Nov 10 2009

More aggressive PT at 11 weeks?

Published by doctorj at 1:19 pm under Uncategorized

My orthopedist has emphasized at every turn the importance of not overstretching the surgically repaired AT during therapy, because of the risk of  long term calf weakness. I have been (in my mind) fairly conservative with my exercises. Stretching has been gentle. Even so, my static range of motion is normal, i.e. plantar flexion and dorsiflexion just lying on the bed is pretty good. With more active movements, however, I clearly have decreased range, plus my right calf is still weak, so that I still limp when walking, and have great difficulty walking down stairs good foot first. I have not even thought about running yet. Then at the eleven week mark, my physical therapist turned up the intensity, with more vigorous stretching and strengthening drills. Even though the tendon is more tender as a consequence, I am hoping for more rapid progress. I must be moving beyond the (ill-defined) period where re-injury or overstretching is a significant risk.

One mild concern: when I palpate my repaired tendon, there is a point at the level of the medial malleolus where the tendon is thinner than above or below. That is, when I run my finger along the back of the tendon, I can feel a shallow depression about 2 centimeters long. Above and below that point, the tendon has some scar tissue and feels quite robust. When I stretch the tendon slightly by dorsiflexing the foot, the thin spot is less prominent but still there. In comparison, my older left repaired AT is fairly uniformly robust throughout its length. I’ll have to ask my orthopedist about it.

2 Responses to “More aggressive PT at 11 weeks?”

  1. Joeon 10 Nov 2009 at 4:49 pm

    I’m at week 15 now and last week I was just able to start going down stairs normal. I noticed this week that I’m able to walk faster now as well. Still have a little limp but it gets less and less each week. I wouldn’t worry about over stretching it at this point. For me it seem that I notice improvement on a weekly basis now. Good Luck

  2. tedbon 12 Nov 2009 at 4:16 pm

    Hi Doctorj,
    I have a similar dip on AT also close to middle of incision point. Didn’t get a chance to ask surgeon why.. keep us posted about what your doctor says.. I ruptured my AT at the top of my ankle..what about you?

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