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Foot & Ankle Problems Message Board


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I had a subtalar fusion in November 2014 for pain due to Osteoarthritis and poor alignment of heel which caused pain with walking.In case anyone is wondering what that is like I am doing this post. Everyone is different and every surgery is different so by no means should you feel you should be like me. This is supposed to be a fairly common surgery but I was unable to find much out there to help me feel like I was at least going down the right path. I seemed to be behind according to some physio protocols and I suppose that could be because I'm over 55. So here is my intro and timeline for my Recovery Phase:

I had used orthotics for about 10 years for plantar fasciitis and subsequent heel spurs. Over the years I kept going over on my ankle and pulled the peroneal tendon until it was permanently puffy and sore. Walking and working 8 hour shifts became more difficult, my active lifestyle on a decline I went to an ankle specialist along with a physiotherapist/orthotist at the same appointment. The Dr offered me the fusion because my subtalar joint was basically fused in the incorrect position which caused various muscle and tendon discomforts, while the physiotherapist offered me different orthotics as I still had a bit of movement in the joint so I opted to try this first. I had one kind of shoe prescribed (a New Balance hiker) but tired of my hot uncomfortable feet and decided to have the surgery 3 years later.

After surgery I had a Slab cast on for the first 2 weeks, then had suture removal followed by two casts to my knee and continuing non weight bearing for about 2 months. My X-ray showed everything was progressing nicely. Besides some numbness and tingling due to swelling the first two months were relatively easy. I was very diligent in keeping my foot elevated above the level of my heart in the first weeks or it would get uncomfortable. Used narcotics for pain control for the first 3 days, tapering from 2 down to 1 narcotic and then substituted over the counter meds as needed.

After 2 months the cast was replaced after the X-ray showed normal healing was taking place, so on with an Aircast Boot. I continued with non weight bearing for about another 1 and 1/2 weeks as my foot hurt quite a bit when I tried to partial weight bear. The light bulb came on and I started pain killers so my walking progressed. I was now able to do cold and warm foot baths for pain relief, ice application and kept with elevation as soon as my foot started to swell and get sore. I rested at least 30 minutes every two hours while doing my water or ice therapy, adding gentle massage of the scars to my regime. I continued to use my knee scooter for grocery shopping and gave it up just prior to my February 25th follow up. I had stopped with Tylenol by this time but found walking awkward and painful for anything longer than 20 minutes.

I got busy doing core strengthening once the air boot went on and started with passive range of motion ankle movements. My Dr said I did not need physio although everyone , including my work said I should go so I had pre-booked a few appointments with my therapist starting February 11th. I went and he was happy with the movement in my ankle, telling me what I was doing was fine and encouraged me to put more weight on it. Told me my walk would improve once my degree of ankle flexion increased and so I started some stretches at his go ahead. I returned once a week to be hooked to the bone growth stimulator and a device that was to aid in releasing any scar tissue. I felt my progress a bit slow but had nothing to compare it to so I relaxed and let it come naturally. I did put the boot on and off for pain, especially if needing to be out on the uneven surface the winter snow left but I was basically home bound in the country, whilst my husband worked his long hours. I tried a stationary bicycle twice but my affected knee complained so I switched to an elliptical for 15 minutes but my foot protested. I started upper arm strengthening on my Bowflex, leg extensions and leg curls to try and strengthen my knees. I tried a couple of 30 minute walks outside but my knee ,hip and foot all complained. I read later that it could take months for my walking gait to be comfortable and my body's "proprioception" would need work and time. I ate nutritiously, protein, veggies and fruit, low carbs and sugar to try and keep my weight from climbing . Abstained from alcohol except for the odd glass of wine on Saturday evening and did not take anti inflammatories or smoke, just as the Dr ordered.

So my last Xray on February 25th indicated the healing was taking longer than expected.The Dr didn't really give me any direction( just put the boot back on if foot hurts and don't need physio)) as far as returning to work so I know it depends on how I'm doing. I was surprised , but am determined this will get better and I will get to walk, garden and enjoy my career sometime! I told work I might be back in 3 1/2 months , then 4 months and now I'm just about at the five month anniversary.
The pain gets better, then I go for a 2 hour walk in a store or down my road for a 15 minute walk and it returns, and I'm sore for the next 3 days. I want badly to go back to work but I am a nurse and on my feet for most of an 8 hour shift. I am presently waiting for Disability and Rehab benefits, but I know I can call and just say I want to come in and make a plan to help me return to work.

I hope anyone who reads this will benefit at least a little. I am a very patient person, and have learned to be even more so. Any questions or even suggestions, I shall check back on this site, even do updates.
Take care and enjoy life, no matter what comes your way!
[QUOTE=AntsyLady;5354119]I had a subtalar fusion in November 2014 for pain due to Osteoarthritis and poor alignment of heel which caused pain with walking.In case anyone is wondering what that is like I am doing this post. Everyone is different and every surgery is different so by no means should you feel you should be like me. This is supposed to be a fairly common surgery but I was unable to find much out there to help me feel like I was at least going down the right path. I seemed to be behind according to some physio protocols and I suppose that could be because I'm over 55. So here is my intro and timeline for my Recovery Phase:

I had used orthotics for about 10 years for plantar fasciitis and subsequent heel spurs. Over the years I kept going over on my ankle and pulled the peroneal tendon until it was permanently puffy and sore. Walking and working 8 hour shifts became more difficult, my active lifestyle on a decline I went to an ankle specialist along with a physiotherapist/orthotist at the same appointment. The Dr offered me the fusion because my subtalar joint was basically fused in the incorrect position which caused various muscle and tendon discomforts, while the physiotherapist offered me different orthotics as I still had a bit of movement in the joint so I opted to try this first. I had one kind of shoe prescribed (a New Balance hiker) but tired of my hot uncomfortable feet and decided to have the surgery 3 years later.

After surgery I had a Slab cast on for the first 2 weeks, then had suture removal followed by two casts to my knee and continuing non weight bearing for about 2 months. My X-ray showed everything was progressing nicely. Besides some numbness and tingling due to swelling the first two months were relatively easy. I was very diligent in keeping my foot elevated above the level of my heart in the first weeks or it would get uncomfortable. Used narcotics for pain control for the first 3 days, tapering from 2 down to 1 narcotic and then substituted over the counter meds as needed.

After 2 months the cast was replaced after the X-ray showed normal healing was taking place, so on with an Aircast Boot. I continued with non weight bearing for about another 1 and 1/2 weeks as my foot hurt quite a bit when I tried to partial weight bear. The light bulb came on and I started pain killers so my walking progressed. I was now able to do cold and warm foot baths for pain relief, ice application and kept with elevation as soon as my foot started to swell and get sore. I rested at least 30 minutes every two hours while doing my water or ice therapy, adding gentle massage of the scars to my regime. I continued to use my knee scooter for grocery shopping and gave it up just prior to my February 25th follow up. I had stopped with Tylenol by this time but found walking awkward and painful for anything longer than 20 minutes.

I got busy doing core strengthening once the air boot went on and started with passive range of motion ankle movements. My Dr said I did not need physio although everyone , including my work said I should go so I had pre-booked a few appointments with my therapist starting February 11th. I went and he was happy with the movement in my ankle, telling me what I was doing was fine and encouraged me to put more weight on it. Told me my walk would improve once my degree of ankle flexion increased and so I started some stretches at his go ahead. I returned once a week to be hooked to the bone growth stimulator and a device that was to aid in releasing any scar tissue. I felt my progress a bit slow but had nothing to compare it to so I relaxed and let it come naturally. I did put the boot on and off for pain, especially if needing to be out on the uneven surface the winter snow left but I was basically home bound in the country, whilst my husband worked his long hours. I tried a stationary bicycle twice but my affected knee complained so I switched to an elliptical for 15 minutes but my foot protested. I started upper arm strengthening on my Bowflex, leg extensions and leg curls to try and strengthen my knees. I tried a couple of 30 minute walks outside but my knee ,hip and foot all complained. I read later that it could take months for my walking gait to be comfortable and my body's "proprioception" would need work and time. I ate nutritiously, protein, veggies and fruit, low carbs and sugar to try and keep my weight from climbing . Abstained from alcohol except for the odd glass of wine on Saturday evening and did not take anti inflammatories or smoke, just as the Dr ordered.

So my last Xray on February 25th indicated the healing was taking longer than expected.The Dr didn't really give me any direction( just put the boot back on if foot hurts and don't need physio)) as far as returning to work so I know it depends on how I'm doing. I was surprised , but am determined this will get better and I will get to walk, garden and enjoy my career sometime! I told work I might be back in 3 1/2 months , then 4 months and now I'm just about at the five month anniversary.
The pain gets better, then I go for a 2 hour walk in a store or down my road for a 15 minute walk and it returns, and I'm sore for the next 3 days. I want badly to go back to work but I am a nurse and on my feet for most of an 8 hour shift. I am presently waiting for Disability and Rehab benefits, but I know I can call and just say I want to come in and make a plan to help me return to work.

I hope anyone who reads this will benefit at least a little. I am a very patient person, and have learned to be even more so. Any questions or even suggestions, I shall check back on this site, even do updates.
Take care and enjoy life, no matter what comes your way![/QUOTE]

AntsyLady:
Your recovery sounds very frustrating to say the least. I had a subtler fusion 5 yrs ago as a result of dislocating my heel when I fell in a gopher hole while walking my new puppy in my backyard. Learned I had a congenital defect called a tarsal coalition, and my heel would heal, even after wearing a cam boot for 8 weeks. Therefore, I had to have a subtler fusion. My initial recovery phase went extremely well. I was back to work in 8 weeks wearing a cam boot and did require PT to get out of the cam boot after 10 weeks. Thought all was well, but then I experienced swelling with work, and used ice and rest often to recover. My job also requires much 'on your feet time', so working became more and more difficult. Around the 5 month mark I began having pain with walking, swelling at the arch of my foot, and ended up again off my feet on crutches with ruptured tendons on both sides of my foot.
An MRI showed the screw had come out of place and my foot was unstable putting excess strain on all my tendons. Again, I had to have surgery to repair the tendons. The PTT, the tendon on the inside of the foot, had pulled itself from the bone and had to be reattached. Anyway, 2nd recovery was quite extensive and very slow, but I was back to work full-time by 5 months post-op. That was 4 years ago. Last week I had to have surgery on the same foot again as I tore 3 tendons again. The fusion has actually spontaneously fused itself after 4 years (I have worn a foot/ankle brace since last surgery). Unfortunately, I have other medical conditions which can cause tendon degeneration and this will probably not be my last surgery.
My message to you: Everyone's recovery differs depending on their personal circumstances. Although your recovery seems slow and frustrating, take it one day at a time and in the near future, life will get better. It sounds like you are doing all the right things. My doc did not send me to PT right away either, but I pushed for it. In the end, PT was extremely helpful for me. I wish you all the luck in the world. Hang in there, some things take time...
Armstead





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