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- rudedog has completed the grueling 26.2 ATR miles to full recovery!
Apr
24
6 weeks post-op in aircast (nearly 2 shoes) and from NWB to FWB in seconds
April 24, 2009 | |
Hello everyone.
I had my 6 weeks post-op appointment to see consultant. I have been in various casts for the last 6 weeks (all NWB). I was epecting to recieve boot/aircast and to progress to PWB. However, the consultant seemed to have different ideas. He had a feel of the tendon, manipulated my foot in different directions and said everything was looking good and that I can progress from NWB to FWB as soon as I can. The consultant initially decided to get me in two shoes (with heals/wedges). I was suprised with this decision as I was expecting a boot or aircast for a few weeks. Anyway to cut a long story short, the consultant then decided to give me the AirCast with one wedge/heal as I did not have my other shoe with me and I was also concerned about the risk of re-rupture and the fact that most people on this blog do tend to have some form of walking brace when they switch from NWB to PWB/FWB. Therefore, the surgeon agreed to give me aircast with one wedge/heal, I was also given a wedge for my good foot shoe. Initially I thought my surgeon was conservative as I’ve been in my cast NWB for 6 weeks. However, after this appointment it seems as if things are progressing quite rapidly. I can now PWB with aircast and both crutches. Depending on how things progress, I am hoping to place more weight on my foot over the weekend. I only need to have the AirCast on whilst walking and weight bearing so I can take it off at night or whilst resting.
After the appointment, my orthopaedic consultant basically discharged me and handed me over to PT. He said that there was no need for me to see him anymore as things are healing nicely and that I could easily make an appointment if things deteriorate. So now I am in the hands of the physiotherapist.
My first PT appointment was basically 20 mins long and was immediately after my appointment with orthopaedic consultant. I was told to do gentle ROM exercises (nothing too physical) on ankle whilst being seated. My next appointment with PT is on Tuesday 28th April 2009. I’m hoping that by that time I should be placing more weight on foot. I was also told by PT that it could take another 6 weeks (a total of 12 weeks post-op) before I can drive, however, this could change depending on how well I progress and whether I can do an emergency stop or not.
Apologies for the long-winded comment, but I do find it astounding that there are so many different rehab protocols for this injury. It seems as if each surgeon has a different protocol.
Anyway, I do hope all of you are progressing well in your recovery plans.
Comments
10 Comments so far
Hi Rudedog,
Great to hear you are progressing so well and quick.
I agree there seems no be a lot of different views on how to treat an ATR and i guess it makes us wonder if we are getting the correct treatment because someone else is getting a different treatment but i guess some injuries are different.
I have read some reports where they try to get FWB as soon as possible as an aid to long term recovery but as we are all petrified of re rupture i would imagine it makes us very cautious. I read one horror story where the guy took his cast or boot off to have a shower and slipped and re ruptured AAAGGGG!!!!
Be careful mate and keep up the good work.
Hi Cactus,
Thanks for your comment. I agree, it’s important not to get too carried away/or to get complacent when given the aircast/boot and the transition from NWB to PWB/FWB. In my case, my major concern was calf atrophy. Yes my calf has shrunk but not a humongous amount considering i’ve been NWB for 6 weeks. I do believe that the bulk of muscle waste comes in the first two weeks after immbolisation and it slowly tapers off after this time. As mentioned before, I have started doing gentle ROM exercises which are designed to slightly stretch tendon and to get some movement back into my ankle so that I can feel a bit more comfortable when I place a bit of weight. I shall definitely try and be careful when it comes to bathing/showering. The aircast is a nice piece of protective equipment and I can feel it protect my ankle when I pump it up. Definitely worth asking/going for it if the surgeon gives you the ok.
Hi Rudedog,
Calf Atrophy is a concern of mine also.
I can actually contract my calf inside my cast and have been doing so but not sure if i actually should be doing it bit i get no pain or anything.
I would imagine the muscle in your calf should come back as you start to use it again, is this correct ??
Hi Cactus,
Well, the calf muscle will *start* to come back when you begin using it again, but getting to full strength again takes months. How long it takes depends on how much atrophy you start with, and how well you work your calf back into shape after that.
Be aware that the subtle limp in your walk will stay there until your calf can support your entire body weight by itself every time your good foot steps forward.
Best wishes,
Doug
Hi Cactus,
Immediately after op, I was seen by a physiotherapist who basically taught me how to use crutches and he also told me to wiggle my toes as much as i can (as long as it does not cause pain) and to basically do two exercises 10 reps each 3 x day.
1. Knee raises without placing weight on foot (i.e. whilst standing up (using crutches for balance) just lift your leg so that your thigh is parallel to floor). This exercise will give mobility to your knee and provide strength to your thigh. By doing this exercise I also felt (albeit ever so slightly) that my calf muscle was being worked.
2. Whilst standing (using crutches for balance) move your bad leg from side to side. This exercise is designed to keep your hip joint mobile and you can also feel it in thigh.
I did the above exercises on a daily basis and increased the number of reps with comfort and time. I also think that it’s difficult to exercise the calf with a cast - being NWB. I think muscle wastage is inevitable and most of it will occur in the first two weeks (post-op) of being NWB. Most people who suffer from ATRs are likely to be NWB for at least two weeks after the event. Therefore most will suffer from muscle wastage.
A correction on above post. The exercises I was given by physiotherapist immediately after op were for 3 x 10 reps thrice a day.
Rudedog,
Thanks for that great advice.
I’ll give it a go balancing between a couple of kitchen chairs, knowing my luck just now I’ll go flying if i try to balance on my crutches LOL.
Cheers again mate.
Hi Ruedog,
It’s great to hear that you are doing so well. As Cactus said ,be very carefull.I’m still in cast due to an accident ( slipped and stepped on my foot while trying to take out the garbage)We discused it earlier how diffrent are the rehab protocols even in one city. You would think that at least in one Country or one city they would follow the same path. Most unfortunately it can happen that the Doc who is dealing with you will not always offer the best solution. I think this is the worst.
All the best for you guys , you are very close to leave the crutches behind so take care.
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I have heel wedges in an Aircast boot and think I’ve been given the wrong ones. Can anyone describe the shape of a right heel wedge? Should the cut out side be on the right (ie under baby toe) or on the left (ie under the big toe)?