Last Ortho Appointment

OK, so I am cleared from seeing my first ortho; no more follow ups. I have done 8 weeks of pt and the dorsiflexion on my foot is still at zero. My workmans comp carrier has been awesome. I have a case manager nurse and a private nurse that comes with me to all my appointments. Since my original ortho will not even look at my foot nor help I have been approved by the medical director to find any specialist that I want too. I found a great foot and ankle ortho from UofM in Ann Arbor, but they only have an opening on valentines day lol. My nurses have found another great specialist out of st. Joseph mercy so I am going to give them a call and see if I can be seen sooner. I was also approved for something called a dynasplint. This crazy gadget puts constant tension on your foot in dorsiflexion. They said it will be “uncomfortable” but it will probably help a lot. I will have to wear it whenever I am home. So right now I am just waiting to get into the next ortho to find out where we stand. It’s either going to be a lengthening surgery, orthodics, or a surgery where they remove the scar tissue (if that is the problem). I don’t want another surgery, but it I have to get it to fix this mess then I will. Depends on the MRI results. Besides, I cannot get any type of surgery until after the coumadin is finished and the blood clot is gone from my leg.

This Week

So it’s been a blah couple of weeks. Ive been doing PT three times a week for an hour and a half each time. I am frustrated with PT though. They have me walking on a treadmill….well, I walk all day long so what’s that going to do?
They have me on heating pads for a half an hour every time…..well, the tendon is shortened sooooo the heat isn’t going to “loosen” up anything.
The want me to step down off a step and do lunges….well, I cannot dorsiflex past zero sooooo I CANNOT do lunges or stepdowns, and they seem to be mystified that I cannot do either of those things.
They think that if I stretch more than the tendon will “come around”… can’t….it’s too short… cannot magically make more tendon.
I got a copy of my MRI today. The radiologist put in the report that the tear was at the tendon/muscle junction. That seems like an awfully high up tear. The tendon was retracted 2.7 cm, and he could only see a couple of fibers; therefore it had done the mophead type of tear. Makes me wonder with that type of tear, how much did the ortho cut off to make it all flush again to sew it together? And once you combined the retraction with removing tendon how large was the gap??? And, why is my ortho such a meaner. He also stated that I had a secondary grade II sprain to the longus muscle in the calf (which explains why I couldn’t bend my big toe for a couple of months). The sad thing is that my ortho didn’t even read the MRI report.
I remember when the MRI was done that something was off. I had the leg/foot scanned three times and then was told to wait for the radiologist. Then they scanned it again higher up; the radiologist came in after that to see me and told me that it was a full tear blah blah. Im thinking that they were scanning the foot in the “typical” tear spot and couldnt find it because it’s so high up.
So, I am frustrated and tired of arrogant specialists.

Second Opinion Update

Went to my appointment for a second opinion today. Doctor said that it is shortened and my option is lengthening surgery (the z one). Only problem is that I cannot get the surgery right now as I am on coumadin for a dvt in the leg. Soooo, he wants an MRI done and then after my ultrasound in January, if the blood clot is gone I can possibly get the surgery to fix the shortened tendon. I have a return appointment in a month with him to check how things are going. Right now he said pt wont be able to stretch the tendon, but they will be able to work on my strength as I cannot even do a two foot heel lift yet.

21 Week Follow Up

Ok, so it was my 21 week follow up yesterday. I had a heck of a time with my ortho (again). As a recap, I cannot dorsiflex my foot past neutral. Most of the time it is at around -5 degrees, but when the pt heats up my foot for a half an hour and stretches the heck out of it he can get it to neutral. Anyway, I let my ortho know that my foot would not go past neutral no matter how much I and my PT stretched it out. She didn’t look at my foot at all, she just said “you aren’t stretching it” and “you don’t want it to stretch and that’s why it isnt stretching”. She said this over and over again, with me saying “i stretch my foot a lot, and I walk all day long, and do pt three times a week”. She would just repeat the statement above without even taking a look at my foot. I am really upset because she won’t listen at all. I limp horribly, I cannot go down stairs normally because my foot wont bend, and she doesn’t care at all. I asked her if the tendon could be shortened and her reply was “no, that cannot happen; you just arent stretching it”. WTH!!!!!!!!!!!!!


This is going to be a long post as I am quite a ways into my injury.
I had a full ruptured right achilles on 7/1/2013 and I received surgery on 7/15/2013. I did mine at work while I was attempting to push a 300+ pound portable toilet at an upward angle onto a large flatbed truck. I was pushing up on my toes with all I had when I thought someone threw something at my foot. Then I fell, and then I yelled and swore for awhile as I already knew what had happened. I was in a plaster splint cast for about a month and then I received a hinged cam boot that was set at 22.5 degrees plantar flexion.
And then problems. Five weeks after surgery I ended up with a blood clot in my leg and was in the hospital for three days. I am now dealing with the “fun” of coumadin for six months minimum. My ortho didn’t move my foot from 22.5 degrees to 15 degrees for another six weeks, then to 7.5 degrees a month later and then finally to zero. I asked about PT and she denied it claiming that it “wont do anything” until fifteen weeks. She still wants me to wear the boot while I am out of the house (its been five months) but ive been wearing two shoes for three weeks now. Only now I have a pretty bad problem. I cannot dorsiflex my foot at all. None. I can barely get it to 90 degrees, and it will not go past that. My PT has been trying to stretch it out for three weeks and nothing. I cannot go down stairs with my good foot first because my bad foot cannot bend forward; and I cannot walk right at all because I cannot even lift my foot upward a small amount. My PT thinks I have a contracture, but when I let him know that I knew what that was, he clammed up. I finally went to my GP about the issue and he is concerned as I have 0 dorsiflexion and limited plantarflexion in my foot, and I now have a referral to a foot specialist next week. My ortho doesn’t seem to care about anything, and I only see her for about two minutes once a month. All she ever does is ask me to wiggle my foot, and im starting to get upset.
Do I have a contracture because she put me in plantar flexion for so long? Is it because I wasnt given any PT? Is it because she debreeded my tendon and then sewed it up without using a graft to make up the missing difference?
Anyone out there not able to do any dorsiflexion after five months?

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