Posted by: janis | February 18, 2014

PT Week 4 - building strength

What a difference this week. Most of the pain on movement is gone. If there is any discomfort now, I’d call it stiffness. Feels like I need a good calf/achilles stretch (but not sure how aggressive I can be with it, so I just stretch it out by walking). Also feeling a faint occasional sensation of adhesion at the incision site. Feels like someone left a strip of double sided tape inside there. I watched YouTube videos demonstrating how to massage that area, but they made me cringe. I should note I’m not a squeamish person at all; my business after all is dealing with literally broken people. The massage technique was just that rough. I do massage the incision pretty firmly every night.

The week 4 PT routine is geared toward building strength.

  • Treadmill at speed and time tolerated with emphasis on good heel to toe gait. Today’s new speed record - 2:8mph. Almost normal! (I’m short)

  • Squat press 130lbs with balls of feet/toes – sets of 10, at least 50 – at extension weighted plantarflexion for 5 count then dorsiflexion/stretch for 5 count

  • BAPS on setting 4, clockwise x100, counterclockwise x100

  • Balance board (finally able to use the taller one for everything!) plantarflexion/dorsiflexion x100, inversion/eversion x100

  • Balance on op foot on balance cushion, Karate Kid style – non op leg bent at knee up high and arms out to side – x15 for as long as I can stand

  • 10 laps walking lunges.  Up on toe when stepping forward.

  • Sumo squats with 25lb kettlebell, up on toes at end of rep - 50

  • New - weighted with 25lb kettlebell on each side, walk across room, going up on toe with each push off. This was hard and damn near impossible on my op foot. If it’s like everything else that I’ve done, though, I will see results in  how I handle stairs or other routine movements, and by next session I’ll be better at the actual exercise.

Having read about many others’ post op experiences, I have to say, I am really grateful for being a best case scenario case at this point. It’s great to have a physical therapist I trust, that knew my abilities pre op. He pushes me for sure.


The pushing is great, but it sounds like you’re doing exercises that are way too hard for you to do 8-10 of them. To me that means too hard.

Adhesions are usually clearly visible. E.g., if you look at your incision while pointing your toes as far as possible, you should see the skin getting dragged along if it’s stuck. Most PTs drool over the chance to break them up, including with very firm massage with spoons and such. (Graston I think.) Major adhesions will hold you back.

I would say it’s too much - except every time he introduces something new, I plod through a few reps, then come back next time and can complete a set, on top of everything else I’m doing. I’m not hurting when I’m done, and I’m even better the day after. Did 10 laps of kettlebell walk yesterday, I looked like a funky penguin. He massaged the incision and tendon yesterday, for the most part that felt good. Though when he got to the spot where the haglund’s deformity was excised, it was a little weird and slightly uncomfortable. Apparently it’s just a matter of desensitizing that area.

I guess if it’s working… but it reminds me of the way I got a month-long painful setback, following my PT.

And the adhesion? Can you see it?

Per my therapist, there’s no adhesion. Just the normal post op scar tissue that is breaking up a little more every day.

Today was finish of week 4 of pt. Felt very strong and flexible. The last couple days I feel like I am walking almost normally. 3mph today!

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