Posted by: tatyana | May 13, 2014

4 weeks 3 days post op — first wedge is out

Finally, the first wedge is gone! By today, I was seriously FWB, was walking like a pro, going upstairs absolutely normally, and could stand on my injured leg for about a minute. But once the wedge was out, I was back to square one. Painful, uncomfortable, very tight in the tendon area… But the OS said that by the end of the day I would feel the same as with three wedges. Well, I do feel much better, but not 100% comfortable yet. I certainly won’t be able to stand on my ATR leg even for a moment.

As of today, the plan is to take out one wedge every two weeks and when I run out of them, I will see my doc again. Will I be allowed to lose the boot at that point? And when we say 2 shoes, do we mean just any shoes? I think I remember my OS mentioned that in the beginning I will have to wear some sort of “worker’s boots” that offer ankle support. Is it true? Those are ugly, how can I wear them in the summer in California?

I am so eager to start walking on my own that I kept bugging my doc about PT. According to my hospital protocol, the PT starts 10-12 weeks post op. According to me, it is way to late! So I was given a resistance band TODAY to stretch my calf at home. I should also do ankle rotations and general ROM exercises. My doc called it “unofficial PT.” I like it! :-)

Also, I am allowed now to remove my boot while at home and just enjoy the freedom. I can massage my calf, move my toes, and let my leg breathe! Oh, how much I missed this!


No PT until 10-12 weeks would be a deal breaker for me Tatyana. I’d argue that this is the most important time for early strides in PT, especially to properly massage the area around the repair to break up scar tissue and any adhesion’s, plus the calf and remaining muscular work below the knee. I began twice a week PT at 3wks. I’d fight hard against that! Don’t worry about what shoes you’ll be wearing when you get to that point - the world completely changes over the next month - but IMO you need to get into PT asap to begin properly gaining that strength back incrementally.

Tatyana, I’m with sporti on this one; I think early PT is critical to ATR recovery. I started at 4-weeks (post-op), immediately after getting out of my hard cast and into a boot. Early PT is pretty simple stuff, but I still think it’s very important and helpful to get professional and personalized guidance on both form and routine. I think you’ll have to be the squeaky-wheel on this issue. -David

PT is good, alright. Removing wedges at bedtime is the smartest. Let your leg stretch overnight, NWB, and THEN put some weight on it. Both at once is “a stretch”.
UWO left all the wedges in until 6 weeks in with excellent results, and it sounds like they get your leg’s vote.

Exeter in the UK has one of the quicker and apparently most successful rehab protocols and this, after 4 weeks, allows for the boot at 30º - 15º PF (ROM); an INCREASING number of exercise sessions; removal of the boot at night (some patients may be nervous of this - all I can say is that the Exeter guys are very good and it worked for me).

Same protocol for surgical and non-op cases.

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