Question about soreness

OK, question for anyone out there — anyone meaning someone further along the marathon course than I am:

I’m 6 weeks, 4 days post-op. I’m PWB (75 percent) progressing to FWB as able, doctor’s orders from last week (see most recent blog entry).

I’ve begun careful “walking” — hobbling — around the house w/o crutches (still in the boot, of course).

Also, “walking” — not quite as much hobbling — on one crutch when at work.

It has been going pretty well. I can see the tendon is ready for FWB, if not for stretching and real walking (even in the boot, it’s a very, very limited, tentative thing right now).

But the foot is now swelling regularly (it wasn’t swelling much at all in the last few weeks before this increased activity. Also AT is very sore, when it wasn’t before.

That’s OK, I figure.

But also, there’s a dull (not sharp) pain that occasionally occurs near the back of the heel.

I’m pretty sure it’s the Achilles. It occurs only when the foot makes initial contact with the ground. Not with any push-off (not that there’s much push-off going on).

Not all the time. But sometimes. And when it does … it has the feel of a dull sprain, or something. As though I’ve strained the thing.

Since I’m doing all of this in the boot (and believe me, we’re not talking about much activity yet), it’s unlikely the tendon has been stretched beyond its current capacity.

When I flex the foot up, down or sideways against no resistance, there’s no pain at all — even at the far outer limits of those flexes. (Which in dorsiflexion is right at 0, maybe a little better but not much).

Thoughts on the occasional dull, sprainlike pain? Again, it’s occasional, meaning … every 10th (?) time the foot makes contact. Also, it’s Day 2 or 3 of all this activity.

But the pain is real, and it’s a little (not a lot) concerning.

Anyone experienced anything like this? Thoughts? Thanks in advance …

George

8 Responses to “Question about soreness”

  1. George, It sounds like we are on the same time line. I am six weeks post op today. I was sent to PT as soon as I went from cast to boot (about two weeks). The doc took the cast off at day 11 and I won’t see him until Aug 5 for my second post op. You’ve seen your doc a lot more from the sounds of it. My PT has been giving me all of the suggestions regarding weight on bad foot. Things have progressed fairly well with no setbacks. I feel a little dull soreness and some swelling after being on my feet all day. I am pretty much FWB on both feet most of the time without crutches but with the boot. I have been practicing with no boot and crutches on the carpet. I get cocky sometimes and go without the crutches for a little stroll but I make sure I am able to grab some piece of furniture or a wall. Things feel very stable and there is no pain at all. Your PT will get you going with range of motion which will make all the difference in the world. I am not sure why your doc is waiting 8 weeks before PT. The first sessions were mostly massage and simple gentle manipulation.

    Good luck and keep moving.

    Chuck

  2. Chuck:
    Thanks for the feedback. My doc is definitely conservative in his approach to post-op. Which is OK; I’ll make do, even as I see others on this site with much more aggressive rehab protocols.
    I guess the only thing that worries me (a little) right now is the slightly strained feeling that I get — like a tweak, maybe — every 10th time I put the bad foot down while FWB or close to FWB.
    Hmmm.
    Thanks again.

  3. George-
    I have the EXACT same heel thing that you describe. Google Plantar Fascitis (sp?) , because it sounds like that’s what you have. Apparently it’s common after prolonged inactivity. I also have the soreness you describe, but usually a good massage makes it feel better.

    I’m not getting much swelling, but I’m sure whatever you are getting is to be expected once weight bearing begins. Just thought you’d want to know you’re not alone.

    My boot doesn’t have any heel wedges in it, does yours? I put an orthotic in my boot that has a little arch (since the boots are total fred flintsone with flat feet), and it seems to relieve some of the heel pain. You can get some of those doctor scholls inserts, or go to heelspurs.com and order some from there. Hope this helps.

    Shay

  4. George,
    if you have pain and more swelling than before I would take it easy. Check with your doc or PT. If you have no pain doing theraband exercises that is normal, that is much less resistance than your full weight. When you make a step you calf muscle pulls hard on that tendon. If you over work it it and gets inflamation, it will be more prone to rerupture.

  5. Shay:

    Thanks for the comment. I’m pretty sure it’s not plantar fasciitis. It was more something with the muscles low, near the back of the heel, but not the bottom of the foot. I didn’t think it wast the AT itself, though. But it wasn’t a feeling I wanted, and it was too close to the AT.

    The good news is, the pain has essentially subsided. Haven’t felt that particular one in a day or so.

    My boot doesn’t have wedges; it’s set to 10 degrees, so it’s angled. On Tuesday (7/28) it’s supposed to go to neutral.

    I’m ready for that. In a week of PWB-to-FWB, my foot has readjusted to the weight and pressure; it felt weird (not the tendon, the foot) at first.

    I’ve been swimming a bunch. No leg motion during the swims, but a little P.T. in the water (even though I haven’t begun real P.T.). It has definitely loosened up the foot each time.

    2ndtimer: Thanks for the advice. Read your entry about re-rupture: Sorry! Wow.

    I’m being careful, and will be more careful. The foot/leg gets tired and achy toward the end of the day; Yesterday and today it hasn’t seemed to swell nearly as much, so perhaps it’s getting used to the increased activity.

    Nevertheless, caution is the right prescription. Slow isn’t a bad thing..

    Thanks to both for the comments.

  6. Hey George,
    I am 6 weeks post op today and have just started pwb in the last couple of days. I too am getting twinges in the ankle every couple of steps and a bit of swelling but have noticed that every day it gets better. It just has to get used to being used again. My doc is even more conservative than yours as i’m not allowed to start physio for another four weeks (driving might be another 6 weeks!) but has allowed me to go from 4 wedges to 2 in 2 weeks and then go flat in 2 weeks after that. All he said to do was to start bending my foot forward and back, thats it!! Must admit, was very nervous to start walking again but i am loving putting my foot on the ground and moving about easier. Good luck with the rest of your recovery.
    Tina

  7. Tina:

    Thanks for the comment and the encouragement. It definitely feels better in the last few days since I started weight-bearing. No more of those twinges in the last day or two.

    Also, it feels great to finally be taking part in the recovery process. Or at least, to finally feel like I’m taking part. I know the first few weeks were important in healing, but this has been so much better.

    The freedom and mobility of the last 10 days or so has been fantastic. It seems the leg/foot/AT is getting stronger each day. No setbacks.

    The key now is to not overdo it. To find the right balance (not too slow, not too aggressive) in rehab. I’ll be cleared for P.T. at my doctor’s appointment Tuesday.

    Already, it is fantastic to have hands again — going with just one crutch and, at home, going without any crutches at all.

    One other thing: Swimming laps has been a great addition to my recovery. It has enabled me to regain some fitness, and to loosen up the foot (no kicking, but the foot gets loose anyway) — and most important, maybe, it has been very positive for my mental outlook.

    Good luck with your continued healing and recovery, and thanks again.

  8. No worries George. Must admit, i’m still with the two crutches at the moment but am building my confidence every day and will hopefully be off them in a week. As its my right foot and i’m separated, i’m pretty much housebound with driving still a way off but i will try the swimming when i can.
    All the best for a speedy recovery too.
    Tina

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