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Old 12-06-2012, 06:44 PM   #1
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So what does gradually mean?

I wrote a long post yesterday about my 2 week visit. I got my stitches out and was told to gradually put weight on my foot. Like a goof, I never asked what gradually means.

I mostly used the scooter today, but did work on walking with crutches (in the boot.). It was okay. The only hard part was my foot hates the boot right now because it hasn't sunk to a relaxed 90 degree position yet... I even managed a few steps full weight but then stopped.

So someone out there who's had to gradually put weight on, after only two weeks, do you know how slow that should be? I called my doc but didn't get a response yet.

I have been doing the only exercise, other than the 'gradual' weight bearing, which is to flex my foot up and down several times a day.

Thanks for any input! This is so different from last time. I had a cast until the 6th week then it was anything goes. Now I can't move side to side and am worried I'll hurt myself by doing too much.
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Old 12-06-2012, 07:15 PM   #2
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Re: So what does gradually mean?

Hey Patti,
I started on crutches with just touching my toe down and put a little more of my foot down every day. Worked my way up to full foot, then one crutch and for the past few days taking a few steps without any crutches. I probably should have used a cane in there somewhere...gonna try that tomorrow. It's taken me 2 1/2 weeks to get that far.
Two things I learned--as you are progressing, do the whole routine. Every day, walk with 2 crutches, then drop one, then the other. Don't just get off the scooter and start walking with one crutch. That hurts! You have to kind of loosen up and build up the pain threshold. Doing some theraband stretches before helps too. The second thing is that the up and down (pumping the gas pedal) motion is the first thing I got back. Side to side is harder and takes longer to work up to. Keep the scooter and crutches within reach so you don't strand yourself.
It hurts but you kind of get used to it. Just try to do a little more every time. For the first week or so I took every other day off.
Good luck!
Ginger

Just reread your post. I was 8 wks out when I started PWB. I can't imagine how it would feel after only 2 wks. Ouch!

Last edited by ginger62; 12-06-2012 at 07:33 PM.

 
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Old 12-06-2012, 08:01 PM   #3
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Re: So what does gradually mean?

It's weird but it feels okay. Tired and sore and yes, definitely need to go slow... But it's less pain now than I thought, more pain earlier. I'm wondering if some of that is because I didn't spend 6-8 weeks in a cast like last time. Most of my pain last time was from ligaments and tendons that weren't even operated on but were tight from immobility.

But I really want an answer from my doc about how slow/fast can gradual safely be. If its at my discretion, great. But if not I need some guidance so I don't push it too fast!!!

Thanks for the advice. I'm taking it. I'll start with the scooter tomorrow. I won't go down to one crutch at all but will consider two again with some weight on it. I did put full weight on today at one point. It was okay but I'm nervous.
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Peroneal brevis debridement; peroneal longus transfer to brevis: tenosynovectomy, 11/20/12

Brostrom ligament reconstruction (success), joint debridment, perineal tendon tear repair (fail): 3/22/12

 
Old 12-06-2012, 10:11 PM   #4
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Re: So what does gradually mean?

If your doctor is anything like mine...his answer will be a frustrating "gradual means listen to your body". I think that is because there is no "right" answer for figuring it out, or even a baseline he can tell you.

My experience was putting a little bit of weight down (in my boot, and then again with shoes) and just ramping it up each day. My key was not backing down when it felt like it MIGHT hurt, if that makes sense. I psyched myself out a lot, by starting to touch down and then going "oh no, don't do that, that might hurt" when it turns out, it didn't and I was fine. Eventually when I got over that hurdle, I just pumped myself up and said "take a step and see how it feels!" And when I didn't let myself chicken out, I found that the steps came relatively fast after that first one in a hotel bathroom (lol), and I was scared for nothing.

For me, the key was figuring out the difference between the actual pain and the percieved potential pain. I'm still battling that now that I'm in shoes and trying to get down to the barefoot stuff, which I know is far away.

Something else that my PT has me doing for ROM is getting my foot well above my heart (laying flat on my back with my foot on pillows and stuff) and doing the gas pedal flexing. In addition to just keeping it moving when it's at normal height, the elevation helps the muscles in the foot flush out the bad blood essentially. I only say this because my PT said I still have a lot of edema to get out of my foot and he said it's because the muscles don't know how to pump the blood efficiently anymore so I need to help them out and remind them.


Sorry for the long rambling, probably incoherant post. I can't sleep, and the insomnia delirium is starting to set in.

 
Old 12-06-2012, 11:45 PM   #5
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Re: So what does gradually mean?

I agree with everyone. Listen to your body. Do your weight bearing with crutches and slowly progress the amount of weight you put on your hands. You can also use a scale to judge how much weight you are applying. A basic pt is spelling the alphabet with your toes. I'm sure you've heard that a million times on here but it really did help me. For strength you can do isometric exercises once you're given that go ahead.
Good luck to you!
~Kimberly
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Old 12-07-2012, 05:28 AM   #6
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Re: So what does gradually mean?

Thanks! I will try that gas pedal up high. I'm really aching this morning. It has only been two weeks. Yikes.

I am going to go a bit easy today, I think, since I am an hurting so much. But it is only 6AM, so we shall see!

I can't do the alphabet thing for a while. I am not to do side to side at all until my 6 week appointment in January.
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Peroneal brevis debridement; peroneal longus transfer to brevis: tenosynovectomy, 11/20/12

Brostrom ligament reconstruction (success), joint debridment, perineal tendon tear repair (fail): 3/22/12

 
Old 12-07-2012, 06:16 AM   #7
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Re: So what does gradually mean?

One more thing Patti,
Make sure your foot is snug in the boot. If you take it off and on now, make sure it's deflated, put it on and then pump it up. I couldn't figure out why mine wasn't fitting right but I was trying to jam my foot in with it already inflated.
Ginger

 
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Old 12-07-2012, 06:27 PM   #8
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Re: So what does gradually mean?

Oooh! I am so glad you told me about the boot. I knew from last time, but it wasn't in my thoughts. My foot was wicked uncomfortable to start the day and deflating and inflating it really helped. Thank you!

My doctor replied and said pretty much what you guys said. I need to just listen to my body... And since I tend to push it I am going to try to be super conservative. And slow.

Also, I know my doctor said I can sleep without anything on my foot, I and going to try to use an extra boot I have for sleeping. The night splint is very uncomfortable and without anything, I'm waking very sore in the morning. I think I'm moving it too much in my sleep. We'll see how this goes!

Thanks for all of the support!
__________________
Peroneal brevis debridement; peroneal longus transfer to brevis: tenosynovectomy, 11/20/12

Brostrom ligament reconstruction (success), joint debridment, perineal tendon tear repair (fail): 3/22/12

Last edited by Snowrunner; 12-07-2012 at 06:28 PM.

 
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