m glad my words have helped you.

    I think EVERYBODY non-op worries about the tendon not fully attaching!! If we could get MRIs or UltraSounds whenever we wanted to, we’d probably go in weekly if not daily!!! I think even some POST-op patients would join us most of those times. But for the overwhelming majority, the ends grow together, and even do so at roughly their original length. The mechanism is still poorly understood, but that’s true of many medical “cures”. (I’m told that aspirin’s beneficial mechanism is still somewhat mysterious, though that may have changed recently.)

  6. I stopped wearing my boot at just under six weeks. It feels good to walk around and ride my bike in tennis shoes. What a incredibly liberating feeling getting the boot off for good. I rode around for a couple of hours today, so I guess I won’t worry about the tendon not being attached.

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