Posted by: janis | January 27, 2014

First PT Session

It went well. His evaluation showed I have really good strength and pretty good ROM for 8 weeks out, so we skipped modalities like the electrical stim and ultrasound. We are focusing on relearning a normal gait, strengthening, and ROM.

Today I did:

  • 20 minutes treadmill walking, focusing on the heel-to-toe movement of the gait and taking even steps. That was so much more difficult to do than it sounded. The clunky uneven sound of my feet hitting the deck was really annoying me.
  • 100 reps each on balance board of: dorsiflexion/plantarflexion, inversion/eversion

That’s it. It was enough to make me pretty sore. I picked up a gel heel insert and that feels heavenly right now in my shoe. At home I’m supposed to do the same ROM stuff as above (seated) plus big ankle circles. He told me I could do flat-footed kettlebell swings if I want and said we may incorporate that next session too.

I will close by saying I know this therapist very well and have been a client for years, either due to injuries or attending the fantastic kettlebell classes he does. He works with my insurance (that pays him a fraction of what my old insurance did), and is actually the person who recommended my OS. I really feel for people who have to go out there post-op and choose a PT on the spot, with no prior knowledge of how they operate.

There was an older lady in the office doing PT at the same time I was. She had painful peripheral neuropathy due to chemo, as well as pretty advanced spinal issues. While I was plodding away on the treadmill, cursing the fact I could only go 1.9mph, she was (barely) ambulating around the office with assistance, while the PT tried to talk her out of jumping in to further surgeries.

After reading so many others’ stories here, I realize how very fortunate I am to have healed quickly and uneventfully. As of now, it looks like I am on track to make the “best case scenario” recovery my OS had described - about 14 weeks total off work. My PT is very confident that I’ll be ready to go back to full duty after my 6 week followup, and that’s the best news I could ask for.

I’m sore but grateful!

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Sounds like a great first session! That’s so encouraging. Glad you already had a PT you knew well and trusted. I, unfortunately, have to go with another PT. The one I was using previously is in the city and I can’t get to her - it’s just not practical to drive into NYC 2 to 3 times a week. (I live in NJ, work in NYC and have been working from home all this time). I’m at least using the PT who is part of my ortho’s practice in NJ.

I’m hoping my ROM and strength is as good as yours. I do feel pain in the insertion, so I’m not sure what that’s all about. But I go for my first PT on Wednesday.

Anyway, congratulations on your first PT session and the uneventfulness of this whole ordeal. :)


Great post Janis.

Keep us the good work.

Great first visit. I wholeheartedly agree with feeling fortunate. Terrific that you have a good PT and a great attitude. Keep up the good work!

Sounds good, J. Unlike your PT, I think an asymmetrical gait — provided all the other ingredients are normal — is a natural and healthy adaptation to the early stages of FWB in 2 shoes. So I’d have you concentrate on the other ingredients and forgive yourself the funny rhythm!

And make sure your inserts (&c.) are in BOTH shoes, or you could develop a BAD asymmetry.

Gait has improved at least 50% since Monday! Much stronger on balance board too. Able to do more reps at one time and less help with the good foot.

The bottom of my heel is numb and will be sore later, but I’m finding that the soreness is not lasting as long as it was before. The seated ROM sequence really helps. Also, I think blasting the bottom of my heel in the hot tub helped.

If you haven’t tried rolling it over a ball (tennis?), it helped a lot of us. Best while seated.

Thanks Norm. I actually have. Also a small bottled water, frozen solid. It feels heavenly. The PT told me to do that till it’s numb.

Milestone, today I woke up, put my feet on the floor, and no discomfort on the bottom of my heel! Of course I am a little sore now, but fitbit says I’ve done over 10,000 steps today.

How is swelling for you Janis?
I am at 7 weeks postop now. Been in 2 shoes a few days. LOTS of swelling at ankle. When does that improve?

Had PT last week and am doing my stretches and strengthening. Probably a big change for new Achilles after hiding in boot for 6+ weeks.

I’m trying to think when I noticed it wasn’t swelling much any more… I want to say it was about 6 weeks out I wouldn’t have swelling after a long day. I didn’t have an ATR though, Joe, I had a haglund’s deformity excision and Achilles debridement/repair. I don’t know if that makes a difference.

I am six months out from surgery and sometimes when I exercise the back side of my ankle tightens up. Does anyone know what that means?

Joe, you may want to check out . I was still being bugged by swelling 20 weeks after my (non-op) treatment began!

I recommend blogging about it, because I think mine cleared up soon afterwards! :-)

Hi Joe, I had quite a lot of swelling still from 6-10 weeks when I had my original rupture.

To help with this, my physio had me fill two buckets of water, one with ice cold water and one with hot water (not so hot that it will scald you but still as hot as your skin can bear) and put my foot in the cold water for a minute, then the hot water for a minute and repeat five times.

It was a bit of hassle getting the buckets of water ready but it really helped with swelling, especially if you can find time to do it two to three times a day. Hope that helps!

My PT used a nifty ice-water sleeve on me, and suggested icing for several minutes in a row, because the inflammation was deep. I put some ice cubes in a bread bag in a wide-mouthed thermos. Kept it handy with a chamois cloth. Pulled out one cube at a time, held it in the cloth, rubbed it over my leg. Sometimes went for two in a row. Worked for me.

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