7.5 weeks post op - 1st PT

Today I had my first PT session. It consisted of taking some range of motion measurments, a 20 minute tendon massage, icing my ankle and getting all of my questions answered. I’m feeling pretty good about things at this point. Over the next week, I will transition out of my boot into a shoe with 2 heel lifts. At the next PT session, I will start some actual exersizes as I will then be at the 8 week period. I believe we will also start some biking

On the down side of things, I am still having some minor pain in my other achilles and calf from over compensating weight. I am just trying to walk as little as possible, which still ends up being a lot.

When I mention that I dont’ know if I want to play basket ball again due to this injury, the doctor and the PT seem so optimistic about me returning and remind me that this is why I had the surgury. This is great to hear, but sometimes I think that they forget how big of a life changer this injury is since they see it every day.

3 Responses to “7.5 weeks post op - 1st PT”

  1. Just curious on your range of motion exercises. I just got cleared for FWB but really feel I need more ‘dorsi’ range of motion to help remedy my limp. Are you seeing much weekly progress in those measurements?

    Also, today I asked my surgeon (who used to be a tennis player) if she felt my good tendon will be at higher risk of rupture just due to the fact that my other one went bad and maybe I’m just at higher risk in general. She seemed pretty confident that there are no stats supporting the theory that people who have experienced a rupture will experience one on the other foot as well. So I plan to stay active, but ease into high risk activities like tennis and basketball by making sure I’m at my preferred body weight and that I feel very fit generally before jumping back in too heavily. I wouldn’t write off basketball if I were you, just focus on being in the best shape possible before participating again.

  2. Hi Jeff,

    I am FWB but with the boot. I am just about to lose it and go into a regular shoe with 2 heel inserts. Yesterday was my first PT appointment, so I haven’t had time to really improve my range of motion. But just through removing the heel inserts, i can get my foot a bit past a 90 degree angle. It is nowhere near the range of my other one yet. But, according to my PT the dorsi range on my good foot is about 25 degrees. She told me that the average person has about 10 degree range of motion. Not sure if that is relavant.

    As for rupturing the other tendon, my PT said that she has dealt with many many ruptured achilles and that she never saw someone who ruptured the other. (However, I have heard some horror stories on here. So I know it is possible). The PT said as I age that I will have to spend more time stretching and warming up. I guess there is enough preventative stuff that we will or can do to really minimize that risk. Let’s cross our fingers.

  3. Jeff, you should stay active, but NOT because your surgeon “seemed pretty confident that there are no stats supporting the theory that people who have experienced a rupture will experience one on the other foot as well” — because she’s completely wrong about that!!

    If you visit this site’s “Protocols, . . . studies” page, you’ll see a link to the 2003 article “Contralateral tendon rupture risk is increased in individuals with a previous Achilles tendon rupture”. The risk they found — though only looking a few years after the initial ATR — isn’t high in absolute terms but is hugely elevated compared to the “normal population” we used to be part of.

    Here’s a short excerpt from the abstract:
    “Ten patients (6%) experienced a rupture on the contralateral side during the follow-up period (OR:
    176 [70–282] vs. the expected rate based on the general population risk of this injury, P<0.001). [The follow-up period was "median: 4.2 years
    post injury". -NotN]
    Thus, this study suggests that patients with an Achilles tendon rupture are at significantly increased risk of a contralateral tendon rupture, as well.”

    The “OR: 176 [70–282]” part means that the Odds Ratio is 176, with the 95% confidence interval running from 70 to 282. In layman’s terms, your odds of rupturing your other AT within about 4.2 years after this one are around 176 TIMES higher than a random person’s odds of rupturing the first one.

    In terms of absolute risk, their 6% incidence in 4.2 years translates into “an incidence of 1410
    injuries per 100 000 persons per year in this selected
    population”, compared to an overall incidence rate (gen’l population) “estimated to be eight per
    100 000 inhabitants per year”. So 6% in the first 4.2 years vs. about 1/30 of a percent in the same period.

    That’s why I don’t feel very unusual or special in this crowd, having done “both sides now”, 8 years apart. (Heck, I wouldn’t even show up as a Contralateral rupture in this study, because my other-side AT seemed PERFECT 4.2 years after I tore the first one!)

    That does NOT mean that you should give up high-risk sports, though the decision is all yours, and obviously personal. (I didn’t, and I’m glad I didn’t, even though I “lost the bet” in ATR terms.)

    Pete, your PT may have just been lucky. In a sports-med-clinic waiting room soon after my second ATR, I struck up a conversation with a guy who turned out to be a former PT-clinic employee. He said that when they discharged ATR patients, they usually said “See you soon!” because so many of them came back in a few years after they tore the other one! I don’t think the numbers in the study seem THAT high, but it’s way wrong to deny that we’re at elevated risk of “doing” the other one.

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