Bill Murray’s groundhog day must be how I deal with Achilles injuries. Recovered nicely from my ATR back in 2013. But, this morning, did in the left Achilles..also playing tennis. Maybe I should stick with Chess?
Just wanted to know if anyone could point to additional updates on the non-surgical route. I’ve still got my VacoCast but any updated information since 2013 as to the timeline of going from cast to boot would be appreciated. Or if anyone knows of a protocol that only uses the Vacocast from non-weight bearing all the way through, would be very helpful. Thanks and will keep all updated on how I deal with rupture #2.
What PT exercises proved most helpful to transitioning from the boot to shoes? More specifically, when did you start going beyond neutral to dorsi flexion?
Everything is going well on my end, except that I’m feeling that I’m behind with getting transitioning to shoes. I’ve had 2 sessions with my PT (one was more of an intake) but I’d like to be doing the things that will get me in shoes sooner rather than later. My achilles does feel “tight” so I’ve not done anything to mess it up…but I sorta have a gut feeling that I’m not on track with the accelerated protocal, I’ve tried to model after. Much thanks for any thoughts!
What has been going on since my last post….well, I’ve been in the Vacocast since 8/20 and have no complaints. Right now my boot is set at neutral. Gradually moved from 20 degrees PF, to 10 degrees PF, then neutral…probably every 5 days or so. No issues.
I started sleeping with my boot off last Wednesday. I sleep much better and have gotten used to putting the boot on in the dark for bathroom trips, taking out the dog out, etc. no big deal.
When my boot is off I do a little personal PT… I don’t go above neutral but will roll my foot from side to side and bring the foot to neutral. Do this for a minute or two. Will be looking forward to seeing what PT has to offer. Right now the plan is to go to PT 3x week for about 4 weeks. So, if I get all 4 weeks in, I’ll be at week 11.
That’s about it….non-surgical approach seems to be doing fine. Will check in after PT starts.
Meeting with my OS was very uneventful. He took off the cast. Looked over the AT and pronounced that it was healing. No apparent setbacks or issues mentioned. I presented him the vacocast and he adjusted to 25 degrees.
He didn’t provide any written protocol at all. He mentioned something about only do PWB until next week. Then you can go on FWB. Reduce the setting by 5 degrees after 2 weeks. Then you’ll go to neutral. To be honest, it was like Charlie Brown’s mother talking to me. I really can’t be down on him, as this is his training and he knows what he knows. However, it is clearly apparent that he has no knowledge of or has forgotten anything written about rehab and AT ruptures since 2007.
That being said, I will be seeing a PT the week of Labor day. So, all in all, I’m very satisfied about where I’m going. Can’t say enough for this excellent resource. I’d be hanging out to dry if y’all weren’t here to answer my posts and to have provided me with the insights on the rehab process. If anyone is interested, Dr. Glazebrook provided me an updated rehab protocol that isn’t updated on his website. I’ll try to attach or otherwise cut/paste the information if folks want to see it. It will likely be the keystone model, along with a blend of Hillie/Suddsy info and UWO protocols that will guide me the rest of the way. Cheers!
Very much looking forward to getting into a boot and learning what the rehab protocol from my OS will be. I hope it’s within the channel of the UWO and other accelerated approaches.
Main question I have, is how to deal with the fact that I’ve been in a cast almost 5 weeks…and how to as quickly and safely merge onto the accelerated rehab highway!
For the last 2 weeks, I have definitely been PWB and FWB with my cast on. However, the only ROM activities have been within the cast itself. I guess my calf has shrunk because I can do some inversion/eversion and raise my foot (within the cast confines…so it’s not much).
If I can give myself credit for the PWB and FWB, then I don’t think I’m too far off track. Any thoughts on getting in the rehab groove (UWO model) would be welcome from my non-surgical brothers and sisters.
Now that I’ve got my blogging abilities in place. A recap of events. On July 17, almost finished playing tennis…going for a shot to my right and then I hear a “Pop” and next thing I know I’m on the ground. Left knee is cut and bleeding but other than that no pain. Couldn’t figure out what happened for a couple of minutes. Felt my legs and ankle, with my right ankle area a little tender, but no pain. Well, upon standing up, I couldn’t put any weight on my right leg, so I knew something was very wrong. Tried to go to the first med in our town, but they were closed for the night. So, I took 2 advil, kept my ankle area iced down and went to bed.
The next day, went to the first med, and was with the doctor less than 5 minutes before he told my Achilles was ruptured.
Doc made a call to an OS and I immediately went to his office. The OS took an ultrasound of my right leg/foot, did the Thompson test and pronounced that, indeed, I had ruptured my Achilles. Don’t recall much of the details of that first meeting with the OS, as I really knew nothing about the injury or treatment. What I do recall is that we briskly went over option of surgery vs. non-operative route. The doc really didn’t have much of an opinion either way, but did say that the both ends of the tendon were lining up real close together, so non-surgery would be a good option. I said “sold” and the nurse put me in a nice green cast with my foot in plantar flexion, gave me some crutches, and sent me on my way. Only advice was to not put any weight on the hurt leg.
Saw the OS last Monday, and I wanted to get out of the cast and into a boot. I was better armed with some info. Doc was adamant that I needed to be in a cast for another 4-6 weeks, and that he would be doing this even if he had operated on me.
I guess my persistence had some impact because we scheduled the next appt. for 3 weeks out with the goal of getting into a boot. Doc did say at our meeting, that this week, I could start putting some weight. However, after spending many hours the last several weeks reading blogs, academic journals, and normofthenorth’s comments, I decided to start putting weight on the foot, last Thursday. This would have been 3 weeks since the cast was put on. I’ve learned that it’s not easy to do PWB with a cast on, but I’m trying to replicate the UWO weight bearing protocol as best as I can.
Last Friday, after a good day and a half of putting weight on my leg, I called the OS office and moved my appointment up to next week. I also ordered my Vacocast boot today, as he was going to put me in the standard black boot. We’ll see how my next appointment goes (especially with me bringing in the boot), but as I told his nurse assistant on the phone when I was rescheduling, we’re going to have to work together with healing. It’ll be interesting to see how we go forward with his conservative nature and my desire to follow the more modern rehab protocols.
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