What a day. Got my cast off (shockingly early) and called to set up an appointment for PT. My PT actually got me in the same day! I arrived to the facility and began filling out pages of questions. This facility also does fitness training and I’m actually a member here so it’s nice to see familiar faces. Well the Therapist finally gets me back and starts evaluating me further. We get to talking and we make a plan that today I will be measured to see my degrees range of motion (ROM), stretch a little, ice, and practice walking with 1 crutch.
She evaluated my gait and felt that I could easily do 1 crutch. Funny… Well she started by having me put myself back to the neutral position, it was hard, but possible, she then further pushed my foot to just past where she said it felt “leathery”. Basically she said it means it needs to be stretched. Okay… Then we tried flexing the other way (pardon my lack of knowledge on correct terminology), then side to side. All went fairly well. I did feel 1 sharp pain when trying to move my foot to the left. Overall, not too painful! Next they iced my leg for 10 minutes to try to bring the swelling down. Basically I have a cankle right now (no distinction from calf to ankle, gross). It’s honestly not too bad but I’ve never seen my leg or foot swell before. It’s kind of interesting.
She then demonstrated how to ambulate with 1 crutch. Funny, the crutch goes on the side of the good leg (I had it on the bad leg). I attempted, no success. It’s very painful to put full weight on my foot. I feel my bones (metatarsals) hurt, then pins and needles throughout my foot when I truly put weight on it. I probably did this for 10 feet, then 10 feet back. It was honestly exhausting! She then did some passive range of motion (PROM) and I was done.
Goal is to work on 1 crutch ambulation on friday at my next PT. I’m pretty satisfied with how it turned out. I feel a tiny bit stronger and I’m looking forward to going back.
3 responses so far ↓
normofthenorth // Nov 8th 2012 at 3:27 pm
FWIW, I think walking with 1 crutch is over-rated, ditto canes, though I did use one for a few days when PWB. Two crutches keeps you balanced, and can be used from NWB all the way to FWB, depending on how you share the weight between the injured leg and the arms.
I’d also be nervous-cautious about “it needs to be stretched”. Unless your OS trimmed too much off the torn tendon ends and repaired your AT short, you should be able to get your pre-ATR plantar-flexion ROM back whether you stretch early and often or not so much. Getting it to heal longer than before is a Bad outcome, that will limit your effective calf strength, and it does happen. It’s probably caused by various kinds of over-aggressive stretching, though this is all based on logic, not science or evidence.
There was another ATR website that published a survey of all their re-ruptured posters, showing what caused their re-ruptures. Maybe 25-30% responded “PT”. And healing long takes less force than re-rupturing, ’nuff said. I suffered a one-MONTH setback after my first ATR, post-op, because my PT had a taste for much more aggression than my AT did. (Details on my blog on this site.)
rupturednurse // Nov 8th 2012 at 3:58 pm
normofthenorth- Thanks for the info! My PT wasn’t agressive at all with stretching, by “it needs to be stretched” I think she was just explaining to me what she meant by calling my tendon leathery? I’m very cautious with what I do. Reading all these blog’s on re-rupturing terrifies me! It’s hard to determine what is the line between acceptable pain, and be cautious pain. Yesterday was only my first PT, we will see what she does with me on day 2 (tomorrow) PS I’ll be checking out your blog, thanks again for the info!
normofthenorth // Nov 9th 2012 at 1:54 am
OK. Unfortunately, “Listening to your Body” is no guarantee of safety. When my PT “bullied” me into re-injuring my first ATR, it didn’t hurt ’til an hour or two after I STOPPED doing 1-leg heel raises. (Details early on my blog somewhere. I only started blogging here after I ruptured the OTHER AT, so this story was 7-8 years old at that time.)
So in addition to avoiding pain and “listening”, I think it makes sense to adopt a policy of INCREMENTALISM: Keep progressing, but don’t make today’s exercise wildly different from yesterday’s or the day before’s. If you felt OK after doing 3 heel raises, or walking 3 miles, then go for 5 or 6 if you like, and see how that feels a few hours (or overnight) later. But don’t jump from Venus to Mars overnight.
Of course, tripping or slipping or twisting your ankle, etc., are all unplanned ways to launch yourself into non-incremental territory, so also Watch Your Step! This isn’t the time to start reading or texting or talking on the phone while walking on the stairs!
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