Foot/Ankle Surgery&Recovery: Re-learning Walking

Posted by DetectiveEstes in Uncategorized      No comments

May
15

I’ll bet most people never think about walking.  Other than when they stub their toe, or trip over something.  But actually considering walking?  Why bother? Isn’t it automatic?  We all know how to walk…..don’t we?  Well, all except for a few of us that had surgery on our feet, or ankles, or knees.  Or those of us who are completely without those limbs.

If you have been following this blog then you know this is a documentation of a recovery from Post Tibia Tendon (PTT) surgery to a left foot & ankle on January 14, this year.  Until this past Friday, May 9, this recovery was only about strengthening the ankle.  As of that day, practice began on learning how to walk again, as well as the continuing strength training.  The surgery, subsequent therapy and ultimately purchase of orthotics were all done by The Orthopaedic Foot & Ankle Center.  They are located at   2922 Telestar Court, Falls Church, VA 22042, phone – 703.584.2040.  My surgeon was Dr. Daniel Cuttica.

A number of years ago I knew a prosecutor.  We got to be good friends and still talk by email sometimes even though he has long moved out of the area.  I had known him probably 7 years before someone told me had both legs amputated from being wounded so badly in the Vietnam War.  He walked absolutely perfectly!!  Since then, I’ve known or seen many more recent war veterans with severe leg injuries, or amputations.  Nearly all of them walk as though their legs were the ones they were born with.  I KNOW that must take long time therapy.  The knowledge of acquaintances with all these successful walkers is what encourages me to drive forward every day, every hour.  I KNOW I can walk normally!  Because I have all of these living examples of near impossible odds to begin with that all walk exactly right!

First was the standard stretching the skin and joints of the surgered ankle.  This happens at every therapy session.  I can’t honestly say I’ll miss it when therapy is over.  It hurts!  The good part of it is that it loosens the skin and joints before the exercise begins.  Next were the treadmill and the lesson on walking.  Matt set the speed at 1.1mph.  Not much for sure..  5 minutes he told me.  Off I went.

The problem with relearning to walk is that, for yourself, you only have your other foot to model your walking from.  It’s quite difficult to study your other foot while you’re attempting to walk on a treadmill and there is no stopping to analyze things.  I’m sure I looked funny to the therapists trying to twist around to see the other side of me walking.  It’s even funny for me to think about!  Finally, I realized I obviously know how to walk since I’ve been doing it so long.  I relaxed and began walking normally with my right foot, and the left simply copied the movements of the right foot at this slow speed.  As the days went by, I got more and more adept at walking with the left copying the right foot’s motions.  I surely know that cannot be how to teach a double leg amputee how to walk, but these are my methods.

As of my last therapy I was up to 2.0mph.  In therapy I’m still at 5 minutes.

The other aspect of walking has to be discussed as well.  That is of balance while walking.  When a person walks there is a second or more where one foot is completely off the ground.  If the other foot isn’t developed enough in the ankle area and calf muscle, when that foot comes off the ground, balance is lost and the walker begins to lose balance.  Depending on how much the foot/ankle has developed will depend on whether the person falls or not.

The exercises for balance are standing in one place and balancing on one foot for a time period.  In all of my therapy, that has been 10 repetitions at `10 seconds for each repetition.  In my last surgery of my right foot, that balance was 3 repetitions at 30 seconds each. Thank Goodness it’s down at 10 seconds now!  Another exercise for balance is a foam balance beam about 4 inches wide by about 6 feet long.  The patient’s therapy is to heel-to-toe walk forward, then backward 5 times.  Since the foam is constantly giving, this takes time and side strength to complete.  After the therapist believes the patient is doing well, then it’s time to play ball.  The therapist stands about 10 feet away.  Patient stands on the balance beam one foot in front of the other, heel to toe.  The therapist throws the patient the ball to catch.  Patient catches the ball and throws it back.  After a few times, the therapist begins throwing the ball on one side of the other of the patient so the patient has to lean to one side or the other and catch the ball.  This is more difficult to continue that balance.  After a few minutes of that, then the patient has to switch feet, putting the one behind in the front.  The patient quickly finds that the back foot is the one that has the weight on it and when the injured is behind, the balance is very difficult.  Following this exercise a ball is placed in a square on one of the gurneys in the room.  The patient stands back about 1 1/2 steps.  The patient steps forward with the new foot and removes the ball from the square then pushes off and stands up.  The ball is returned to the square in the same manner except by stepping forward.  These exercises build balance when walking.

Next will be a short lesson for me in doing what my therapist says do, or be in lots of pain.