Monday, 2 April 2007

Of Achilles Tendons, Equinus and Physical Therapy

I went to the doctor today to discuss the results of the latest MRI. The good news is that the Achilles tendon is not ruptured and so it is just the tightness and tendonitis that is causing the pain. My heel and the area above it were so tight that to prevent any pain I had to keep my foot in a position where my toes were pointing downwards (equinus) and I had to put inserts in the boot to maintain that position while I was wearing it. The doctor told me that while he had allowed me to do this for a few days until the MRI results came back (to prevent further rupture in case there was a tear), now that it was clear that the Achilles tendon was not torn, I had to keep my foot in a normal position even if it was painful as failure to do so would make everything tighter and also make therapy much more difficult. He also said that I could now put a small amount of weight on my foot while using the crutches as long as it is only to go to the bathroom or kitchen. I was warned against going outside for a stroll on a nice spring day! Well, needless to say, putting on the boot when I was finished and then walking- and he stood there and made sure I walked correctly, putting weight on the heel and not gingerly on the toes- hurt although after the initial pain, it is much better and I am wearing the boot normally for the first time in a week. It may seem minor but for me it’s significant. I also spoke with the physical therapist and he is supposed to call me back to let me know when I can start therapy.

My GP and podiatrist along with a number of other specialists all share office space and the physical therapist is located in the basement, which meant I had to go down and up a flight of steep stairs. This was the first time I have done that since January and it was difficult. I am not sure how much sense it makes having the physical therapist in the basement and only accessible via stairs when many of the people he would be treating would have suffered injuries and may not be able to cope with stairs. On the other hand, therapy comes after the injury has healed or is almost healed and is meant to enable a person to regain full use of the limb etc, so it may be that the stairs are part of the therapy process!

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