definition of PWB and FWB
Can anyone tell me for the progress tracker if PWB and FWB means with or without a boot? Big difference so matters for the averages
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Can anyone tell me for the progress tracker if PWB and FWB means with or without a boot? Big difference so matters for the averages
Filed under: Uncategorized and
A lot of talk about crutches over the past few days. In the UK we mostly use elbow (or European style) crutches. Surely these must be more comfortable? I’ve used them twice over the years without problem, once with my atr for a few days, and once when I had had foot surgery a long time ago.
Someone on here said some time ago that you can buy these in most countries, including via Amazon.
What do you think?
I should have been more specific…its not the actual scar on the skin that is the problem, its the internal scar tissue. My hubby makes keloids so I know what those look like and this isn’t one of those. Its more that the scar tissue around the achilles is thick and bulbous under the skin. I am thinking I just wasnt aggressive enough in massage as it was healing. PT appt this week so we’ll see what can be done
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Kristen - Some people are prone to what is called keloid scarring (think I have the spelling right). The scar will raise up over time. There are a couple of things that can be done. The first are some injections into the scar (subtances evades me at the moment but my memory is saying a steroid) and the second is laser. I took my daughter to a plastic surgeon years ago to have this treatment for some prominant scars and it worked great. The doc did say there was a chance they would return but they haven’t. The injections did not help much but combining with a few treatments with the laser did the trick. Relatively painless and my daughter is a sook when it comes to pain. Still had to hold her hand and she was all grown up.
Hey sorry about that Norm and Kristin, just for that, I’m going to a small donation at the weekend to the site
Hey, RRR, you tricked me into misspelling Kristin’s name!
Kristen, it’s funny how the easy things are often harder than the hard ones when we’re hurt! I’m dealing with a deteriorating right knee now. It enjoyed warmup plus an hour of Competitive 4-on-4 indoor beach volleyball last night, but today it doesn’t enjoy standing after it’s been still for a while.
A couple years ago I strained a Medial Cruciate Ligament (”MCL”) in my left knee in the middle of a Whistler ski week (trying to get up out of super-deep snow with no pitch!). It didn’t bother my skiing AT ALL — but when I swung my feet out of the bed to get up, I thought I would DIE! So I skied normally, but I worked up a new “bed dismount” move!
Go figure!
Many thanks kristen
Hi Kristen.
TEST? No one said nothin ’bout a test. I DIDN’T STUDY!
Is it closed or open book? Can we use notes or do we have to memorize everything?
I NEED HELP!!!!
Jack
(Sorry, I’m bored!)
Wow…RE reading these posts really brings me back. An update? Well I just finished a run on a Jamaican beach so I guess things are going well…lol. I think that I got to about 90% around a year and have pretty much stayed there. I have struggled with what to tell people who ask ” so are you all healed up?” Or ” are you back to 100%?” On one hand I am in better shape and can do more than I could 10 years ago, but on the other hand my Achilles is certainly not what it once was. Last summer I was happy that I did the same150 mile bike ride that I did the day before my injury and a month later I did a duathalon with the same time I did pre surgery.whooohooo! It’s the little things that are still hard…certain shoes rub, driving long distances are hard and walking down stairs in the morning is with I limp if I don’t stretch first. Still, its a amazing what the body can do to heal. I feel like I could do anything I wanted to do for my age so I am grateful.
Test
Hi Kristin
I have been following this thread how is life now
N
A quick update…2 months later (7mo) and life is a lot better…80 percent is about right. Still a ways to go but I can spin bike, cross country ski, and yesterday I ran two half miles (not quite the half marathon I did last year, but still!). I too tell people that I am getting better but there is a ways to go. I tell them about the NYC marathon tracker and most people are taken aback, as if they don’t want to believe that it could actually take a year. I need to work on not limping. Walking is still my hardest activity (not counting jumping which i cant do at all). Some days it’s easier than others. I have found that most of the pain comes from a tight calf muscle so if I take a foam roller to it and keep moving I am better. the best is that most days I am grateful for what i can now do and feel positive about where I will be by summer.
Aussie Vic - another 2 months should see you with some real gains and although I do not know how your physio is treating you, I do know from my own experience and others I have contact with on this site, 8 months would have you at least 80% and most likely more so the school camp may not be as much of a problem as you think. What to tell people? I still get asked and it is best to say ‘it will take a long time but I am getting better’ ‘a broken leg takes less time to heal’. Most people see you walking around and think you are OK and are just bleeding the system. If you were limping still then they would think you were still recovering. NOT limping is one of the best things you can do for this recovery. I live in Victoria now (High Country) and my page is Xplora. Good luck with it.
I have not yet made a post but have really appreciated reading the blogs. I am 6 months Post Op and have been back at work (Teacher) for a month. I have been very fortunate that the injury happened at work so Work Cover is covering all Physio costs/Medical bills -I was playing Teachers Versus Students AFL footy and it snapped clean. I have been given a FullTime teacher to support me and I still go home after 4-5hours of work, swollen and sore and having to spend lots of time resting up and Icing. I feel that people are looking at me as if I have it really easy -I don’t limp much now (I have really tried hard to work on a straight gait). I keep getting people say how’s your foot ? and I just don’t know how to answer it without sounding too whingy, so I say “It’s getting better” -which although true -the improvement seems so slow. I feel that the Work Cover people are trying to rush me into going back to fulltime work, without support so they can save money -I am meant to attend a School Camp in 2 months and wander whether I can commit to that -lots of walking.
I too ruptured my Achilles playing soccer, I am only 3 weeks post-op though. I can relate to many of the things said in your post and subsequent comments such as self-pity and lack of understanding from others. My attitude has become a little more upbeat since I got a new, lighter cast… it’s the little things in life! One thing I’m going to try to keep my spirits up is keeping a log of all the things this injury has taught me. While this has had some pretty negative affects on my life and could have not happened at a worse time I really have learned some great things about myself and life. Some things I have learned have been pretty immediate and obvious but as time goes on I think some important lessons will be revealed, anyways I’m hoping. Another thing that I thought sounded pretty cheesy at first but I’m definitely going to try when I start physical therapy are self-affirmations. For me, I tend to get discouraged and stressed easily and I know that will make my recovery harder and probably slower so I’m trying to do whatever I can to stay positive and hopefully it’ll work! Good luck to you and hopefully you will find somethin
[...]7 1/2 and still struggling…ugh! There is just no way around this being a year long recovery, is there?
Is much as it sucks that you are going through this now, you will be an amazing trainer and fitness instructor because of what you are going through. I am sure you will have an eye out for injury prevention and will be able to help motivate people of all abilities (everyone struggles with something).
Hopefully when we are all able-bodied again we will always appreciate the gift that it is.
Kristin,
I am dealing with the 7 1/2 month funk and aside from our 18 year age gap, it pretty much sounds like we’re dealing with identical issues. I am currently enrolled in a college certification program to become a personal trainer/group fitness instructor. I’ve spent this entire time on crutches, debilitated, watching others exercise without appreciation or recognition of my reality and it is far more crippling for me to not have the exercise outlet and the independence I’m used to. Your posts are so perfectly worded and I can relate as I am not generally a patient person… All of the patience I have is diverted to what seems like a never-ending healing process.
Didn’t skate-just let the kids have all the fun….earlier in the day I had a great experience doing a spin work out on my new bike trainer and it felt great so I didn’t want to trash myself for evening. Also, I didn’t think the skates would feel great on my scar…even tennis shoes hurt there. I am psyched for biking though!!! Today was power yoga and I am happy to say that my arm muscles were shaking more than my ankles
I hear you all on the limping. I don’t know how to ‘not limp” though. I think the problem for me is that I have some joint immobility in the front of my foot. My PT explained it that my ankle bone is supposed to slide back out of the way of the leg bone when we walk but mine is stuck so the leg bone can only go so far before it hits a wall. There are manipulations that others can do that help but it is only good for a few hours. I am hoping that when that resolves it will help a lot because its hard to strengthen the calf if I can’t really even use it.
Great ideas everyone! It does help to hear from others who are at different points to realize how far one has come and how much better it will get. I have to r
[...]So how did the skating with the family go Kristen?
For easy cross-crountry skiing, see if the golf courses in your area are open for that. Some places I’ve lived at, the golf courses essentially turned into cross-country ski parks in the winter time, and they were easy/flat trails very suitable for beginners… or us rehab cases-
Hi Kristen,
I’m just a little over 5 months from ATR and have felt a lot of the same emotions that you have. I think my biggest concern is re-injury. I don’t know how much I should push myself. So far I’ve only done 3 to 4 mile walks but I’d love to be able to add a slow jog and build up to more. By the way, my surgeon said bike riding is a great post ATR exercise.
I really enjoyed my physical therapist and his sense of humor. Back at about 3 months post-surgery, he said to me, with a smile, “Force yourself not to limp. Limping is for losers.” I kept this in mind and really worked hard at not limping, even if I had to walk very slowly - and I love to walk fast.
Limping becomes a habit that you shouldn’t let yourself develop. Good luck with your recovery. Sounds like you’ve found some great ways to keep yourself motivated.
Housemusic:
> Because I am not really living, and I will never have the life I had before.
Most folks with this injury DO have a full recovery. There really shouldn’t be any reason that you won’t be able to resume all of the activities you had pre injury. Take away lessons about patience, persistence, and discipline; things you’ll need for recovery, and apply them to whatever sport/endeavor you want to get back to.
Like him or hate him- Lance Armstrong’s book has some interesting observations- he asserts that his experience with cancer was key to being able to endure the suffering needed to win all those races
Claudia…you hit it on the head. It is a loss and a grieving. I feel like I have lost much of my social life, my health, my mental health, my libido, my passion/goals, my self-esteem and confidence, and a year of my youth (if I can say that at 44!)
Yes, it is nice to spend time reading, watching movies, knitting, meditating and other joys of slowing down, but I feel like at my age time is ticking and by that time I am back to half-marathons and duathalons I will be in my late 40’s so I think the length of this recovery gives me a sense of urgency that I might not have if I were 10 years younger. I had basically ignored my health and body for years while I gave birth and nursed my babies and finally I started to prioritize myself and it was paying off with weight loss, lower cholesterol, fun and energy. The day before my injury my husband and I finished a 150 bike ride and I had said that I felt as healthy and strong as when I was 25. I was on top of the world! I had just joined a soccer league and was so psyched to learn something new and spend time with my sister-in-law and being coached by my son. More layers of loss.
Its
[...]I feel there’s a readon for both good & bad. The hard part is to decipher which is which. My ATR has been eye opening on many levels. Either good or bad there is a reason for everything, thats my mantra.
Positivity has been key for me….it is what it is & things could always be worse. Stay strong & keep the course.
kristin123,
Thank you for your post, I feel the same way.
Coping with a devastating injury is overwhelming and healthy people cannot relate to us. Only someone who has experienced this can know how difficutl it is.
No matter how you sugar coat it, an ATR is a life-changing event and we are survivors. It is frustrating when people around you want you to be doing better, so they can also feel better, but you are not. That’s why when people ask me how I’m doing, I just say “I’m surviving”. Because I am not really living, and I will never have the life I had before.
As you said, we loose so much, and so many dreams and goals have to be postponed or abandoned. To me, this is the saddest part of this injury, the lost opportunities.
In a way, we were robbed of time. This is the aftermath of injury, it is both physical and emotional. Nothing we can do to change our fate, we just have to accept it.
Just know that grief is a normal part of the healing process, and mourning the loss of vitality is necessary to reinvent ourselves. Best wishes for your continued healing. Claudia
cool! Speed skating….I’d do it just for the cool olympic-style outfits That seems a bit out of my reach at the moment, but maybe this winter. Thanks!
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I am near Milwaukee…what’s at the petit? Not sure ice skating would feel all that great although I am taking my kids today.love cross country skiing but need snow and to find some flat trails…my usual spots are quite challenging. I was planning on trying snowshoeing too once we get snow! Keep the ideas coming!!!!!
I just downloaded a spin workout and felt great breaking a sweat. I actually think certain activities like biking are easier than walking. I have been focused on the walking difficulty…ie “I can’t even walk, how can I workout” but maybe this is a later skill to master?
Sorry if I have been whining, I feel like I have been optimistic and looking for the opportunities in this experience, but sort of feel like I have had enough. Hopefully this is a low point and I can only go up from here
And of course, if you’re in Milwaukee… I would be remiss if I didn’t suggest you go check out the programs at the oval (Pettit National Ice Center)- I’ve got friends/contacts over there who could help get you started
Wisconsin. Mid winter… snowshoe’ing? Or, cross country skiing?? Both are fun things you could do with your family too-
kristin…I’m only three months since surgery and was given green light to put weight on foot yesterday, just a few hours of “walking” with use of a cane, but I’m happy. Point being, you are 5 months advanced and let yourself be human to have bad days (mindset), but reflect on the 5 months of progress from time of surgery. This is NOT a lifetime disability, you know that and with a family of 5 you have alot of demands. While giving yourself some room to feel down, you then must (as you know) take control of your thoughts…and appreciate the day…for what it is. You won’t get it back and I would suggest not “look past” it as we may not get another one. When I go to PT…like you I realize our fate is not as bad as it seems. There are people I see with nebulizers (lung issues) in PT and people with strokes. It’s not easy to say we got it good…but I just thought you can reflect up the fact that one day…you will run, if you want to do it. We each are in this and time is the issue, not question of “if”. I would just hope you don’t allow feeling down (which is human!) to pull you FAR down. You need the positive (if only, o
[...]Great suggestions. I feel like I’ve been trying to take that approach…focusing on more Yoga, bought a hula hoop for hoop dancing (not a great outdoor sport in WI but I am working on setting up a class with a teacher friend), have been trying to embrace swimming with a friend who had bunion surgery and just got a new bike trainer (cycling is my love) so hoping that will give me a spring training goal. I am still looking for a new fun activity and do believe that this injury is an opportunity to learn and try something new. Don’t think I am ready for boot-camp yet. I have a feeling that in another month or two more things will open up to me. Other activity suggestions welcome!!!!
I think you put it perfectly Ryan…I am able to do more in yoga, walking etc than last month, but the pain is the same at the end of the day (if not a bit more). Maybe I need to adjust my expectations and accept pain and build in couch time every evening along with more Ibuprofen during the day
Thanks all for helping me to feel that much of this is all normal. Feeling better already!
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[...]Kristin-
A possible suggestion for you: find something “completely new” to do. Perhaps a new sport/activity/exercise-class which would involve your Achilles and beneficial to rehab… but at the same time, not have a previous benchmark that you were always comparing against. Might give a fresh perspective/outlook, and provide something where you could see steady improvement; because you’d be so bad to start Cross-fit? Boot-camp? Are/were you a cyclist? Is there something you always wanted to try?
I’d also suggest trying to find the middle ground- a way to push yourself that doesn’t cripple you the following day. People ask me if I’m feeling better… the answer is honestly no. I have found a pain/discomfort level that I can tolerate. I’ve been at that level for probably a couple of months now. I dial up my activity to a level that gets me back to that pain level. What IS changing is what I can do. I’m not really feeling any better… but I’m skating faster, riding harder, jogging longer, etc. But, at the end of the day, I usually hurt about the same
Thanks much. I had heard the plateau was coming but it caught me off guard I guess because I never really had quick improvements. This whole recovery has felt like a plateau. Of course I look back and I can do things now that I couldn’t 2 months ago so I know it’s getting better. I am not really afraid of hurting it as much as i just have a lot of stiffness (ankle joint locks when walking forward likely due to imobilization for so long) and also tightness in calf muscle.
Another factor is that over thanksgiving I was on vacation in the Carribean and it felt great. I don’t know if it was the rum or the ocean water or beach walking or what but I even heard myself say “I think I am ready to start running when I get home” By the time we landed in Miami I was stiff and in pain again.
I figured the stair trick out too and that does help speed up life. I think you are right that it does help to have psychological tricks. I need to find the next trick to help me thought the next week.
You’re welcome to support from me — or a kick in the rear, if you think it would help!
The “mental game” is often a challenge, especially after the rapid pace of the early achievements gives way to what one sage here called “the frustrating plateau”. All I can say is hang in, keep moving, and keep believing that it will get better. Because it WILL!
And one more thing — actually a trick. If your problem with stair-walking is going down normally, because you’re nervous about flexing your “bad” ankle that far with that much weight on it, I discovered a little technique that can get you walking down stairs normally — or at least so normally that nobody will be able to tell that you’re using a trick. And you’ll get down the stairs twice as fast, too.
It works in 2 shoes, and it also works earlier, for people who are still in a boot or a walking cast. (I keep meaning to post this on a blog page by itself, or to have Dennis post a link to it, because many people have told me that it worked magic for them. . .)
Basically, instead of always leading with your “bad” foot then catching up with your “good” one, do this:
When
Well put, Kristin. And to be honest, I thought I was patient before this, but this injury has certainly been trying my patience. I am 12 weeks post-op and yet to get to the PT stage….maybe next week.
Tendon healing is much like watching paint dry! I have decided most people that experience this injury are active and have been active their entire lives. It is difficult to sit and wait, but it is worth the result:)
Good stuff, Kristin!
Many years ago I had a nifty book about how to grow an avocado plant from a pit, and at one point the author wrote something like “This is a very challenging time for the gardener, because nothing is visibly changing, and you shouldn’t actually do very much.” ATR rehab has periods like that!
You have really hit the nail on the head here about the process we are going through. I will try to carry that thought with me every time I feel the need to go faster. Healing has been going well for me- no glitches so far and that makes me get a little overconfident and I should be thinking things through better. ( I guess these sentiments can apply to all aspects if life not just ATR recovery). Thank you for the insight.
shaving and exfoliating had to be the highlight of my whole year….just pleasure after so long. I couldn’t believe how much skin came off. My leg looked like an emaciated hairy reptile. It was only a matter of a few days though that it looked fairly normal again.
I love your story, only because I can relate so much! I cant wait to shave and exfoliate my right leg. My left looks like a mutant leg. Everytime the Doctor changes my cast, I think to myself. Please dont judge me! I hope that your recovery goes great and you can start to drive again! NOW FIND YOUR RIGHT SHOES!
Take it slowly…that about sums up Achilles recovery…no rushing this recovery
Take it slow. You will get better results walking slower and properly than quicker with a limp. Do this and within a couple of weeks you’ll be walking pretty much perfectly
hello,
I’ve been in shoes for just under a week. I’m still on crutches but the difference it makes is amazing. You’ll be surprised how quickly you get over the ‘fear’ as things start moving again, it will feel odd a first but just take your time.
My thing was that after 6 months in casts (long story) I walked lob-sided so I need to get weight onto my bad leg and level myself up.
Already in just under a week my walking is getting a better and with any luck I’ll go down to one crutch soon.
Look after yourself and enjoy the new found freedom!
Mark
What nickokie said. In the UWO protocol I followed, PWB began at 2 weeks post-whatever (op or non-op), and began with close to ZERO weight on the injured (and booted) foot. For the NWB period it was held up in the air, then when PWB started, it began to “shadow walk” — doing the motions of walking, while the crutches still bore all the weight. Gradually (in my case over the next 2 weeks), it began carrying more weight.
At 4 weeks post-__, the UWO protocol says “WBAT” = [Full] Weight Bearing As Tolerated, i.e., a relatively quick transition from PartialWB with crutches to FWB without. Some people use a single crutch or a cane for the transition, some not. Some use a boot that can be set to hinge in the plantarflex direction, while coming to a firm stop in the dorsiflex direction, usually at “neutral” = 90 degrees ankle position.
In almost all protocols, the transition is done in a walking cast or (better) in a boot. Both those appliances provide protection to the healing AT by transferring the walking force that’s normally borne by the AT and calf, to the cast/boot and the front of the shin.
Some docs/protocols specify fra
[...]You will be in a boot for both PWB and FWB. PWB is basically walking in either a walking cast or some sort of walking boot with the aid of crutches, but actually putting your bad foot down and bearing tolerated weight on it. FWB means you have ditched the crutches or walker whatever you are using and walking on your own. You will still be in some sort of boot or cast though.
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It goes like this:
Treatment decision (op or non-op)
PWB in Boot/Walking Cast
FWB in Boot/Walking Cast
Move from boot to 2 shoes regardless of WB
You will be in a boot for both PWB and FWB. PWB is basically walking in either a walking cast or some sort of walking boot with the aid of crutches, but actually putting your bad foot down and bearing tolerated weight on it. FWB means you have ditched the crutches or walker whatever you are using and walking on your own. You will still be in some sort of boot or cast though.
What nickokie said. In the UWO protocol I followed, PWB began at 2 weeks post-whatever (op or non-op), and began with close to ZERO weight on the injured (and booted) foot. For the NWB period it was held up in the air, then when PWB started, it began to “shadow walk” — doing the motions of walking, while the crutches still bore all the weight. Gradually (in my case over the next 2 weeks), it began carrying more weight.
At 4 weeks post-__, the UWO protocol says “WBAT” = [Full] Weight Bearing As Tolerated, i.e., a relatively quick transition from PartialWB with crutches to FWB without. Some people use a single crutch or a cane for the transition, some not. Some use a boot that can be set to hinge in the plantarflex direction, while coming to a firm stop in the dorsiflex direction, usually at “neutral” = 90 degrees ankle position.
In almost all protocols, the transition is done in a walking cast or (better) in a boot. Both those appliances provide protection to the healing AT by transferring the walking force that’s normally borne by the AT and calf, to the cast/boot and the front of the shin.
Some docs/protocols specify fractional or % portions of full weight for PWB. Those are often so confusing (for patients AND docs) that they’re more trouble than they’re worth — especially because it’s a moving target.