Posted on June 26th, 2012 by kimjax
I’m now at 8 weeks and FWB all the time in my fixed boot. The PT won’t give the ok to "unhinge it" for ROM until I meet with my doc in July. I tried it unhinged yesterday from 30-10 and it felt much easier walking. I was able to use the flat sole on the Vaco with ROM, but need the rocker sole while fixed.
My question is what were the pre-req’s (conditions) that your doc/PT used to ok use of the ROM function of the boot? I’m currently able to get limited (5 degrees) active DF, but completely back to normal on the PF. (totally pointed toe/foot, but barely forward over the foot when standing.)
My ankle is finally starting to loosen up! Just making small gains in ROM - but gains all the same. 
I feel great on the stationary bike in my boot - will try it this afternoon in shoes slowly. I’m practicing walking about 10′ unhinged, then barefoot, and in shoes - just not enough ROM in the ankle to shoes safely yet. I’d love to unhinge the boot as it seems to help loosen the ankle. I’d love to hear any guidance.
Emailed the doc about this and sleeping without boot as well. I’m hoping to hear back but he’s at the big Ankle Conference discussing more interesting and complicated cases this week! Kim
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Posted on June 22nd, 2012 by kimjax
I’m into the 7th week and feeling good most of the time. I get pretty big swelling every afternoon and ice at 2pm, 5pm, and before I go to bed. It really helps with comfort during the night. I found "platform sneakers" to even out my stride with the Vaco boot - ugly as can be - and pretty ridiculous looking on a nearly 50 year old woman. My only consolation is that the "combo platform sneaks and one biking glove for crutching look" embarrasses my teens - payback after years of their interesting wardrobe choices. My feet are now evenly on the ground.
I can now walk without crutches easily, but it’s not the smooth walk I had expected - it’s a limpy kind of thing since I haven’t been cleared for the ROM hinge function of the boot. I got complacent and took a long stride up a step in the house - inadvertently pushing off the ball of my foot and got a sharp pain in the AT. No damage done, but it was a warning that I’ve got to pay attention to my walking. sigh.
I’m riding the stationary bike in two shoes and REALLY want to flex some muscle (at least what’s left of it) but am afraid to push the AT too hard. My PT just says "no terrible pain" - but of course I had no terrible pain and was in great shape before I just "popped my AT" 6 weeks ago. I wish they’d just say: "60 rpm at Level 2 for 15 min." or something like that. I just would like to get my heart rate going a bit. I’m letting go of the fear and pushing everything a little harder. I’m making progress and feeling no pain except in the stretching. The scar looks good - this is an afternoon shot so lots of swelling:
I ordered a night splint so I’ll review that when it comes in. I’m tired of sleeping in the boot and haven’t had good sleep in 7 weeks. With the pressure on my high instep, I have to change position constantly to get circulation back to my foot.
My lack of DF is really holding me back. I can’t walk in two shoes because a small stride would stress the tendon beyond it’s cemented "zero degrees.". I did start standing and limping a little in two shoes and it feels good. I LOVE being on the bike in two shoes and almost feel like a normal person when I’m on it. Since I gave up running years ago (beat up knees), road biking is my passion now and that and normal walking will be enough for me. That gives me hope!
I need some STRETCH!! doryt - if you’re reading this, I’m stretching multiple times a day with every exercise I can find. I got +10 degrees with a really aggressive PT - for just a moment while he pushed -but can’t get it on my own. Maybe +3 at best. I compared it to my other foot at max DF and I don’t really have much on either foot. But on the ground, the good ankle flexes and the injured one won’t. Does anyone else feel a ripping feeling in the ankle when they stretch? I’m beginning to think that my scar tissue is all sticking together and holding me back. Not sure what to do about that.
I’d love some examples of what others are doing on the stationary bike and the kind of fatigue/pain they feel in the ankle while doing it. Off to PT shortly - and the DF torture machine. I’ll try and get pics of that for all you rehab junkies. Blessings, Kim
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Posted on June 18th, 2012 by kimjax
I’m at true zero degrees in the Vaco now, (reads -5 degrees) because a pad behind my AT pushes my foot forward in the boot. The top plate fits funky because of my high instep - but the light weight and features are still worth it. As I posted before, I’m unable to walk comfortably with the flat sole. The company recommends you use this sole at angles less than 10 degrees. After trying numerous times yesterday, I decided to try the large "rocker" sole again and I was able to walk normally!!!! I’m not sure why I need this at zero degrees - but the advice to push my shin against the front now works, etc. Pics of the different soles are below:
I have to wear the funky clog because it’s the highest, stable shoe I own. Unfortunately, it still doesn’t come up to the height of the big sole. Aside from that, I was walking like a champ without crutches or pain by the end of the night. I had very little swelling (could be my new icing setup) and felt a nice "finally used them" soreness in my injured leg muscles - hooray!!!! Ditto for this morning - I felt so good I cranked the boot down to the -5 degrees, which is actually zero. (checked it on two other boots)
I’m not sure why Vaco says not to use this sole at this point, and feel good that I’m actually strengthening my leg with actual painless WB! So I’m going to use the big sole for a week to see if that will help build leg strength to the point that I can cope with the flat sole. It may be the pushed forward placement of my foot messing me up - not sure.
Life is starting to improve. I can carry my food to my seat, keep my foot on the ground without terrible pain, and hold things in my hands with one or no crutches. If my kids bump the boot, I don’t freak out anymore since my leg feels much stronger and safer. I’m still wary of slips and falls, especially when taking the boot off for PT. I rode 6 min. bootless on my bike, and can do longer in the boot. Not a huge accomplishment compared to others, but moving forward for me! I’ve gained 10 degrees of flexion this week - and will hang there for at least another week. The flatter the foot gets, the easier it gets to walk. For those behind me, work on ROM as soon as cleared, as this has been my biggest hurdle to moving forward. It’s more important than strength! Blessings, Kim
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Posted on June 16th, 2012 by kimjax
Thank you, Brian, for posting about this setup!! I got the Cryo Cuff by Aircast and it works GREAT! The combo of compression and icing (perfect, super cold temp) is really helping my ankle swelling with new PWB and more stretching. Better than that, it really reduced pain in the achilles after deep stretching and walking. Love everything about it except the price. ($79 + shipping on ebay new) It’s simple to use and set up, and lasts nearly all day without refilling ice. It was the first night without swelling after doing it before bed. I can keep it next to me and use it when needed.
I’d love some advice from boot walkers. I’m walking with one crutch but am able to rock the boot forward to a perpendicular leg position only, making it kind of a limp. My knee wants to hyper-extend back unless I really focus on curling my toes and pushing off with the ball of my foot. This causes pain occasionally in the AT and I’m not sure I’m supposed to do it. Any suggestions/comments? I’ll check with the PT on Monday - but with my boot cranked down to zero, walking is becoming a little more doable.
I’m doing better with the stretching thanks to all the advice - and not worrying since some of you started much later as well! Blessings, Kim
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Posted on June 15th, 2012 by kimjax
My dog’s face says it all. The doc called yesterday and told me that if I don’t move forward with ROM that I’ll need a surgery to release my tendon in the future - HELP! I have very little ROM at 6 weeks - I’m still at 5 degrees and stretching doesn’t work - the AT is like a board. Sooo…in great terror of the above, I cranked the Vaco down to zero yesterday and have been in misery for 24 hours. (Think Jodi’s last post) Has anyone else struggled with ROM at 6 weeks? The PT stretches it brutally every time I go (3x per week), and I made gains for the first 2 weeks - then came to a standstill. I actually lost ROM when I started PWB last week. sigh.
I don’t do any theraband stuff - does that help? The PT said it was too early. I switched to my other boot in the afternoon - but couldn’t get the heel down to zero. Apparently, the big foam build up in the heel of my Vaco liner has me somewhere above 0 degrees - which is still painful - so won’t be able to use the other boot for relief of hotspots until I get more flex.
Please post any success stories with limited ROM at first. What is the window for stretching the AT and calf to zero and beyond? Am I past it at 6 weeks?? The doc is scaring the tar out of me! Thanks, Kim
19 Comments »
Posted on June 12th, 2012 by kimjax
When the toenails are painted - life is returning to normal. Another benefit of the Vaco boot - provides stable back protection while the front is open. Anything that makes me feel better about the 100 year old lady leg and atrophying muscles is a good thing - and looking at the pink makes me happy.
PT was a medieval torture session yesterday with glass suction cups applied to the scar, moved along it, and pulled off - OUCH. Apparently, this loosens adhesions - but all I felt was pain. I’m continuing PWB walking with one crutch and while my AT is sore, the resultant swelling lessens with each day. It bothers my knee to walk in the 5 degree from flat position unless I use the big round Vaco sole - which the instructions say to discard at 10 degrees. I’m keeping it until I get more dorsiflexion. Massaging my ankle with lotion while elevated is key to relieving pain during the day. Can’t wait to try my new cryo cuff when it arrives. I wore a heeled shoe to Church on Sunday (that’s for you, Starshep!) - and endured the strange feeling of embarrassment while being pushed into the building in a wheelchair. Not sure why this bothers me. I feel so impotent in the thing.
For those behind me on this journey, you’ll see great improvement once you’re allowed to place some pressure on the foot while on the floor, etc. It will help with getting the blood flowing upward. Also, just being able to stand on the foot gives me the ability to manuever in the kitchen, etc., while using both hands. HUGE improvement in functional living! I’m not sure why I have so much AT pain compared to others - limping around bearing weight definitely makes the AT tender near the bottom. It doesn’t "feel" too early, however - and I love the feel of pressure on my foot. No bottom of the foot tenderness at all.
Sleeping is returning to some normalcy as well - only waking up to change position occasionally and falling right back asleep. I’ll be at 6 weeks tomorrow - and walking comfortably with one crutch. Still reaching to get to a flat 90 degree foot. (need 5 more degrees - and they’re not coming easy) Not so many little aches and pains - just a few hotspots (from the boot) and tenderness around the scar. Seeing some forward motion and seeing a light at the end of this tunnel! Kim
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Posted on June 9th, 2012 by kimjax
After my big FWB adventure, my tendon became very sore and swollen at th attachment site. Yesterday, I took it easy, and the intern at PT said not to worry - it’s still attached. This am the swelling is making the scar pucker and it’s very sore to the touch…
Did anyone have this sort of tenderness and swelling from initial FWB? Hoping I didn’t mess this up in my enthusiasm! The main PT wasn’t there and Doc isn’t available. 
8 Comments »
Posted on June 7th, 2012 by kimjax
I dropped the crutches and took a few steps today - big deal for me since I’ve been a complete wimp about trying it. My Vaco boot is still at 5 degrees, so I need the big sole to get a "roll and bend" and the knee. It’s also MUCH higher than my good foot - so I get the hip hitch thing going:
Compared to all you young athletes, I’m having to put LOTS of concentration into each step, and my calf hurts afterward. The PT promised me that I wouldn’t hurt it in the boot with all my weight… I’m thinking about buying the lift kit for the other foot - but expect to be in the lower sole soon - not sure if I want to spend the $$? Any input?
I picked the crutches up after about 4 x10′ walks - as it’s making me nervous to do so much in one day. How much should I do? I’d love some advice! Wish my doc was available - but I actually learn more here :). Massage is really loosening up the ankle - but I still have a very limited range of motion. My doc told me that both ends of my tendon were like mop strings and he had to cut off a lot to find good solid tissue. This is making me heal tight. Anyway - I’m so excited and had to post right away. No one here would "get it" - except my kids who cheered - since they know I’m one step closer to the cooking and cleaning again. ;) You young guys are INSPIRING me (and I hate to get outdone as well!) Can’t wait to go to PT tomorrow (now 3x per week) and show them some progress! I’m so happy! Blessings, Kim
23 Comments »
Posted on June 1st, 2012 by kimjax
Hi all,
I had my first PT appointment today, and was a little nervous after reading about others’ torture sessions. I was surprised to find that it was not painful at all. The first thing they did was measure my flexion - pointed down and upward. No problems with down - they measured only 20 degrees from 0 on the up side. :( My boot currently says 10 degrees on the Vaco - but I’ve pushed the foam up on the heel to give me relief from pressure in the toes - effectively creating a heel. My Maxtrax boot is at 15 degrees - but I keep them both pretty loose so my heel pops up a bit at rest. I switch out the boots to avoid hot spots - but the Vaco is by far the lightest so I wear it the most.
Next, they had me lift my injured leg to the ceiling, boot off, and they massaged downward to relieve the swelling. They left for a bit and told me to continue - which totally grossed me out. None of this was painful - but massaging around the cut was a little yucky. I have a lump of scar tissue right above the top of my scar that he says I need to massage out. It makes me very nervous pressing firmly on the AT - but he says I’m worrying about nothing - it’s stitched together well and won’t rupture unless I fall on it or step on it without the boot. I’m supposed to do this massage each day - and it does feel like it’s relieving pressure! (although I can’t see much difference. My calf looks like a 100 year old lady’s leg - pretty nasty - and looks like there’s no muscle left at all and the skin hangs loose. The skin is also really dry and scaly - you have to scrub it off. Does anyone put vaseline on their scar to make it heal better? That’s what plastic surgeons do for facial stuff.
Next he had me flex my foot towards my shin, including toes, while I freaked about re-rupturing. He told me not to worry. There was no pain involved, just a creepy tightness and it didn’t move far. Next I moved foot inward towards other leg, then outward. I had lots of flex in - almost none out. He told me to use my crutch handle to wrap around the toes and pull the foot towards me a few times a day to give it stretch. He seemed concerned about how tight (short) it was healing.
He then showed me exercises to lift my leg up while on stomach, lift it up on side both induction and abduction?. Also straight leg quad lifts. He told me I could rest it out of the boot when no kiddies were around, but it tends to go to point and is a stretch putting it back in the boot at 10 degrees. I do it anyway because it feels so good to be FREE and in the air. (sorry cast peeps - I know you’re still locked up!)
I left feeling better than when I went in - no pain - and did the massage again last night and this morning. I felt lots of relief both times. I hate flexing my foot - it feels so creepy - but need to work on stretching it. I’m praying the stitches hold! I’d love any advice or extra tips from anyone else’s PT! I have no pain after doing this stuff although the boots seem to cause pain and hot spots like a cast. I am able to put a little weight on it - but they won’t tell me how much. Just "whatever I can tolerate - not FWB." Hmm…
He told me to ask the doc if I could swim. I’m nervous about hanging out around pools with wet decks, etc., on crutches. I’ll be doing PT 3x per week at $20 copays - ouch. Hope this helps someone to know what to expect. I was worried about nothing. Blessings, Kim
19 Comments »
Posted on May 24th, 2012 by kimjax
I saw the doc yesterday for my 3 week postop visit and to get my stitches out. The wound is healing nicely and he said the various aches and pains are normal from all the tissue irritation during surgery. He said the swelling and pain in the down position would likely last for some time - and then eventually start to go away. The cuts are odd looking (see below) - can’t figure out if it’s percutaneous or single cut - and the swelling is oddly shaped from the lumpy Vaco liner. That must be why I get hot spots, etc., during the day when it swells. He said I blew the AT to pieces, and he had to go pretty high to find good tissue - the reason I am healing tightly and have discomfort as I gradually stretch it down flat.
I’m allowed to wash (and shave!) the leg - hallelujah - leaving the earthy look behind. Something you guys don’t have to sweat. I have to put the boot right back on after washing, and I’m doing it separately from my regular shower as the foot kind of "flops around" and makes me nervous during showering. I’m not allowed to set it on the floor without the boot - but have to let it hang naturally.
I’m not allowed to take the boot off except for bathing - and still no weight bearing. I start PT next week at week 4, and will be able to remove it for that I guess. I see the doc again at 6 weeks. I’m pretty pleased with the healing - I had all sorts of imaginations about what was going on under the dressing - but didn’t look with the orders to keep the boot on. I’m supposed to get to 10 degrees by week 6, and am currently at 17 or 15. Any suggestions on when to make the move to flatter degrees?
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