Apr 11 2015

6 weeks post op/ PT/ Vacation concern

Published by lindaf at 6:17 am under Uncategorized

Met with OS on Thursday for 6 week post op visit. All was fine- went from 2 wedges to 1 wedge in boot but must continue sleeping in boot. Incision was healing nicely. He gave me first PT referral for six weeks 3 times per week. I will return to see OS in 3 weeks to check progress- and assume removing the last wedge.

Had my first PT visit yesterday- all was good there as well. He said repair looked strong and I have good muscle tone in my legs so he feels that I will have a positive outcome. Now first order of business is to work on ROM and breaking up scar tissue. I really don’t know all the official names of the first few procedures but they all felt great- laser treatment for incision, moist heat, massage, electrodes to stimulate blood flow, ice ,etc. nothing hurt. Then we moved to ROM exercises including towel stretch, pressing foot forward on gas pedal, and writing alphabet with big toe. Definitely felt a little pull/ stretch on the achilles- but nothing too much. I am assigned these exercises 3 times a day. I asked about stationary bike- he said not yet- though I told him I had been already doing since week 5 for 20 - 30 minutes in boot without a problem - so he then said ok.

He felt that I would probably be in boot for another 6 weeks. Sounds kind of long based on others getting into shoes a little sooner- but at the same time not unreasonable. I will see how I progress and perhaps we can move that timeline up if he sees I am doing well. Good news is that gets me out of boot before Memorial Day Weekend - which is our unofficial start of summer here in NJ.

My one concern is showering when on vacation. I have shower chair at home, but can’t bring to St. Martin. I shower without boot- any thoughts or suggestions? I leave 4/18.

19 Responses to “6 weeks post op/ PT/ Vacation concern”

  1. donnaon 11 Apr 2015 at 11:08 am

    Hey Linda great report! Pretty close to my 6 week experience, except they put me on the bike, I went 2x week, and never slept with the boot.

    You said: “Sounds kind of long based on others getting into shoes a little sooner- but at the same time not unreasonable.”…I agree. This was my protocol but since I was ready for two shoes between week 7-8 they let me but only in absolutely safe situations, they based that on rerupture rates highest between 6 - 12 weeks and too much stretching before 12 weeks when tendon is strong enough for stretching to start. I still had to wear it if tired, if I needed to be up and about a lot, or in unsafe situations…glad I have good commons sense and body awareness (I tend to be super mindful) because I never came even close to one mishap. Hopefully you’ll be ready for two shoes sooner and they will support something similar for you.

    You said: “Good news is that gets me out of boot before Memorial Day Weekend - which is our unofficial start of summer here in NJ.”…that is nice to have a summer without the boot, just keep in mind it will take time to get the strength, flexibility, etc…as well as learning to walk again so try not to plan anything where you will need to be at preinjury ability until you are closer to the 12 - 16 week mark and you’ll know how you’re doing.

    Finally…you said: “I shower without boot- any thoughts or suggestions? I leave 4/18.”

    I’d suggest calling wherever you are staying and asking. I’d think most in the business of accommodations will have equipment available for the handicapped or even a room with a handicapped bathroom.

    Big smile for you!

  2. LindaFon 12 Apr 2015 at 5:59 am

    Thanks Donna for the thoughts on a handicap room and/ or equipment. I also asked my PT and he said I could stand flat footed in shower with cane, but I am not sure I would feel comfortable with that - mostly on the transfer in and out of the shower.

    Any thoughts on a pedicure before my trip- ie the injured foot?

    Also I would like to do stationary bike more often than 2x a week. Do you think that would be a problem if I am not experiencing any pain. Do you think that risks tendon elongation? I am easily at 35 minutes on bike and was thinking about going to 40 minutes today.

    Another interesting thing that my PT told me is that your injured foot/ calf is now like the baby brother of your un-injured side and will learn from it. Even when you work out your non- injured side it helps your injured side. I had gotten a recommendation earlier from someone else on the blog that when doing ROM exercises do both feet at same time. That does really help me as it reminds your injured side what is “normal” range of motion looks and feels like.

  3. nico76on 12 Apr 2015 at 8:11 am

    hi Linda, my insight on the stationary bike is to modify th position of your foot on the pedal in order to work out different muscle group.

    If you place your foot on the middle of the pedal, it will mostly be the quads which will work while the more you push the pedal with your toes, the more the calf / tendon will be involved.

    Therefore, by slightly shifting the position of your foot, you can train easily 2 different muscle groups, and, during one work out, split like first 20 minutes on the quad and then last 20 minutes on the calf. However, remember to adjust the wattage (i.e. less resistance at first when working the calf).

    hope that helps

  4. beachy12on 12 Apr 2015 at 1:38 pm

    I got a pedicure at 5 weeks. My incision was closed and scab free, so I didn’t see a problem. I’ve been seeing the same girl for over a year, so I felt comfortable and she knew I was having/had surgery. I explained I only wanted her to do my toes and not touch my heel and ankle area. Made me feel better to look down and see pretty toes. Have a great vacation!

  5. LindaFon 12 Apr 2015 at 4:57 pm

    Nico76- thanks for insight on stationary bike and foot position. I had seen previously on the blog that I should keep my foot in middle of pedal- so it makes sense that I have been primarily working my quads and probably the reason I wasn’t feeling any issues with my achilles. I will ask my PT tomorrow if he thinks I am ready to use more of my upper foot to get more of a workout in my calf/ achilles. Either way I have to think it is good for blood flow to the achilles so it should help with healing.

    Beachy12- thanks for the info on the pedicure. Yes, it makes you feel so much better to have painted toes especially for a beach vacation. I am six weeks post op- though my incision has totally healed at the top, I still do have the surgical tape and some scrabbling on the middle and bottom portion of the incision. Does that seem long to still not be scab free? I am not sure. I may not put the injured foot in the water and just have them cut, file, and paint the nails of the injured foot since I am not quite 100% healed yet.

  6. beachy12on 12 Apr 2015 at 5:50 pm

    I definitely would not put it in the water if it’s still scabby! I wouldn’t risk introducing any bacteria to the wound. Everyone heals differently, and the surgical tape is probably keeping some scabs on there, wouldn’t worry about it. Enjoy your pedicure!

  7. donnaon 12 Apr 2015 at 5:59 pm

    I agree with beachy…get the pedicure without the soak…I am on a budget so I do my own pedicures, it’s not as hard as you’d think, though very time consuming! My fav color is candy apple red! YAY that.

  8. donnaon 12 Apr 2015 at 6:09 pm

    As for ROM using both feet, makes sense…I always did mine with both feet.

    To answer the cycling question are you doing it in the boot? If so do as much as you want as often as you want…no pain… no problem. Pain, back off. I don’t see you needing to do that incrementally as long as you are in the boot.

    If you are not in the boot I’d answer differently. Let me know and I can let you know how I did it out of the boot….

  9. LindaFon 12 Apr 2015 at 6:56 pm

    Donna-still cycling in the boot- not that brave yet to do anything out of the boot yet except showering and ROM exercise. Good to know I can go as long as I want on the bike because I really miss my cardio workout. The bike is better than nothing. No pain so I guess I am good.

  10. beachy12on 12 Apr 2015 at 9:47 pm

    LindaF, just saw you are going on a beach vacation. I live in FL at the beach, don’t walk in the sand without the boot. I’m 16 weeks, and have been in 2 shoes for 10 weeks now (recently put back in the boot) and thought it’d be ok to go to the beach a few weeks ago, lol! Sooo painful to walk in the sand, lol, learn from my stubbornness! My PT was not happy with me.

  11. donnaon 13 Apr 2015 at 1:04 pm

    Linda, Staying in the boot at 6 weeks is a good idea…smile.

    Stationary bike in the boot is not a problem…I did cycle at 6 weeks in sandals but only at PT to warm up and get the ankle moving, only 5 - 10 minutes with no resistance, just pedaling with all the force on my heel, no using stirrups, and so slow I wasn’t anywhere near a cardio workout.

    At 12 weeks I started cardio on various stationary bike at my gym in gym shoes and using stirrups to get an even cadence of pushing down and pulling up to work the quads and hamstrings evenly…did not use it to work the calf, the bike actually isn’t great for building calf muscle over all, it’s not as effective as using weights, unless you ride as much as a professional cyclist would you won’t build much calf muscle…and then I did it very incrementally and build resistance and time slowly.

    I only started using the indoor cycling (spinning) bikes the last few weeks (around week 20) clipping in with my bike shoes…I started standing climbs activating my calf this past week, when my calf muscle fatigued because it’s not really strong enough to climb like I used to I pointed my toes down to give it a break… I am only at 5 sets of 30 second stands per a 40 min. ride at my maximum heart rate (150-160)…toady I’m going to try for 7 sets of 30 second standing climbs hopefully fully using my calf.

  12. LindaFon 14 Apr 2015 at 9:19 am

    Thanks Donna for additional insight on bike. Sounds like you are making great progress.

    Beachy- yes I could imagine that the beach could be hard on the achilles and definitely plan to be in boot when walking on beach. I think I will only be taking it off when I am sun bathing on chair- certainly don’t want a boot tan line :)

    Where in Florida are you? I got hurt in Stuart, FL and had surgery in Vero Beach.

  13. donnaon 14 Apr 2015 at 12:46 pm

    Yes Linda progress, albeit slowly…patients is a virtue and this injury will teach you that if you’re open to it. At 23 weeks Thur. and based on my experience and that of those who share on these blogs, I’d say I am in the middle range in terms of how close I am to pre-injury movement, ability to do this or that.

    I get very frustrated on “bad” days and very excited on “good” days only to have another “bad” day…ha ha…I think I’ve finally got past something or got something all figured out and wham…it does make me laugh in hindsight…however, that is the KEY to mental health with this injury for me…to stay even keeled with what for me is a very unpredictable rehab….knowing I can’t predict anything in terms of good vs bad days…I suppose bad vs good days are all relative anyway….what may be a bad day for me, may be fine for someone else…my point is that I’ve learned it doesn’t matter how aware, educated, alert, doing your best you are…some days things just hurt, swell, or fill in the blank…and other days, again despite what I do or do not do, the tendon feels great and all is well. This injury has been as unpredictable as I found mothering and raising my now 26 year old son. Overall whether a good day or a bad day… it is as it is and there is no sense arguing with reality.

  14. beachy12on 14 Apr 2015 at 4:03 pm

    I’m up in the panhandle. Port St. Joe, FL

  15. moustaon 16 Apr 2015 at 12:30 am

    Hi Linda
    Regarding showering, I recently started being FWB in boot, what I do when I shower is I cover the boot with a shower bag and stand with the boot in the shower. I bought a $10 shower bag that has an anti slip material, after I finish showering I wash my injured leg. It has been working pretty well for me so far and made it unnerving to go in and out of the shower.
    Good luck with your trip and have fun!!!

  16. LindaFon 16 Apr 2015 at 9:10 am

    Good point Mousta. I still have my shower bag from when I had my cast. I can always bring that as a back up plan if I can’t figure out a way to sit without the boot. I can easily stand in shower with FWB so that wouldn’t be a problem. Good common sense. Thank you.

  17. bettyon 24 Apr 2015 at 12:48 pm

    Linda, leaving for St. Croix for 2 weeks. I will be at 7 weeks from rupture date. Non surgical for me. Still in boot but can excersise in sneakers 2 feet next week! Any suggestions for the beach vacation? Insights that you may have? Thanks

  18. LindaFon 26 Apr 2015 at 9:51 am

    Betty- I am still in St. Martin. Internet has been spotty so first time I have gotten on blog in week. Sorry for the delayed response. Overall trip has been fine with of course some limitations. I had no problems with flight. Airline had wheel chair for me at both ends. While I can certainly walk in boot and cane ( and even without cane) it was good to limit walking in airport and can save my walking time for shopping or sightseeing etc. I wasn’t able to get in pool because incision was not 100 % heeled before I left though I am basically 95% heeled at this point. Since you went non surgical you may be able to swim in pool - I would ask your PT. I have been to gym basically everyday up to an hour on the stationary bike and seated upper body workout with weights- of course in boot. Doing my towel stetches when I can. I would wear boot when walking on beach and can certainly remove when sunbathing. A few mojito’s have helped any inconvenience of the boot and injury and a lot of good seafood dinners didn’t hurt either. Enjoy your vacation.

  19. bettyon 26 Apr 2015 at 2:14 pm

    Hi Linda, thanks for taking time out of the sun to get back to me. I am anxious to get to St. Croix next Sunday. I go back to doctor tomorrow. Also, PT twice before I leave. I am doing seated knee raises w 5-10 lbs. on my knee. I feel the more I don’t use my leg the more I will be scared to. PT with 2 sneakers this week is scareing me and not much does… Doing bike as well with situps, push ups, seated weight lifting etc. I am hoping to get a smaller size boot tomorrow. My toes are 3″ from the front! Catches on everything and I am tripping literally over my own 2 feet. I’m a size 5 1/2 shoe and it is just too big. Mojitos sound like the perfect medication