Had my first post-op appointment today, and the sutures out, which was a little ouchy but not too bad. The wound looks great, no problems there at all.
Much to my delight I was told I would go into a range of motion boot, rather than the fibreglass cast recommended in my op report.
The prosthetist/orthotic guy came to fit me in the boot and just gave it a big dorsal push, saying they needed to get me to 10 degrees off neutral. The sensation was absolutely horrible and terrifying, the pulling was intense, and he was unable to get me past 30. I don’t know if I was just being a complete squib, but my foot has been almost completely plantar flexed for 16 days now and I actually think it’s pretty amazing that I got it as far as I did!!! And I already feel like I can go a little further, so maybe slow but sure is the way for me?? Did others have this happen?? I know I have to get to neutral before they will let me PWB and I know that won’t happen by me doing nothing….but well, that pulling sensation just absolutely terrified me - more than anything it felt as though the whole tendon was going to break through the skin!!
Anyway they have left me with some room in the boot so that I can touch weight bear and hopefully get my heel down flat at 20 deg before long. I am confident it won’t take too long….in the 2 hours since I have had it on, I have managed to straighten my leg with my foot in this position, which I could not do at first.
I got barely a chance to speak to the surgeon at all, apart from hearing him say the wound looked great. I really wanted to ask if it’s ok for me to start contracting my calf muscle. Anyone know?? I am seeing the physio tomorrow anyway so hopefully he will enlighten me.
I sure did not get any tendon massage, or foot bathing out of the team I saw today, though!!!
My left calf is now a little smaller than the other, though I am sure that will become more pronounced. Funnily enough it’s also BROWNER. I had a spray tan a couple of days prior to rupturing, and it’s worn off the rest of my body but stayed on under the cast!!! Eeewwww. Definitely looking forward to that shower with the boot off, when hubby gets home!!!
So next appointment is 2 weeks, by which time hopefully I am well and truly comfortable at 20deg and ready to go for 10 or even neutral.
Ok, I am off to squash some pretend flies with my left toes!!!
Here’s to everyone’s recovery. We will get there!!
That’s great news, getting into the boot so soon.
Range of motion can increase pretty quickly, if given the chance. I started walking/shuffling in my shoes at 2 1/2 weeks postop, keeping my injured foot way out front at first, so the tendon didn’t stretch too much, my weight being carried on my heel. Over the next week, the ankle got much more flexible, and I could step my good foot farther forward each day, to the point where my good foot’s heel could get in front of my injured foot’s toes. It was pretty quick progress, going from a goofy shuffle to pretty good walking in the space of one week. Not being in a boot meant that I could keep progressing every day, and not have to wait for a PT or doctor visit in a week or two to get the boot adjusted and allow more progress.
Perhaps you could talk with the PT about being allowed to adjust the boot on your own, using their guidelines, as your comfort allows? I never had a boot, but I assume the adjustment isn’t that complicated. That might be something to ask about tomorrow.
Regarding working the calf muscle, it is good to hear your atrophy is not too bad. Two things could help keep that from getting worse. One is using a vigorous vibrating massager on the calf while gently stretching it with your own leg muscles. Animal experimentation showed that muscle atrophy can be greatly lessened by doing this just a few minutes a day. I used such a massager, and it may be one of the reasons my atrophy was pretty minimal, (along with calf work starting a day after surgery). The second is to start, very gently at first, to flex that calf muscle, and increase the force as much as feels comfortable. This goes against conventional wisdom, but it makes sense that, if they can push on your foot to the point that it scared you, you should be able to lightly flex your calf. Perhaps that is exactly what the squashing flies exercise is about.
You can push your toes into those poor imaginary flies in two ways, though. One is to move the toes without using the calf at all, the other is to flex the calf some while doing it. I think the latter would be better, getting the calf working some. Did they go into specifics about this? If not, that would be something to ask about tomorrow.
Good luck,
Doug
November 20, 2009 @ 7:20 amG’day Rutha,
I echo what Doug says in that getting into a boot so soon shows great progress ( in the UK I got away with 5 weeks in casts before the boot - they like to prolong the agony here!).
On the stretching out of the tendon, I had a similar sensation to you i.e. that the tendon was about to be snapped as they pushed my foot from a full equinus position up to 20 degrees plantar flexion. It was very painful, in fact the most pain I have had in the whole injury through recovery phase. The good news is that I found the move from 20 degrees to flat was fairly comfortable in comparison.
Not long now until PWB & FWB!
PS If you meet my Aunt & Uncle say hi to they for me (they live in Burpengary), small world!
November 20, 2009 @ 10:56 amWow guys thank you SO much you have both made me feel a LOT better and a lot more positive!!
Highflyer, I could not agree more, flexing into the boot yesterday was definitely the most painful part of my injury so far. And since they did it I have had tenderness all through the calf and even up a bit through the knee joint so obviously good old gastroc got a bit of a work up!! Overnight the boot became WAY too big….amazingly the swelling in my bad foot completely disappeared and when I woke it was smaller than the good foot. Which meant the boot had a lot of room and my foot had returned to a more comfortable level of plantar flexion. So it was time for another big dorsiflex after showering this morning which really hurt again! Coming good now though after a bit of rest time. And yes it is a small world, I am on the other side of Brissie from Burpengary but know it well. Which part of the UK are you in?
Doug, they have left me space in the boot to work my way to 20deg, I really hope to be there in the next few days. But will definitely ask the physio if he wants to help me get it to 10 etc etc so I am ok to PWB when I go back to surgeon. Love the vibrating massage idea, I could not stop rubbing my calf when the boot was off this morning so might get myself a massager and make that a daily ritual. Your quick progress with your tendon stretching gives me hope…my biggest concern at the moment is the amount of pain involved with stretching it back so hopefully, like highflyer, that is just to begin with, and will get easier.
Looking very much forward to the physio session today…will let you know if i learn anything of interest!!
cheers
November 20, 2009 @ 5:14 pmDear Ruth,
November 20, 2009 @ 6:05 pmI’m from Portsmouth on the South Coast (so it only rains here for 3-4 days in a row!).
Have been to Brisbane twice & love Queensland, almost emigrated out there a couple of years back, but couldn’t leave family in the end.
Just a thought, it may be worth checking with your Doc to see if you could take the boot off while in bed - they let me as soon as I was in it.
Take care
Chris