Jul 10 2011
First steps in shoes and a driving test @ 6 weeks
Yesterday I was feeling pretty good about my recovery, having just learned to take steps in the boot during week 5 for the first time. I decided to get some heel cushions/wedges (Scholl’s) and try on my running shoes. Wow, feels so much better than the boot! My ankle and leg are obviously still very weak - having little to no calf strength means I’ve got a good limp yet, and my ankle has weakened enough to where I definitely wouldn’t try the shoes on an unpredictable surface just yet as an ankle roll isn’t out of the question. The best part about it though, is that after concentrating on and ’shooting for’ the proper walking form, my calf definitely feels used afterwards, which to me means huge progress. Still have to be careful though - with two shoes on and weeks of inactivity my instinct is to take off running or just start jumping in place!
Here’s a short video of my first steps. (I’m mumbling basically the same thing I’m describing above)
I also took a test drive in my wife’s car (not mine, it’s a manual so I’ll start with two pedals). Felt pretty good, however I’m not quite ready to hit the interstate towards downtime in morning traffic. A few more days of practice and strength in my calf should do it though. The problem now is that with my heel on the floor mat rolling from gas to brake, my calf still gets worn out pretty quickly, so I have to lift my leg from gas to brake. Fine if you are driving in calm traffic, not good when you are constantly getting cut off in traffic. I’ll get there very soon though.
I’m just pleasantly shocked at how quickly things are coming back after finally (carefully) applying some weight.
9 Responses to “First steps in shoes and a driving test @ 6 weeks”
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Great video! Very encouraging, great progress. Keep it up. I’m at almost three weeks post-op and I’m getting to PWB. Seeing you gives me even more hope and motivation! Have a great week.
Thanks, TJ. I just read about your accident - sorry to hear it, but you sound like you have the right attitude for a quick recovery. My doctor recommended no weight until 6 weeks, but as you’ve read many people have a much quicker protocol. I began ‘cheating’ on week 5 and the past week have seen tons of improvement, including a decrease in the blood rushing to the foot you are experiencing when standing. As my doc explained, the calf acts as a pump and when it’s not stimulated all the blood is going to pool in the foot, so whenever the calf can be active will be when the blood stays where it should.
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That’s excellent!! I also started walking at 5 weeks in my boot. But, the boot is hard as a rock and my heel starts hurting quickly. Today, I put a shoe on for the first time. Felt so much better that the boot! But, with no protection I will only walk around the house a little. It will be back in the boot to go to work tomorrow. My limp looks just like yours
My tendon is very tight and I can’t roll my foot forward properly. I am also finding that the tendon on my good foot is quite sore, after weeks of crutch walking and putting more stress on it. My tendons never hurt before, but now sometimes my good one hurts more than my bad one. Good luck and ‘keep on walking’!!
Jeff: I am just two weeks ahead of you, and you will be amazed at how quickly you advance, as you walk with shoes on. Keep it very slow and steady, and watch out for those steps off of curbs. I thought the boot was great after the cast, but shoes are the best yet. Also the heel cushions do help. If your heel starts to have that agitated, burning sensation, just sit down and rest it for a few minutes. Best of Luck!
I was happy walking vigorously and fast in a boot, with my other foot “built up” so I was walking with my hips straight, until 8 weeks — though at 7 weeks I switched to a hinged boot, that protected me from dorsiflexion while allowing full plantarflexion. You’re getting more aggressive exercise and stretching in 2 shoes, and also exposing yourself to much more risk of injury (as you also say). Where the best tradeoff lies is a good question. My tendency is to go with the evidence from big studies, but some individuals have demonstrated good individual results with much more aggressive approaches.
There’s a popular approach in “life coaching” to imitate the habits of successful people. The problem with that approach is that nobody’s done a study to find out what % of people who act like that actually become successful people, and what % go bankrupt or otherwise crash and burn. If we knew that the habits that created (say) a billionaire also created 90% disasters, most of us would hesitate to go down that route.
In the ATR rehab field, we do actually have some studies that demonstrate very good average results with with very low failure rates. (The so-called “UWO Study” is my fave, from 2010.) Its protocol (posted at bit.ly/UWOProtocol) is faster than most, though not as fast as some “successful people”. And in this case, the “success” isn’t making a billion dollars, it’s just recovering maybe 3 or 4 weeks faster than some other people.
Thanks, runnerwannabe.
It sounds like you and I are in the same place. My next goal is to get rid of the limp, which I think all comes down to loosening the tendon enough for about 10 more degrees of dorsiflexion. I did have the same aches in my good AT until I started weight bearing and now that has subsided quite a bit. I’m being very cautious and conscious with my steps in shoes, staying on flat surfaces and trying to roll the foot properly while ‘listening’ to my tendon tell me when the stretch is reaching its comfortable limits. I also make a point to do my ROM exercises before lacing up the shoes. When going to work or doing things outdoors, I’m sticking with the boot for now, as I know just one instance of my mind forgetting about my injured foot (which is easy in shoes) could set me back big time!
Thanks, Chuck! It sounds like you have enough ROM that you are walking limp free most of the time at this point? Did your dorsi ROM come back gradually with walking or did it mostly improve through PT? I feel like my calf is springing back enough to where I’m noticing daily improvements in strength, but my ROM is where I think I ‘m stuck or at least very slow in progress, which of course is also where I’m most timid because of re-rupture risk.
Hey Jeff: The ROM has come back gradually. Although I can walk without a limp, I am still a little slower than I used to be, with no big bursts out of the chair, across the room to the refrigerator. I do a lot of flexing of my ankle, front, back and side to side. I have been doing this 5-10 times a day for a couple minutes at a time. Also, I highly recommend massaging your AT area with Vitamin E cream. If you have someone that will help you, even better. My wife massages the scar tissue every other night, and every morning when I get up, my ankle feels almost 100%. A lot of the flexibility will come back with more walking, too.
Getting normal dorsiflexion (and some strength) lets you stride full length, but you’ll still have a “dip-limp” at the end of the stride until your calf gets strong enough for the foot to “push off”. That’s not nearly as much strength as a 1-leg heel raise, but it’s a lot, and takes weeks (and weeks) for some of us. Doug53 first labeled that period the “frustrating plateau”, following a series of relatively quick “landmarks”.
Keep walking, keep watching your step, and it will come. . .
BTW, Runnerwannabe, couldn’t you put a squishy footbed or a slab of foam in your “hard as a rock” boot?