Considering that the cure used to be amputation (though perhaps for an injury that was more serious than mine) I figure physical therapy is the easy way!
I am making this a separate account for interested family members, and anyone who wants to know what is ahead…
June 22-First day: Mostly testing to see how much mobility I have in the foot (almost none) and how much strength I have lost in the leg (almost all).
Active Range of Motion
- Trace alphabet in air with foot
- Wiggle toes
Strength Development to do at home (3 sets if 10, 3x a day)
- Straight leg lifts keeping the lifting leg very straight (only to the height of the knee of the bent (good) leg)
- Bent leg lift sitting on a chair
- Side leg lift, being careful to keep the hips stacked and the leg slightly to the back
- Inside leg lift
- Back leg lift (lying on stomach)
- Keeping leg straight, put a towel under the knee and push down.
Strength exercises on machines:
- Straight leg side lifts
- Bent knee, lift calf forwards (9 lbs)
- Lying on stomach, straight let, bend calf back (10lbs)
Ice as needed, 5-10 minutes
She didn’t want to put any pressure on the foot herself until she got the ok from the doctor. Massaged the foot and the calf.
Range of motion:
- All previous exercises
- Flex foot up and down (3 sets of 10, 3x a day)
- Inversion-Eversion (side to side) holding knee still (3 sets of 10, 3x a day)
- Same as last week, just didn’t do the side leg lifts on the machine
June 29 Therapist got the ok from the doctor to put pressure on the foot, so she did a manual stretch forward and backward.
Range of motion:
- All previous exercises
- Calf stretch with a towel or elastic band, keeping knee straight (30 seconds, 3 x daily)
- Tennis ball manual massage of instep
- Manual stretch of foot forward and back (30 seconds, 3 x daily)
- Put a bunched out towel on the floor and try to pull it in with the toes (visualize doing it if you can’t actually do it)
- Same as last week,
- the range-of-motion exercises from before, but with a stretchy elastic strap giving resistance
- working with the foot on a board that has a ball in the middle of the underside so it rotates-forward and back, side to side, and rotating
- therapist stretching foot
- then calf strengthening on machine
- We added a movement pointing the foot all the way to the right and out, then moving it all the way to the left and in, against the pressure of the therapist’s hand.
- Started working more on the toes, stretching them, then having me push back against her hand.
- Also started working the area around the scars to break up adhesions
- MEAN massage of foot and calf!
- The big addition was putting the foot (toes only, and still wearing the boot) on the ground when walking, with virtually no pressure. “Walking on eggs.” It’s actually harder and slower than not using the foot at all!
We added a leg press, using the hurt foot, with 25 lbs, and then added 6 more.
Also picking up marbles with the toes. I could only do it with the fourth toe. (The next day I could do it with all but the bit toe, which still doesn’t work.
Nothing really new. Spent a bit of time making measurements to see how my flexibility and strength have changed, to take to the surgeon on the 15th.
My calf muscle is still really tight. Massage is excruciating!
Went over the x-rays with therapist. Surgeon said there is scar tissue on the ligament going to the big toe, which is why the toe won’t work. Therapist noticed a lump on the side of the toe itself, so we have to find out if that is scar tissue.
Standing facing a barre, shifting weight from uninjured (right) to injured (left) foot, keeping torso straight
Standing with barre on left side, left foot flat on ground, behind right foot. As much weight as possible on left. Slowly lift heel, rock to ball of foot, lift foot, step it forward, put down heel, ball of foot. do 10 times.
Walk, using crutches, but putting as much weight on left foot as I can take.
We did these with bare feet because when I work out it’s in bare feet, (also because I didn’t bring a shoe), but I am going to try doing them with a shoe on, since the foot feels very unstabilized.
More catch up…Since I went back to work, I haven’t had time to list a blow-by-blow description of PT. Basically, we are now concentrating on getting the toes to move forward and back, and getting some mobility in the talus. I am still doing the leg lifts, but with ankle weights (at home), and the ankle exercise with the resistance bands. We usually don’t have time at the PT session to do all the machines, but I focus on the machine that has you lie on your back and flex the foot forward and back with weights. (not a very clear description!)
I have added calf stretches done on the edge of a step, and I practice going down steps when I am going home in the evening.
We worked on going down steps. Established that there are two reasons I have trouble:
- My ankle is too tight.
- My toes aren’t strong enough. I can’t go up on the ball of one foot without the help of the other one.
More exercises to do!
I was, however, able to stand on the left foot (without shoes on). tho I cannot balance yet, because the toes don’t touch the ground.
Had a good pt session today. I have stopped writing down all the exercises and find I have forgotten some. I also don’t realize that this or that one is important until the therapist finds I haven’t been doing it!
So today we’ve added pushing a weight back with my toes, balancing on a tippy circle, marching slowly in place, and balancing on the left foot with my eyes shut (holding on to a bar).
Much improvement. I can walk without my cane, although I use it because I need it for balance if the ground gets uneven.
It’s been a bit sobering…my foot HURTS! I almost feel that it has betrayed me. This isn’t a bad thing, though. The physical therapist has abruptly upped the ante on me, and since I fear the insurance case supervisor will run out fo patience soon, it’s a good thing. We are re-training the arch muscles and the toes, and I am now tired and hurting for two days after a session.
Exercises include: throwing a ball back and forth while standing on one foot (or trying to!). To be fair, my therapist stands on one foot, too; jumping and prancing (alternating feet) on a mini trampoline; standing with the toes squished up against a step, and balancing on one foot on a squishy hemisphere. The band around my big toe really burns afterwards.
A few weeks ago, I decided I needed short-term goals. I chose a few that were measurable: balancing on one bare foot (the hurt one) for 7 seconds, walking downstairs without holding onto the bannister or using my cane, increasing the legweights to 5 lbs. for most of the strength exercises, and being able to sit in seiza for 5 seconds without support. The therapist suggested that for this one, we count the number of folds of towel I need under my ankle. Within the first week i had done the stairs (not gracefully, but who said it had to be graceful?), balanced once for 7 seconds, and am working towards the other goals. Yipee!
I am in shock! I just discovered that the hospital has been charging all my pt to the wrong insurance company and then taking a co-pay from an overpayment I had on the books, without telling me, billing me, etc. By chance I finally got to the patient advocate, who forwarded my story of woe to their finance department. The billing people, of course, had been worse than useless. I will post a detailed story later!
But I will have to continue with physical therapy, since my toes still don’t work properly! Last visit we added:
- A four-direction lunge exercise
- jumping, while lying on my back on the pilades reformer machine
Afterward, my foot and leg were both exhausted, but now I can move the heel of the injured foot off the ground without providing power with the strong foot. Just a little, but it’s a start!
Managed to balance on one foot for 20 seconds (with shoes on). this is a new skill. Added several exercises that involve jumping or skipping. They really exhaust my foot!
Had a few breakthroughs: going from cat/cow yoga pose to downward dog, plank, and slowly back to cat/cow. This involved using the toes of the hurt foot.
Did a standing back roll and a full back roll, catching myself with my toes. Yippee!
Much later...I am discontinuing this page because I am not doing formal PT any more…so I am putting the entries on the regular blog…