4 Weeks Post-Op

Here is where I am. I would truly like thoughtful feedback (no mindless reprimands please).  Brief history is this is my first rupture of my RIGHT AT but I did my left one 16 months ago and had a very good recovery. I am feeling like this one is going even better. The (same) ortho decided to only keep me in cast 2 weeks and then put me in boot (as opposed to another 2 weeks in 2nd cast last time). Immediately started swimming and pilates (adjusted for NWB). So 3rd week post-op dedicated to staying in boot except for sleep and exercise. Then 4th week started leaving boot off around the house. I decided yesterday to stop with the crutches and am in 2 shoes (with heel lift). Mind you, I am walking peg-leg and not pushing off at all - just a flat footed walk with a big limp.  I have had essentially zero swelling since week 3. Looking at my feet you could not say which one had surgery 4 weeks ago. Even the scar looks ‘beautiful’. Doc felt it today and commented “not at all hot or swollen.”   He recommended staying on crutches 2 more weeks (no I didn’t say I went without them day prior) and get to FWB in 10 more days, but stay in boot. However, have done the 75% FWB for a couple days now.

The thing is, I feel no issues around this, no pain at all, it is very strong  and I am being very careful. I don’t have the fear of shoes that some have mentioned and having been through this before (very recently) I think I have a good benchmark to compare.  I cannot deal much more with crutches as they provide nothing but a hassle - I truly feel they are more dangerous, slipping on wet floors, getting knocked by passersby etc..   I do still scoot around on the scooter at home and not trying to bear weight at all times, just getting on with life. Though crutches are faster at this point so I haven’t thrown them out entirely when I am out of the house.

I am not trying to be a hero in this and I am not pushing forward with PT before Doc says but I do plan to listen to my body on this. Also, just read Parissky’s post which is not far off from what I am doing so that made me feel less like I am a lone ranger. Anyway, that is where I am, being ‘carefully aggressive’ with my own treatment. Thoughts?

And, just for the record, having done this twice, the difference of having a cast for only 2 weeks is huge, in the sense that all those little muscles get to move much sooner with ROM excercises and band exercises and the atrophy of calf is much less. I think this is the way to go to get people back on the road - much greater ‘prevention’ and much less ‘recovery’ of collateral damage.  I predict that within 3-5 year the recommendations will be much more aggressive. Considering they used to have people in casts with no activity for months it seems.  We shall see I suppose!

7 Responses to “4 Weeks Post-Op”

  1. Duke, I couldn’t agree more. I got up on my feet in my shoes as soon as I could, and would have done it sooner, if I had been smart enough to think of putting a wedge under my heel. I hit the calf strengthening early, too. I think the trick is to be aggressive and be careful at the same time. I remember going out and shoveling snow, in my shoes, 23 days postop. That sounds crazy, and it probably was, but I kept my injured foot out in front of me all the time, so I couldn’t fall forward over it and overstretch the tendon, even if I slipped on the ice. That’s not a good example of what is advisable early in a rehab, (”Don’t try this at home!”), but it illustrates the combination of being aggressive, yet with caution thrown in. Overall, rehab protocols seem to be getting more aggressive over time. How far will it go? Like you, I think it is better to prevent the atrophy with a fast rehab, but there is risk when going faster than the well-tested protocols.


  2. Sounds like calculated risks, informed, eyes open — all Good Things in my book. You may well be extrapolating on the trend, ahead of your time — let’s check back here in 5 years and see! ;-)

    Meanwhile, do Watch Your Step!

    BTW, I don’t think I understand when you say you’re 75% FWB while you’re walking around without crutches. Does the 75% mean you’re 100% FWB 75% of the TIME? If so, I do understand!

  3. Hi Norm,

    Well the 75% is really trying to reflect that I am walking a bit off-kilter on purpose - peg leg more or less, and, for example, as I am walking down stairs I am not going 100% on the recovering (we won’t say ‘bad’) leg but leaning on the railing, leg at an angle etc.. And, yes, still some using the knee walker and crutches here and there. So didn’t feel like 100% weight bearing was accurate but, really not sure what is. Thanks!

  4. Hi Duke88,

    I see from your blog that we both ruptures our achilles tendons on the 10th Oct 2010 and I also see that we where both born in the same great year 1966 and that we are both female. It will be interesting to see how our recoveries compair! I see from your blog that your doctor lets you go swimming, mine will not even consider it, you are lucky on this front.

  5. And I ruptured mine on Oct 11th so I will also be very interested to monitor progress. Had my op on Oct 14th.
    My doctor is adamant I will be in a cast for 8 weeks after the op.
    Changed every 2 weeks to alter ankle angle.
    With one change left I’m at about 90degrees.
    But I ain’t doing any rehab with a cast on for another 3 weeks. Thats for sure..
    I’m really impressed with Duke88 progress.

  6. Hi Duke 88,

    I was wondering how you are doing?


  7. I don’t think it is ever too late. It may be more difficult now as in huritng more and take longer. You could start some physical therapy and get suggestions of things that you could do at home. Also, I think you should have a therapist to tell you the things that you should do, after an evaluation. Anything that anyone could tell you on here could be the wrong therapy Good luck

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