Feb 18 2010

The Four Week Mark…is my calf still there?

Published by norcalsurf70 at 12:00 pm under Uncategorized

At 4 weeks and 1 day, I’m now able to walk around on the boot without crutches and don’t have the pins & needles any longer.  The mobility has been great and it’s lifted my spirits quite a bit and I’m able to do a few things around the house.  I still have sensitivity and color changes as the blood flow changes, but the pain is gone.  It’s really just stiff at this point and I continue to do my simple toe exercises to lightly work the foot and AT.

In doing the simple exercises, I can feel a light connection to the calf muscle, but can’t seem to get it to "fire" much at all.  Granted, I can’t move it any way close to my good foot, but I’m concerned about the calf connection.  I can point it down, but pointing up is a problem - it’s just really stiff.  The muscle has also atrophied and is definately smaller than the other good leg.

Petco, you mentioned in a recent post, that you got your calf to ‘fire’.  Was it a strong solid connection or light?  Can you point your toe up very far?

Anyone else out there have thoughts or experiences from the 4 week mark regarding the connection to the calf muscle?

I’ll certainly address this next week at my next Dr. appt to ensure I don’t have any other hidden issues…

7 Responses to “The Four Week Mark…is my calf still there?”

  1. "Frouchie" or "Grouchie", or just "Chris"on 18 Feb 2010 at 12:35 pm

    I’d say your moving along faster than I did. CONGRATS!!!

    After surgery I was in ACE wrappings with cotton stuffing and a splint for 2 weeks. On the 3rd week I was put in a cast and it remained on until week 8. From week 8 until week 9 I still wasn’t walking around too much. But week 10 tossed the first crutch away.

    Each week it seems like I can do a little more.

    Try to remember…”Slow and Steady Wins THIS Race”.

    Good Luck.

  2. petecoon 18 Feb 2010 at 1:06 pm

    I wouldn’t worry about it…I feel the same way. I mentioned that the doctor said he felt it “fire” well, but I certainly can’t or couldn’t tell for sure. In fact, I am still confused about the one exercise I am “allowed” to do - the pushing down of my foot inside the boot. This is supposed to help my calf not atrohpy so much, but I am still not clear on what part of the calf I am supposed to be tensing. It is different if I push on the ball of my foot vs. the toes…don’t know which one is right. As for pointing my toe up, I actually can do pretty well with that now, when I am warmed up like after walking in the boot for a while. I often raise up the foot until I feel a stretching sensation in the tendon - but I am not supposed to do this per my doc. He prescribed a very small range of motion just to get the tendon used to “sliding” again. I bet you the more you walk around in the boot, the more flexible you will become pulling the foot up. Best of luck!

  3. norcalsurf70on 18 Feb 2010 at 1:47 pm

    Thanks, guys for the comments. It’s certainly a waiting game and the healing process is long. “Slow and Steady”!

    I’ll post an update after my dr. appt on 2/25. Based on Peteco’s recent visit, I’m not expecting too much…maybe start PT? I guess we’ll see.

    Healing thoughts to all!

  4. placervillemadmanon 18 Feb 2010 at 3:08 pm

    I never tried to get my calf to “fire” until the 8 week mark… at that time I would feel the tendon and muscle engage but their was no heel lift whatsoever. I still can’t get heel much more than half an inch off the ground when I try a single leg but thats to be expected. My calf is starting to come back with the exercises but it was pretty pathetic once i got rid of the boot. in fact, i tried my ski boots on and the leg that had the ATR and i had to buckle the thing as tight as I can to get a good fit. I normally am in the 1/2 to 3/4 range on by buckles. It is going to be a while until you can get up on the front ball of your foot with any strength.

    Do a much “simple” exercise as you can…it does make a difference!


  5. normofthenorthon 18 Feb 2010 at 3:51 pm

    After I got FWB in a fixed (AirCast) boot (between 4 and 5 weeks, but no surgery), my main exercise was walking in the boot. I could gradually feel my calf-and-AT contributing more, pushing the ball of my foot down on the sole of the boot, as I walked. Otherwise, your stride is relying totally on the stiff shank of the boot being pushed forward by your shin — which is also what prevents your pace from dorsiflexing your ankle and rerupturing your AT!

    I think that gradual and natural increase in “contribution” was maybe the best exercise I did. And at around 7 weeks, I switched into a hinged boot (limited to 0 degrees dorsi, but free to plantar-flex), and I really love that gizmo! I’m still using is some days at 10 weeks, especially when I go out (and ALL the time when I bicycle!).

    (My last post demonstrates that I probably should have worn it when I went out yesterday, because I screwed up a little without it! No real harm done, I think/hope!)

  6. MaryJeanon 23 Feb 2010 at 8:35 pm

    I am trying to push my heel down in to the bottom of the boot and cant get it there yet and I am 5 weeks post op, Is there a certain angle Ineed to be at? I think the disk on mine says 15 also my boot seems about three inches longer than my foot Is this normal?
    Shouldnt it fit like a shoe or at least a ski boot?
    norcalsurf70 Good luck with your flight if you already had it. My husband works at an airport and he says there is lots of help -the wheel chair guys getting you around. just ask and they will tote you around and your luggage…just check it at the entrance.
    I feel like frankenstein in my boot and I want to walk, think I am ready. should the boot be put at 90degrees???? I havent been back to my office yet either…..and no face to face meetings….not ready yet….slow….Im think 8 weeks post op to be in half sales mode……let me know how your sales travel goes. MaryJean

  7. normofthenorthon 24 Feb 2010 at 12:39 am

    MaryJean, I doubt that the length of your boot is a big problem, as long as the various straps can be tightened enough to control the way your foot flexes, and keep it positioned at the back of the boot. (On the other hand, the manufacturer may well make a smaller boot that fits you better.)

    But the angle of your ankle is important, and becomes especially important as you start putting weight on your “bad” foot. I’m not sure I understand your descriptions, so here are some questions and assumptions:

    Do you have a hinged boot, and it’s now “fixed” (non-hinging) at 15 degrees below neutral? And the reason you can’t put your heel down to the bottom of the boot is that your ankle won’t flex that close to neutral? And are you still supposed to be NonWeightBearing (NWB), or Partial, or what? (My protocol specified “WB As Tolerated” starting at 4 weeks, and I didn’t even have surgery, so that’s not too fast.)

    If my assumptions are right: Fifteen degrees sounds like a fair amount of plantar-flexion in most cases, but maybe not in yours.

    You ask “should the boot be put at 90degrees?” — but having at 90 degrees would put the heel of the boot much LOWER (farther away) than it is now, so that should make it worse than 15 degrees below 90, right?

    For all of us, there’s a couple of progressions, usually all gradual: (1) from NWB to FullWB and (2) from way toes-down (aka plantarflexion, aka “equinus”) to neutral (and eventually stretching to some dorsiflexion, often shortly after the move to “2 shoes”).

    If I were you, I’d contact my surgeon and tell him/her that your heel can’t reach the bottom of your boot. (And also check if you got the right size boot.)

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