Eager

I am 3 weeks post op and I’m in a cast. I was pretty thin before this surgery, but now my quad is very skinny compared to my other leg and the cast is appearing loose. I am very eager to get out of this thing and start rehab.

I have heard some different timelines from multiple people, but I was curious if it is possible to be starting PT at about the 7-8 week mark? I will be PWB at 6 weeks post op in a boot and I plan on getting an aggressive PT plan because I need to get back to normal.

When does the swelling stop?

When will I be able to start PT?

When does the appearance of muscular atrophy go away?

9 Responses to “Eager”

  1. It takes months for the muscular atrophy to go away. And, possibly, your calf will never be as big as your other leg. As to PT - it’s up to your doc since only s/he knows what kind of repair was done and when it is ready for PT. I was very intolerant of a loose cast /splint so I was in getting mine changed about every 5 days - LOL!

  2. As cserpent said, hard to know a PT start time because of how we all vary in our recovery. I started PT at 6 weeks post-op and they gave me basic range of motion exercises…I couldn’t do much else at that point. My foot barely moved at all! In hindsight there was no need for me to burn PT visits on my insurance that early (I was limited to 18 or 21 or something like that).

    In my case it took a good 5-6 months for me to stop noticing swelling. I wore a compression sock to help manage the discomfort. But it definitely got better over that time - it wasn’t like the swelling from the first few weeks continued for months and months.

    As far as atrophy goes, I’m at the one year mark and my calf is still a little smaller than on the good side. What surprised me most was how much I lost in my quad/thigh area. I’d say that evened out a few months ago. I think the leg lifts, clamshells, and other strength/mobility work helped with that.

    Good luck on these early stages! Life will be so much better in the boot. I hated my cast soooooo much.

  3. I found this rehab protocol which outlines some things you can do to keep up your quad and glut strength while NWB. It’s from the Banff Sport Medicine site
    http://www.banffsportmed.ca/sites/default/files/bp_attachments/Achilles%20Tendon%20Rupture_0.pdf

    i’ve also been doing some cat/cow and one-legged down dogs to get the blood flowing. also i’ve been doing some push ups on my knees, on my bed where it feels safe. i’ve added in some upper body work out with some weights and exercise band.

    i guess i’m just getting board sitting here. i live in a house but the entrance is up steep stairs and i also live in a neighborhood with no sidewalks and lots of hills. i haven’t ventured out much because of it. i hope to start work next week (2w5d post op).

    i see my DO in 6 days, 3w1d post op for stitches removal and hopefully PWB in this boot, i have the vacoped. i don’t have any swelling, but i’m not getting up and about much. i do have some heel pain and what i think is incision pain, but no redness or fever so i hope it’s ok.

  4. sorry there are some typos! i cant’ figure out how to go back and edit.

  5. As others have pointed out, PT starts when the doctors says so. My rupture was at the top end of the tendon and didn’t start PT until 13 weeks. I’m 8 months out now and one calf is still significantly smaller than the other.

  6. Thanks for the responses, emupilot, afkv, and pjhalifax and cserpent. I was just freaking out a little bit, and I think i finally started getting very frustrated that I did this to myself.

    For an update, today I went into the doc and complained about my cast because it was very loose. Also, on friday I fell and put weight on my bad foot, causing some pain. I wanted the doc to check it out.

    He said everything looked good on my achilles and told me to take it easy. I begged for a boot instead of another cast and he agreed. So I immediately went home, and took a shower..washed my leg and rubbed my calf.

    One thing we noticed at the doctor was a pretty bad blood blister under my heel. Remember I mentioned some pretty awful pain the first 2 weeks after surgery under my heel? Well it turns out that it was actually the splint that they put on after the surgery. When I called to complain about the pain a nurse told me it was just the nerves coming back to life…but turns out not for me! Just a lesson learned…if you are in any discomfort make sure you insist on getting it checked out.

    It’s much mo’ betta being in this boot. It is easier to stay up on crutches because it is more forgiving with swelling. And I can finally let my leg breath at night!

    Enjoy the week!

  7. Glad you’re in the boot popouch! I was sooo happy to get in the boot too. Since my post-op instructions said come in if you have any issues with the splint/cast I did exactly that - LOL! As soon as I felt some continuing discomfort I went in for a change. Once I was just starting to get a raw spot on the top of my foot. Had I left it alone it would have turned into a bloody raw spot on the top of my foot. Once I was in the boot I could put on nice soft socks :) FYI - if you want to keep your boot from being scrungy - always wear socks - make sure the go up to the top of the boot too. :)

  8. And - if you read my blog - the “PT” I got at six weeks were just some basic rotation and stretching exercises the doc told me to do. At each visit the doc gave me a few more exercises to do and a few times I emailed him to ask if I could do some others. Some he said I could, some I couldn’t. I didn’t actually go to real PT until I was fully weightbearing which was at maybe 10 weeks?

    http://achillesblog.com/cserpent

  9. Eager is right! I’m two and a half weeks post-op. The atrophy is quite stunning. At least two and a half weeks until I’m partial. I’m still sleeping with the boot (very loose), but it is really nice to take it off a 4-5 times/day for some light stretching and ice. Man, do I love the ice!

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