PTT Insufficiency: almost six months post-op

Almost five months post-op

I've just returned from a seven-day business trip. Traveling wasn't too hard, though long walks through a terminal can make connections tight. I packed the removable cast, just in case, and it took a lot of space and weight. I don't think it is necessary any more.

The foot is basically pain-free. There are occasional twinges, and standing in line is a distinct pain. I often seek a chair. But work is pretty much back to normal, except for the time spent traveling to PT. The gait is a bit strained, the foot is not entirely flexible.

I had a check up (no x-ray this time) a couple of weeks ago, and physical therapy began last week. The preferred PT, Frank D'elia, is in New York, which implies a minimum three-hour overhead plus about $30 per visit. I am trying to find a local therapist that Frank can speak to an approve for me.

I hadn't been told this before, but there is a limited time a leg or foot can remain immobile before it loses the ability to recover. That time is said to be about a year. This means that the PT has got to work before then. The foot seems to be improving daily, and I am doing the exercises regularly, and in spare moments.

One exercise is simply balancing on one foot. The right foot isn't very good at this (<30 seconds), and the left is much worse. I was never good at this. Another is to rise up on tiptoe. Before surgery I could do about two or three tip-toe-ups. Now, nothing happens. So I am letting the right foot help a little while the left gets stronger. There is also a sort of toe-pointing exercise I do with a big red rubber band. As I get stronger I will graduate to other colors.

So far PT has involved ultrasound to the left PTT and stimulation of the attached muscle while I squeeze a pillow with my toes. No great discomfort here, just some moderately hard work.

I gained about 10 pounds (to 235) sitting in a chair this summer. I've lost about four of that. Apparently walking is fine, but not especially therapeutic for the foot. It will help me lose some weight.


If you are still reading this, you've read a lot. I've received more email from various people, including some new patients of Dr. Deland.

I've run into one alternative to surgery mentioned twice. It is called a "gauntlet" ankle brace, and I am told it is available from Ernesto Castro in Mesa, Az. ( One email message and one network search mentioned this. You may want to check this out: I make no recommendation here.

February: eight months post-op.

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