- wilfus3 has completed the grueling 26.2 ATR miles to full recovery!
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- wilfus3 has completed the grueling 26.2 ATR miles to full recovery!
Sep
11
Question for my non-surgical brothers and sisters
September 11, 2013 | |
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!
Comments
2 Comments so far
I followed the UWO protocol — bit.ly/UWOProtocol — pretty slavishly. The recent analysis of the data from Exeter suggests that going a week or two faster than that (esp getting to PWB and FWB faster) is even better. And there’s tonnes of data showing that going slower is much worse, at least for re-rupture rates/risks.
UWO has “wean off boot” after 8 weeks in a fixed (non-hinged) AirCast boot. I self-administered myself into a hinged boot at 7 weeks, which felt comfy, convenient, and sensible to me. And the Exeter study used hinged Vaco boots and set them to hinge (only a bit at first) starting fairly early, IIRC. UWO got excellent results, and Exeter got better results (at least in terms of rerupture rates).
In the first 10-ish weeks of rehab, I believe (though with no evidence!) that the PWB-then-FWB standing and walking, in a boot then out, are at least as important to recovery as the various prescribed stretches and exercises — UNLESS those stretches and exercises do HARM, in which case they’re MORE important!
I think for me the use of the Vacocast and its range of motion has helped get me back into shoes earlier. Bending the foot in the boot while protecting from dorsiflexion in those weeks gives you some semblance of a normal walk I think. The theraband exercises seemed to help regain some strength in the ankle tendons. I also did a week at the end with the boot set to -5, so it allows dorsiflexion to a low rate. I am still not doing any weighted exercises past neutral at this point and do not plan to for a few more weeks.