Jun 17 2015

16 weeks- scar tissue

Published by lindaf at 6:31 pm under Uncategorized

Just wanted to check in and provide you with my 4 month post op report. Remembering the early days after the injury where time seemed to stand still to today where I no longer count the days, hours, or minutes to my next Doctor’s appointment or milestone. I am grateful for where I am, and not forgetting when some of life’s basic functions were out of reach. Overall I have had a good recovery, though some minor, and probably somewhat normal issues along the way.

- The bottom part of my incision still has a slight scab on it, though the rest of the incision has healed normally.

- I have returned to my outdoor walks and can walk about 3 miles, and have gotten my one mile split down to about 19 minutes.

- I still do have a slight hitch when I walk and PT thinks it has more to do with scar tissue than my ROM. I agree, as I can feel discomfort/ tightness/adhesions in my outer ankle/ achilles/ heel area. Funny though, when he tells me to walk as fast as I can, the hitch goes away.

- PT continues and I am continuing with all of the typical therapies, stretches and heel drops and toe raises. I haven’t tried a single toe raise yet, though don’t feel I am quite ready for it yet.

- Calf size is about one inch smaller on the injured size, though thinking that isn’t too bad. I have pretty muscular legs anyway.

- I can swing a golf club and can now get off my injured side (back foot). I expect to hit golf balls next week and will try to play soon if everything feels ok :)
I guess my biggest concern and discomfort is with the scar tissue and discomfort/tightness that I am feeling. I am planning on adding massage therapy to supplement my PT, to help with the scar tissue. I am interested in hearing what others have done to help break up the scar tissue and how long it takes to resolve this issue or anything else I should be doing?

6 Responses to “16 weeks- scar tissue”

  1. donnaon 17 Jun 2015 at 9:08 pm

    Hey Linda…glad to hear overall that things are OK. I use a medical massage therapist to work on the scar tissue and will have 16 one hour sessions in total. All her clients are recovering from body injuries. She really knows her stuff. Many massage therapists won’t know anything about breaking up scar tissue or increasing ROM so shop around. Also, your PT should be able to do massage, mine did but because we always had so much to work on I got the outside massage so in PT we could use our time in other areas. I also used a compounding cream with four medicines in it, one of which was an acid that really helped with the discomfort and scar tissue. It was prescribed by my OS. I used it for 6 weeks before I developed a allergic reaction to it. See Beachy12’s page because it caused her cat to die so if you have pets it’s not a good idea. It’s nasty stuff but I’m glad I had it when I did and for the short term it helped. I think I’d have more scar tissue if I hadn’t used it. I also have been doing self massage on the incision since week 6.

    I have an adhesion at the top of the repair site that is inhibiting my ROM and causing discomfort in the tendon in general, my OS just recommended he inject a fluid into the tendon sheath to get the adhesion to let go. He said he’s had good luck with it, and other than that there is nothing much he can do for the adhesion’s, scar tissue in general. Massage, medicine, and injection. I am 7 months and am going to wait a few more months, finish up the massage therapy and see if the adhesion clears up on it’s own or at the least stops causing discomfort because he said the shot is really painful.

    If you have specific questions let me know.

  2. LindaFon 17 Jun 2015 at 10:46 pm

    Thanks Donna- full of good advice as always. My PT does spend some time on massage, but to your point, there are other things to work on. I will try to find the right massage therapist to supplement the PT. I do have a cat and do remember what happened to Beachy12, so probably won’t want to take a chance with the medicine yet. Not sure if there are other options?

    When you do self massage, how do you do it? I have tried it, but not sure I am doing it right. Plus it kinda bothers me with how it feels and don’t want to chance doing more harm than good, though not sure if that is even possible.

    BTW, Did you find your new house yet? Hope you are feeling better soon. It is a long road, but you are over half way there. My PT just reminded me that it will be a year ( unfortunately)!

  3. crawllimpwalkrunjumpon 18 Jun 2015 at 6:19 am

    I am truly amazed by your story and the fact you can walk 3 miles already and play golf!. I have a feeling, I may have to retire from the love of the game in basketball finally after two partial tears. I’m starting to think…maybe golf can be a new substitute..thinking miniature lol. But truly happy for you…giving me some goals now. As for your scar tissue, I really do think based on my last experience, just hope maybe you give it bit more time. When you are kinda forced to walk fast, yea the hitch does seem to go away. I’m starting to think now, when I limp..its more mental than actual pain. It’s a tough barrier sometimes to break through. I’m fighting it lately as I have very little actual pain. So today…going to try a mile today in Central Park.

  4. cpoon 18 Jun 2015 at 11:04 am

    LindaF, I am a few weeks behind you, in week 13, and have the same issue, so thank you for posting your question. And thanks, Donna, for weighing in re massage therapy. I will investigate that.

    I still have a slight limp, but my PT tells me I have enough dorsiflexion to walk normally…so I think it’s probably more mental when I feel the tightness. I also cannot do a single heel calf lift, tried it at my OS’s request this week. He says that is my gating factor for when I can return to hiking, but green lighted me to bike and swim. Small victories…there are no shortcuts!

  5. donnaon 18 Jun 2015 at 11:41 am

    Linda your PT can show you how to self massage. I also found some good YouTubes. I use a piece of sticky paper my PT gave me to get a good grip on the tendon, I don’t know the name of it, your PT might. My scar tissue is less since I’ve now had 12, 1 hour massage sessions, and most of the tightness in the ankle is gone. Just this discomfort when I walk for long periods that will turn into pain if I walk too much…it’s caused by the tendon being pulled/tugged on, because it’s not sliding where the adhesion is at the top of the repair site.

    No house yet, still looking…good news though is that my room mate of 5 years was sad I am leaving and upset that he’d ever find another great room mate but I found one for him…my 26 year old son is moving here (Colorado) from Mass to be his new room mate when I move out! YAY! We’re very close and I really miss him in my daily life.

    At 7 months things are still not right but Life does go on and though I am not 100% it’s not horrible either…and it is true that each month it gets better…it’s a really really slow recovery. Endurance, strength, and balance are not the same as pre-injury and that just is what it is. I don’t argue with reality I just do my best and focus on what I can do. When I saw the OS Monday he said it’s one year to 18 months for full recovery and added full recovery is different for everybody.

    cpo: In my case my push off increased as my calf strength increased. In other words when you build calf strength the limp will diminish baring no other complications. It may not be mental at all, you are just not strong enough yet.

  6. hongkongexpaton 28 Jun 2015 at 5:31 am

    Linda, I haven’t been very diligent with massage but here’s some advice that was given to me by various people:
    - PT1: Break up scar tissue by rubbing in a direction perpendicular to the tendon.
    - PT2: During the initial couple of weeks out of the cast, try to break up some of the swelling behind the achilles by digging in behind the achilles from both sides. I wasn’t a fan of this PT2 but I think this helped.
    - OS: The achilles will take years to return back to pre-injury size. There isn’t any particular massage you need to do, but to help with the adhesion of the surface skin to the layers below, gently knead the achilles with your palm.