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Old 01-28-2012, 03:51 PM   #1
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Thumbs up Physical Therapy afted PTT Reconstruction & Calcaneal Osteotomy

I am 6 weeks post-op from ptt reconstruction, calcaneal osteotomy, and gastroc recession. My recovery seems to be going very well. I am now in a cam boot with crutches and my doctor said I can wean myself off the crutches in a week.

I am supposed to start physical therapy in 2 weeks. My surgeon has prescribed PT 2xs/week for 6 weeks. Unfortunately after several conversations with my insurance company, I am very distraught. Due to a high deductible, I am financially unable to afford the only 'in network' PT in my area. I am looking for suggestions and ideas on how to approach my PT.

I was told by a friend who is a chiropractor and who also owns a gym that I could join the gym and my entire monthly membership would cost less than 1 PT session. He said that they have all the equipment that the PTs would use and he would assist me with my therapy. I realize that he is not a physical therapist but he is a Dr. of Chiropratic, has a lot of training and education and has had a successful practice for close to 20 years. Any thoughts on this approach? Would I be sabbotaging my recovery? I simply cannot afford paying the full amount the PTs require so need an alternate approach.

Thanks for any of your ideas and suggestions!

 
Old 01-28-2012, 07:14 PM   #2
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Re: Physical Therapy afted PTT Reconstruction & Calcaneal Osteotomy

While I understand that financial concerns are an issue, I would most likely not take that approach. Could you discuss the problem with your doctor? Is it possible to have the pt, evaluate you and set up a "home program" for you to follow. The pt may be able to monitor you once every two weeks or so and modify the program as needed. That would at least keep the cost down. If you had the specific exerises written out; then you can show them to your friend and maybe he can supervise to be sure you are doing them correctly. You don't want to do ANYTHING to sabbotoge the recovery!!! Is there a university that has a physical therapy program near you. If so, they most likely have an on campus practicum site where you could be treated for a reasonable ammount of money. The students would be closely supervised by fully credentialed people.

Last edited by roxygirl1; 01-28-2012 at 07:21 PM.

 
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Old 01-28-2012, 09:15 PM   #3
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Re: Physical Therapy afted PTT Reconstruction & Calcaneal Osteotomy

I work in healthcare and agree with all the comments provided by Roxygirl. A PT is the most qualified person to assess your extremity joint ROM, strength, joint mobility, gait etc. From there they can provide the best treatment for your individualized impairments. This may include numerous exercises for a home routine. But will likely also include manual therapy to regain normal joint movement and ROM, soft tissue work to improve the restrictions from immobilization and scarring, and continual gait assessment to improve your walking function.

I would have the intial PT eval and discuss with the PT your financial constraints. They should be able to tell you the most suitable treatment plan based on clinical findings and work with you to design primarily a home exercise program, but will have you come in at a reduced frequency for program review/progressions and provide manual therapy and/or gait training, etc as needed. Talk to the PT facility and ask if they have a discounted rate for cash paid service at the time of treatment, as it is often at a reduced rate. I would also consider PT services from the outpatient dept of a hospital as they may offer charity care for individuals requiring skilled care, but have challenging financial situations.

I hope my post is not redundant from prior posts, but I wanted to convey the importance of receiving some aspect of PT in your recovery from this surgery. As patients undergoing this major surgery, we are making a large sacrifice in the lengthy recovery process and you want to ensure the greatest potential recovery of your function, and PT is often a large contributor to this.

As a side note, I am nearly 13 weeks post-op from a calcaneal osteotomy, gastroc lengthening and 1st TMT fusion procedure and just started PT within the last few weeks. I have a conservative surgeon, but started some gentle PT exercises myself at home a month ago. My PT is working on soft tissue release techniques throughout my calf and foot/ankle region, and performing ankle/foot joint mobilizations to improve my foot motion. These are treatments I would not want to leave out of my therapy, as it is more rapidly improving my walking function and easing the discomfort in my leg as I progress to full-time walking in a shoe.

I hope you can receive the treatment you need to get back on your feet.

 
Old 01-29-2012, 06:06 AM   #4
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Re: Physical Therapy afted PTT Reconstruction & Calcaneal Osteotomy

This post was dear to my heart as I am 18 months post op ptt/spring ligament repair, tendon transfer, calcaneal/cotton osteotomy, gastroc release. I feel that PT was very helpful, especially in the early stages of my recovery and again when I was pwb at 9 or ten weeks. As soon as the surgeon saw that I was unable to move my great toe (5 weeks), he gave me an rx for pt to mobilize the great toe and light rom for the entire foot. Only a very good pt could correctly do soft tissue work to ensure that scar tissue does not pose a problem as your recovery progresses while not stressing the surgical areas. I was luck that my pt's first job several years ago was working for a foot and ankle ortho. The pt facility is the outpatient division of a local hospital and the therapists there are all excellent. One I was able to start bearing in a boot, walking was very uncomfortable. The pt was also certified in graston. The first two graston treatments were not fun but they made a HUGE difference in my ability to walk. Although my surgical foot will never be 100% normal, I am able to work full time (school based SLP) and then run my errands after work with no pain. For the most part, I forget that I ever had surgery. I have some reduced sensation and a kind of rubbery feeling in part of my foot but honestly, that is a small price to pay to get my life back. Prior to surgery, my foot had pancaked, my ankle was starting to collapse towards the floor and after taking 10 or 15 steps, I would get a sharp pain along the ptt, extending into my arch. My husband reminded me that prior to surgery, he would hear my crying at times just walking from room to room in my house. I credit my good outcome to my surgeon, pt, me following post of instructions, my husband for waiting on me and maybe an element of luck.

Is there someone that can help you out financially to ensure that you are able to have pt?

 
Old 01-31-2012, 01:19 PM   #5
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Thumbs up Re: Physical Therapy afted PTT Reconstruction & Calcaneal Osteotomy

Thanks for the replys to my post. I must say, initially I was a little surprised at first by the responses, but after considering what all was written I made several calls to find a pt that will work with me. And I found one the came highly recommended that will do sessions for $65/day. I thought that was very fair.

I neglected to add that I myself am a licensed massage therapist and my focus is deep tissue, neuromuscular work. I have done a lot of soft tissue work on clients and feel very qualified to work on myself. In fact I have already started some very light work on my scar tissue and seeing results. I have also been workig with ROM and that is already progressed a lot. If feel that being only 6 1/2 weeks post-op and walking in my cam boot unassisted with very little discomfort is pretty remarkable considering the complexity of the surgery I had. I've read horror stories of folks here that cannot walk unassisted after 4 months post-op.

I thought I would also share that I have also been applying a blend of essential oils mixed with vitqmin E oil on my incision scars and tissue 3xs/day since I got my cast off and I believe that has also helped accellerate my healing and recovery a lot.

As it stands right now, I plan to meet with the pt on 2/16th for an initial assessment and see just what the they recommend I do with what I have to work with. I am glad I got your advice.

One last note, because I am doing so well, I made the decision this a.m. to start seeing massage clints again and I will try and do a couple a day with an hour or two break between so I can ice and rest my foot. But I think I will do fine.

 
Old 01-31-2012, 06:13 PM   #6
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Re: Physical Therapy afted PTT Reconstruction & Calcaneal Osteotomy

It is wonderful that you found a pt who will work with you for a reasonable price. It sounds like your recovery is going very well. Just don't overdo things

 
Old 01-31-2012, 08:12 PM   #7
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Re: Physical Therapy afted PTT Reconstruction & Calcaneal Osteotomy

Glad to hear you found a PT at a reasonable rate. I am sure your background and eagerness to start self treatment at your current status will help you progress at a good pace through this recovery.

 
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calcaneal osteotomy, insurance alternative, physical therapy, pttd post-op



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