Gaining DF at 18 weeks

Just a quick update to say that I’ve gained some DF this week - coinciding with swelling subsiding.  The main difficulty with DF seems to be scar tissue and skin all sticking together around the ankle, but it’s loosening with more fast walking.  Despite increased exercise, my swelling is really slight as well!  The only thing different has been extra fast walking each day (I was relying mostly on biking) and swimming laps with kicking.  The kicking really seems to loosen the tendon as well.

So for those of you fighting lack of ROM, I think it’s more than just healing short in my case - more mechanical restriction of all that glued together tissue.  You’re not doomed to be short forever at 3 mos. like my doc said - it continues to loosen (like the folks here said!) Pic below is after a long walk - I’m a little swollen - but not much.

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I’ve been able to get about an inch off the ground for a single calf raise, and my AT feels really strong and flexible.  My calf is building every day - it’s slow but steady.  Just waiting for the rest of this scar tissue to release and I’ll be back to normal.  Hang in there, newbies - it goes fast once you’re able to start WB - no need to rush.  Blessings, Kim

22 Responses to “Gaining DF at 18 weeks”

  1. Kimjax,
    Thank you- my doctor just said the same thing- what you got is what you will have for ROM.(12 weeks) My ankle is still very swollen at time Did you wear a compression sock? If you did when did you stop. I love swimming it makes the ankle feel great. After an hour in the pool I seem to be a lot looser for a while then I have to elevate and ice again.
    Your blog gives me hope. (PT says the same as you did but this doctor is all gloom and doom- no bedside manner.

  2. oldlady - I tried the compression socks and they didn’t work for me. (didn’t reduce swelling and were painful after a couple of hours) The swelling went down suddenly in the last couple of weeks (16-18) for no particular reason. I’ve upped my walking distance and speed and am building strength by calf raises (finally) and I think that’s loosening up the ankle quite a bit. The swelling seemed to hinder my DF as it was painful on the sides of my ankle when I stretched - NOT in the AT. I’ve stopped icing and started using heat (hot soaks) before I stretch it now. The skin over the AT does not move freely, either, so I’ve got a lot of adhesion going on with the tissue underneath - all of which is improving with time and motion. Hope it continues - it’s such a relief to finally feel some “stretch” back there! My doc was doom and gloom also. :(

  3. Kimjax’
    Good to hear your DF is coming back. Just goes to show how recovery is different for everyone. I also noticed a significant decrease in swelling this week after coming back from the gym. It was down so much I almost thought something was wrong. LOL

    oldlady,
    Compression socks definitely helped with my swelling I use a medium pressure sock and didn’t have any problem with it hurting even after wearing it all day.

  4. Hi Kim

    I’ve had good progress at 18 weeks too! The pain on one side of my tendon, which my physio said was down to scar tissue, has finally gone away allowing me to stride almost normally. I have been massaging it, as well as increased gym work (bike, rowing and stepping) and walking so feel it has been down to this. Yesterday was the first day I forgot about my AT when walking around! And my stride started to get its usual energy back. I’m so happy, at last I believe I might really get back to normal, I realise that I haven’t really believed I would get there till now!

  5. Outstanding progress. I really happy for you. Keep working hard & moving forward.

  6. Very good update! Pictures are good too! Can you define DF? No idea what that is. Thanks! Continue with your great progress. Blessings!

  7. Am I to understand that there is some sort of conventional wisdom which says whatever length your tendon is at 12 weeks is where it stays?? I don’t think mine will likely be stretched to normal length by that time. What a scary thought. But it sounds like some people are still making progress well after 12 weeks. Hope that applies to older guys too.

  8. mcdarling - DF is dorsiflexion: how far you can move your foot towards your shin. I can do a ballerina point (plantarflexion or PF) but am very limited in the DF area. (see previous pics) My doc had to cut off quite a bit of tendon because it was shredded from my “blowout,” and it’s healing short. It was very painful to make each new flatter degree adjustment when I was in my boot early on. But I’m also hindered by tissue adhesion from the healing after surgery, so as that breaks up, I get more flexibility. I saw your post about jumping with the teens - hilarious. (except for the rupture ;) )

    daves - I’m an oldie, too (49)! It’s all coming back slowly but surely. :) My PT said I’d continue to improve - just the doc was gloom and doom. I got out on my road bike today and felt great! When the AT is warmed up, I walk almost normally. It just gets tight after sitting for extended periods.

  9. Hala - are you using a stair stepper? Do you go up on your toes or just lift the foot flat?

  10. Dave S

    Don’t worry. I’m 50+, full rupture, non-op, and was walking very well quite early in my rehab. I saw a physio every 2 weeks when I had my boot adjusted and was in 2 shoes by week 9.

    However, the biggest gains in strength and flexibility were after 15-16 weeks when I upped the exercise regime with the help, first of all from another NHS physio, then a sports physio who I will see for another couple of weeks.

    Heel raise on ATR foot is now the same as on the other side. Just don’t start slacking!

  11. hilie - you can do a single heel raise already? I can only get about an inch off the floor - but am getting stronger every week. I do fine with single heel raises in the pool - but the calf just isn’t strong enough yet to do it dry.

  12. Feel better now… thanks hillie & kimjax.

  13. Kim

    At 27 weeks I’m further on than you and at 18 weeks as you are now, I couldn’t do a single heel lift on that side at all. I think that it was about 20-21 weeks, since when the recovery was quite quick, albeit with plenty of exercises.

  14. Hi Kim

    I’ve actually been doing the cross trrainer and a cardio wave machine, so perhaps not true stepping, sorry. As with the rowing machine, if I don’t have quite enough ROM with the bad side, I lift/adapt slightly. If anything hurts though, I dont do it! I haven’t attempted any single calf raises yet, my physio has said not to but I look forward to trying!

  15. Great - that’s something to aim for! My PT keeps telling me to try a single and I get about an inch off the floor. I keep asking if it will re-rupture to try this and he says, “NO!” (I’ve been asking this about everything since week 4 and it’s now a running joke with them all) He seems to think that my AT is very thick and strong now. I just worry a little since it’s so inflexible.

  16. Hi, I am 67 18 weeks post op and i feel good. I have my brace off, and real shoes on. I still have a small wound at the end of my scar that just will not heal. Causes by a stitch not healing. My df is fair but my therapist is very happy with my progres. I can finally see the light at the end of the tunnel. Yea!

  17. I am 18+ weeks and am having real problems with swelling, pain and df. I can go up on toes, point toes, but lunging towards wall is minimal. Any suggestions on getting the df working.

  18. Marg - have you talked to your doc about the pain? I have pain when I overdo fast walking - but it’s not terrible - just reminds me that things are still stretching/healing. I have no pain in every day walking, biking, etc. I also have trouble with DF - but it improves little by little. There are some days where it seems to go backward - usually when I haven’t done exercise to loosen it up. I am doing a LOT of stretching, twice a day, after warming my leg through exercising or heat. I still have trouble with the wall lunge as well, but hoping the increased walking will continue to loosen it up. My swelling really resolved about the 20 week point. I’m only about an inch off the floor on my single calf raises, but really max them out in the pool. That really helps my calf as straight leg raises use different muscles than seated. HTH!

  19. One more thing: The PT told me that part of the problem is that the bands at the front/sides of my ankle are tight from atrophy and disuse. When I stretch, I often feel pain in the ankle rather than stretch in the AT. The PT will hold the front of my ankle back to allow me more stretch on the lunge. He says this will improve as the area gets more use and loosens up. Apparently, the upper front bone doesn’t stay where it should be and causes obstruction.

  20. Saw the Dr. today, week 19 will be spent having my scar reopened. The small sore at the end of the scar still has not healed so he will open it up, clean it out and re-stitch. The good news is he thinks the report from my PT was great. He even told me I can take the small brace off when I am walking on flat surface. This will pass just a small set back.

  21. Marltom- I’m so sorry to hear this - but it sounds like you have a positive attitude and you’ll be able to move forward with the PT. I hope this is a short setback and you’ll be on your way to recovery once again. :)

  22. Hi Kim and all:
    Just wanted to update you about the pain! I had an ultrasound yesterday and met with the surgeon today. I have alot of scar tissue and inflammation. After discussion, he gave me a shot of cortisone in my ankle. Hoping that it relieves the pain. If it doesn’t, then we will talk about further surgery to remove the scar tissue. He said that the achilles is in tact and healing wonderful. Just the scar tissue giving me some issues. I am sstill in pain tonight and the cortisone, if it is going to help, will start to give some relief in 48 hours or so. Anyway, thanks for all the help. According to my doctor, at this point, 18 weeks, swelling is normal, pain is not! I will keep you posted.

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