Less than 2 weeks post op and FWB!
Uncategorized September 30th, 2009So I went for my first visit to see the surgeon after my op on 18 September today. They took the cast off and I was amazed how little the scar was and the fact there was no swelling (you can compare the ankle in the photos attached). The surgeon then declared I am to move into a Aircast boot with 3 support heels (see photo) and to take one out every 2 weeks. He then stated I should go to full weight bearing immediately but still use crutches as it will be quite painful for a while. I can take the boot off whenever I like - especially when relaxing in front of the TV and excercise my tendon but not to bring the foot upwards too much - take it easy! I can also shower fully after the weekend but not have a bath until next week as the wound still needs some more time to completely heal.
I couldn’t really take all this in as I was expecting to be at least NWB for another 2 weeks and only then move onto PWB. I did ask what the catch was and he said nothing - just be careful. Because I had this new key hole technique the incision was only 1-2cm (see photo) and I could be more aggressive.
I am back in hospital in 6 weeks time for the final heel removal and checkup. I forgot to ask and he didn’t mention about physio so I guess it would be best to restrict myself to PWB/FWB and moving my ankle around although I did want to ask about cycling and forgot! I guess I should be able to do that in about 2 weeks or so.
All in all a good day - let’s hope this continues.
All the very best
Graham
September 30th, 2009 at 18:46
Graham,
Holy smokes… Congrats. That incision is real small. Anyway, be really careful as you don’t want a 2nd surgery to repair the first one (speaking from experience).
wai
October 1st, 2009 at 10:52
Thanks wai
I am now worrying this is all happening all too fast. I don’t even know if the tendon is still attached - I guess I would of known of I had re-ruptured it?? Should I be able to feel the tendon, would it be limp and soft under the skin and not hard like my healthy one? There is no swelling in my ankle as can be seen from the photos.
October 1st, 2009 at 13:55
Hi Graham, thanks for leaving a comment on my blog at http://rupturedachillestendon.blogspot.com/
It was interesting reading about the key hole surgery and the resulting so little swelling. Gosh I wish that had been my results. I would not have had to endure so much pain at the OT !! It will be interesting to plot your recovery against mine. I definatley think you will be driving in well under 8 weeks ! Good luck and I look forward to your updates. cya David
October 1st, 2009 at 15:01
Hi Graham,
Don’t worry too much, but be careful of missteps and of stretching the tendon too long too early. If it makes you feel any better, I started shuffling along in shoes only at 2 1/2 weeks postop, so I had to be especially careful. The boot and the heel lifts should keep the tendon from stretching too much as you walk around.
If the tendon is reruptured, very lightly flexing your calf won’t move your foot against gravity. Since you have a removable boot, you can do that simple test.
I’m not sure I understand how a smaller incision means the rehab can be more aggressive. Did he explain that in any detail?
Good luck,
Doug
October 1st, 2009 at 15:06
Thanks Doug. You have so little time with the surgeon on the NHS he was off to see another patient before I could get out a load of questions. I guess it might be something to do with the fact the incision is so much smaller than normal you don’t have to worry about it opening up under tension?? I don’t really know.
I can raise my foot very slightly before it tightens - only a small amount mind. When you say flexing your calf are you taling about pinching it and seeing if your foot moves slightly (as like the test to see if you have ruptured it?? Can’t remember its name)? Thanks
October 1st, 2009 at 15:19
The Thompson test seems to be less reliable postop, from what I’ve read, (maybe the tissues scarring together messes the test up?), but if it works, that’s obviously a good sign. By flexing, I mean actually contracting the calf muscle, as if you were going to jump, but very easily, so the tendon isn’t pulled as hard as when you are pulling it with your current stretching exercises.
Doug
October 1st, 2009 at 15:27
OK thanks. Still not sure what you mean will have a try when I take the boot off next. I see from your blog you have a number of other exercises I might try as well
October 1st, 2009 at 15:51
Graham - At this stage I would stick to very gentle movements/exercises, just enough so the ankle joint doesn’t stiffen up too much. I would avoid any dorsiflexion (toes towards your shins) as your doctor mentioned. Another 2 weeks would probably be a good time to give the exercise bike a try with the boot on. Start with low resistence and try to use your heel rather than forefoot to reduce the stress through the tendon. Just be careful.
October 1st, 2009 at 16:04
Thanks Tomtom. I plan to remain gentle but as my surgeon said its OK for FWB I want to push it on. I can walk with the aircast boot on if I keep my bad leg only on the heel of my foot and shuffle my good leg forward. No pain only sometimes some ‘pins and needles’. I have 3 inserts under my heel in the boot. I will try some of the suggestions doug53 mentions on his blog about leg calf exercises and middle/index finger under my heel as well.
October 1st, 2009 at 17:49
Graham - Sorry I wasn’t clearer. Didn’t mean to imply you shouldn’t weightbear/walk per your doctors instructions. What I meant to say is that you should work into the range of motion exercises very gradually at this point. Be careful not to stretch the tendon (dorsiflex your foot) too much early on. Sorry for the confusion.
October 1st, 2009 at 21:26
Graham,
My 2nd surgery was a new ruptured that occurs about 3 cm below the original ruptured. Very strange. It happened 14 weeks after 1st surgery. So, I am 2nd post-op since 9/21/2009. Wearing a light cast a few more days. Will probably be wearing a mobile boot after that.
Just take it easy and go for PT. I didn’t, and it probably hurt me.
wai