Posted by: univofpittbull | June 29, 2011

First PT Session = Blah

5- Weeks Post Op

So, I went to my first PT session yesterday afternoon with a beaming smile on my face.  I was expecting to get a nice plan laid out for me which would make my road to final recovery a bit clearer.  What I got instead wasn’t much at all.

I walked in, filled out the usual forms, and anxiously awaited in the lobby.  I couldn’t help to notice the place had about 5 workers (It was later determined that 3 were PTs and 2 were “aides”) but had 7 or 8 patients.  For the most part, patients were hustling and bustling on their own while the PTs and aides ran back and forth setting timers and handing off dumbbells.  Not a good sign.

I got called back a few minutes later by a lady who introduced herself as the Manager there.  I popped off my shoe and she asked a few questions about the injury.  She also told me that she sees way more ACL injuries than achilles injuries while playing soccer on turf.  Next, she broke out a plastic protractor type thing to check my ROM. ”Okay…Good…Mmmm Hmmm….Alright.  Your range of motion is pretty good.” 

She told me to flip over on my stomach with my foot hanging off the table.  I complied and before I could ask whats next she grabbed my heel and pulled it down putting me into a nice stretch.  She then ran her fingers down the sides of the tendon while squeezing.  I don’t know if you guys ever got a good sports massage on your hammies or calves before but they hurt sooooo good.  This was no exception.  Just as I thought “This is what I was waiting for.”  She stopped. 

She jumped up, said the scar looks good and told me to put some vitamin E on it .  She then told me that we’ll be dropping PT from twice a week to once a week until I can walk in 2 shoes.  Huh? Really? After that, she left.  What the?  About 5 minutes later an aide came in with a print out of home exercises that had the exact same images that are referenced in the Rehab section of this blog.  Like, exactly the same.  The aide walked me through the highly complicated exercises one by one and the told me to put my boot on and go home.

I spent a grand total of 5 minutes with the PT.   I know this was an evaluation period of sorts but I was expecting more.  More massage.  More instruction.  More attention.  Instead, I feel like I just got a real life version of an intructional email.

Before leaving I tracked down the PT and asked if there was anything else we’d be doing today or in the near future.  “Massage? E-Stim?”  Her replies were they’d work in massage in future sessions and she doesn’t believe in stim.  “Strength test?”  Answer was that there was no need since I have no strength.  A little frustrated I politely said thank you and left.

I was a bit steamed but have decided I’ll give it another week to see if the lack of intimacy and information was solely because it was the first visit.  In the meantime I’ve talked to a friend who is a PT and who’s husband does PT for a MLB team.  She said massage is a must and I should be getting it 2 or 3 times a week.  She also said it may be worth it to check into other rehab facilities which are more focused on athletes and will have full sessions with PTs instead of aides.  We are paying for an hours of a PTs time afterall.

On a side note.  I set my boot to 10 degrees dorsi this morning after I got work.  I’m limiting the plantar flexion to 0 degrees while i sit in my office chair and stretch for a while.  I found the boot is the best stretching aid I have since i can tell exactly how far I am going.  I’ll lock it back into 0 degrees before walking until i know i can get to 10 with no problem.

Cheers everyone.

Responses

Man I hope my first PT session is a little more exciting than yours, that sounded like a big waste of money….I will update you after I go.

hey there…i had surgery 5/18th..full tear..on june 16th i got the walkng boot,,..what a homerun…im able to walk w/out the boot around the house..very carefully …seeing the doctor tomorrow..hoping to use shoes w/ some elevation in the bad heal….

Hi,

I did mine too playing soccer! I did it at the beginning of April. I can closely relate to how you feel with your therapy, I had that same feeling at the beginning. I even felt offended by it. It is as though they do not care at all about our injuries. The good things is that as your therapy progresses you will be doing exercises that would be very difficult to do at home because of lack of the right equipment. At around week four was when things got challenging and exciting for me!

I hope you heal nicely! Things in your therapy will get better, of course. If you can afford to go to a place that specializes in athletes, do it!

eek. How do you find a good PT. I am in the Chevy Chase area and there are a ton of PT facilities here. I have no idea which to choose. is E-Stim electro stimulation? (embarrassed that i dont know that.) How did you choose your PT facility. Was it recommended by your surgeon. I am so axious to start PT, I could bust out of my skin. Always enjoy reading your posts. Thanks

Good question Polly,
I figured they were like any other contractor you have to employ to get a job done. The first one I went to get my boot fitted could not understand the instructions my doctor had written and it was not because of the bad writing. I tried to explain it as it had been told to me and he didn’t seem to want to listen. Thanks for the boot but that’s it for you. I started to get proactive and rang or visited a couple more, well in advance of the time I was due to start. I asked questions and found one that was willing to listen and discuss.

Shop around, after all they are taking your money. You are employing them and they should be happy to justify their service. If you can’t get past the receptionist then you probably have your answer. I started with “I am looking for a physio to help me with my ATR recovery and I have a few questions.” The receptionist will always ask what your questions are because they will probably get into trouble if they bother a PT needlessly. Once they realise the questions are beyond their ability they should pass you on.

I ended up starting physio early and she told me it was just as well I did. The first one has set my boot up wrong and did understand why he couldn’t understand the doctor’s instructions. I had plenty of time with her, mostly getting history and discussing treatment but then she did some massage which she said was very important to break up the scar tissue. It was a bit early to start exercises but they came in time and I found it helpful to have someone make sure I was doing them right from the start.

Your first PT session sounded like mine, and probably everyone elses. I’ve been in a boot for 5 weeks now and have had 3 PT sessions so far; progressing from basic ROM & toe-crunches to dorsiflexion to walking in the pool - also get a good 20 min massage on the AT. According to my PT and his recovery protocol, 12 weeks is the point at which resistance is added so don’t expect too much to soon. I’m walking at home without the boot but not pushing off yet, figuring the boot will come off at some point - hopefully next week! - so better for it to not be a shock.

I just had my first PT appt at 4 weeks post surgery. Luckily, my therapist was very nice and took a great deal of time with me. He did measurements for ROM and then reviewed the PT protocol from my surgeon that they have on file. Then, he printed out a specific exercise schedule for me and had me go through each exercise. He gave me exercises for my foot and ankle as well as ones for my thigh and hip to prevent weakness from lack of normal use. Funniest one is the toe scrunchy one. He had me put my feet on a towel and try to grasp the towel and bring it towards me. Easily done with my good foot, but failed miserable with my Left. hard to believe that your toes weaken so badly! Mine are also still swollen and still have some numb sensation. I was pleased with my experience and am to go weekly.

I am sooo happy that I knew great PT Assistants and chose the PT based on the assistance as I see them more. Week 2 after surgery my doctor had me start PT witha 20 lft in the CAM. Goal is to be to a 0 incline within two weeks of pt starting. In the beginning I thought no way as the scar tissue was so tight and the repair pulled with ROM and massage. My PT assistant worked not only the muscles and ROM but I have found she has had to work my mind as well. It is more than achilles repair to me but also the anxiety and fear I have and a good PT, in my opinion, works the mental as well. I go back to my doc for a recheck in just a few days (6 weeks) and I admit I am nervous as the doc said I will be walking again then and to this point I have had a no wight bearing restriction on the injury. VERY anxious about putting weight on it as I am perinoid of reinjury. Thank God for great PT assistants who are helping my mind prepare for the next step or in my case my first step in 6 weeks of waiting.

I actually know quite a few PTs but they’re all out of the area. I have been getting a lot of tips from them though that I use daily. Especially with how to do some self massaging.

My second PT visit is in a few hours so I’ll be addign a new post tonight. Hopefully, there will be some improvement.

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