Physical Therapy: Week Five
After searching unsuccessfully for a physical therapist located near my home with immediate openings in Virginia, I ended up choosing a physical therapist located in the District. Today was my first visit to see the therapist and was impressed with my initial appointment. My therapist worked on my Achilles quite aggressively which is in sync with my orthopedic surgeon’s aggressive approach.
She poked, prodded, compare/contrast the good and bad Achilles, and took a bunch of measurements. In the end she told me that my Achilles has a flexibility of -8. However, in order to return back to running the flexibility of my Achilles needs to be around +15. It looks like it’ll be a long road ahead of me.
She assigned me 8 isometric exercises to do at home and while at work sitting at my desk. She’ll be measuring for progress at each of my follow up visits over the next two weeks and will be able to easily tell if I’ve been slacking off. The expectation is that the flexibility of my Achilles will improve at each visit.
Up until now, I’ve only been doing one stretch prescribed by my orthopedic surgeon. Both my therapist and orthopedic surgeon told me that the more my Achilles becomes flexible, the faster I’ll be able to begin to walk and become full weight bearing.
The biggest surprise to me is that I’ve been stretching out my Achilles and calves to the point of slight pain, yet my therapist (and orthopedic surgeon) really want me to push a little harder! All I can say is that its not easy tolerating that uncomfortable, painful feeling. But I guess what hurts makes you stronger….whoops! I think I told myself this very same thing just before I ruptured my AT!!
The protocol my therapist assigned me is as follows:
1. Isometric Inversion. Sitting with leg crossed, press inner border of foot into hand. Hold 6 seconds. Relax. Repeat 10 times. Do 2 sessions per day.
2. Isometric Eversion. Sitting with leg crossed, press outer border of foot into hand. Hold 6 seconds. Relax. Repeat 10 times. Do 2 sessions per day.
3. Isometric Plantar Flexion. Using a strap around the ball of the foot (yoga strap, dog leash, belt), press foot while providing resistance with the strap. Hold 6 seconds. Relax. Repeat 10 times. Do 2 sessions per day. Do this exercise with the foot bent at 90-degrees, 60-degress, and 45-degrees.
4. Sitting Toe Raise. While seated, raise toes off floor. Keep heels on floor. Repeat 20 repetitions per set. Do 3 sets per session. Do 2-3 sessions per day.
5. Sitting Heel Rise. While seated, rise up on the balls of feet. Repeat 20 repetitions per set. Do 3 sets per session. Do 2-3 sessions per day.
6. Single Leg Toe Curling. With foot resting on towel, slowly bunch towel up as you curl toes. Repeat 20 repetitions per set. Do 3 sets per session. Do 2-3 sessions per day.
7. Soleus Stretch. Standing with both knees bent and involved foot back, gently lean into wall until stretch is felt in lower calf. Hold 20 seconds. Repeat 3 times. Do 2 sessions per day.
8. Gastroc Stretch. Keeping back leg straight, with heel on floor and turned slightly outward, lean into wall until a stretch is felt in calf. Hold 20 seconds. Repeat 3 times. Do 2 sessions per day.
Wish me luck!
Hey Wayne-
I still can’t believe you and I both ruptured with a personal trainer supervising. Nice. Everyone’s first question is, “Did you get a refund?” LOL I don’t fault my trainer at all…I’ve been working with him for years and I know he feels bad. Anyway, congrats on the first day of PT. I start on the 29th. I’m nervous about it, but hopefully they’ll start slow. I’ve been in a splint since my 2 week visit and the doc has me taking it off twice a day to do one simple stretch for about 10 minutes. I for surely notice an improvement in my motion since the first time I did it, so I guess there is something to this PT afterall. ;-0
Good luck with the rest of your journey. Sounds like I’m just about a week or so behind you.
BTW, how did you go about trying to find a PT? My doctor gave me the name of this chain-like place in the area that he uses, but there’s something about it being a “chain” that makes me nervous, yet I have no idea where to begin trying to find someone reputable. I don’t personally know anyone who has had an achilles rupture, so word of mouth is out of the question.
Comment by swill — June 17, 2009 @ 5:38 pm
I lucked out with the PT. I located a couple that were conveniently located near work and reviewed their web sites. The one I chose has many professional athletes and the local ballet company as clients. So the chances were that these guys are pretty good. Good luck with your rehab swill.
Comment by wayne — June 17, 2009 @ 7:03 pm