Physical Therapy and Rehab

After the cast came off, I was still not allowed to walk or put weight on my foot. My doctor recommended starting some physical therapy. I was anxious to do whatever I could to walk and get my life back again, so I went to a facility that could get me in the quickest.

I really thought I was going to go one or two times to PT then do everything on my own. But my German ancestry kicked in, and when the therapist said come back two to three times per week, I did. Basically what we started with were some foot range-of-motion exercises and some treatments, or modalities which included muscle stim, cold, laser, and deep foot tissue massage. The exercises included moving my foot up and down (or plantarflexion/dorsiflexion) 20 times, in and out (or inversion/eversion) 20 times, tracing the alphabet with my foot in the air, and some stretching by pulling a towel around my foot. I found the modality treatments to be practically worthless for me, and I also tried some other types of treatments in my clinic. I've got to admit, however, the exercises probably strengthened me faster. I also went in the pool for water therapy. I had to crawl up and down the steps into the pool before I was allowed to bear weight. For those first sessions in the pool I basically sat on the steps doing the range of motion in the water. They explained to me that the resistance of the water would enhance that exercise.

Finally, 12 weeks after surgery, I was allowed to walk on my foot. After the cast came off, I was given an orthopedic boot to wear, even though I was not to use it for walking, more for protection I guess. I didn't wear it at home, though, cause I wanted the freedom to move my foot around. On the 12th week appointment, the doctor took more x-rays, looked at my foot, and said everything looked good, and I could start walking. I sat on the examining bench, looking down at this shriveled, weak leg, and asked how I was going to do that? He just said, put one foot in front of the other, and I could use the boot to walk, and transition out of it whenever I was ready. I really didn't know how to do it, but the guy from the cast room gave me some advice. He said to use the crutches, but put my foot down, heel to toe while walking. I can't tell you how good it felt to unbend my leg, and put my foot down for walking! But how weak that leg was! I pretty much kept ditching the crutches as soon as possible. The boot was so confining I took it off for most of the time as well. I remember how I had to hold onto the bed to walk around at first. I remember I would wake up in the morning, sit on the side of the bed, stand up, and wonder, am I really going to be able to take a step? I would wobble a little, but then go forward.

I continued therapy, and it really helped. The water therapy was particularly helpful. I would continue the range of motion exercises, and would practice walking back and forth in the pool, forward and backward, placing my foot carefully heel to toe. In the water I could almost feel like I was walking normally. I did a lot of exercises: from balancing on one foot, to jumping jacks. I balanced on one foot and played catch with the therapist, I did a toe tapping exercise alternating legs, I squatted with paddles on my hands moving the water back and forth to build strength and balance. I also used flotation devices and do flutter kicks and scissor kicks. The water resistance helped build up my strength, and also helped with core muscle exercise.

I also did some exercises out of the water. Some of them I hated, in particular using a wobble board. I had to stand on this board that had a half-ball on the bottom, so I had to balance and move my feet back and forth (holding on to a bar, of course). It nearly killed me at first, my foot turned all purple and hurt so much I thought for sure the screws and plates were going to pop off! The funny thing is though, in combination with doing some exercises at home, the next few times on the wobble board I found it was getting easier to do, so even though you don't see the results right away, and you're sure these people are just sadistic, the exercises do help and make you stronger.

So how long does it take to walk normal, and maybe even go back to running? For me, it has taken a long time. I'm writing right now in December and I started bearing weight the end of June. I am still not normal. My foot feels stiff, and if I've been walking a lot, it starts to burn. I can tell it's still weaker than my left when I try to stand on one leg. It's sort of like you have to walk one mile but you're only going to move one inch a day. I used to feel like I was walking pretty normally, then at other times, I felt like I was limping pretty bad. After about three months, I felt I was doing pretty good. What happens is, you're walking along, on two feet, you hardly have a limp and you feel stronger and stronger. Sure, you have a hard time going downstairs still, and your foot hurts more after walking a while, like when you go shopping, but still, you feel pretty good. Then, you see your friend, who had a broken ankle. And you ask him how he's doing and he says he can't do a single leg heel raise on that ankle. So you try it on your good foot and can do it easily, but when you try it on your broken foot, you realize you can't raise your heel at all. And you feel terrible and discouraged all over again!

The Cast Comes Off

Every three weeks, the cast was cut off, x-rays were taken, then the cast was put back on. After six weeks, I was hoping maybe the cast could come off permanently, because the surgeon initially told me I would have the cast on six or nine weeks. Now, he did say likely nine weeks, so sure enough, I was casted again. However, I must say that my foot did look all that much better after nine weeks, a little less puffy and bruised.

It was quite a relief to get that cast off. Now mind you, I was still not to put any weight on my foot for three more weeks. Of course, my leg was all hairy and there was a tremendous amount of dead skin. There was a rather strange sensation all over my leg and foot as well, I guess it was just not used to any touch for so long. It felt good, however, to be able to rub my foot! The pain level dropped a lot also. I found I could stop taking the Vicodin, and that over-the-counter Tylenol worked okay now.

If you are lucky enough to not have to be casted, count your blessings!

My foot looked really good to me. However, when I placed my bad foot next to my good foot, I could see quite a difference. My right foot was bigger, basically, although I can't say it looked necessarily swollen, but there was swelling in the tissues just the same. There was a rather strange phenomenon also - If I put my foot down, it would get red or purplish, but almost immediately on raising my leg above my head, it returned to normal color! This gradually subsided.

Getting Mobile

Of course they sent me home with a set of crutches. After all, I was not to put any weight at all on my foot. It was weird using them. I would go a couple of "steps" okay, then I would feel unstable for a couple more steps. It was hard to hold up the painful leg with that heavy splint on it too. And there was a learning curve, such as, when using crutches on a gravel driveway, such as ours, be sure to plant them firmly before trying to swing forward, or you will fall, which I did. And negotiating steps is a real challenge, especially going downstairs. You're standing there at the top teetering on two small crutch stubs with your leg + splint suspended in air and you have to go down a step without falling. Scary! Of course there are methods, such as use the handrail and one crutch, make sure the bad foot goes down first, using your crutch with the bad foot, or you can scoot down the stairs on your butt. Also, if you wear a robe, be sure not to get the crutches tangled under your armpits! I pretty much decided the crutches were a pain and there was too much room for disaster, so I started using a wheelchair around the house to get around.

I had also seen the Roll-a-bout scooter like device for lower extremity injuries, and decided right off that was what I wanted to use. I got a prescription for it, and while I was waiting for it to be sent, I used a footstool with wheels which I happened to have quite a few of around the house. For me, I felt more stable to be able to plant my knee on the footstool and use my good leg and the knee to "walk". Plus, I could have my hands free.

I really thought I would be able to do anything and go anywhere with the freedom of the Roll-a-bout. But it really wasn't like that. In the first place, I really wanted my foot elevated as much as possible to be sure to keep the swelling down, so I had to spend more time lying around. Also my knee really started to hurt when using it on the scooter. I bought a construction grade knee pad, which helped tremendously, but still, you're just not going to go for long distances on it.

After I recovered a little from the initial surgery and casting, I attempted to drive. Of course, I could not use my right foot. Non-weight bearing means not even for driving, and anyway, I didn't have an ounce of strength, not even in the toes. So I used my left foot to drive, and it really isn't that difficult, it takes all of five minutes to get used to it. I thought I would drape my right leg over the middle console into the passenger side, but I ended up just tucking my right leg under my left while I drove.

It is such a long time to be not walking. I thought I would never be able to walk again.