Posted by: jimr | August 16, 2008

Day 44 Post Op

This is my ATR incision scar 44 days after my surgery.  It feels good.  The scar tissue is softening up.  I have been taking showers without the plastic coverings.  This photo shows my heel is slightly swollen from walking around too much in my Aircast pneumatic boot.  I worked for five hours today at the bank and we were busy with the influx of medical and graduate students arriving from all over the US and the world to attend Brown University and the Rhode Island Institute of Design.  I used a hospital issue ice pack to ameliorate the swelling.  I am doing range of motion (plantar/dorsiflexion) physical therapy three of four times a day at home.  The planar flexion is improving, the opposite flexion (moving the foot toward the front of my leg) is tight and less flexible.  The incision scar which my surgeon used plastic surgery to close looks better everyday.  (Note: no staple or suture marks)  There is a slight indentation about 2.5 cm above the incision (in the photo0 from the end of the incision.  I can live with this!

Responses

jimr - your leg/foot look great. Im in week 6 post op. but I still have a fair amount of swelling. How often do you ice your leg? Are you still toe wriggling? I need to find one of those ice bags.
I have reached a definite wall when it comes to upward flexing of my foot; it has improved but my ankle feels locked. Downward flexing is normal but also inward pointing of the foot is still not all the way there yet. Thats a pretty neat scar, hardly noticeable.

Jacksprat: My PT told me to ice my AT and heel 15 minutes a day. I actually do it several times a day, for 15-30 minutes as needed. The ice bag I use was given to me by the hospital after my surgery. Its useful because it has two sets of ties.

I am still wriggling my toes and I have full feeling in my toes.

Keep doing the range of motion exercises. I did some independent research on “tendon healing timeline” and I learned that at day 42 fibroblasts (cells that give rise to connective tissue) become primary cells and give rise synthesize collagen (the main structural protein found in connective tissue). At two months, the collagen is mature and realigned along the tendon’s axis. I think its important to do the exercises and massage therapy consistently. Keep in mind, we all have different body physiology, and chemistry which affects the healing process.

I think a person’s attitude is important as well.

All the best for a full recovery! BTW, I am 64 and very active and fully intend to return to my sporting ways!

Hi Jim, always enjoy your informative posts, especially since we’re at the same stage in recovery.

I’m working on PWB now but it is quite scary trusting my leg to any weight.

Hi jimr - thx for the info, I am going to look for an ice bag like yours, Im tired of thawing frozen vegeatables on my leg :-)
Interesting what you found about the healing, some important numbers there.
Glad to hear you are not going to let an ATR hold you back! Dude, you have “the right stuff”!
Happy healing!

Hi Kevin: Thanks for your comments! Keep working for PWB! The first few steps I took for PW B were with much trepidation. The body is a wonderful system because it will “tell” how far you can go with PWB and FWB. The key is to listen to your body.

Of possible interest to you (and Jacksprat) is the reference I used to research the tendon repair timeline: http://books.google.com/books?id=snfZl1KxHA0C&pg=PA47&lpg=PA47&dq=timeline+on+tendon+recovery&source=web&ots=brGnorCf8Y&sig=ZgXqMJydR2a8hWrLPOz_UiMTJfM&hl=en&sa=X&oi=book_result&resnum=8&ct=result#PPA48,M1

(Page 48 contains the timeline for tendon recovery)

Its very long, so cut and past. It is a little technical, but there is a glossary in front. There are some exercises for recovery for tendon injuries but I am following my therapist’s advice…more or less!

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