2nd Post-Op Appt

I had my second post-op appt yesterday (6/3). I feel that it went well. The incision area is healing so fast that the staff had a hard time removing stitches.

My splint was also removed and I was finally given the much awaited boot. My doc said I can bear weight on it at times but I still should mainly be using crutches. So I guess technically I’m at NWB stage. Two heel lifts were placed inside, and I am to remove one of these in two weeks.   I need to do more research on this, because I’m not understanding the advantage of placing the foot at this angle.

I have my next appointment on June 23. At which point we will evaluate the need for crutches. After reading quite a bit on this subject, I’m a believer in bearing weight on the leg in the early stages. I also expect to start physical therapy around week 5 or 6. I spoke to my Doc about starting P.T. asap, he said it was no use in starting too early because the tendon is still healing. I plan on researching this more and calling some of the local clinics to see how their protocols are set up and what they advise as far as beginning therapy and stage of ATR.

I have also started taking glutamine since it aids in tendon health. Hopefully this will be of benefit in the healing process.

5 Responses to “2nd Post-Op Appt”

  1. Glutamine or glucosamine? A bunch of us have taken various supplements during our rehab, though I don’t think there’s any good evidence to show that any of them actually helps. (I started popping MSM a few months ago. Who knows?)

    I didn’t follow your first paragraph, when you jumped straight from removing stitches to “placing the foot at this angle”. If you mean “Why does it help to immobilize an ATR ankle in a toe-down position?” it’s to keep the two torn (and maybe repaired) ends close together, with as little tension as possible pulling them apart. Gradually, as you remove heel lifts, you stretch the tendon (and your poor knotted-up calf muscle!), back toward “normal”.

    All rehab protocols except the most extremely aggressive ones start in a heel-lifted position (aka plantarflexion, “ballerina position”, or “in equinus”), usually for a few weeks. My study-tested protocol was significantly more aggressive than most, but the heel lifts were maintained for a full 6 weeks. OTOH, I was doing gentle exercises up to the neutral (90-degrees) position starting at TWO weeks.

  2. I haven’t heard much about nutrient supplements duting ATR healing.
    Personally, I have increased my doses of Vitamin C, Glucosamine with chondritin, Vitamin D and have started taking a Zinc supplement as these, I think, help in connective tissue regeneration.
    I am a little concerned about my first PT session as I plan to take my first long drive from Toronto to Memphis -1600 I’m- two days later. I have heard that that there is some discomfort after the session.

  3. The only thing I’ve been told is to eat a high protein diet after surgery to promote healing of the incision. I’ve heard that from the last two surgeons. I don’t know if they have any scientific evidence that it helps, but it doesn’t do any harm to increase protein for a couple of weeks. Unless there’s solid scientific evidence that something works it falls into the category of “snake oil.” I have never bought into the “maybe it works and even if it doesn’t work it doesn’t hurt.” Lots of people consume all sorts of crap under the delusion that it’s good for them when there is no real scientific evidence to support it.

  4. My computer had switched some things around on original post. It has now been corrected.

  5. OK, the first paragraph is clear now.

    Bearing partial weight while keeping the crutches is what we usually call PWB, partial WB. My protocol called it “protected WB” but I think it means about the same thing. Gradually re-introduce your foot to the job (and joys) of carrying weight, and re-introduce your leg and body to the rhythm and “swing” of walking on two feet.

    The thickness of the heel lifts matters, as does the size/length of your foot, since what probably matters most is the angle of your ankle. But nobody knows what the right angle is, or for how long, so this part is all TLAR (That Looks About Right), aka “the Goldilocks Principle”. Your progression Looks About Right to this experienced non-professional!

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