Week 4: 4cm or 2cm?
I’m now entering week 4 and wondering if I should reduce the heel lift in my air cast boot by 2cm further, so down to 2cm from 4cm, as per UWO non-operative rehab protocol? But Wallace says 4cm to week 6. Am thinking I might do what I’ve been doing all along & average it out so wait until week 5 and then go to 2cm. In fact I have appt with OS at week 5 so can ask him (although I think I know more about non-op recovery than him at this point!)…
In other news, my physio appt last week was ok (uk NHS)- she agreed that all ankle exercises as per UWO protocol are good and she also recommended spelling out the alphabet with my foot as a way to alleviate the boredom of circles! She also gave me hip/gluteal exercises but doesn’t want to see me again until week 6 - she says the real physio only gets going once the boot comes off. Am seeing another sports physio tomorrow privately so will see if he says differently.
Finally I STILL cannot get the timeline widget to work despite repeatedly trying to install/activate. Sigh.
Happy healing everyone!
November 4th, 2014 at 12:04 am
1st, your ATR Timeline Widget looks OK, except that it’s at the very bottom of this page, about a mile down! I’m guessing that that’s an artifact of how your theme — XHTML WPMU Theme pack by WPMU-DEV. ยท CSS — deals with it. You could certainly try another theme and see if that makes it better.
2nd: The approach of the most successful non-op protocols to immobilization and NWB and 2 shoes is pretty consistent, but their approach to changing ankle angle (heel lifts or hinged-boot angle adjustment) is quite different. Primarily, there are 2 main approaches: stay in equinus for around 6 weeks then jump to neutral “cold turkey” (like UWO), or start sliding toward neutral a bit earlier, and more gradually. Of course, there’s also another “branch” that’s unique to Wallace (among the most successful published studies), which is to choose the initial equinus angle based on a detailed exam (visual and palpating-manipulating) of the torn AT ends.
I don’t think the evidence can give you much guidance about which angle, and which schedule, is best for you, so compromising among the best studies is probably as sensible as anything.
Me, I was a fairly slavish UWO follower, except in 2 steps. The first was at 6 weeks, when my leg found the “cold turkey” jump to neutral too abrupt, so I spread it out over a couple of days. (The second was about a week later, when I started using the old hinged boot I’d kept from my first ATR, 8 years earlier, and walked around with it set free to hinge from neutral to extreme plantarflexion.)
My results aren’t perfect — and neither are the results from my surgical ATR #1. But both are good enough to get me back to competitive volleyball at the same (or even higher?) level than pre-ATR, which is a good working definition of Good Enough.