‘Hello leg’

At last ditched the cast today and said hello to my leg again. After all that I’ve read on various blogs I was pleasantly surprised to see that there was hardly any size difference in my calf muscles. I was able to flex my foot into a rt angle position under the guidance of the consultant and am now in a walking boot for the next 3 weeks or so. I was told that physio would not start until at least week 8 and possibly week 10. When I walked out of the hospital to the car park my ankle felt a little stiff but otherwise walking was OK and not painful. The boot is set to lock at rt angles so as not to overly stretch the tendon as yet. I am told that the boot must be worn ALL the time, even in bed!!. What do you think about the time to starting physio and not being allowed to remove the boot. Comments gratefully accepted.

8 Responses to “‘Hello leg’”

  1. I think the timing of the physio depends on what the definition is. I had the first meeting with my PT when the cast came off, not really doing much work with her, she mainly checked some of the ROM, and took me through some exercises to start with right away. Regarding the boot, I was actually encouraged to take it off when at home on a sofa etc, with the thinking that with the boot off I’ll always do a little movement etc, obviously also need to take the boot off for the rehab exercises. Having said that, was told to sleep in the boot for sure for the time being.

    All in all, having boot on all the time when moving around seems normal, but not having any exercises etc until 8 weeks seems like a long wait to me.

    And I am jealous of a calf with no size difference, can’t say the same unfortunately…

  2. Lad, if you can install the ATR Timeline Widget (instructions on the Main Page) we’ll all be able to see how long it’s been, which leg, where you are, etc., and give you smarter answers.
    Is your boot locked/fixed at neutral=90°, or is it hinging down and stopping there?
    The fact that you’re walking well in the boot is very good news, but most of us - and the most successful published studies - seem to have benefited from early PT. I followed the UWO study, so I started PT, very gently, at 2 weeks in. That study got very good results, post-op and non-op, though that isn’t proof that PT is essential - or even helpful, though it seemed to.

  3. I was encouraged to start PT as soon as my cast came off (4 weeks post op). Though my PT initially composed of mostly gentle stretches and ROM - it helped a lot!

    I too, didn’t have a huge difference in calf size but part of that probably had to do with swelling and the fact that my injured leg was always a little bigger than my non-injured leg. They both look pretty symmetrical now at almost 5 moths.

  4. Hi gravity,

    Thanks for your response. I am thinking that 8 weeks before physio starting is probably too long and I’ve done as was suggested to you and removed the boot whilst I am sitting on the couch. This gives me the opportunity to massage my leg and also to perform some gentle flexings. I can flex pretty well until I feel a tug on my tendon so I will probably continue with this for the time being. Walking in the boot is fine, except walking up slopes does pull on my tendon a touch however it is sooo nice to be out of the cast and be full weight bearing.

    [WORDPRESS HASHCASH] The poster sent us ‘0 which is not a hashcash value.

  5. Hi norm,
    Thanks again for you response.
    I’ve installed the timeline as you suggested and updated my present condition to FWB. The boot is set to neutral (I think) as it will allow me to flex my foot downwards as far as I want but when walking it automatically locks at neutral so that my tendon cannot stretch. I have taken comments from gravity onboard and am removing the boot when I am sat on the couch and gently flexing my foot until I can feel a tugging on the tendon. I will probably continue this until my next appointment in 3 weeks time. Walking in the boot is fine although walking up slopes is causing a tugging on my tendon and it is not possible to drive as yet unfortunately. Happy days!!

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  6. Waiting until the 8-10 week mark seems like too long to me. The initial stuff is very gentle, getting a good range of movement. The next step is adding proprioception and balance which can be done seated so is very safe. The way I look at it is that there will be lots of exercise needed and starting early gets things started in a very controlled and incremental manner.
    It may be worth seeing a private PT and setting up a progression to get you through the next few weeks.
    I slept in my boot till just after 7 weeks but took it off often when elevating, icing and of course doing my PT routine. All the best!

  7. I couldn’t bear wearing my boot in bed after week 5, and even sometimes took it off while asleep. I would wake up daily with it thrown across my room lol!

    My physio starts this Friday after 7 weeks, and I’m excited. I agree exercise is key to getting it going, I walked 15 miles 3 weekends ago, and while it tired me out for a week I felt it was really beneficial! I hope things get better fast for you!

    Regards

  8. Hi, jump man,

    Had a slight setback last weekend. Caught the boot toe going up some steps and automatically thrust my bad leg out behind me to check the fall. NOT A GOOD IDEA! When my toe contacted the step my heel jammed down and gave my tendon the equivalent of 2 months Pt in one second flat! The pain was horrendous and I thought I’d reruptured. Spent the next two days on pain killers with my foot up whilst the bruising came out. Back in the boot now but still pulling a touch on the tendon where it wasn’t before. A quick Thomson’s confirmed I’m still attached. I sleep in the boot at present but like you pulled it off last night as it was too tight. Woke up my wife with the Velcro tearing undone but without the boot going to the toilet is a crawling session.

    Good luck with the basketball

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