ATR in the UK - week 8, day 2: Physio & wedge removal

I had my first session with the physio last week, and finally feel I’ve started to make real progress with my recovery.  The appointment was 6 weeks post injury and I’d been in the boot 5 weeks, so it was a bit overdue but the earliest they had due to the length of their waiting lists.

I was met by a male student who didn’t look anything like the Specialist Physio Rochelle I’d been told I would be treated by, which concerned me slightly, but once he’d finished taking my history she arrived and supervised while he assessed my range of movement and then did some basic manipulation.  We were all pleasantly surprised by the range of movement I had, as I was able to achieve plantigrade with only a little assistance, and inversion/eversion were almost the same as for my good foot, and I was able to give plenty of resistance to pressure when needed.

Based on that, the upper of the 3 wedges and the shallow heel cup were removed from the boot, and I was given what I imagine is the standard exercise to do 5 - 6 times a day: with my leg straight use a towel to pull back the ball of my foot until I feel the pull in the tendon/ muscle and hold for 30 seconds, then repeat.  I was also told to ditch the crutches and go full weight bearing unless I need to go a long way outdoors, and booked another appointment for 2 weeks later for further wedge removal.  However after I got home Rochelle phoned to say that if I didn’t have any reaction to removal of the wedges after  4 - 5 days I could remove the next wedge myself at home, and the last one would come out on my next visit to get me back onto the schedule they’d normally aim for.

I had no reaction so duly removed the second wedge on Saturday, and again have had no reaction since, though I did find that without the heel cup there’s a lot of space in the bottom of the boot, and my foot was sliding around quite a bit which could make the boot uncomfortable as a result.  I’ve therefore put the heel cup back in which has been a definite improvement even if my foot is slightly more plantiflexed, but I don’t think this will be a problem since after a week of the stretching exercises I can now achieve a few degrees of dorsiflexion without help.  My whole foot and ankle feel a lot stronger, and the swelling on my foot has also almost disappeared of its own accord which is a nice bonus.  The swelling above my ankle reduced slightly by itself, but adding extra padding inside the boot to increase pressure in this area has been really effective to the extent that when I take the boot off my injured leg is almost the same shape as the good one.

Getting around without the crutches is made a lot easier by the Evenup, and I have the stamina to do the school run on crutches Ok, though if I’m running late it does leave me puffing a bit, which I guess is no bad thing.  My cough has reduced to the extent that I’ve started some core & upper body exercises, and I’m going to have a look at some of the other exercises on Evan’s videos this week.  Overall I’m mostly feeling a lot more positive now, but I can always find something to worry about, which is now how difficult it’ll be when the boot comes off.  I’m expecting the last wedge to come out at my appointment next Tuesday, and to be in the boot at plantigrade for a week or maybe two before I’m back to shoes - does that sound about right to those of you who are now back in two shoes?  The other thing I’m wondering is how I’m ever going to get the full range of movement back in that ankle: I can achieve about 25 degrees of dorsiflexion with my good foot and at the moment that just doesn’t seem likely to be possible on the injured side, but I guess I just have to stick to the exercises & keep thinking positive!  Hopefully another update more promptly after next week’s appointment.

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