Physiotherapy post Achillies tendon rupture.

[Night Train]

Thank you so much for those links.

I have been looking for various forms of exercises but not really being sure what is best.

I think you are right about needing to take ownership, but I was brought up asking and listening to the doctor's advice. I guess in this case it is wise to be forearmed with some knowledge of my own as well.

I am currently walking short distances and a attempting stairs with the orthopedic boot on. without the boot I cannot even attempt a step yet as there is little strength in my calf. However, exercises I have found so far have helped gain the strength I do have.

Back to the Hospital on Thursday.

 

[Night Train]

OK, back from the hospital.

The consultant came and had a look at the range of movement and does a simple test of strength by asking me to push the ball of my foot against his hand. He is happy with progress and tells me to carry on as is until the next appointment, in 6 weeks. He says I will now have a physiotherapy appointment to look forward to.
He tells me my broken toe isn't healed but is knitting together so will heal in time.
He then leaves.
I have to ask the nurse to ask him what I do about wearing the boot.
She returns with wear it for the next three weeks, then realises my appointment isn't until 6 weeks and so asks again. She returns to say wear it for the next six weeks!
She then asks if I am wearing it through the night. I say that I am, and she says carry on wearing it through the night.

So another six weeks. I reckon as my strength increases and the physio is ok with it I might just take it off once in a while to see if I can walk without it, with a view to eventually driving and cycling again before the end of the year.

Roll on Physio appointment!

 

[Wobblers]

OK, back from the hospital.

The consultant came and had a look at the range of movement and does a simple test of strength by asking me to push the ball of my foot against his hand. He is happy with progress and tells me to carry on as is until the next appointment, in 6 weeks. He says I will now have a physiotherapy appointment to look forward to.
He tells me my broken toe isn't healed but is knitting together so will heal in time.
He then leaves.
I have to ask the nurse to ask him what I do about wearing the boot.
She returns with wear it for the next three weeks, then realises my appointment isn't until 6 weeks and so asks again. She returns to say wear it for the next six weeks!
She then asks if I am wearing it through the night. I say that I am, and she says carry on wearing it through the night.

So another six weeks. I reckon as my strength increases and the physio is ok with it I might just take it off once in a while to see if I can walk without it, with a view to eventually driving and cycling again before the end of the year.

Roll on Physio appointment!

Just seen this, NT.

Twelve weeks in an aircast seems to be an awfully long time. I would have thought that they would have wanted you to be on your feet without the boot after 8 weeks: it'll help with the healing of your toe (is it the big toe?) as well as help to rebuild your muscles and regain mobility in the tendons and ankle joints.Your toe should reach full strength within 12 weeks. I'm not sure about the ligament, but at the muscle/ligament junction there is a good blood supply so healing should be swifter than lower down the ligament. It would be a good idea to ask the physio about it, once you actually get an appointment. It might also be worthwhile paying for a physiotherapist privately if you can find one that specialises in sports injuries, especially to the ankle and calf.

The impression I get with hospital consultants is that they don't take the time to explain things. It's probably worthwhile going into the appointment with a written list of questions to ask them! Certainly, that's going to be my strategy for my next appointment...

I hope you get your physio appointment quickly!

 

[Night Train]

As it happens I am currently dunking my foot in alternate hot and cold water as I type, balanced on the edge of the bath!

I saw the physio this morning. She couldn't (wasn't allowed to) advise me on the boot but did suggest I try to get a cancellation appointment for week three to see if I can lose the boot sooner.

I have been given some nice stretching exercises to regain the range of movement in my foot for this week and the dunking in the water is to encourage blood flow in my foot to reduce the swelling. It is a strangely pleasant sensation!

I was advised to do the stretches with a towel around my foot to pull on. Until I demonstrated that I could easily get my hands around the soles of my feet with straight legs, and that I do that daily to maintain my general flexibility.
I can do the splits at the drop of a hat.
Anyway, I have to hold each of the three directions of stretches, pull, push and rotate, for 20 seconds each for 20 minutes, then do the foot dunking thing for 20 minutes, and then repeat the stretches for 20 minutes, each day. So I am doing them now and then I'll have a shower and the boot will go back on until tomorrow.

It was funny, the physio got my records and was reading out the consultant's notes and instructions to me. I had to tell her that his instructions were what I had told him I had been doing off my own back! She then checked and told me that I hadn't been seen by the consultant at all but have been seen by two different locums!

Unfortunately she also said that I wouldn't be driving or cycling any time soon.

 

[Night Train]

This week the physio has given me yellow band of silicone (?) rubber that is about 1m long and 100mm wide and very slightly thicker then balloon rubber. It is very wobbly and has huge comedic potential!

I have to exercise while sitting with my legs out stretched on the sofa and with a cushion under my calves and knees.
One of the exercises is to hold onto the ends of the band, with the ball of my foot in it like a stirrup. I am then to point my foot against the pull of the rubber to as much tension as I can manage and repeat 5 times.
The other exercise is to have the stirrup again but to pass the band behind my other foot so that when I pull on the band my feet are pulled towards each other. I then have to rotate my foot outwards against the tension of band 10 times.

That is all I am allowed to do for now, twice a day, along with the stretching exercises. The physio said she can't offer me any more exercises until the consultant allows me to loose the boot.

I have made an appointment for this Friday to see if I can stop wearing the boot.

 

[VamP]

I bet you feel a whole lot better now you have some rehab to do and feel like you are gaining some control over the rehab process. Stay positive, be religious about the rehab and good luck!

 

[Night Train]

Yes, thank you.

One of the best parts is the physio telling me I can do the stretching exercises as much as I want. It means I get the boot off every couple of hours and exercise!
Also, though she told me walking about and doing stuff with the boot on won't help, it also won't do any harm so that is almost an understanding that I can do what I like as it won't make things worse. Hobbling about as much as I can get away with if great, including a trip to the seaside last weekend!

I am just getting back into using the gym in my parent's conservatory now so I can rebuild my core fitness and work off some of the Cake baking I have been doing recently!

I initially felt the yellow band exercises were a bit wimpy, only 5 and 10 reps at the limit of my strength. I tried the same exercises with my good leg and it was nothing at all, like a weight lifter lifting the bar with no weights on it, but that only goes to show how badly the strength has gone in my bad leg.

I will continue as instructed as the physio clearly knows what I can and can't do at this stage.

 

[Wobblers]

It looks like you're making progress, NT - it's very morale boosting when you can start to do things again! It's good that you've got a physio who knows what she's doing. Hopefully they'll let you lose the boot today; that ought to help things improve a little faster.

 

[Night Train]

Thank you McWobble.

Just back from the hospital.

What a difference a different consultant makes.
Seeing the locums at Mr S's clinic was a bit pointless really. Long 2 hour waits, only being seen for a minute or two, no information, no time to listen to the patient, little explanation of the conclusions or results.
Today seeing Mr M in another clinic I was seen only 5 minutes late, Mr M spent time listening to me, talking with me, examining my leg, taking me for a walk to see how my leg was performing, re examining and discussing the options with me. He told me I could dispense with the boot and get on with physio.
However, he called me back just before I was about to leave and had to retract. Mr S had written in my notes that I was to keep the boot for 6 weeks and Mr M couldn't counter that.
He did offer a compromise that I could dispense with the boot except for walking.

So the boot is off, it will stay off until I need to walk anywhere. I can make it across the room without it, and have been doing so a bit anyway, but I will wear it to go down stairs or to go out or if I am standing for any length of time (baking).

I am happy! And so looking forward to sleeping without the boot on!

I have another appointment made now to see the physio a week on Monday. I should then get some more intense strength exercises to work with.

 

[Night Train]

Finally!

After 13 weeks I am free of the orthopedic boot!
Today's locum was quite good, he spoke to me and asked me how I was and how I was getting on. He then asked if there was any pain in my calf and grabbed it to give it a good squeeze. I said there was no more pain the if he did that to my other leg.
He then grabbed my toe and shook it about a bit and asked if that hurt. It didn't.

He told me I could lose the boot, and the toe strapping and probably the crutches too and get on with the physiotherapy.
I have a physio appointment next Tuesday so I am looking forward to that.

In the meantime I am walking very carefully testing the motion of my foot on uneven floors and stairs.
I am happy!

 

[Wobblers]

Bet you're glad to be free of that boot!

I was told I could lose my air cast boot on Friday, so it seems to have been a good week all round!

How's the physio going?

 

[Night Train]

Bet you're glad to be free of that boot!

I was told I could lose my air cast boot on Friday, so it seems to have been a good week all round!

How's the physio going?

I have another visit tomorrow afternoon to the physio.

I have been working on the strength exercises as much as I can and stretching so I am doing really well.
Yesterday Arch and I went for a countryside walk and I did almost a mile without sticks (though I got a telling off for not taking them). I was finding the walk was so much easier without the boot on, as my ankle could flex and I didn't need sticks, but I didn't have the the strength to keep myself stable when the ground was rough or down hill.

It will come though and I can comfortably push the clutch pedal in the car about 3/4 of the way. I will need a bit more work before I can push it all the way without straining and be able to repeat several times on demand.

I am very tempted to take the Brompton out this week to try a bit of cycling. I will just need to be careful putting my foot down.

 

[Night Train]

Right, the physiotherapy session was good. I have lots of home work to do.

Firstly (Arch, I hope you are listening) I should stop using crutches altogether.

I need to cycle (on a trainer).
I have to do 2 minutes as a warm up tomorrow, then 3 minutes the day after, then 4 minutes the day after. Adding a minute a day each day.

I need to do stretches like this for 20 seconds, then rest and repeat about 20 times or stop if it hurts.
Daily I need to try to place my left foot further away from the wall while still keeping my heel on the floor until I can place it as far away from the wall as I can do with my right foot. Need to go back another boot length.

Then I need to do this stretch in the same 20 second rest repeat as above.
daily I need to try to move my left foot further from the wall until it matches the distance I can do it with my right foot. I need to go from 2" to 6".

Then I need to stand at the kitchen worktop to steady myself and lift my weight onto my toes, equally on both feet, raising both heels to the same height. Hold for 5 seconds, rest repeat, as above.

Then I need to stand only on my left foot, with my eyes shut, for 2 minutes. I can steady myself with the kitchen work top.

Then I need to do 'steps' leading with my left foot, up and down on a stepping block or the bottom of the stairs. 50 steps.

Then I need to try standing on the step on the ball of my left foot, right foot hooked behind the achillies, and then raise my weight by lifting my left heel.
I can do this fine right footed but not at all left footed yet.

Then stepping on the spot (on the floor) with high knees. 50 steps.

Then walk to warm down for 2 minutes.

I can do the above as often as I feel able to during the day.

 

[Arch]

Firstly (Arch, I hope you are listening) I should stop using crutches altogether.

I'm listening....

Very glad to hear it all. It won't stop me worrying you're overdoing it, of course, but that's just me!

BTW, was there something wrong with that wall, that you had to hold it up for them?

 

[Night Train]

BTW, was there something wrong with that wall, that you had to hold it up for them?

Just testing it for subsidence.