First physio - or was it? Advice please!
Hmmmm. What to say about my first physio session? Well, it has raised a question on which I’d appreciate some advice (although I have a pretty good idea what you will all say!)
Turned up at the NHS day hospital about 20 mins drive from home (hubby still doing taxi duty) having taken a couple of ibuprofen in preparation for a good pummelling. And I was looking forward to a good pummelling in a healthy masochistic way.
(I’ve ditched the crutches altogether now, having decided they were more of a trip hazard than a help.)
Didn’t have to wait (v. good) and was scooped up by Mandy who was very pleasant and explained to me that she’s a trainee physio (not so good, but then they have to do their training on someone I suppose) . We then spent ages going through a full case history (dull but necessary) and medical record.
Mandy assessed my leg in various different ways (push against her hand this way and that etc etc, taking copious notes throughout) and seemed happy with what I could do. She nipped out of the cubicle from time to time to check things with her supervisor. Then she gave me a printed out sheet of 3 exercises (the basic initial stretching stuff) and said that they’d normally say come back in about 3 weeks but could I come back in just over one week because her training posting is only 5 weeks and she’d like to track my progress.She advised me to get used to standing up straight barefoot which is still a bit of a challenge.
And that was it! I asked if she wasn’t going to do a bit of manipulation/massage/pummelling that day and she said (and this is the bit I want your comments on), “No. We wait until 12 weeks after the surgery before we start working on it because that is the golden healing time and we want to let everything get really well healed first.”
Now this was news to me. I’m sure I’ve read blogs from all of you in which the physios got to work on the ROM and flexibility as soon as the cast came off (or a load sooner for folk with ‘aggressive’ doctors).
I have found a private physio based at a medical centre about 30 mins away and had a good chat with him over the phone a few days ago. He has plenty of ATR experience and works out of a very snazzy centre with all the kit (with a price tag to match). His advice was to go and see how I got on with the NHS and then give him a call if need be. He certainly didn’t say anything about some magic 12 weeks.
Suggestions please!! (Although I think I know what I’m going to get!!)
Smoley
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Smoley,
I’m in week 13 now and have been doing PT since week 6. My first PT appointment they went through the same things but then did the massage and manipulation like you mentioned. Since then I’ve been going once a week and each week they progress further, adding more expercises ect….I would look into the private PT if you’re able to do that. Sounds like they have more experience…Sounds like you are not in the US?
Joe
Hi Smoley,
I understand your frustration. I can tell you here in Ontario we have free physio only at the hospital. (cutbacks… few years ago the health care system covered 20 sessions at any clinic. I sprained my knees then, and went to the first therapist I picked out of the phone book… not a good idea)
At the hospital of course they are terribly overbooked. I had to wait 6 weeks to get in. My first surgeon did not send me to physio before I got out of the boot,after 11 weeks.
My second surgeon after the surgery told me to start physio at 6 weeks. Of course we did not do much, as I was in the boot. But they kept telling me the massage of the tendon to get rid of the scar tissue is important, and that the ultrasound helps that too.
I was not in a big rush to try the hospital the second time around, kept going to my private physio, but when I did, the treatment was disappointing: they gave me ultrasound once, and after 3 sessions they deemed I do not need their help anymore. I see mostly elder patients there, and it seems the hospital is satisfied if we can do our daily chores like going up the stairs and climbing into the bathtub, they are not there to facilitate our return to sports etc.
The private physio therapist however revved up my treatments at the same time when the hospital sent me on my way - to do muscle stimulation because my calf is very weak. (at 4 months, as the surgeon gave green light to exercising)
And they are a busy clinic, do not lack clients, and since I ran out of insurance they charge a very reasonable rate at $40. So I do not think they are greedy trying to find excuses for me to keep going.
I hear about all sort of torturous manipulations, but I did not really experience that. My physio did not forcefully stretch my tendon, rather gently, or told me to do it myself. Yes, she massaged the scar tissue, that is not pleasant, but I never needed pain killers.
So I am not sure what others mean by it.
What I do not like as you describe your situation is that they would send a trainee to deal with an Achilles. I think it is a rather serious injury for that, at least the more experienced PT should have come and checked on you.
You are at a very important stage of your recovery to go unsupervised for 3 weeks. So I vote for going to check out the other place…
I don’t have any PT experience to speak of quite yet…I’m 3.5 weeks post-op, so its coming up soon. However, I did want to let you know your analogy - “mad as a box of frogs” did make me chuckle……hell, it made me literally “laugh out loud”! I think we all get “mad as a box of frogs” from time to time, being laid up with our shared injury and not out enjoying fabulous fall weather, cycling, running….hell, I’d rake the leaves right about now!
Cheers on your recovery. Ciao………..Stroh
Smoley-
My surgeon told me at the 5 wk post-op visit that I could start PT (fingers don’t seem to want to type “physio”), and it took me almost a week to get in - figuring out where to go, then a time with them, etc. My PT was stunned that I walked in without the boot and proceeded to tell me that his “magic number” was 8 weeks. So, for two weeks I did some own-muscles-only stretching and circles and alphabet tracing with my toes. He has been doing some very firm massaging on the top and sides of my foot to help with oedema (there’s some English spelling), but not much massage posteriorly. I, too, was expecting to be manipulated/pummeled much more than I have been - the only “therapy” that seems to be directed specifically to the tendon is the ultrasound. Now, during each session (I’ve been going 2x/wk) there has been either a new exercise added or the intensity of the exercise increased, and I’ve found that the improvements in my walking have made significant gains after each session, but for now, I’ve checked my “bring it on” attitude at the door. Maybe PT is not as intense as we’re anticipating because of the long road nature of the recovery from this injury.
Cheers, Ron
Smoley:
Read your comment on another blog about the tanning creme (BTW, I also ruptured during tennis.) and I laughed so hard! I am almost 6 weeks post-op and haven’t found much to laugh about lately, so thanks.
Kath
How disappointing for you. My first physio session was fairly basic on the day the cast came off, but I definitely had some serious massage of the tendon on the second session a few days later - would’ve been just short of 10 weeks post-op cos of the 9 weeks in cast. Seems the 12 weeks is some mystical number they’ve conjured up from somewhere…
I too would be concerned about having the trainee..can you try a few private ones as well? You need to have confidence in your physioterrorist.
Good luck.
My Dr mentioned something like 8 weeks?
I am seven weeks in the UK. Still NWB, just gone into a boot…which I am finding far more uncomfortable than the cast. I have been told January (2nd week) before physio…which is the 12 weeks you talk about! I am so weary of the process and surprised every day by how sore it still is!