garyf’s AchillesBlog

Physio? What physio!!

Posted on March 3rd, 2011 by garyf

So, today was my first physio ’session’ - I use the term session loosely as it only lasted 10 mins and went something like this…. “so Mr Forster how is the tendon, any pain when you do your exercises at home?” Me - “no, but I have been getting a burning sensation in my heel when I do too many stretches” Physio - “oh, that’s not good make sure you cut the reps down if it happens again. Now, press your foot against my hand….seems quite strong, ok we need to strengthen the calf up”. Goes away and gets me a Theraband (I already have one) and shows me some stretches (which I’m already doing at home). “are you a member of a gym Mr Forster?” Me - “no” “have you got a mountain bike?” “yes” “great, get on it, by the way it could re-rupture at any time so don’t sue me if it does as it’s weak now. Carry on doing 2 legged toe raises and I’ll give you a 5 week open appointment, which means you can ring me to ask any questions you may have - take care”. So that was that, no massage, no extra stretches or exercises and no further appointments. I’d put 2 hours on the car park and had been in for 10 mins so was not amused!!! My question to you folks is…. What exercises can i do at this stage? I’m 11 weeks post ATR, i was put in a cast for 8 weeks and have been out of the cast for almost 3 weeks. I’m in 2 shoes and FWB with a pronounced limp!!

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11 Responses to “Physio? What physio!!”

janet, on March 3rd, 2011 at 5:18 pm Said:

WTH….I’m horrified…..I obviously haven’t started physio yet….but from everything I”ve read…ummm…should have been more than that.

You must be supremely disappointed.
GerryR, on March 3rd, 2011 at 5:32 pm Said:

Well, I don’t know what PT is usually like in the UK, I would have fired that clodhopper on the spot. That is a joke. After my last surgery I went a minimum of one day a week and had been in two shoes for several months. Find someone else if you can, interview them and ask them specifically what their plan is, and if they don’t have one, move on.
iski7b, on March 3rd, 2011 at 5:42 pm Said:

That’s terrible! I hope you can switch to someone more competent, soon. Very upsetting to hear.
gailbuddy, on March 3rd, 2011 at 7:43 pm Said:

Please find someone that can help you. I owe my swiftness of recovery to my PT. It’s hard to give advice as I don’t know your circumstances i/e health insurance,etc. But be assured that was a travesty. You can get great exercises on UTube but the guidance of a really good PT is invaluable in my experience. Ask around….good luck
lsjoberg, on March 3rd, 2011 at 9:38 pm Said:

as a lifelong sports addict I was a little skeptical about PT for the achilles, but the dude has been a savior so far, especially with helping me get over the emotional and mental hurdle of using the dang achilles again. do you have a local gym that you can ask around about PT? my PT was recommended by just everybody I asked…
normofthenorth, on March 4th, 2011 at 2:02 am Said:

My answer to your exercise Q is +/- like this:
- Build up calf-and-AT strength doing what you’re doing: 2-leg heel raises, shifting weight gradually to your right leg; Slowly build up to heel raises on low steps or boards; 1-leg raises. Theraband work can supplement heel raises. Eventually move toward jumping and pliometrics.
- Work on flexibility and ROM: If your ROM, either PF or DF, is much more limited than your left leg, the GRADUALLY stretch it, initially “actively” (using internal muscles) then increasingly “passively” (using towels, hands, walls, the floor. . .). Save FWB stretches for last, and treat them with caution.
- Work on proprioception and balance. 1-leg balance, initially in a doorway or other protected place. Build up to 1-leg with motion and/or distraction (bounce a ball, bend your knee, etc.). Some people like balance with eyes closed, me personally not so much.
- Start integrating, e.g., with an “agility ladder”.

I don’t think there’s a lot more to do, until you start getting back to the sports activities you love.

I was”raised” with two basic Rules of Thumb for intensity, which I still like:
1) Choose an intensity that lets you do around 8-12 “reps” with an appropriate level of effort. Do a few sets, and a couple of times a day, but maybe only every OTHER day. (See #2.)
2) If you’re NOT a bit stiff the next day, try a bit more; if you ARE still stiff TWO days later, rest until you’re not, and then do less.

If I had to add a third, it would just be “Be incremental. E.g., if you’re doing your first [whatevers, call it 1-leg heel raises], just do a few, without too much weight, and see how you feel the next day, before doing a lot with a lot of resistance.”

My PT gave me the most benefit in the early weeks, and I don’t think it was long after your “age” (~10 weeks) that he handed me over to a gym-trainer colleague (and I didn’t stay with her). You’ve gone non-op, so you shouldn’t have a lot of (or any) adhesions between your layers of tissue — but if you do, a PT can help break them free. PTs can be helpful in many ways, but I don’t think you’re likely to suffer from the treatment you’re getting.
garyf, on March 9th, 2011 at 5:05 pm Said:

Thanks Norm, there’s a really good range of things to do here and I’ll definitely make a ‘routine’ around them 

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garyf, on March 9th, 2011 at 5:08 pm Said:

Thanks for the comments lsjoberg. I totally agree that I need to build my confidence up as I keep thinking my AT is going to snap! No local gym but there is a private sports physio close by so I think I’m going to invest in a few sessions.

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garyf, on March 9th, 2011 at 5:11 pm Said:

Thanks gailbuddy. I don’t have any insurance but there’s a private sports injury physio nearby so I’m going to pay for a few sessions - even if it’s just to get my confidence back that my AT is not going to snap at any second!

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garyf, on March 9th, 2011 at 5:22 pm Said:

Thanks for the comments Gerry. Good call about the PT, I’m going to go to a private physio - expensive but worth it, even if it’s just for a session or 2.

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garyf, on March 9th, 2011 at 5:26 pm Said:

That’s exactly what I thought. The health service treatment I’ve had so far has been questionable to say the least but let’s look at the positives - almost 12 weeks since the accident and 14th March will be 4 weeks out of the cast and in 2 shoes and no re-rupture so it’s all good!!!

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