5 week post-op checkup, PT ahoy.

I had a 5-week checkup today with no surprises (it’s actually day 34 but who’s counting?). That’s a relief given my fall last week and the fact that every little twinge made me think I’d messed something up. I’ve felt good but it was nice to see the doctor give my leg a once-over and say that everything looks like it should.

I’m cleared for neutral in the boot, I can slowly start PWB, and I’ll have my first PT appointment late next week. Also continuing the gentle ROM exercises with the boot off. Neutral isn’t too much of a stretch now (ha) but I’m going to leave my little heel wedge in for one more day so I can get used to the idea. The fall spooked me so I’m feeling extra careful these days.

Has anyone “interviewed” PT places before the initial session? I didn’t get much guidance from the doctor - he said all 3 that are in-network are good - but I want to be confident in the PT plan. I suppose I can always change providers if I don’t like how the first visit goes.

Aside from having the checkup to look forward to, this was a fairly boring week. I have random pangs and twinges in my calf and ankle. Nothing that causes alarm, really. The incision looks good - most of the scabby stuff is gone. The skin around the incision is sensitive, especially by the end of the day. Sometimes it feels angry and irritated, other times it’s almost numb. I’m assuming the nerves are still figuring out what the heck is going on down there.

Overall, I guess boring is good at this stage. At least next week it’ll be boring with a dash of PT!

12 Responses to “5 week post-op checkup, PT ahoy.”

  1. Yay for you! Glad you get to start bearing weight! I started at 6 weeks rather than 5 and found that after the first day I rarely needed a crutch. I think one day when I did a LOT of walking/standing I used the crutch to help myself along towards the end of the day. Now (I’ve been FWB in the boot for almost 2 weeks) I don’t even bother with the crutch. Of course that may all change tomorrow when I get to start 2 shoes :) Hopefully you were told to do massaging of the incision as well - I think that helps things de-tenderize. I had to start off pretty gentle but now I just have one last area on my heel (which is above the slow to heal part of the incision) which is still a bit sensitive. It gets less sensitive each day though which is a good sign.

  2. Glad everything went well with the visit - walking again is the best thing in the world. I have not interviewed PT places - I have one close to my house out in the boondocks so I hope they are OK. If not, I’m going to have to drive a long way for another, so I hope that doesn’t happen. My Dr. was not clear on this - how much pressure and for how long are we supposed to be massaging the incision? Up and down or across? I’ve been massaging up and down, but honestly it kind of queases me out a bit. Is this to de-tenderize or break the skin loose from the tendon?

  3. That’s the first I’ve heard of massaging the incision. How firmly are you supposed to do that? I’ve probably done it a little when I feel around on the tendon, but I don’t mess with the incision itself much.

    I’m going back and forth on researching PT places. Right now what seems most important is the place’s hours. One is open Mon-Thurs and a half-day Friday, for example, and the other one is open Mon-Sat. That’s a big difference as I think about getting rides to the early appointments before I’m cleared to drive. Fortunately they’re all pretty close. Other than that, I’m not sure I have the time or energy to asking questions before I get there. This whole process has me pretty tired of all things medical. Just tell me when to show up and what to do and let’s get on with it.

  4. The massaging is to help break up scar tissue and improve blood flow in the area. I actually massage my entire foot - but put a lot of focus on the achilles and incision area. My doc told me to start it at 3 weeks since the incision was closed up by then. I go side to side on mine - well kind of a circle actually - with my thumb. I do it as hard as the incision area will take. Initially that wasn’t too hard at all but now all but one little area gets a good, stiff massage. I’m sure I’ll learn more ways to massage it once I start PT - but that’s not until 5/1. I also started applying the silicone gel at 3 weeks. I wasn’t quite ready for the pressure of the silicone sheet yet at that point. I do NOT want serious scarring on my heel since that will REALLY bug me when I start playing soccer again so I started using it as soon as I could - which is when the incision heals.

    Do a google search on “scar mobilization” and you’ll find out more about it. One thing I read said don’t spend more than 5 minutes on one area of the scar - LOL! I count to 20-30 seconds per area (the width of my thumb is one area).

    One interesting thing I noticed after I started walking - I got bumps that formed along the achilles in a couple of spots. Don’t know if that is scar tissue or ??? Everything was smooth before I walked. I massage the bumps extra hard. I’ll have to send a picture of them to the doc so he can tell me what they are.

  5. Glad to hear that your fall did not cause any damage!
    As far as PT I did not “interview” PT places, because from my previous experience when you ask at booking who is good at “x” they will tell you all of our therapists are good at it, so there is no way to choose particular therapist that way. I did not find good review boards for therapists either, so as patients we are little bit in the dark.

    I chose a PT clinic that is in the same hospital where my doctor is. That way the doc can read the PT notes and PT can read the doc’s notes immediately within the same system. That was my thinking and it worked out well from that perspective. I know that is not always an option though,,,

    Now, as far as which therapist to choose within the clinic that’s the harder part. I got lucky and got assigned to a PT that was great and knowledgable about achilles tendon rupture. His approach was logical and he communicated everything clearly from the beginning. He reads research papers and applies rehab techniques based on ones progress. I heard really bad stories about PT from others, however. Many had to switch to get appropriate care. If you feel something is not right with a therapist’s approach, I would book with someone else immediately. Since this injury requires much longer PT than many others, having PT that is good at it is really important. Hope you find a good one fro the beginning! :)

  6. When they were setting up my PT appt I told them my goal is to get back to playing soccer. That changed the person who they planned on assigning. So I got a “sports” oriented PT person. I won’t see him until May. I have no clue if he’s good or bad but I’ll know more in May. So, if you have a specific goal after PT be sure to tell them that when discussing possible therapists.

  7. I ended up choosing a sports-centered PT place so we’ll see how that goes. Right after the injury I was saying I never wanted to play a sport or move quickly again, but as time has passed and my leg starts to feel slightly more normal I know I’ll want to get back to tennis and running. I figure I’ll know pretty quickly at the first appointment - either it’ll feel like a good fit or it won’t.

    This place also has the best hours so I hope I like it!

  8. pjhalifax, when’s your first appointment? Let us know how it goes. A sport centered place sounds like the right choice. I’m anxious to start PT, but I’m only just past 3 weeks, still NWB, so I’ll have to live vicariously through others for now!

  9. My appointment should be around the 6-week mark, so next Thursday or Friday if I can get one of those days. The PT place was closed Friday for the Easter holiday so I hope to get an appointment confirmed when I call on Monday. I’m excited to start, but also a little scared…I want to get on to that next stage but the thought of someone pushing and pulling on my foot freaks me out. (I don’t even know what they’ll do but I imagine them pushing on me in uncomfortable ways.)

  10. And I can’t wait to start PT - but have to wait until May. :( Good luck with yours! Of course I’ve taken my mom to many a PT session after shoulder surgery and 2 hip replacements so I know that the end result is good as long as you do what they tell you and rigorously follow the at home exercise plan.

  11. I’ve been in PT for the last year after my first surgery. It involved manipulations by the therapist to help increase range of motion and decrease swelling. And then a graduated exercise and strengthening program to get my ankle working properly again, as well as proper gait training. It’s amazing how hard it is just to learn to walk properly again after an ankle injury. It’s natural to compensate, using other parts of the foot incorrectly and then running into further problems. They are there to make sure that doesn’t happen. My PT is absolutely awesome, and while it was painful at times, it was mostly rewarding. But patience is required. It’s a slow process.

  12. I’m more excited now that I made the appointment (Friday morning). I also made a list of what I’d like to accomplish, and when I was finished I realized again how much this injury has impacted my daily life in so many ways. Despite pre-PT anxiety, I do want to get started so I can get my life back to normal. I’m very tired of the iWalk, boot, and not being able to drive.

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