Posted by: timbertopper | May 17, 2010

First physio today

I know all my blogs are out of order but I am just back from the physio and wanted to record this whilst fresh rather than with the benefit of reflective hindsight.

I’ve had a ROM-walker boot for one week since my cast was off, and have been waiting the whole week to get a physio appointment to find out how it would help me progress.  I’ve been guessing what angle changes would take place,and how frequently and been reading other blogs on their experiences.  So I was surprised when my PT told me I could lose the boot and go to trainers now, except as I only had one trainer with me that wasn’t an option for today.  Having had a cast on for this length of time, getting a boot has been a great step (excuse the subconcious pun) - if for nothing else letting me get to the itching and have a wash.  I’m really happy to feel as if I am moving on, although feel I am missing out a little.  I will still be with the sticks though for a couple more weeks.

The PT session went well - ten minutes on a stationary bike (the joys of cardio-type work have never been greater), 2-leg heel raises, balance board for 1 minute, half squats, etc.  The step ups were fun merely for the joy of having to regain my proprioception: gravity has never felt quite so uncertain.  There is a lot of work to do: my right leg looks like it was when I was twelve (albeit hairier) but I now have a schedule and some renewed goals.  On to the next step.

Responses

Timbertopper

It’s good to hear things are going well. It sounds like the physio session was a success and you have made good progress - first time round the physiotherapist sent me home with a ‘theraband’ which i found useful for strengthening my ankle / AT.

Looking back over your posts, not sure - did you have the surgery or the alternative conservative treatment?

daviduk

I think I saw a reference to surgery in there somewhere, David.

Thankks for catching us up on your story, Timbertopper. It’s an unusual sequence. I wonder if you tore your AT early in the story or just partially tore it then “did it all” at the end, or what.

If your “ROM-walker boot” is the type that can be set to hinge — allowing extensive plantarflexion, but with dorsiflexion stopped at 0=neutral if not a smidge before — I’d suggest continuing to use it, at least some of the time. (I used mine for a while only when I went out, then only when I did scary things like bicycling.)

Your rehab progress sounds nicely quick in most dimensions, but not in WB. I’m not sure why you still expect to be using crutches for another couple of weeks.

It sounds as if you’re already FWB in your physio session, maybe even barefoot (which many of us found uncomfortable when we were first FWB). If the bottom of your foot/heel isn’t too sensitive (and you can’t comfort it with footbeds or Crocs, etc.), you should be able to get to FWB quite soon — and ditch the crutches.

In my protocol, the WB went from 0 up to 2 weeks, then protected=~partial from 2 wks to 4, then “WBAT” (as tolerated) from 4 wks on, still in a fixed boot. In my case, I think it was around 5 weeks when I started forgetting where I’d left the cane.

A cane or a single crutch can still be useful in crowded places to help defend your personal space (and to avoid being tripped or stepped on), but early WB seems to help the intermediate-term outcomes (and maybe the longer-term, too), according to the comparative studies that I’ve seen.

good progress
2 heels rises and balance board at 7 weeks
that fast ;-)

Hi Normofthenorth,

Thanks for all your comments. It is a useful guide to what I can expect and what goals I can perhaps set myself over the next few weeks.

On my pre-history we (friends and I) did explore whether my achilles had already been damaged before the big event. The general feeling is something had probably been done to weaken it but I still had the same level of functioning as before and the swelling that occured went down very quickly. The medics couldn’t be certain either but they were more interested to treat the actual damage than to guess what had gone on beforehand. Suffice to say though that when you are carrying over 100kg on weakened body parts it doesn’t take much to cause some mayhem to yourself!

I had my second physio session yesterday and will blog on that later - but during it I have moved on with some of the issues you discuss re WB so perhaps am coming up on the rails in that respect, having initially spent at least five weeks in a cast.

A smiling T.

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