7 Weeks NWB 2 to Go - Some Questions
Ok I’m 6 Weeks Post Op NWB.
I have been cheating and putting some balancing weight (ok… walking a few meters here and there without the crutches…) on the foot for the last couple of days since changing the foot angle to 0Deg (up from 15deg).
No pain while doing this at all but I do notice at the end of the day my foot has started to swell again.
Ok so I will stop and go totally NWB again for the last 2 weeks, but I do believe from reading the forum that this is not unusual and many people have swelling as a normal part of recover for months afterwards.
Now my main question is how to treat it.
I’ve been told by my brother in law who did the same thing a few months ago that ice was no help and I kinda got to agree from the point of view that:
a) ice is normally to stop bleeding, in my case there seems to be no bleeding or bruising.
b) blood flow promotes healing and swelling reduction and the Achilles has low blood flow, so ice would slow it down even more.
Alternatively should I bee putting heat on it ?
Otherwise apart from a bit of stretching pain for a couple of days after changing the angle of the boot (each 2 weeks) its been pretty painless, of course there’s the occasional pain when i roll over in bed and catch it (even in the boot) or occasionally catching it at other times. But otherwise good.
I cheated big time during my rehab, (putting away the splint and crutches for good by four weeks, starting single leg calf raises by nine weeks). While I avoided doing things that hurt, I never worried about swelling. Swelling is just going to happen. I certainly never used it as a criterion to slow down my rehab.
I wore compression tubes (”Tubigrip”) regularly to control the swelling, mainly because it felt less stiff when the swelling was gone. I only elevated my leg when it was convenient to do so. The only time I iced my tendon was the night after the surgery. I found compression to be very helpful.
The trick is getting the right amount of compression, enough to keep the swelling away, but not so tight that the compression itself gets uncomfortable. When I wanted any swelling to go down fast, I would put an ace wrap over the tubes, and take the wrap off about 30 minutes later.
A little trick I added was put a small pillow around the back of my tendon, to push the swelling out of those little hollows between the tendon and the ankle bones sticking out on each side. Getting rid of all the swelling that way made things feel especially good, although the pillow made it appear as though I had a lot of swelling.
Best wishes,
Doug
My understanding is that if the tendon area feels hot, you have an inflammation (besides swelling, some of which is normal) then you have to back down, elevate and ice.
“Chronic swelling also impedes the body’s ability to heal and may actually weaken surrounding tissues”
Thanks Guys,
Definitely not feeling hot.
I did ice pack it with a strap around it and the swelling went down pretty quickly.
Probably the compression more than anything.
I have been using compression tube bandage, its firm but not too tight.
guess I just got to get used to it
jphicks - I agree with Doug that swelling is going to happen. It’s a sign our body is trying to heal itself. But, I think it is important to try and manage the swelling as best as you can. Like Doug, I find compression to be helpful and something you can use all day long. I wouldn’t be too quick to give up on icing. I’m not a doctor, but I’ve never read anything that’s mentioned ice could be detrimental after injury. I would definitely ice if the tendon is showing any signs of inflammation - reddish, warm to the touch, etc. You should not apply heat, such as a heating pad, if the tendon is inflamed.
Others have recently discussed cold-hot contrast baths. I’ve tried this in the past with some success. The contrast temperature can help to re-stimulate circulation in the ankle and push out some of the edema. Again, I would be hesitant to try this if the tendon is inflamed as the heat could cause increased swelling.
Sorry, I was too slow with my comment. After reading your update I see some of my comments may not apply. It sounds like you have a pretty good handle on things. If you notice a difference after icing I would definitely continue to do so. Cheers!
Thanks tomtom…all feedback is welcome, if its a repeat, its reinforcing.
Thanks all.
I’ll keep icing, as it seems ok, again it might be that I’m using a ice pack strap that provides a lot of compression which could be the major contributor.
I’ll also try hot water massage setting on the shower hose and see if i get a bit more relieve with that, not that its painful, just significant swelling.
In the scheme of things waiting 2 weeks, when I see the doc, to do any more activity/cheat with early PWB is not really a problem, ill take it easy and keep the post updated.
Thanks agaon