Paranoid

I am now 16 days post op.  It’s funny how quickly the time goes….but at the same time how long the process feels.  I cannot remember what it feels like to be “normal.”  Sometimes that makes me feel a bit sad.  But no pity party for me…..I’m constantly encouraged by the little bits of progress as well as reading about all your adventures.

As I posted earlier, I had my first post op appointment last week and the doc took off my splint and put me directly in the boot (NWB).  He directed me to work on my ROM everyday and try as hard as possible to flex my foot forward (toes down) and backward (toes up)!  He said there was no way I could do damage to my repaired AT by flexing my foot with my own muscles.  Immediately after taking off my splint, this was near impossible….I could barely move my foot in either direction!  Only my toes would move!  But after a week of moving my foot around I almost have full range going forward and can almost get my foot to 90 degrees going backwards.  I can also roll my foot in circles without any discomfort.

This lead me to my post title….now I’m paranoid.  I know I’ve only been following my docs directions but at some point I feel that I”m damaging the repair process my moving/flexing my foot so often!  I don’t feel much pain at all when moving my foot which makes me feel that I may be weakining my AT and then when I put my foot down for my first steps…..it will snap!

What are all your thoughts on this?  I’m sure the doc knows what he’s doing….he’s a well respected orthopedic surgeon that has done many many many AT repairs in his day (he did 3 between my surgery and my post op appt)!  So I trust his direction but my mind is constantly playing games with me!  I do feel that it is a bit aggressive to be flexing your foot as much as it allows 10 days post op…but I also have heard that it is good to work on your ROM as early as possible. 

So the question is, do you think I’m doing any damage to my repaired AT by doing these exercises so early?  I have not walked on it or put any weight on it….have just been flexing it and moving it throughout the day.  For the most part it feels great and I actually feel like I could flex it backwards past 90 degrees if I really tried hard.  I would think I would start feeling pain if I were tearing the sutured section of the AT….or if I were weaking it in some way……but I don’t know that for certain.

As always, appreciate your thoughts and comments!

 

Also - wanted to give a Chi Town shoutout!  Anybody on here from Chicago?

10 Responses to “Paranoid”


  1. 1 Joe November 4, 2009 at 9:59 am

    Limmerez

    I think you’re fine doing this. I had a discussion with my doctor about different approaches. My doctor is somewhere in the middle but there are doctors out there that are very aggressive and have their patients on their feet within two weeks. Your doctor is going with what has worked for him in the past. Your body will tell you if you are pushing it to much as well. Just stick with what your doctor recommends and you should be fine..

    Joe

  2. 2 strohdecaire November 4, 2009 at 10:41 am

    I think you’re making great progress……..I’m in the same boat as you are…….16 days post op (yesterday), my surgeon put me in a boot and had me doing some ROM exercises…..no weight yet, but at least I’m not in a cast…..thank God! When he asked me to move my foot as close to 90 degrees as I could, my first inclination was “are you serious?”…..but he’s been doing this for 43 years, so I put my full trust in him. I agree with Joe……your body knows its limits and will tell you when enough is enough. Keep hanging in there…..it sounds like you’re making awesome progress. On a side note, I’m not from Chicago…..I grew up in Flint, Michigan…….I have relatives that live in Waukegan and Libertyville, so Chi Town was a summer destination for us.

  3. 3 mari November 4, 2009 at 11:49 am

    This is why I think I ‘freaked out’ a bit the other day.
    I’m so worried it will snap. My surgery wasn’t for a ruptured AT, he cut it.
    So in a way I’m also afraid to put too much weight on it.

    My Dr was glowing about my process but as others said, take your time and listen to your body.

    Good luck!

  4. 4 tomtom November 4, 2009 at 12:28 pm

    Limmerz - It doesn’t sound like your doctor is having you do anything too unusual, however, I would say the movements should be gentle and not “as hard as possible”, especially with dorsiflexion (toes up). Too much dorsiflexion before the tendon is ready can cause the tendon to heal too long. Doug53 and I have preached about this in the past, so I apologize if this is redundant, but I think it is important to remember during rehab. I have first-hand knowledge of the tendon healing too long and it resulted in a second surgery.

    You also want to make sure the incision area is able to heal/close properly. Aggressive movements could impede the healing and cause the incision to open in spots. This can lead to infection which is a road you definitely don’t want to go down.

    I don’t mean to cause a scare, I just want to point out that gentle movements are best early in recovery. You should be just fine if you don’t push the dorsiflexion and keep and eye on the incision.

  5. 5 doug53 November 4, 2009 at 4:10 pm

    Hi Paranoid,

    I don’t think you’re going too fast at all. Your flexibility is slightly ahead of where mine was at 16 days postop, from doing the same kind of stretching exercises. I was also doing some light calf strength work (which I started the day after surgery) to limit atrophy, and was about to go into a full weight bearing shuffle in my shoes in the next day or two, and my tendon has turned out fine.

    Tendons and ligaments, as a general rule, heal stronger, not weaker, if they are mobilized early.

    There are things to be cautious about, of course, like awkward steps or falls, stretching too long, and doing anything that is truly painful, but I think most of us are capable of much more than our docs and PTs allow.

    Happy healing,

    Doug

  6. 6 eschao November 4, 2009 at 4:26 pm

    Hi Limmerz,

    Glad to hear you are from Chicago — I am from Chicago as well, and also got the ATR playing basketball — though at the beginning of the game. :)

    I think it does depend on the doctor as to the treatment. My PT preferred to be a bit more conservative — not as much stretching and mentioning that stretching too much weakens the tendon — if you do too much early. When I talked to the doctor, he acknowledged the PTs point but didn’t appear to be ask worried about it. My interpretation is that there is a balance between stretching to recover and not stretching too much to maintain strength.

  7. 7 ultidad November 4, 2009 at 6:26 pm

    L-
    My surgeon had me doing the same thing after I went from splint to boot (2 wks post-op). Same wording, even - only do what your own muscles can do. And I’m doing just fine, now almost nine weeks out (funny, I had to use a calendar to figure the time out). I think part of what prevents anything bad from happening is how weak our muscles get during the NWB phase.

  8. 8 tedb November 4, 2009 at 7:43 pm

    I’ve had the opposite treatement.. ie in cast toes pointed down for 6 weeks.. then had to work on ROM afterwoods. Now finding it difficult to stretch past 90 degrees.. so I would of prefered early ROM. My tendon is prob better healed at rupture point than early ROM tendons at the 6 week mark.. but run a greater risk of damaging it trying to stretch it afterwoods since it is tighter. Also walking is harder since I have less ROM. My surgeon doesn’t have as much experience as yours so your treatment is probably better.Your treatment puts you on the road to recovery faster.. mine is a bit more conservative and less chance of rerupture in early weeks since I’m in a cast. Hopefully in the end.. mine will be ok also.. albeit a few weeks/months slower.

  9. 9 smoley November 7, 2009 at 5:45 am

    Limmerz - You know, you wouldn’t be normal if you weren’t a bit paranoid!
    Smoley

  10. 10 3littleones November 10, 2009 at 11:01 pm

    Hi Limmer,

    My husband is from Chicago, we try to get back when we can, it is such a great city! I am a few days behind you and just posted a similar post before I saw yours. I have a feeling this “paranoia” must be part of the healing process. I feel better knowing I am not alone! How are you feeling now? I just had my first day of PT today and my AT hurts. A glass of red wine seems to be helping! :)

    Cheers,
    Catherine/3littleones

Leave a Reply

*
To prove you're a person (not a spam script), type the security word shown in the picture.
Anti-Spam Image

Powered by WP Hashcash




  • limmerz has completed the grueling 26.2 ATR miles to full recovery!
    Goal: 105 days from the surgery date.
    Achilles NYC Marathon Course Sidebar Image

    Click here for the Group Marathon Tracker

ATR Timeline

  • Name: limmerz
    Location: Chicago
    Injured during: Basketball
    Which Leg: L
    Status: NWB

    529 wks  5 days Post-ATR
    528 wks  5 days
       Since start of treatment