dwolf’s AchillesBlog

Comment by normofthenorth

November 6, 2013 @ 4:39 am

If your AT-and-calf are tightening over night, it might be worth trying to accommodate the boot for a bit longer, or a splint if that’s easier to manage. I wrapped my boot in a plastic bag when I went out, then sat near the front door to take it off when I came in. Others have done the opposite, and wrapped their boots for indoors, or for bed.

Part of the progression through rehab is the gradual “stretching out” of the AT-and-calf, from the initial plantarflex-equinus position to neutral, then into dorsiflexion. If your AT-and-calf are “regressing” each night, that might be slowing you down, compared to having the boot (or a splint) “holding your ground” ’til morning.

Just a half-baked opinion. Otherwise, I do like your approach of letting your ankle (and AT-and-calf) get used to the “stretch” UNweighted, before you load it up. And when ATR patients get to the point where they’re removing heel wedges or adjusting boot hinges toward neutral, I advise them to do it at bed-time and spend all night letting the leg get used to the “stretch”.

Comment by normofthenorth

November 6, 2013 @ 4:43 am

In those early weeks, a lot of PT is gentle massage and manipulation, stimulation with various high-tech gizmos (ultra-sound, electro-stim, lasers), and icing. I’m a “dove” when it comes to early (DF) stretching. I forget exactly when bit.ly/UWOProtocol starts allowing passive stretching with therabands or towels, or active dorsiflexion past neutral — but you can check it out yourself. Unless you’re convinced that your surgeon repaired your AT too short, I’d be gentle with stretching for a while. (I was gentler than my PT recommended for my second AT, and I still healed a bit long in the AT-Gastroc system.)

Comment by Ron

November 6, 2013 @ 6:05 pm

Hang in there Dwolf,

I agree with Norm. At nearly 7 weeks, I also did a little ROM work after I got into bed. Since I no longer slept with my boot on after week 5, it was easy to do. Don’t know if you are bootless at night or not, but at 6 weeks you should be.

Just taking that boot off will help a lot because you foot will move a bit. Talk to you doc about it.

Good luck and hang in there - it gets better.
Ron

Comment by Steve

November 6, 2013 @ 6:41 pm

Hey Guys,

I started “walking” in the boot at week 7. Walking is a loose term. I will say that my achilles and calf are also very tight in the morning. I am 12 weeks now and walking in two shoes. Take it easy and be patient.

Good Luck!

Steve

Comment by dwolf

November 6, 2013 @ 10:37 pm

Thanks for the advice! Yeah I think I will keep the boot on when I sleep now, it’s easier and less painful in the mornings. Thanks again!

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Comment by dwolf

November 6, 2013 @ 10:39 pm

Thanks for the advice and positive thoughts! Congrats on walking in two shoes again!

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Comment by mhamay

November 7, 2013 @ 7:40 pm

I got one of the “plantar fasciitis” night splints and have found it has helped with morning pain/stiffness and increasing ankle flexion- it holds foot at 90 degrees all night.

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Comment by Jesus

February 5, 2014 @ 10:06 am

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