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Old 05-05-2012, 02:28 PM   #1
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Questions regarding physical therapy & recovery after PTTD (or similar) surgery

Hello all,

I just came back from a one month post op visit after my calcaneal osteotomy, Lateral column lengthening and FDL tendon transfer (to correct PTTD in my right foot). About half of my staples and sutures were removed on this visit. My Doctor asked me to come back two weeks later to have the rest of them removed (6 weeks post-op) at which time she will put me into a walking cast which I will have for another 6 weeks (3 months total time in a fiberglass cast). I believe the walking cast will bring me from NWB to PWB to FWB in those last 6 weeks.

I was surprised to hear that my doctor would have me start with 6 weeks of physical therapy at the end of this three month mark (when the walking cast is removed). My surprise came when I asked her about how long the PT would last and she said, it is up to your therapist. I asked her if some patients only need 6 weeks and she said yes. I thought the PT was more like six to nine months and my Doctor said to me that she thought that was a very long time for PT.

So I'm curious, what people's PT experience has been after PTTD (or similar) surgery?

How long do your doctors recommend for you to have PT (or if not recommend, how long did the PT go on for before you ended it or went from twice a week to once a week to stopping)?

Also, I was wondering how many months people's pounding pressure continued in their foot when the foot is below the heart. At this point (one month post-op) I still feel a lot of pressure in my operative foot whenever my foot is significantly below my heart for more than a minute or two. Does this decrease quite a bit after three months? Six months?

Thanks for any feedback.

Last edited by posttibtend; 05-05-2012 at 03:06 PM.

 
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Old 05-05-2012, 04:38 PM   #2
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Re: Questions regarding physical therapy & recovery after PTTD (or similar) surgery

One month is VERY early in recovery. Expect the blood rushes to continue for another 4-6 weeks. I was NWB 8 weeks, followed by several weeks in a boot anytime my foot was on the ground. I started pt at about 5 weeks post op because I couldn't move my big toe. The pt was NWB, just focusing on mobilizing the large toe. If I had not had the problem with my toe, I would not have started pt until 8 weeks post op. My doctor said that pt could be anywhere from 6 weeks on up, depending on how your progress

 
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Old 05-06-2012, 12:04 AM   #3
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Re: Questions regarding physical therapy & recovery after PTTD (or similar) surgery

I didn't have your exact surgery. I had a reconstruction where they repaired 3 ligaments, a tendon, and drilled/broke the fibula to deepen the groove so the tendons won't pop in and out anymore. I was in a fiberglass and NWB for 6 weeks and then in a boot for another 4. I hope to be moved out of that on tues. Anyway, I started PT at 6 wks when I came out of my cast like you will when you come out of yours. Currently, I'm about to start my 6th week I think. I have a ways to go. I've been slowed down by a very stiff and sore great toe joint (where it meets the foot) and a cyst has popped upon it. A lot of times docs do leave it up to the PT and every case is different although 6-9 months is quite a long time for PT mainly because most insurance companies won't cover it for that long and because the patient usually is able to do the exercises at home by that point. However, I know I have about 6 wks left probably which would make 3 months. 6-12 wks is average time for most surgeries. My place has a maintenance program that once you're done (whether doc says done or insurance, whatever), you can pay $40/month and come in and use all the equipment unlimited and you can do it for as many months as you like. Forever if you want. It's great if you don't feel like you're done or ready to be done or if you are working up to a goal (I'm going to do it up till Dec when I do my 1/2 marathon for example). And most PT programs are 2-3x/wk for so many weeks. They dont usually taper to once a month then done. As far as the rush of blood and pain whenever your foot is down, it's still way early for you. Mine was still killing me at 4 weeks out and your recovery is longer than mine. Hang in there though! It does get better!!!
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Old 05-06-2012, 04:19 AM   #4
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Re: Questions regarding physical therapy & recovery after PTTD (or similar) surgery

You are still very early in the recovery process and will experience the blood rush for a while. For me, the blood rush pressure lasted until I was out of the cast (8 weeks). I started physical therapy (and massage therapy) at 8 weeks post op and it lasted approx. 3 months. When the physical therapy ends is decided on what the therapist reports back to the doctor and is at the doctor's discretion. I have had a second surgery on the same foot due to a work injury and have had physical therapy since August (only stopped in November for the surgery and post op). Because of still having ongoing problems, my doctor has me going 3 times a week.

 
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Old 05-07-2012, 07:21 AM   #5
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Re: Questions regarding physical therapy & recovery after PTTD (or similar) surgery

Thank you Roxygirl1, Hollywood48, and Missyluke,
That was very valuable information. I'm really happy to hear that my PT may be more like three to six months rather than nine months to one year. I understand it will be up to my PT and doctor to ultimately decide how long this period is. I was pretty shocked to see how much my lower leg, ankle, and foot had shrunk after just one month in a cast and I realized the PT might be quite extensive (after 3 months in a cast) but I imagine the muscles begin to take shape again more quickly than I had first thought. Also, it was encouraging to hear that the pounding pressure in my foot may be more manageable in two to three months. All of this is very reassuring thank you.

 
Old 05-07-2012, 10:51 PM   #6
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Re: Questions regarding physical therapy & recovery after PTTD (or similar) surgery

Oh I know!! I about fell off the table when I saw my calf when I came out of my cast at 6 wks! It was half the size of the other! And I'm an RN and KNEW it would be that way, but still when you see it on yourself....Ugh! It was depressing because my calves were 2 of the few defined muscles I had left from my gymnastics days and I had a defined one on the right and a withered old woman looking one on the left! They didn't even meet in the middle where they were supposed to touch briefly! LOL! You're right in that it comes back somewhat fast. I can already feel the muscle building and it is trying touch in the middle (isn't there yet). My PT said it would be a year before it was completely back, but that I would feel normal way before then!
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Brostrom-Gould, repair retinaculum, peroneus longus tendon repair, fibular groove deepening for peroneal tendon subluxation- 2/22/12
-Modified Brostrom (failed)- 8/15/01"]

 
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foot surgery, physical therapy, pttd, recovery



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