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    Old 11-05-2008, 06:21 AM   #1
    sandcastles
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    PT after PTTD surgery

    Hello everyone,

    I hope that everyone is doing well.

    I was hoping that you may be able to help me. I started PT last week (surgery was PTTD, double calcaneal osteotomy and FDL (tendon transfer) July 23, 08 (15 weeks).

    My question is: Must we really feel pain (pain that brings us to tears and leaves us in the 6-7 range on the pain scale after the session?).

    I want to gain strength and I will and would do anything to achieve that. I don’t know if this knock on your as* pain is normal in PT.

    My foot has a lot of edema for being three days post PT (it’s like an x-large golf ball right on the ankle). I thought that PT was going to be a gradual process - that it would be about focusing on building strength and acclimating your foot to normal conditions.

    Thank you very much,

    Sandy

    Last edited by sandcastles; 11-05-2008 at 06:22 AM. Reason: edit

     
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    Old 11-05-2008, 02:45 PM   #2
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    Re: PT after PTTD surgery

    Sandy-

    Let me say I'm glad (although not really!!!!!) that you mentioned the golf ball ankle. This is where my residual swelling is and it is driving me nuts. The rest of my foot has gone down nicely but my ankle is tempermental and likes to flare up at times. Anyway, it would be of my opinion that PT shouldn't be painful. It might produce an achy feeling from working the foot but not pain. Have you just started PT? I'd have a talk with your therapist. They follow a real progression to gradually build strength in a way that shouldn't make you hurt. Perhaps you need to cut back to fewer exercises or fewer reps until you don't have intense pain or swelling after a session. I started jumping and hopping tasks yesterday in PT and really felt an achy foot last night!!!! I guess the difference between achy and pain is it goes away over night or within a couple hours. Also my PT said to ice after a session if the swelling was bad. Good luck!

    Last edited by smile2006; 11-05-2008 at 02:50 PM.

     
    Old 11-05-2008, 09:08 PM   #3
    emmie54
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    Re: PT after PTTD surgery

    'Sandy, I had an overzealous PT tear my peroneals during my rehab. I assumed since he had been a PT for 25 years and a partner in a reputable group that he knew how to treat post PTTD surgery patients. It wasn't until later that I learned that he had never treated anyone with my surgery. Be very very careful.

    It was no way to prove that he did it (although I have no doubt and know exactly when it happened) my doctor was furious. After my peroneal surgery my surgeon sent me to a foot specialist physical therapist. A WORLD of difference in the treatment. The foot specialist just did manual PT with her hands and put me on NO machines, etc. They did ultrasound, manual massage, etc., but no equipment, stairs, nothing physical except what she did manually to me. She told me my strength would come back by walking better. She taught me a few exercises I could do on my own for specific strengthening. I did SO much better the "gentle" way.

    please please be careful! Because I never got properly rehabbed from PTT surgery, then had another surgery right on top of it, scar tissue had built up deep in the joint which eventually impinged the joint causing a third surgery

    emmie.

     
    Old 11-06-2008, 08:27 AM   #4
    sandcastles
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    Re: PT after PTTD surgery

    Hello Em,

    Thank you for the reply. I am planning on looking for a PT that (hopefully) focuses primarily on the foot and ankle. I live in NH - so I will most likely have to go into Boston to seek a specialist.

    I agree with the issue of pain (trying to push the healing process) vs gaining strength and endurance slowly and effectively and most importantly, safely. My bones are very weak - even though I am 50 I have t-scores of - 4.4 (spine, neck and hip) which sets my bones at about 90 years old.

    I have always been so active - - so it’s easy to empathize with my “colleagues” here on this site . . . this is very frustrating, exasperating and at times down right depressing to be so incapacitated and dependant. I hate it!

    Thank you for the words of encouragement and for the suggestion to locate a “specialist”.

    Take good care,

    Sandy

    **************************************** ******************

    Ms. Swim,

    I’m sorry that you, too, have the golf ball syndrome. It’s actually painful! Mine happened after a very tough Orthoic fit with the PT. Ice and elevation will placate the foot yet it will not eliminate the swelling to any significance. I’m hoping that it’ll pass in the next few days.

    We all know that you are “Super woman” and that you have been a exemplary patient. I hope that your swelling is temporary - and that you’ll be back to running soon.

    Take good care,

    Sandy

     
    Old 11-06-2008, 12:17 PM   #5
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    Re: PT after PTTD surgery

    Sandy, I was 51 when I had the surgery and very active, too. Worked in the yard all the time, ran here and there, loved to walk for exercise (ha ha!) and MOST of all, loved to shop the mall. Since having three foot surgeries in three years my life has changed dreamatically. But, finally, I find I am gradually getting back to the things I used to love doing. Maybe not at the level I once did, but at least I am doing it. Hang in there, it WILL get better. It was the hardest thing I ever did but I got through it with my sense of humor and my sanity and I know you will, too.

     
    Old 11-06-2008, 12:25 PM   #6
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    Re: PT after PTTD surgery

    Hey girls -

    Timely post as I had my first PT eval today. He had never heard of PTTD. Asked "so, how did you do this?" Not good. Nice guy (about 15) but I'm calling around now to find someone who's more knowledgeable .

    I haven't been cleared for WB yet but, typical Mason, am down to one crutch and am lurching 10 steps or so without if I am motivated by say, chocolate or a nice merlot. I guess I'll have to fake being scared to put my foot down at my Dr. appt. I'll channel you, Hurts, in your first few days of WB! :-0 Walked around all day yesterday at an Open House with one crutch and a 3' heel. Only thing sore was the ball of my "good" foot from my cheap boots. Wasn't even noticeably swollen (more on that in a sec) So I'm either doing well or I've shredded the tendon and there's nothing there TO hurt. Could go either way...

    PT Dudeling just did range of motion measurements (which he said were great) and gave me a few exercises. I'm going to Doc on Mon & get cleared for WB. PT said I was about 2 weeks past where he would normally start so just do the alphabet til I get released for WB. I was looking forward to the macaroni or beans or whatever ya'll got to stick your foot into at first. Nada.

    I did get to peel off the UberVelco boot, then the fuzzy sock to get Foot Nakie with him. Aside from the FrankenScars, he got to see my patchily shaved leg, my untended piggies and one single lonnnnnng hair right on top of my foot. Lovely. He poked around at my Veal Calf until it was flapping like a windsock. Yet another unnervingly humbling experience of which I am finding increasingly tedious.

    Re:swelling & golf balls. Just in the last week I've started to see my arch! Wow! (Pat, I'd like to buy an arch, please) But I do have swelling on both sides of my ankle. When I overdo (daily) or don't ice/elevate (never), it swells on the OUTSIDE more than the inside. Didn't even have anything DONE there, did we? Anybody else with this? Goes right down with ice/elev tho.

    Also, which one of you had (this is indelicate) the "hole" in the back of the heel? Anybody remember this? That's the only band-aid I have left but it's a little deep and, well, gross. This is where I had pain the entire time and I think it's from me rocking my ankle up & down from splint to now. (good for ROM, tho!) Didn't we have stitches there? I can't even see that scar...

    Sorry I've been a little AWOL - Internet connection iffey lately so I'm reading everything on my iPhone but can't post from there lest I be uncharacteristically brief. God forbid.....

    ttyl!
    M

     
    Old 11-06-2008, 03:34 PM   #7
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    Re: PT after PTTD surgery

    Hello All-

    Definately find a PT who has knowledge of the issue you are dealing with. I am going to quite a large place and was lucky to get someone who has dealt with the PTTD thing alot. Also, my doctor gave me a PT protocol handout that I took to the therapist. It basically lists expected limitations of the patient, goals and exercise across three phases of PT. So my PT has been basically following that progression. I guess this would be especially helpful if the PT was less familar with the injury/surgery.

    Mason, I was the one who had the hole in my heel. About a week after my cast came off so did a scab and a chunk of skin around the incision in the heel. It happened easily after a bath but after my skin dried out that baby hurt. I put neosporin and a band aid on it for about a week until it healed up. The little hole was from the stiches!!! It still has some calloused skin on it.

    Good luck to all, whatever stage of recovery you might be

     
    Old 11-08-2008, 09:12 AM   #8
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    Re: PT after PTTD surgery

    Hey,

    My PT's wife had the same surgery by the same doc one week before I had mine. I wonder if she knows how important hearing about her progress was to my peace of mind. Still is, too. I'll come in to therapy complaining about the pain-of-the-week (so weird, it moves around). My PT will look startled and say, "my wife was just complaining about that."

    May I tender my resignation to the WPBB Club (Weather Prediction By Bones)? Someone signed me up when I wasn't paying attention. Rediculous level of pain when a front is about to come through--if that coincides with your PT appointment you might be thinking that you overdid.

    As you heal, you do more, walking on parts of your foot that may not have seen much use in decades.

    Tendons got rearranged. They're likely rubbing around on tissue that never had that. We're breaking in our new feet, kind of like breaking in a new pair of shoes. There may be some scarring in there that needs to loosen up, too.

    One week, instead of E-stim, we tried iontophoresis with a topical anti-inflammatory compound. It very well may have been a coincidence of timing (weather??), but for the next few days, the ache was nearly intolerable. I haven't felt brave enough to test it again yet.

    I get anxious if I've got fewer than one and a half tubes of Arnicare Gel in the house. I've been slathering it on the hurting places that I can get to (around the anti-scar pads) several times a day. Amazing stuff.

    hugs,
    Lisa

    PS. Mason, you crack me up, I love reading your posts. A good sense of humor will get you through most anything--and your's is carrying us with you. Thanks!

     
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