Physical therapy is kicking my butt
September 19, 2012
Well the title basically says it all. I moved out of my cast into a CAM walker 12 days ago. I haven’t used any walking assistance since. My surgeon told me I could weight-bear as tolerated, and so far, I’m tolerating. Started PT 8 days ago. Ultrasound for 8 minutes, then 10 minutes of manual massage, then 10 minutes of biofeedback calf strengthening, then picking up marbles, then ice. Same routine the 2nd visit with the addition of Theraband exercises - plantar flexion to more plantar flexion. The goal now is calf strengthening without stressing the tendon to make sure I don’t stretch the repair.
Another addition on my 3rd visit was Graston technique.
http://en.wikipedia.org/wiki/Graston_Technique
http://www.grastontechnique.com/AboutUs.html
Holy crap, that was intense. My PT scrapes this metal tool along the tendon, and dear Lord, it hurts. There’s very little science behind it, although in theory it sounds good. Breaking up scar tissue/adhesions sounds excellent - I’m worried about the resulting inflammatory response and the build-up thereafter of further scar tissue/adhesions. I talked to my surgeon and he said some anti-inflammatories afterwards wouldn’t hurt, so that’s what I’m doing.
It has been interesting to see the results thus far of the biofeedback. They attach two electrodes to your calf and measure the force of your contraction. I don’t know the units, but my good calf could generate 190 units of force (?), while my bad calf was in the 30s. That was the first visit. The second visit, I got up to the 90s, and I was at 130 at the third. Who knows how reliable these machines are between sessions, but my good calf continues to register in the 190s. In between PT sessions I am doing the same exercises non-stop, so it is likely that this is helping me get some calf conditioning back.
One question for you guys - during the CAM walker phase/PT, did any of you experience little twinges on the medial and lateral sides of the tendon when you turn a certain way? I know that the tendon is intact, and I am in my boot with a heel lift constantly, trying my hardest to not stretch out the repair. I am utterly terrified that I am micro-damaging the tendon and weakening it, setting myself up for another rupture. After I got into 2-shoes the first time, the first few days of walking (no prior PT, was in a cast for 7 weeks) were rife with these twinges. Just would like to know what you guys experienced.
September 19th, 2012 at 19:33
Hoody:
Glad being non-surgical I didn’t have to go through that Graston stuff. I’m sure my PT would have enjoyed himself inflicting pain with that one.
I did experience twinges on the side of my tendon when I’d move a certain way, usually during a side step. It seemed like the momentum of the boot would cause it to keep going when I tried to stop my foot. I solved it by trying not to move those certain ways. Ultimately those twinges stopped happening and didn’t cause any damage.