Boot Time = Muscle Atrophy
I spent post-surgery weeks 2-6 in the boot, full weight bearing. I used it to work, but a clock started ticking as soon as I put the thing on. I could stand it (pun intended) for about 4 hours on my feet, then had to get the thing off & get the ice on. I think I was icing at least 4 times per day during this period. Doc’s orders were that I could move foot in dorsiflexion, bringing toes up and let it fall back with gravity. That’s it, nothing else til next office visit at 6 weeks post-surgery.
I think around week 3 is when reality sunk in. Looking at the non-existent calf muscle is frightening… brain sending signals for your calf or toes to do something and getting no response is terrifying. I was wrapping the straps of the boot further and further around as there was less and less meat on my leg. I am an active person - I enjoy snowboarding, mtn biking, xc skiing, rock climbing, surfing, SUPing… like many people, its part of what keeps me sane. This time was the hardest psychologically for me - being able to get on my feet to work and then have to just sit back down… bit of a downer.
At week 4 I took another shim out of the boot as instructed by the doc, so only one left in there.
At week 5 I was really chaffing, I wanted to start some PT- I felt the time was right. I got some info through this site and connected with someone on a PT "fast-track" who had started in on PT at week 5. I very gently started some ROM exercises, & it felt good to be doing something!
Week 6 office visit:
So I show up for week 6 visit and the doc checks out my Achilles. We chat a bit about how its feeling: pretty good all things considered. And he tells me to start wearing 2-shoes with heel lift around the house and try to wean myself off the boot over the next 2 weeks. This was a bit of a shock for two reasons - firstly I had been instructed to do just about nothing up to this point, and secondly, per reading a lot of the stories on this site, I was given to understand that this was a BIG step. He also said, when I asked, that I could get on a stationary bike.
And that was it… so I asked, "What about PT?" To which he responded that he would write me a script if I wanted, but claimed that there was no evidence of PT getting people back to normal activity any faster than just easing into walking, etc. Now, I like my surgeon. He’s given me good information and been very straightforward throughout the process… but this seemed really strange to me. I took the script and went to a PT that I know and trust (we have some really good PT’s here in Vail). The whole process is a reminder to me that I need to really take time to organize my thoughts and questions before seeing the doc - the only way to get the information I want is to ask.