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    Old 10-01-2015, 04:35 PM   #1
    gicki
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    Weight Bearing with 1 Crutch with Lots of Heel Pain

    On Monday at PT, she said, "Okay get up and walk with 1 crutch." I looked at her like she was a crazy women!! Okay so here I go. I looked like a circus act as it hurt in my heel to step down on it. Not stabbing pain, but deep pins and needles tingling pain. It freaked me out and I thought I was hurting my self. Then after about 5 or 6 steps it got better. I used two crutches at home last night as I was afraid to do too much too fast.

    Now today I am experiencing the same thing. This boot is so uncomfortable you can't walk like you think you should. Next week she is going to make me walk without any crutches and I am scared to death to try it as 1 crutch is hard enough. And then the following week into shoes. I want to get into my shoes but scared to do it at the same time.

    Does anyone have any suggestions for me. Is the heel pain normal? Will it get better once I am in my shoe? Next Weekend I will have to go shoe shopping but I don't even know what to look for. I would appreciate any suggestion anyone would have for me.

    Thanks,
    Gicki!
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    Old 10-01-2015, 08:51 PM   #2
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    Re: Weight Bearing with 1 Crutch with Lots of Heel Pain

    The heel pain is very normal. There is nearly always someone on here posting about it. My last cast was a walking cast and I was sure that I'd transition to the boot fine. instead I was barely able to put weight through it initially and refused to leave the hospital without removing it to check for what felt certain to be something wrong with the boot.

    One trick that did help me was to remove most of the air from the boot before putting it on, every single time. That way my heel was all the way back and that seemed to help it be more supported.

    You can only do what you can do. PT is treating humans, not robots. So if you work at the one crutch thing this week and don't feel ready to progress to a shoe you need to tell them that. You aren't being a bad patient or hindering your progress if you need to go a little more slowly. Everyone is different and heals at a slightly different rate. When I was transitioning from boot to shoe I was told to wear the shoe an hour a day at home only and increase an hour a day as tolerated (I was 16 weeks out so fairy well healed). I think I went back to using one crutch for a while with that but I don't even remember now. I wore my boot and carried my shoe to PT for a while, maybe 2 weeks, before I could walk from the parking lot into the PT area and feel safe. If I remember correctly it was 2 1/2 weeks before I was predominantly in a shoe and brace and I still didn't do long distances or uneven surfaces or anything remotely challenging for quite a while outside of PT.

    This is not going to heal in a few weeks. So if it takes a little more time now it's not time you're going to notice. And honestly sometimes you need to be slower at first and then are faster later. That happened to me; in Nov. we thought mid-January to finish PT. I tore some scar tissue and we had to back way down for several weeks. I thought that would slow me down but instead the inflammation had time to resolve and I finished PT 3 weeks later with all goals met.

    I was so far out when I started with the shoe that pain wasn't a real problem; I had 6 weeks of PT before I was allowed to have the shoe on and put weight down and for about 2 of those we were just waiting for the dr to clear me because I was ready. But I still had to learn to use my foot completely differently and it took some time. The first day the PT stepped a couple feet away while I was standing on my healing leg alone for the first time and I wound up sitting gently and slowly on the floor. He stayed pretty close after that. It's a gradual process and there's lots of re-learning and adjusting to new sensations. My ******** memory today is from my first day putting any weight down in a shoe and how "springy" my recontructed tendons and ligaments felt. And that doesn't always feel good.

    Just take your time, tell the therapists how you feel and what you NEED versus what their agenda is (that is based in nothing because you are the expert on YOU). Remember that pain is your body's way of saying NO and that no pain no gain is not true for rehab. In rehab pain means slow down and we'll get there.

    It will happen. It just won't be all at once.
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    Old 10-02-2015, 09:33 AM   #3
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    Re: Weight Bearing with 1 Crutch with Lots of Heel Pain

    I agree with JustMeJen. Tell your therapist what you are feeling. They are there to push you, but to also listen to you and not push to the point of making you go backwards in your recovery.

    My therapist pushes me hard because I am willing to tell them when it is time to back off. He actually told me the first session that I had an aggressive personality and to not push too hard. So, sometimes, it is me pushing harder than him. But, there has been several instances where I said "Hey, the tendon is a little angry right now." And he instructed me to stop exercises for two days. I came back better than ever.

    As far as the boot, I found I had to put a sole insert in mine. Otherwise, my heel and arch would ache by the end of the day. This solved my problem and I was able to walk very comfortably in the boot. I am now out of the boot and into a lace up brace in my shoes. But, I didn't have the extent of surgery that some others had -- I had torn peroneal tendons repaired and torn ligaments.

    Hang in there. It does get better.

     
    Old 10-02-2015, 01:12 PM   #4
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    Re: Weight Bearing with 1 Crutch with Lots of Heel Pain

    I agree too. I tell the therapist each time I am not interested in pushing limits,, I do no want a rerupture and I'm in the window period where it happens,, Therapy is a trip,, I am nowhere near full weight bearing in a boot and today he made me put on both shoes and do therapy to "build confidence",,, the only thing I built confidence in was upper arm strength from leaning on the bars and crutches! Scared to death,,

    Sounds like you are coming along nicely gikki,,, there is so much patience involved in these surgeries.

     
    Old 10-02-2015, 02:49 PM   #5
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    Re: Weight Bearing with 1 Crutch with Lots of Heel Pain

    Thank you all so much! I think by using one crutches my weight is not distributing properly on my foot. Of course I have no idea how to walk on a foot with an arch either. Before I always walked on the inside of my foot from being so flat for all of those years. Today I would take my old foot over this. It aches on the outside of the back of my foot under the ankle where the double Evans osteotomy is and the heel. I know they say the boot is suppose to give us support and cushion the foot, but I do not believe that is true at all.

    willoween, What kind of insert did you get and how long did you walk in the boot fwb before transitioning to a shoe. There are days I would rather be in a shoe, as I think it may feel more comfortable. I just want to be up and walking and have my life back.

    Thanks my friends!!
    Gicki
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    Old 10-02-2015, 03:12 PM   #6
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    Re: Weight Bearing with 1 Crutch with Lots of Heel Pain

    I think the brand of boot matters a lot but the brand is a personal preference. I had an Aircast one after I hurt myself and hated it so much that I dreaded going into a boot post-op but the Donjoy boot that I actually had was very comfortable.

    If you have a shoe for your good foot that has a thick sole that might help distribute your weight better. I'd worn Brooks Addictions for years and they have a thick, non-bendable sole and that worked very well for me with the boot although once I was in a shoe that was the exact opposite of what has worked well for me.

    You might also ask about using a cane instead of a crutch; maybe that would feel more natural to you. I know it is sometimes done because I remember people saying to me "when you get a cane...." and I never used one, just 2 crutches to 1 to none. That was usually the people who wanted to tell me the boot was the worst thing I'd ever experience and who were very disappointed when I'd talk about how liberating it was after 6 weeks of bedrest and 10 weeks in casts and how well I was doing with PT.

    The other thing I remember is that it helped me immensely to do as much PT as I could. I would take off my boot and sit on the couch and watch TV and do exercises on and off for about 2 hours every night with rest breaks as needed. One night I happened to put my foot beside the other one and realized it was an inch shorter. It was being pulled in by scarring on the bottom of my foot, even though I didn't have surgery on the bottom of my foot. (My surgeon believes in maximizing scar tissue to get the kind of healing he wants for tendons and ligaments and then gradually reducing the scarring in PT which is a somewhat unusual approach). So after a good bit of massage and stretching that scar tissue it tore loose and suddenly I could do more with my foot as far as my exercises and I also could walk/WB better. Until we got that to go away I had this tight band down the arch of my foot. In time your foot will get used to being stretched and stepped on differently and the functional healing will start.

    I know it's hard to not get frustrated but try to hang in there for a few more weeks. You'll probably be surprised at the difference.
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    Old 10-02-2015, 06:11 PM   #7
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    Re: Weight Bearing with 1 Crutch with Lots of Heel Pain

    Try a heel cup in your boot. I did that after this last surgery when I started weight bearing, and it made a world of difference. I hardly had any pain in my heel after I started using that. Maybe you can get them at a pharmacy, or a sports store. They're usually sold in pairs. Or, maybe you could ask your surgeon's office if they carry anything like that. The brand I used is called Tuli's classic heel cups. They come in different sizes. I think you could probably even get them online.
    Another thing that I found extremely helpful with walking in the boot was this thing called the Evenup Shoe Balancer that straps to your shoe on the other foot. It elevated my shoe more evenly with the boot so that my gait was more symetrical, thus putting less stress on the operated foot. It looks a little dorky but it really helped! You can only get that online. I don't know why they don't market it in stores. It's such an awesome idea.
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    Old 10-04-2015, 02:47 PM   #8
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    Re: Weight Bearing with 1 Crutch with Lots of Heel Pain

    JustmeJen & Left Foot,

    Thank you so much for you suggestions and words of encouragement!

    I do have a shoe with a thicker sole that I have started to wear. I made an appointment to see the Surgeon on Tuesday before my PT on Wed and Friday as I am very unhappy with the therapy I am having. Especially after asking for someone that had experience in my procedures and it is very evident she has not. I have on incision that is stuck to the side of my heel and PT is not helping me at all as far as my scars are concerned. I asked her about it and she rubbed it one time for about 3 minutes. She has not tried to help me with bending my big toe from my bunionectomy as she said she is not sure if it is suppose to bend and doesn't know where my pins are. I am just so frustrated and depressed and I have been trying to wish this away and just want my flat foot back!! There is no way I am ever going to do this on my left foot. I just want to walk. That is all I want and get my life back as I am a single mother. I have made a lot of bad decisions in my life, but letting someone cut on my foot is the absolutely dumbest thing I have ever done in my entire life. I am looking for the day I can just walk again. I know i have come along ways, but I don't know how I am suppose to improve if Therapy is not helping me. I think I jumped into this surgery without understanding how difficult it would be. I broke my foot a couple years ago, and I had it in my head that this would be just as easy, and that is not true at all.

    When you were in the boot FWB, how long before you transitioned to the shoe. They only want me in a boot FWB for 1 week before going to the shoe. Part of me thinks that is too soon, but then a shoe may feel better than this dang boot, as long as I can find a good fitting shoe that is comfortable.

    Looking for better days! Just want to get healed up so I can go on with my life as we all do. May be time for some stronger antidepressants to get through this difficult time.

    Thanks again!
    Gicki
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    Old 10-04-2015, 03:22 PM   #9
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    Re: Weight Bearing with 1 Crutch with Lots of Heel Pain

    Depression is a very normal reaction while healing from these surgeries. It's hard to have to wait so long to feel better. And it's hard that you wait so long to walk and then walking is still so hard.

    I had different surgery than you but I was not pushed into walking nearly as quickly. I got a walking cast at 6 weeks and a boot at 10. I was allowed WBAT during the day with the boot (I had a splint and crutches at night) for 6 weeks. So I was 16 weeks out when I was starting to walk with just a brace and shoe. That's a lot different than 8 weeks. And even at 16 it wasn't easy or completely painfree.
    Every dr is different but I think most people are in the boot longer than your dr is suggesting.

    I think going back to the dr is a very good idea. If you don't live in a city I think it can be hard to find someone with experience with these procedures. MY PT had never seen it before but he was good about keeping up with what he needed to know. I did have to request some things though, like passive stretching/massage in the beginning when I couldn't do it myself very well (too hard to hold at an angle that didn't hurt because of where my incisions were). Nonetheless if the PT isn't familiar she should be reading about it and contacting the dr for guidance, not just not doing things because she is uncertain. I also just don't like it when therapists say "here, do that this week and it's very hard and hurts but I'm warning you now next week I'm going to make it worse" because how does she know what you need next week now? You're working on what you can and it hurts a lot. That's a sign you aren't ready to move on. This is not a fast recovery, you are going to be in PT a while. Taking a week or two or three to feel comfortable with one crutch is not going to change anything in the long run.

    I hope that you eventually feel like it was worth it. I am so glad that I had my surgery and feel that everything was totally worth it. But I'm now 15 months out and looking from the perspective of the only time I have pain is if the weather is changing and I can walk with only a very slight limp. It improved the quality of my life greatly. I know it is so bad now but I really hope that in a year you'll feel better about it.

    Just try as hard as you can to not be pushed further than you are ready for. Even your surgeon needs to let you heal as you can, not by some random pattern of "this week, next week". THat only would work if humans weren't individuals. That is terribly depressing to go through and it's pointless. Try to remember this isn't forever and you will feel better, gradually and with enough time.
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    Old 10-04-2015, 04:18 PM   #10
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    Re: Weight Bearing with 1 Crutch with Lots of Heel Pain

    Jen,

    Thank you so much! You do give me hope for better days ahead. I has never in a cast at all. My surgeon does not believe in them I was ins a soft splint for 6 1/2 weeks. I was then placed in a boot as the Surgeon said I had advanced healing with the bones being 75% healed. So he put me in a boot for Weight Bearing as Tolerated, ordered PT for 6 weeks and said for them to transfer me to a shoe at 4 weeks. Made a follow up at appointment for 6 weeks and said I would be walking to that appointment in a shoe. I am glad he is so confident in his work, but I was thrown back by these dates. I couldn't believe it, but what did I know he is the specialist. Due to the PT I have been receiving and her dead set that next week I am to walk FWB in the boot with no crutches and the following week to transition into a shoe I told my boyfriend that we needed to go for a follow up with the doctor cuz we are not one bit satisfied with my PT. I have followed all of their instruction to the letter. I do get worried that by pushing me to hard, we are going to ruin some of the work they did to my foot. I am sure that is not possible at this point, but you know how we worry.

    So when you transferred to FWB, how long were you able to be on our feet. Right now I working from home, so I am able to elevate and ice as needed, but I will need to return to work soon. I love about 20 miles from work and since my right foot was worked on I am not able to drive. What foot did you have worked on. When were you able to drive and return to work? I know I have so many questions. Just nice to hear from people that have gone through similiar procedures.

    Thank you for making me feel better.

    Gicki
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    Old 10-04-2015, 04:49 PM   #11
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    Re: Weight Bearing with 1 Crutch with Lots of Heel Pain

    I was PWB in my walking cast and then WBAT in my boot. It took a couple weeks to be done with crutches and fully wobbling around; I think it was about 12 1/2 weeks when I could walk from the parking lot into PT without needing crutches. When I went from the boot to a shoe and brace my dr. had me start with one hour per day at home and work my way up and after I could tolerate more time then start trying it outside my home. I think that again took a couple of weeks before I was doing it all the time (and because I had tendon/ligament repairs I still had a brace so I wasn't walking totally on my own for 6 1/2 months post-op). Drs are so weird with their beliefs about casting, bedrest, healing times, when to start WBing, etc. From what I've seen on here everyone pretty much gets to the same point eventually but goes through very different things getting there. My ortho was very conservative with healing time and that was frustrating sometimes (I was on bedrest for 6 weeks with constant elevation and really up only for the bathroom and a shower every few days plus appointments and even then I rode in the car with it elevated as high as we could manage in the backseat) but it also I think saved needless pain and kept everything healing well before it was overly stressed. Aside from positioning it for casting nobody even moved my ankle at all for I think 6 weeks and then the dr just barely wiggled it to see how tight the repairs were.

    As frustrating as the slow route was it also just worked. Even at 16 weeks the first time I stood only on my bad leg in PT I couldn't keep the tendons/ligaments from collapsing and I wound up on the floor. So everything was weak but it was also solidly healed and I know that I avoided pain and by the time I had that fall it was safe to do that. PT wasn't painless and I took naproxen through the early part and again through the early part after the boot but it was not terribly painful which I've read so many people who started earlier than I did go through.

    My surgery was the left so I was able to drive about 6 weeks out, once I had my walking cast. I'm disabled so didn't have to worry about work; if I had been working I would have been out for a long time because I lifted people as part of my job and I wasn't stable enough to do that for a long time. Once I had the walking cast I could tolerate it being down for a while but kept it elevated as much as possible for a long time. (Once I was in PT I did it to reduce the puffiness between sessions). They said I could drive when I could slam on the brakes and not avoid that because of fear of pain. Which is a lot easier when it's the left and it is in a cast/boot and isn't realistically going to get to the brake anyway.

    All you can do is follow the dr's instructions and be honest that you aren't ready to be 100% without support. You can't make yourself heal faster than you are going to heal and nobody can/should expect that. You had a LOT of work done in there and not only are you still healing everything has to learn to work differently than it ever has before. And it takes time for everything to learn to do that. Even 15 months out I am still startled every time my ankle wobbles and my repairs kick in and I don't fall or sprain it or both. At the same time I've been without a brace for about 7 months now and it still feels strange sometimes to trust the repairs, especially since my ankle can be wobbly and I lose my balance but then it works the way it should and I am fine other than looking a little clumsy.

    I hope the dr is helpful.
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    Old 10-04-2015, 09:35 PM   #12
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    Re: Weight Bearing with 1 Crutch with Lots of Heel Pain

    Gicki I'm 4 weeks behind you in recovery from PTTD surgery so I follow your recovery closely. Since I'm behind you I don't have many words of wisdom to offer like the fantastic other posters have. But I would like to echo one thing they've been saying. Don't be afraid to speak up to your PT. You are your own best advocate for your health and wellbeing. May I share an experience I had with a PT earlier this year?
    I was trying everything I could to avoid having this surgery. I did 8 weeks of PT trying to "rehab" my left PTT. During a session my PT gave me a set of stretch exercises to do. While performing these exercises my left foot ached pretty badly so after the first set (was told to do 3 sets) I stopped doing the exercise and asked the PT if we could go on to something else which we did. At my next doctor's appt I was telling the Dr about said exercise and he said it was a good thing I didn't proceed with that exercise. He said though it was a great Achilles tendon stretch it wasn't one recommended to someone with a potentially torn PTT. So moral of the story is I listened to my body and spoke up for myself. I encourage you to always do the same. Though your PT is trying to help you I believe it’s more between you and your Dr as to where you should be in your recovery.
    And I totally get where you’re coming from with second guessing the decision to have this surgery. I honestly was lying awake last night having the same thoughts myself. I truly believe the people on this board who either had multiple surgeries on the same foot or have endured this surgery on both feet are superhuman. I’m freaking out about wearing out my right foot (non-surgical foot) while trying to heal my left one. I truly don’t think I would have the mental strength to go through this again.
    And why oh why did I have this surgery in the first place? Yup, I’m having these thoughts as well. I try to remember how my foot/pain was before surgery and am asking myself all the time – couldn’t you have just lived with it? I am a huge hiker/walker and wanted so badly to get back to those activities ASAP. So I too might not have stopped long enough to really consider the total package of what having this surgery entailed. I’m telling you all this to hopefully give you some assurance these thoughts, doubts and feelings seem pretty normal.
    I hope this week brings you a tad bit closer to feeling “whole” again. I hope you accomplish something this week with your foot that you couldn’t do last week. May you receive some answers to whatever questions haunt your mind.
    As always I wish you all the best with your progress and look forward to future posts from you.

     
    Old 10-04-2015, 09:36 PM   #13
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    Re: Weight Bearing with 1 Crutch with Lots of Heel Pain

    Oops - somehow double posted.

    Last edited by Avson; 10-04-2015 at 09:40 PM.

     
    Old 10-05-2015, 06:04 AM   #14
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    Re: Weight Bearing with 1 Crutch with Lots of Heel Pain

    Gicki, sorry for the delay in responding back to you -- busy weekend. I went to my local drugstore and got an arch support type of insert. Like a Dr Scholls. I think mine is a Triad brand. I just needed the support in my arch because the boot had no arch support.

    I was in the boot for 4 weeks. But slowly transitioned out of it at home. I was in the boot for one week before starting PT. That first appointment, the therapist asked if I had brought my shoe. I was shocked that he would want me in a shoe so soon. I did that first session in the boot. The next week I started in the shoe. But only at therapy. By the third week, I started walking around the house without the boot. Started with just the morning, getting ready for work. Then after 3-4 days, started doing more in the afternoon after work. By the 10 week mark (6 weeks of NWB and 4 weeks in the boot), I was walking around the house without the boot. My OS moved me from the boot to a lace up brace in the shoe. I do not have to wear the brace when inside. Although, last week (week 1 of the brace), I continued to wear the brace to work. This week I am going to transition out of the brace for work.

    Remember, I did not have the extensive work you had done. I had my peroneal tendon repaired and some of the ligaments repaired.

    You can do this. Try keeping a journal. This will help you in the long run when you get discouraged. Read back and see where you have come from.

    I agree with discussing this with your surgeon. I would also be uneasy with a therapist that wasn't sure what to do and when to do it. They need to discuss this with your surgeon. I am lucky that I am do therapy at the place my surgeon suggested and usually refers his clients to. So, I know they have rehabbed this type of surgery before. I chose not to go back to the PT that I used before the surgery. I was unsure whether they had rehabbed this type of surgery before and was unwilling to take a chance and be pushed too hard and have a set back.

     
    Old 10-07-2015, 09:43 AM   #15
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    Re: Weight Bearing with 1 Crutch with Lots of Heel Pain

    JustforJen, Avson & willoween,

    Thank you all so much for making me feel like their is light at the end of the tunnel and better days are a head even though this is a very long journey.

    Yes I do live in a remote area but my surgeon does come highly recommended for foot reconstruction. Even though his bed side manner is a bit to be desired, I am hopeful my surgery is a success.

    Here is my update from my appointment yesterday. Remember I went in 3 weeks before he wanted to see me to touch base.

    After I registered, they sent me down to xray, which surprised me as I didn't think I would have xrays at this appointment. After Xray I proceeded to the exam room using my crutches in my boot. When he walked in the room, he asked me how I was doing and of course me being me had to be a little funny, but I guess he doesn't have the sense of humor I do. He got mad at me for still being in the boot and I proceeded to tell him he didn't want me in the shoe until next week and we were here early. He said okay that right you are early. He said the Xray looked good and the first osteotomy on my heel where the skin is stuck, is healing very well and the other one is not as advanced in healing but he is not concerned. He also expressed the fusion on the top of my foot takes longer to heal, but to not worry as the bracket and screws are holding perfectly as it should be.

    When I asked him if the skin would ever come loose, he snipped at me and said you are only little over 2 months healed and I that I was expecting to much. I explained that I was expecting anything, I just wanted to know if it would ever release and if there was anything I could do to help it along. He stated to just message it with Mederma as it has Vit E and that will help break up the scar tissue. I proceed to ask if my big toe should bend and PT was clueless and he made me feel like I was the bad one for not working on ROM. Now the toe is very stiff due to not starting ROM exercises on it and he showed me an exercise to do and sent new orders over to PT. He said if I want a different PT I have to request it.

    Next we talked about going in the shoe and the nurse fitted me for a lace up brace. What a pain in the butt that is going to be to put on. He said I need to work my muscles more on the back on my left where they cut the muscle. I asked him what she he recommended as my boyfriend is taking me to get a shoe this weekend. He said he didn't care what type of shoe I got as long as it is comfortable. So this weekend I will go shoe shopping. I guess it is time to ditch the crutches. My thoughts are if I need to use 1 crutch or a cane for a while I will. Oh ya, he also stated that the side of my foot is probably hurting cuz I am walking on the side as I am afraid of hurting the foot. He said there is not way with all the hardware in there that I can hurt anything and to step straight down, so I will have to work on that.

    So yes they are pushing me really hard to be in a shoe at Week 10. I also asked when I could drive and he said we will see how strong I am at my next appointment. I almost cried as I wanted to be able to take my daughter trick and treating. The nurse said by then around town should be okay, but not to go on the highway. So we will see how I am doing then, My fingers are crossed.

    I am looking into going to a message therapist to have them work on my scar tissue to break it up a bit, I think that will help my heel and my big toe movement.

    I am staying hopeful that I will do okay at PT today when I have to walk without a crutch.

    Sorry this got so long, just didn't want to leave anything out.

    With out these boards, I don't know what I would do. You guys are the best ever!
    __________________
    8-3-15 Gastroc Resection, Double Evans Calcaneal Osteotomy, First Met. Arthordesis with Silver
    4-8-16 Hardware Removal, Calcaneal Osteotomy, Elevation First Met.
    10-13-16 Screw Removal, Wolff

     
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    flat foot surgery, pttd, pwb



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