ATR + (almost) 10 weeks

Tomorrow will be 10 weeks since my ATR. I went through conservative treatment (no surgery). My right leg was in a cast for six weeks, first four in a “toes-down” position, last two in a more neutral (but not exactly 90-degrees) position. My doctor by-passed the boot and went from NWB in the cast to FWB once the cast was removed. Below is a summary of my week by week experience since the cast was removed:

ATR+Week 6: Cast removed in the morning. I started experimenting with walking without crutches and managed to get rid of the crutches the same day. My walk was anything but graceful but I did not need those crutches anymore. A big sigh of relief and a sense of freedom.

Started PT the next day. PTist put me on stationary bike and theraband (blue). In addition, I found massaging my AT area helpful. Stationary bike is amazingly helpful in relaxing the ankle and gaining flexibility.

Week 7 & 8: Continue with stationary bike & theraband. I tried toe-lifts (both feet, flat surface) after a 15-min bike exercise. I found it easy to do so added it to my exercise routine. My PT thought is was ok to do so. My routine was:

  • Stationary bike - every second day, 15-20 mins at a low resistance
  • Runners’ stretch (face against a wall, stretch one leg at a time) - everyday
  • Theraband (blue) - 2×10 repeats everyday
  • Toe-lifts, flat surface - 2×10 repeats everyday
  • Ice treatment after exercise

I was having swelling at my ankle after work. I have an office job. Normally, I walk around quite a bit but have been spending more time at my desk since injury. PTist recommended compression socks, which helped with the swelling. I started wearing them regularly.

Week 9: PTist thinks progress is very good. I gained ~80% of my flexibility (which was not much to begin with) and, say, 50% of calf strength (% are my guesses, not the PTist’s). I asked whether I could ride my mountain bike (on a flat trail) and she said “no way!” OK, you gotta ask. She added dropped toe raises to my routine. I don’t know if this is the right name but here is how it is done: One stands on a stair on the balls of the feet, with heels sticking out. Holding to a support (eg., handrails), slowly lower the heels as far as one can comfortably go. This stretches the calf muscles & the AT. Then, lift the body on the toes as much as possible. Repeat.

I added this exercise routine, repeating everyday. After a couple of days, while walking down the stairs, I felt pain in my now-healing AT. The pain did not linger but repeated every time I stretched my AT. I stopped the dropped toe-raises and reduced other exercises until it was time for my PT session. I also had a bit more swelling during these few days, which I handled with ice compressions.

At the PT session, PTist agreed with my exercise reduction and suggested an in-between exercise: put the good foot up the stair, keep the bad one one step down. Then, do toe raises on the bad foot. This way, some of the weight is on the good one but the bad one carries more than half the weight.

Week 10: Exercises going well. I am feeling ready to go back to dropped toe raises but will wait until I see my PTist. I am walking with an obvious limp but it is getting better day by day. At slow speeds, it is almost unnoticeable. I even danced (or so I think) at a friend’s wedding this past weekend. I cannot wait until I can get on my bike and go for a ride outside. Also, I am really hoping that I can squeeze in a SCUBA diving trip before the summer is over. I will see my doctor this Friday and will ask him a few questions.

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