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Rehabilitation

Rehab After Triple Arthrodesis

03/02/2011

Question:

I had triple arthrodesis in June. Was laid up for 9 weeks, in a cast, with foot propped up on pillows. Had several casts during that time. After the final cast was removed I had developed 2 wounds on the foot. The surgery was performed in Maine, while we were on vacation up there. We then drove back to Florida ( where we live), and I was under the care of a wound specialist down here.
 
This delayed my rehab on walking, because of where the wounds were located. During the weeks of wound healing I walked around with an aircast boot. At the end of January, the wounds were finally healed, did away with the boot, and am now walking a little. Some days, the pain is bad. Am trying not to depend on pain killers, but some days, I have to take something. My doctor is in Maine and I was never assigned any physical therapy, except to be told to walk every day (heel-toe). I do treadmill about 15 min. a day, and my question is this - when I`m sitting down, is it okay to move my foot in a circular motion, do the alphabet with my foot, do strengthening exercises on my leg, etc. What are the proper exercises following surgery of this magnitude? Would appreciate an answer and thank you for your response.

Answer:

This is a great question and I am glad you are taking a proactive position in your own care. We all need to move our joints every day and we would stiffen up to the point of not being able to move if we didn?t. This is why you were stiff after coming out of the cast and why your rehabilitation has been delayed due to the continued immobilization caused by your wound care. One of the big reasons that we swell so much when our lower extremities are immobilized is that the major mechanism we have for bringing blood and fluids back to the heart is through the action of the deep muscles in the calf and thigh.

Most airlines have illustrations in their flight magazines showing you how to exercise on route. It only stands to reason that continuing that active motion while resting, reading or watching TV is a good idea. It will do no harm and may help to improve your function. This is especially true before you get out of bed in the morning. A few simple stretches as you described will loosen your joints from the night immobility and may help improve your function. Certainly the type of gentle exercise you described (writing the alphabet with your foot) might be beneficial and I would also recommend talking with a physical therapist who specialized in lower extremity rehabilitation for muscle strengthening work specific to your needs.

Jeffrey M. Robbins, DPM

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Response by:

Jeffrey M Robbins, DPM Jeffrey M Robbins, DPM
Clinical Assistant Professor of Surgery
School of Medicine
Case Western Reserve University