Mc walker settings

I am a non-op ATR dude at week 4 1/2.
Cast 2 weeks now on crutches in my Don joy mc walker boot.
I wanted to know what degree settings some used. I was at 30 degrees plantar for 2 weeks and now at 22.5 for 2 weeks. Doc ( jerk hates atr non-op) said every 2 weeks go down another pin see ya in a month. So that would take me to neutral at 10 weeks?
I want or wanted to be at neutral off crutches in 8-9 weeks. Do you think it would be safe to skip a week and jump to 15degrees now? Then 7.5 in 2 weeks then neutral at week 9?
Any advice or tips?

15 Responses to “Mc walker settings”

  1. I am non-op but partial rupture so I don’t know how much help I can be. I know there are concerns about the tendon healing long…Being an ultrarunner my doc was actually worried about me healing short so he had me in a boot at neutral right away as he wanted me to have as normal a running gait as possible when I return to running. I was a little concerned about this when I first visited some of the blogs here…But so far so good my leg is pretty strong, not sure if it’s because my rupture was partial and so maybe there is less of a concern for healing long. I think there is a bit of a consensus around these blogs that you should listen to your doctor tho there is probably room to move forward a bit quicker than some of the docs suggest. Every one is different and I would at least try if I was in your position but back off if it’s too weird or painful.

  2. I am also non-op at week 4.5 - I was in a cast (NWB) for 4 weeks, then on Tuesday 4/3 my doctor put me in a fixed boot at neutral, and now I’m PWB but still with 2 crutches [sigh]. It was painful to put my foot in the boot at neutral, and the tendon area was sore all that day, better on Wed., and fine yesterday. So based on my experience it seems like you could move it up a notch and see how it feels.

    How do you like your boot? Mine is an Ossur air boot and it still feels very heavy to me.

  3. Hi Cindy,
    Glad to hear that things are working out ok so far by going the non-OP route. Just curious (also a question for others who went non-OP), did you have a MRI before deciding to go the non-OP? If so, was it a complete rupture and how much separation was there between the two sides of the tendon? I “only” had a 0.5cm separation, so was tempted to go the non-OP route…
    Thanks,
    Brian

  4. I had a complete rupture - you could feel the gap in the tendon down low near my heel- the doctor showed me & I felt it. (Plus I had a positive Thompson test.) He said an MRI wasn’t necessary & that the treatment would be the same in any case (casting in plantar flexion so that the ends of the tendon are next to each other & can heal). We didn’t really talk about the width of the gap. He told me that years ago surgery was standard, but that he feels that non-op works just as well as surgery with less risks. And on Tuesday the tendon had rejoined - it was visible & palpable again, which was a great relief. Now I’m just paranoid about re-rupturing during the healing process.

  5. My insurance for new job does not kick in until June 1st. If I would have had insurance I would have had surgery. I would know the Achilles would be seen together and fixed. This non oP crap and just keeping fingers crossed and waiting. I have to be at work by may 18 so if I can’t walk and fly overseas for work I am screwed and have no job with a house, wife as 2 kids.
    If my a miracle this heals in 11 weeks and I get to work and it pops again I will have surgery ASAP! Letting my insurance expire for 3 months was a major brainfart.
    Get the surgery people! Don’t cross your fingers and hope get the Achilles seen together! I have had my knee surgeries and always fixed them and i knew they were fixed!

  6. djh232, feel your pain, but and ryanb etc know more than me, all of the more recent studies (such as the UWO one http://achillesblog.com/files/2008/03/jbjsi01401v1.pdf) have shown there to be next to no difference been operative and non-operative rehab treatment for achillies rupture on a modern early mobilization protocol, so you’ll be fine, just don’t try and go tooo fast…

  7. Oh I have read the UWO protocol and many other. I just think getting surgery is a better route and wish I would have had that option! I just don’t see why one would want a longer wait and have to heal longer and done ever
    Know if it is healing correctly. If it is sewn together then I KNOW it is together and up to me to let it heal and rehab.
    Just my opinion!

  8. Sorry for the typos people! My iPhone autofill messes me up!
    Seen = sewn

  9. sure, I was non-op too, and was 2wks cast, 2 weeks fully wedged in boot PWB, 4 weeks 50% planarflex FWB in boot then 3 weeks neutral in boot / barefoot when at home so took much less “steps” than you state in your OP, think most would be neutral by around 8-9 weeks FWB if it feels ok go for it.

    keep the crutches for longer excursions but I found I could do without from pretty much the point I went neutral (used them on and off before that) just try and make sure you walk as “normally” as possible not turning your foot out too much

  10. Hi All
    If it helps anyone my recent recovery so far is:Full Left ATR, Non-op.
    Weeks 1-7 Boot fitted with 4 wedges.
    Week 8 Started Partial weight bearing.
    Week 9 Full weight bearing (still wearing boot).
    Week 10 Final wedge removed. Started physio. Walking around with boot fitted. One crutch helps.
    Continued wearing boot day and night!
    Very weak on ball of foot. Tyring hard with physio but this sems to be a slow process. .
    Week 11 Walking with and without boot fitted. No crutches. Without boot walking is slow.
    Week 12 - Discarded boot at last and walking much better.
    Still limping due to weakness on ball of foot.
    Week 13 - Getting stronger, limp almost gone.

    .

  11. Thanks!

    Here is mine so far NON-Op

    Week 1: cast
    Week 2-3: boot down 30 degrees
    Week 4: down 22.5 degrees PWB
    Week 5: down 15 degree PWB( I have hobble to bathroom without crutches)
    Week 6: ???

    Any ideas, advise , or comments?

    I will need to be able to walk though an airport come week 11

  12. Brian:
    I had a complete tear and went non surgical too. Thompson test confirmed it. MRI was not necessary and at about $2.000 a pop, the insurance would have frowned on it. If I went the surgical option, an MRI would have been necessary to confirm the location of the tear. Got my boot 2 weeks ago and the doctor said there was still a small gap. I could feel it and it seemed less than a .5 cm. Went for another check up yesterday and the gap had closed.

    dhj:
    I know what you mean by keeping your fingers crossed and waiting. I asked my doctor if there is ever a case with non surgical if the tendons don’t come together and he said flat out NO. I then asked him what is the general cause of re-rupture and he said just the quality of the repair the body does. Yes the latest studies do indicate little difference in the results of surgical vs. non surgical. Time to recovery does seem a bit faster for surgical but I was FWB at 5 weeks in my boot. Doesn’t seem like you can go much faster than that. And with non surgical, the very real risks of serious infection or the skin not healing properly are just not there.

  13. Thanks for the reply starshep

    Are you off crutches FWB at 5 weeks. I just hit my 5 week mark today.
    I hobble here and there without crutches. Not anywhere far. Couch to chair. Chair to bathroom etc.
    What degree is your boot set at? I am in the Don Joy max traxx boot.

  14. You should be able to walk through an airport by week 11, in or out of the boot, most people as far as I have read on here and from my own experience will be comfortably FWB by that point if there have been no other complications.

    From where you are now its just a case of building up to FWB and then work on walking, if it gets sore and swells stop and do RICE, as for the wedges once you are near flat you should be able to “walk” you can try lowering faster it will feel very tight, again let pain guide you.

  15. by “in or out of boot” I ment if you are still in the boot you should still be at the point of being able to walk, you might not yet be able to go without it!…

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