October twenty something…Post EHL Surgery

I’d just like to end the month with a few of the obvious things that I miss since I’ve had my EHL Tendon Surgery..

I’m missing:

v  Being able to go down on my hands and knees….to retrieve things that roll under the bed.

v  Downward facing dog

v  Bull-riding

v  Doing Grande-Jete’s

v  Scrubbing the bathtub

v  Running and Walking

v  High heels (getting tired of my left Converse sneaker)

v  A good morning stretch, it’s tough to stretch out your whole body and have to avoid your right leg and all associated with it.

v  Sleeping all over the bed, not just in the same 2 positions night after night..Rotisserie chicken is what my hubby is calling it.

v  Good posture

v  Driving

v  Eating anything I want and then working it off.

Happy Hallowe’en..

Regards,

Zipperfoot.

Severed EHL Tendon- 10 Week Post Op

The Zipperfoot Gimp Limp. This is how I would describe my style of walk. 10 long weeks, leaps and bounds in terms of physical transition.  I’m hoping that within the next 10 weeks I will be much closer to my goal of walking without the Gimp Limp.

Weeks 1&2: Post surgery cast and immobilization. Pain, pain killers, lethargy and sleepless nights are what make up the first 2 weeks after my surgery.  I have one appointment with the Orthopaedic Specialist post-surgery to change my cast in week 3.

Weeks 3-6:  I’ve transitioned into a full hard cast. I get a brief visual of my foot before the second cast is applied.  I hobbled around a little more during these weeks; however I was still totally dependent on my crutches. I was doing what I call the 5-10 meter marathons. I start twitching my toe slightly, giving me hope that the tendon was reconnected. I start to notice that my toe is starting to droop back down slightly which again is hopeful that I am on the right track. I have my second appointment with my Orthopaedic Specialist since the surgery. He gives the go ahead to transition to cast number 3 (The stabilizer boot) and requests that I proceed with Physiotherapy. The stabilizer boot will most likely be with me for an indefinite amount of time; it’s removable and makes life a bit easier. I start using a cane, which gives me a little more freedom than the crutches.

Weeks 7-10: Physiotherapy and Rehabilitation. It is the main focus all day, every day. I visit the Clinic at least 3 times a week. I’ve made huge amounts of progress. I dropped the crutches and the cane.  We work constantly (and painfully) stretching out the EHL Tendon.  I take a one day break once a week to heal the muscle pain in my legs and foot. Inclusive in all this is the electrode, heat and ice therapy.

I plan to return to work partially in the coming weeks, albeit I will be working from home, it will be a gentle integration back into mainstream civilization. Physically I don’t think it will be happening for a long time. I’ve had some candid and “real” conversations with my physiotherapist, I’m still going to be on a heavy physio schedule for November and December. Although we have made progress, the road is still long and winding ahead.

On a side note, a yearly work tradition that I will be missing this December due to my injury, is a Slap Shot competition at the Hockey Hall of Fame that I usually participate in (and win!).  Ron Ellis gave me some sage advice about giving up my title last year.

Those who know me will understand.  ;)

Severed EHL Tendon- 9 Weeks Post Op: Healing the Hallux

Nothing to do with Harry Potter, I assure you.

Now that we have been working the ankle and the calf muscle (by know means being anywhere close to normal flexibility) it’s time to move onto the Toe. Partly psychological, partly physical, the movement of the big toe is a scary thought. I’ve managed to twitch it from time to time but to try and bend it forward- not likely.

As I mentioned previously, Jake (Physiotherapist) will bend my toe gently behind a towel. At first I was unable to stomach the visual. As my toe is being bent forward and backward (gently), I can see the EHL Tendon at the top of my foot stretching to the limits. Let me say that I do have a hard time trying to keep my lunch down. To me it is the creepiest visual. Like some horror movie special effect. I’m waiting for something to pop out. Maybe it’s because I have boney feet- not sure. It’s not pleasurable to look at or feel.

Of course, part of my home routine on a daily basis is to mimic the same toe stretches. I have to flex that toe whether I like it or not! So for the past few days amidst all the other physio chaos at home with calfs, ankles and quads; I have to bend my big toe as often as possible.

My legs feel like they’ve been hit by a truck!

If you’re a runner you may understand. Running until the muscles in your legs are screaming, now run further and further until they are rubbery and your feet begin to clumsily lose grip to the ground below. Muscle fatigue. Now get up and do it again a couple more times today.

  On the up side, it’s a sign that the muscles are working hard to gain control, even for what we take for granted as the simple act of taking a step forward.

Severed EHL Tendon- 8 Weeks Post Op

Here I am 8 weeks later. I thought I would be up and running. Well not really.

I’m in some intensive physiotherapy, really trying to work Zipperfoot and get it moving. The excitement and anticipation of the physiotherapy has worn off, it is now pure gruelling work.

My tri-daily workout consists of Ankle Isometric Exercises and this week’s new edition Knee and Hamstring strengthening. Realistically we are starting from scratch, basically in both legs.

My right leg was totally inactive, while my left leg took the brunt of all the exertion over the last 8 weeks. Unfortunately it still did not receive enough strengthening activities over the last while, so it too has fallen victim to muscle and strength loss.

The Routine:  Range of Motion for Ankle

Dorsiflexion Exercises: this consists of having a pillow rolled between both feet, one foot on top of the other to create some resistance (Injured foot on top position) and squeeze together.  Hold in this position for 10 seconds, and then relax. 10 Repeats. (3 times a day).

This should mimic some downward pressure on the bottom of the injured foot; yes it’s on a comfy pillow- Thank God!

Plantarflexion Exercises: with a rolled pillow against a wall, press ball of foot into pillow. Hold in this position for 10 seconds, and then relax. 10 Repeats. (3 times a day).

Eversion Exercises: with a rolled pillow against a wall, press outer part of foot gently into pillow and hold for 10 seconds, and then relax. 10 Repeats. (3 times a day).

Inversion Exercises: with rolled pillow between feet press inner borders of feet into pillow. Hold in this position for 10 seconds, and then relax.  10 Repeats. (3 times a day).

I also do a hamstring stretch for both legs, with a hold of 10 seconds, for 10 times on each leg. I do this as often as I can during the day.

I’ve been doing this routine for a full week with icing in between the sessions. The foot tends to swell quite a bit if I’ve worked it a bit hard. I’ve got a few degrees of voluntary motion in my right ankle now. I know there is a light at the end of the tunnel; I just wish I could speed up the train a little….

The top of my foot where the scar resides is still extremely sensitive and tingly to the touch. We do heat and electro therapy prior to Jake (the physiotherapist) doing a very aggressive massage on Zipperfoot to get the tissue stimulated. Usually I have purple spots in certain areas of my foot afterwards, likely bruising of the tissue from exertion. He works my dorsiflexed big toe behind a little towel. I can’t look at him bending my toe back and forth (even ever so gently). The sweat that pours out of me is indicative of the “mental” workout I’m getting. He knows how far he can push me, and then pushes a bit farther than that just for good measure.

The good part is that I have transitioned clumsily to a cane, so I have less dependency on my crutches. I still wear the Aircast everywhere. I don’t think that is going anywhere anytime soon!

Coming soon…Vastus Medialis Oblique therapy and the dreaded Wall Squats. Time to rehab those Quads !

Physiotherapy: It's all in The Clinic

I began my first physiotherapy sessions this week. I was really nervous, as I didn’t really know what to expect. Well-- no secrets here; its pain!

I wanted to stay closer to my neighbourhood, so the first clinic I originally booked was a high profile athletic facility with private physio rooms and apparently staff that was extremely educated in their perspective field of Athletic Physiotherapy and Rehabilitation. Yet when I inquired about how much experience in rehabilitation they had on Severed EHL Tendons, they were not that familiar with it. It is not considered a “sports injury”.  To add insult to injury they had a monstrous flight of stairs to reach their posh star studded facility on the second floor. (Can’t imagine [for example] someone with a torn ACL, navigating that staircase??!!)  I inquired with the cutesy sounding receptionist where the elevator was for us people who were unable to take the flight of stairs. Sorry no elevator. Suggestion: scooch up the stairs on my behind. Everyone else does it.

[Insert expletive!] at this suggestion and I laughed maniacally. She got the drift, and at my request suggested another homelier clinic down the street by the library.

I placed the call with my armour on. Physiotherapy is expensive, so I don’t care what the clinic looks like. The cost will be the same. I need them to work on my foot not their décor. First question I asked; do you have an elevator? Response: who wouldn’t? Pearse you are a star.

What a terrific bunch of guys and gals, and what a great job they do. They are committed to the cause; to get everyone back on track and on with their lives. Professional and motivating.

My consult: we do a quick assessment; and yes (in case anyone is wondering) Severing the EHL Tendon is extremely rare and every Physiotherapist  would love a crack at this type of rehab on a patient. It’s a physiotherapist’s dream child.  They call each other and taunt fellow clinics; guess what we’ve got?! The jewel of physiotherapy cases; a dormant but potentially fully functional foot and a tendon that has been craftily and tightly braided back together and then wrapped with special dissolving sutures all within  the complex nerve and tendon maze of the amazing extremity called the foot.  It’s all memory recall for the nerves, tissues and muscles.

I’ve been assigned a vigorous schedule of physiotherapy 3-4 times a week in the afternoons for about a month, and then we will decrease by 1 session a week and so forth. The short term objective at this time is to at least attain a short range of motion for the ankle through massage with some possible movement in the toes.  We’re simultaneously trying to rebuild the calf muscle with electrotherapy, thus contributing to muscle stimulation. It’s like putting your finger in an electrical socket, but having the shock only affect your leg.  There is a level of intensity the therapist can control based on my tolerance.  As a concentration tool, I have my stress ball in my hand, so I don’t grind down my back molars when pain points are hit. No one said it was going to be easy.

Let the games begin!