Archive

Monthly Archives: September 2013

20 Weeks post lisfranc surgery

 
20 weeks post lisfranc surgery

After my setback last week it feels incredible to arrive at 20 weeks post lisfranc surgery with very little ongoing pain.

 
This week my physical therapist had me try walking backward on the treadmill!!!  I was apprehensive, wondering if walking backward was something I also had to re-learn.  He assured me that my muscle memory would take over and I would do just fine.  So at .8 MPH and while holding on to the treadmill side handles, I walked backward for 2 whole minutes.  I have to admit, I was super proud of my accomplishment.  My therapist even shouted out, “that’s my girl!”  
20 weeks post lisfranc surgery scar
 
With that success under my belt,  my physical therapist then had me try walking sideways.  I couldn’t believe my foot was ready for new adventures in walking, but it was!  Walking sideways was a little tender and my foot felt a little tight, but it was not painful.
 
20 Weeks post lisfranc surgery
 
 
I have also experimented with leaving my treasured cane in my car during activities that don’t require a lot of walking.  (like short errands, dining at restaurants etc.)   I thought leaving my cane behind would be hard because my foot may start to hurt and I wouldn’t have anything to lean on.  But that has not been the case.  I have been able to walk reasonably pain free as long as I walk slowly and carefully.
 
But, being cane free has led me to discover something quite unexpected.  Walking slowly causes people around me to become impatient, even though I am carefully trying to stay out of everyone’s way. I have even had a few people bump into me!  For 20 weeks I have been used to people giving me a wide birth and without my cane announcing that there is something going on with my mobility, people naturally assume all is well.  No one suspects that even a little shove can throw me off balance, causing sharp pain while I regain my footing.
 
 
20 weeks post lisfranc surgery
 
I have been longing for the next step of my recovery, which would be to get rid of the cane. But, after a few attempts being in public without any signal to the world that I am recovering from a foot injury, I am no longer in a hurry to give up my cherished cane…..at least not quite yet.
19 weeks after lisfranc surgery scar

This week has been a rough, painful week.  Every step I took, even in sneakers, caused a sharp, shooting pain in my mid-foot.  What bothered me the most was that my foot continued to have intermittent shooting pain even when at rest.

 
I know my tendency  is to overwork my foot, so I cut out HydroWorx water therapy.  I was not able to do my home therapy exercises and painfully made it through necessary daily activities.
 
I was really looking forward to my physical therapy appointment so that I could discuss the possibility that I may have sustained a stress fracture. During my appointment my therapist compared my recovering foot’s flexibility with my “normal foot.” As he manipulated my recovering foot he noted my muscles in my foot were very stiff and not as flexible as last week.  
 
While pressing on various parts of my foot he and I discussed at length the type of pain I was having making me clarify exactly where I was having pain.  He made me differentiate between aching, shooting pain and just being stiff.  When he forcefully pressed his thumbs underneath my foot, tears sprung to my eyes. 
 
 I looked up at him and he said, “I guess that hurt, right?”  
 
I said, “You have never hurt me before, so it took me by surprise.”
 
As he continued to test areas of my foot for amount of pain, I learned to be a little more vocal about the pain level number I was experiencing while he pressed.  
 
After a few minutes he took both his hands and squeezed my foot, scrunching all my toes together.  I realized he wasn’t looking at my foot anymore and was watching me carefully for my reaction. 
 
I smiled at him and said, “now that doesn’t hurt at all.”
 
He smiled back and said, “good, that means you do not have a stress fracture.” 
 
 He went on to say that if I did have a stress fracture, I would have probably kicked him when he squeezed my foot with that amount of pressure.   I assured him I would never kick him, but he did make his point.  I felt like a huge weight had been lifted from me.  
 
 
lisfranc physical therapy
 
Together as we talked, we discovered the pain I was experiencing was a lot like when you get a charlie horse in your calf, only mine was in my mid-foot.  That is why my pain continued intermittently even at rest.  I felt like a huge weight had been lifted off my shoulders.  What I was experienceing was overworking of the muscles in my foot which is a normal part of walking again!!!  

19 Weeks post lisfranc surgery

 

19 Weeks post lisfranc surgery image right side

I had a setback a few days ago and my foot has been extremely painful when walking.  I rested it for 3 full days and then had physical therapy yesterday. My therapist took it easy on me not wanting the muscles to get irritated again.    After walking today doing normal activities, it is once again very sore.  I think this picture shows how swollen the top of my right foot is compared to my left

 
18 weeks post lisfranc surgery

My scar is still noticeable, but now I am more concerned about walking pain free. My goal is to walk without a cane and sneakers!

 
 
 
 

 

18 weeks post lisfranc surgery scar

 

18 weeks following lisfranc surgery left side view

This picture shows what happens when I push myself too hard.  The bump (swelling) on the top of my foot is at my incision sight and causes pain when I walk. I am trying not to wonder if I am always going to have pain when walking and swelling  when I rest.  I am back to icing tonight!

At 18 weeks following lisfranc surgery, my favorite part of physical therapy is when my therapist manipulates and massages my foot.  This is no longer the painful experience it once was and I can actually move my foot better when he is finished.  I do think his hands have magical healing powers!
 
 
lisfranc physical therapy massage and manipulation

 

18 weeks post lisfranc surgery physical therapy

The next best thing to my therapists medicinal hands is the ice machine at the end of my therapy session.  This machine works very similar to how we breathe.  It fills the boot with air and after a few seconds, lets the air out  while keeping my foot at a nice icy temperature.  15 minutes of painless ecstasy!

Icing after lisfranc physical therapy
17 weeks post lisfranc surgery setback
Icing and elevating again



When I woke up today, I could not walk a single step without a pain level of 5.  Each time I tried to follow through with a complete stepping motion, I felt a sharp stabbing pain in my mid-foot, right where it needs to bend.  The pain was so immediate and intense that it caused me to suck in air to try and manage the 

onslaught of stabbing discomfort.


 I thought about canceling my Physical therapy appointment because I knew there was no way I could do any of the physical and balance exercises.  But in the end, I thought it might be important to talk with my therapist about my pain since it is very different from any of the other pain I have experienced during my lisfranc recovery.


I am sooo glad I went!  My therapist meticulously sorted through my activities from the last 2 days while massaging and manipulating my foot.  Together we pinpointed exactly which part of my foot was sore and which muscles were involved.  He also noted that my mid-foot was swollen in the exact places that were painful. 


Turns out that once again, I have overdone trying to be “normal” walking person again. Yesterday in HydroWorx therapy I was walking fast against the jets and played catch with a beach ball.  All of which puts a lot of strain on my mid-foot.  In addition, the water level was a little lower than usual.  I did ice after HydroWorx thinking that would keep my foot from swelling.


In the afternoon I went to the Parade of Homes which requires that you take your shoes off while walking through the rooms.   The muscles used while walking have to work twice as hard when you walk barefoot and my foot was not used to this new intensity.  


So today my therapist did a lot of massage/manipulation followed by electrotherapy with ice.  I was concerned having a titanium plate in my foot would be painful with electrotherapy, but it actually felt great!  And of course ice ALWAYS helps.  I am so thankful I have a therapist who took the time to listen and got to the bottom of not only where my pain is, but what most likely caused it to happen.  


After talking with my therapist, I am not worried about the intensity of the pain anymore and know it is just a matter of doing too much too soon.  The harder part for me now is that once again I am stuck at home, sitting in my favorite chair, elevating and icing for the rest of day.  I just hope tomorrow I will be more mobile again otherwise it will surely be another day of rest for me!

 Remember the last time your foot “fell asleep” and you tried to stand on it?  As it wakes up you feel tingling and eventually it feels like needles being poked into your flesh.  As the nerves in my foot regenerate, I have had that feeling multiple times on the top of my foot and especially in my big toe.But lately, the feeling has become more intense. For the last couple of days, my big toe feels like it is being stung  numerous times by small bees, not just on the top of my big toe, but underneath as well.  It is a different kind of pain than the feeling of needles in my foot.  It is a sharper intense “ZING” sort of pain which makes me suck in my breath.  It only happens when I am at rest and not when walking on my foot.

I talked to my physical therapist about this today and he said this was great news! To be able to feel sharp intense pain in a toe that has been numb for 17 weeks means my feeling is starting to come back in full force.

In addition, regaining feeling in my big toe is integral to being able to put weight properly through my entire foot.  When I can’t feel if I am transferring weight through my big toe, I cannot make the proper follow through for walking.

My therapy session today included .13 miles on the treadmill (1.5 miles per hour for 5 minutes) and 1 mile on the stationary bike.  I also did leg lifts, calf strengthening and lots of balance work on the bosu ball.  My new therapist is gentle and kind but makes me work up to my potential.  I am so glad my insurance cleared me for 8 more therapy sessions, which means my total for lisfranc surgery recovery will take 28 sessions.  (I have also had 36 HydroWorx sessions as well.)

As far as pain free walking goes, I tried walking through Macy’s today without my cane and in my sneakers.  I had to walk slowly and very carefully, but I was able to do it with a minimum amount of pain!  I was stiff,  but it felt more like when you first wake up in the morning kind of stiff and not the “I have to sit down right now” kind of stiff.

After Macy’s I went to Kohls and also left my cane in the car for that errand.  There again, I walked at a snail’s pace, but I did it!!!  I cannot tell you the amount of pleasure I got from walking through 2 stores without any assistance and almost pain free.

I am spending the rest of the day resting in my chair, (with ice) but I am satisfied, happy and have a sense of accomplishment that I haven’t felt since before my lisfranc injury.  There is light at the end of this lisfranc recovery after all!!!!

Looking back on my 17 weeks of lisfranc surgery recovery has been like watching an infant grow.  You don’t really take note of all the day to day minuscule changes, but after 4 months, you realize HUGE changes have occurred!This is what happened to me this week when I arrived at 17 post lisfranc surgery.  My physical therapist gave me permission to walk on the treadmill!!!!!!!

treadmill at 17 weeks post lisfranc surgery

Okay, so I don’t get to walk more than 1.5 miles per hour with no incline and have been instructed to walk no more than 5 minutes a couple of times a week, but still…..I am back on my treadmill!!!

By the way walking 5 minutes at 1.5 miles an hour means I can now walk .13 of a mile without stopping and limited discomfort….not completely pain free, but no more than a 1-2 pain level!!!!!!!!!!

Dusting off my treadmill at 17 weeks post lisfranc surgery

I have been instructed to still “listen to my foot” and quit if it becomes painful and I start to limp.  5 minutes is just the right amount of time to practice correct “heel, toe, follow through” at a slow pace.  Now that I have learned to walk again, the treadmill is letting me practice all of the correct walking motions that I have been taught!

17 weeks post lisfranc surgery image
17 weeks post lisfranc surgery scar
Left side view 17 weeks post lisfranc surgery image

By the way, my foot envy broadened today with the official start of the NFL season.  I spent most of game time today watching the Vikings player’s feet with complete fascination and awe!!!!!!

Right side view 17 weeks post lisfranc surgery
%d bloggers like this: