First PT Appointment

November 15th, 2018

Had my first PT appointment today. Well, it was more of an evaluation. She took some measurements and tested my foot strength in different directions, which she said was good. I’m about where she thought I should be at the 6 week mark. She also showed me a few ROM exercises to do at home….you all are familiar with them. Heel pumps, alphabet, circles, towel scrunches. Just a few reps, three times a day. She said lower reps but more often are preferable at this point. She also said I should still be icing for the swelling, which I have not been doing. The swelling hasn’t been horrible, but yes I have a significant cankle going on, so I will add icing into my routine now. She said to expect some swelling in that ankle well into the 6 to 10 month range. Ugh.

I also got to take a wedge out of the boot so now I’m down to two wedges and PWB with the crutches. Boy I definitely notice a difference in that one wedge! My little achilles is not super happy with the added stretch. But I suppose that’s the purpose of this and will get better with time. I find using one crutch on the opposite side a little easier than the two crutches. I have set aside my iWalk for now in the hopes that I will never have to use it again (at least with this foot). It was invaluable for getting around those first 5 weeks, but I hate it. I might consider strapping it on in the morning just because I am so tight in the morning before the tendon warms up a bit.

I searched through the blogs for people who have had the Haglund’s procedure done with the detachment and reattachment of the tendon and shaving the heel bone down. It did not set my mind at ease! A lot of those people seemed to have a much harder time recovering from this then the standard ATR. A large number of the posts I read seemed to say that even a year later they were not at a 80-90% or so recovery level. My only consolation is that I know cserpent has had it done twice! and she seems to be cruising along in her recovery. My inspiration!

I am grateful that at least I am at PWB status now (so much easier to get around the kitchen). I try to remember that everything is in baby steps and already I have come so far. Those first 5 weeks were some of the most difficult of my life.

Question for all the gimpers out there…when did you transition from PWB to FWB? I forgot to ask my PT and the doc didn’t really give me a timeline for that. I’m not trying to push my limits, just curious. Was it after all the wedges were out or before?

Happy healing everyone and don’t overdo it on the Thanksgiving festivities!

8 Responses to “First PT Appointment”

  1. cserpent on November 15, 2018 8:31 pm

    Way to go June! I wouldn’t be surprised if those who don’t recover well from the surgery also didn’t do all the exercises/PT/… (icing!) that there were supposed to do. I learned from my mom’s multiple surgeries (hips/foot/shoulder) that if you do the PT that you’re supposed to, as often as you’re supposed to then you have a good chance of excellent recovery. I saw the difference between my mom’s ability to move compared to her cousin after hip replacement. My mom is moving great (especially considering she’s 80!) and her cousin is using a walker and doesn’t actually walk much. My mom did all her PT exercises as required (and sometimes a bit more) and her cousin didn’t.

    And you absolutely should keep the swelling down! That just slows down the healing process and extends your recovery time. And try doing your first set of exercises first thing in the morning when you get up. That may loosed up the achilles enough to get moving. That’s what I did when all my exercises were ROM type - I just woke up, did those exercises and then strapped on the boot and got walking :)

    You should be able to transition to FWB before all the wedges are out. It has more to do with how long it takes your achilles to get more flexible and the entire leg/foot to get stronger. Again - keeping the swelling down helps the healing process go faster :) No cankles allowed! That will probably mean you need to sit and elevate at times. I only got to the point where I’m not swelling much after the least provocation about a week ago. I was just about to buy compression socks to help with the swelling and then, presto, my foot pumps started working better. I’m at 13 weeks now. However, I know based on my right foot that I’ll still need to ice in the future if I overdue it.

  2. cserpent on November 15, 2018 8:34 pm

    And listen to your foot! Mine starts getting achy when I’m overdoing it and, always, when it starts to swell the added pressure causes the foot to ache. And once you get into more strenuous PT exercises remember that if it hurts - stop doing it :) It isn’t supposed to be painful during rehab.

  3. jeff16 on November 15, 2018 11:00 pm

    Junebug-when my doc gave me the green light to do PWB at 6 weeks he said to go FWB when I felt comfortable. He thought about a week or so but I felt good enough to get going after a couple of days. Had some tingling in the heel at first but quickly got over it. Hope that helps.

    Congrats getting to this point! Ditching the crutches, iwalk, and/or knee scooter is huge step.

  4. junebug on November 16, 2018 11:01 am

    Great suggestions/comments guys. Thanks for the input. I iced last night while watching TV, and it may be my imagination but I think I noticed a teeny tiny difference this morning. I also took your suggestion and did a few of the exercises in bed this morning before I got up. I image that I’ll probably one crutch it for about a week, maybe a little less, before I ditch it completely. I’m just not that brave yet.

  5. kamueller on November 16, 2018 2:31 pm

    It took me about five days to ditch the crutches. The more I walked on it, the easier it got. Started with two crutches on Monday, went to one in about a day, spent a day bringing the crutches too work for “just in case”, then I ditched them completely by Friday. I still have the wedges in, as my 6 week appointment is on Monday. I just get used to walking with them.

  6. dan914 on November 16, 2018 2:38 pm

    junebug, I’m non-surgical, but I don’t think it makes much difference at this point. I think it was about two weeks as I transitioned from PWB to FWB, from the time I first got the boot (week 3 post-injury). At first I just couldn’t put much weight on it at all, partly physical, hugely psychological, I think. I have some cankle still going on at week 11. My PT doesn’t seem worried about it all as long as it’s not painful or inhibiting me in any way. Frankly I wouldn’t notice it if I didn’t look at it. I do ice after my PT ( home or at the PT clinic), and usually once in the evening as well. I find it very soothing.

    Life gets better soon, when you get to FWB.

  7. kamueller on November 16, 2018 2:46 pm

    @junebug I would ask my doc if you have to be PWB for a period of time or if you are allowed to transition to FWB as tolerated. Walking in the boot gets easier as those muscles start to come back and crutches become unnecessary after a week or two. But you would feel better if he or she gives you permission to do so.

  8. junebug on November 16, 2018 5:25 pm

    Thanks for the replies everyone! Very helpful and insightful. So glad this site exists so that I know I’m not the only one going cray-cray. I think Dan914 is spot on… some are physical hurdles but a lot are going to be psychological.

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    I’m a 48 year old gal that loves to run, hike with my dog and do yoga. I am constantly on the go and have a hard time sitting still. This injury is slowly killing me.
    • junebug has completed the grueling 26.2 ATR miles to full recovery!
      Goal: 365 days from the surgery date.
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