Today was PT appointment #1 and I liked the DPT who worked with me (and the practice overall). She measured ranges of motion on my good and bad ankle, showed me some basic ROM exercises similar to what I’ve been doing, and added in a contrast bath recommendation to help with swelling. 3 minutes hot water / 1 minute cold water repeated 5 times, twice a day. She did some really gentle stretching of my foot/ankle and then hooked me up to a TENS machine for the last 10 minutes. I can’t say I felt any different after the TENS thing. It was an interesting experience nonetheless.
(edited to add exercises)
Here are the specific exercises if anyone’s curious:
- Ankle Pumps - bend foot up and down at ankle - 2 minutes, 3 x daily
- Ankle Circles - move foot in circular direction - 2 minutes each direction, 3 x daily
- Calf Stretch with Towel - hook towel under foot and pull until you feel a stretch in calf - 30 seconds x 5 repetitions, 3 x daily (taking it easy on this one as I’m still wrapping my head around pulling on my foot, even gently)
- Straight Leg Raise - lying on back, raise leg with a straight knee, hold 3 seconds. 2 sets of 10, twice daily
- Hip Abduction - Sidelying - lying on side, raise top leg with knee straight and toes forward, hold 5 seconds. 2 sets of ten, twice daily
I forgot to note the ROM measurements but the therapist said my good calf is really stiff, and that a similar level of inflexibility could have played a role in the rupture on my bad leg. I’d thought about that as I looked back on my pre-injury fitness and it makes sense. I hadn’t spent as much time stretching as I used to back when I was running regularly. She’s going to make sure to emphasize stretching and strength work on my good side as well; I’d mentioned that one of my main goals is protecting my left leg and improving flexibility overall.
There’s some kind of disconnect between what my orthopedic surgeon wrote on the PT prescription regarding PWB, what he told me in the office last week, and how the PT folks are interpreting all of that. I’m going to proceed as planned, which is gradually getting used to PWB with the crutch for help. The therapist thought the instructions indicated starting PWB 2 weeks from now, at the 8 week post-surgery mark, and that doesn’t sound right to me. She’s going to call the doctor to verify. I also have another doctor’s appointment next week so I’ll run that all by him again. I don’t think that had a huge effect on the early PT schedule because all I’m doing out of the boot is ROM stuff anyway.
It’s funny - I’m kind of numb to getting mixed instructions from the doc and now the PT. I get the sense both are caught firmly between the old ways and the new with regard to this injury and the options for recovery. I’m glad I found this site and have been able to combine all of the information from multiple sources to come up with a general plan that feels comfortable.
All in all, I’m glad to get started on this next phase but there’s also a bit of a letdown feeling. There’s not much new to do at the moment - maybe a slight increase in the exercises - and scheduling 2-3 visits a week is quite a task until I can drive myself. I have to get my wife or my parents to drive me and watch my son, and that’s a tall order during the work week. I could only schedule 2 visits for next week…that might be the most I can do on a regular basis. Seems like most of the real work is done at home, anyway, so maybe that’s not the worst thing in the world. Now that I think about it, 3 visits a week doesn’t feel that necessary.
But hey, progress is progress! I’m happy that ROM is steadily getting better and there’s no pain to speak of. I think I’m just in one of those valleys you hit during the recovery. There’s still sooooo far to go.