Rehabilitation program helps in quick recovery, reduces pain, promotes movement of the stiff muscles at injured site, restores normal function of the injured site, and prevents recurring damage to the injured tissue. It is aimed at restoring the physical, sensory, intellectual and psychological function of the patient. Rehabilitation procedures are performed by a multidisciplinary team that comprises of physical therapists, orthopedic physicians/surgeons, athletic trainers, and massage therapists.
Indications include big toe fusions, hammer toe corrections, Morton's neuroma excision & sesamoid excision. Allows a very stiff sole to prevent unwanted post operative foot movements limiting pain & improving mobility post operatively. Frequently used for 6 to 8 weeks. Not required to be worn in bed but usually at all other times when weight bearing.
The heel weight-bearing post-operative shoe ( www.darcointernational.com/orthowedge ) This link includes a video of how to use the show which you should practice pre-operatively.
Indications will include bunion correction surgeries where the alternative is to use a plaster cast but where with current internal fixation techniques & forefoot offloading, this can be avoided allowing the wearer to regain movement in the big toe post op early & so minimise stiffness post op. Also allows wound surveillence and cryotherapy (ice) to be applied to minimise swelling. Used for 6 to 8 weeks post op. Is NOT required to be worn in bed but is at all times when weightbearing. May be used without crutches if able. Please note that a single shoe will make you very lopsided!
Indications post operatively are mainly in step-down immobilisation after a cast has been removed to allow the transition from complete immobility all the time to freedom of movement in a stepwise manner. It allows protection during the early days of mobilisation in the recovery phases post op, whilst being removable to allow rehab physio, cryotherapy (ice) and activities such as washing, showering & dressing to be undertaken more easily. Does NOT have to be worn in bed. Generally it is worn most of the time initally when weightbearing but used progressively less frequently as the patient becomes both more confident & comfortable out of the boot. The suggestion is that it be removed at home & in familiar circumstances & for short walks first before being too adventurous & removing it for longer walks before you are ready.
Indications post op include step down immobiliastion after ligament & tendon reconstruction in the ankle, usually after the removal of the moonboot. By this stage in rehabilitation, the patient has regained ankle dorsiflexion & plantarflexion (up & down movement) but remains weak in inversion & eversion stability & proprioception (balance). The brace can be worn inside normal footwear and provide additional support whilst regaining confidence to transition from significant immobilisation to complete freedon - occasionally with the addition of taping techniques such as zinc oxide tape or Kinesio tape. Usually worn for 6 weeks. Does NOT have to be worn in bed & is removed for washing & showering. The plan is to allow the wearer to remove the brace in a stepwise manner as they gain more confidence such that by 6 weeks after they were instructed to first use the brace, they are out of it full time. As with the moonboot, initially the brace should be removed whilst in familiar circumstances such as home and for shorted walks gradually building up exercise tolerance.
Indications after knee reconstructive surgery usually where additional limitation of range of motion is required to support the healing & protection of reconstructed structures such as meniscal (cartilage) repairs and patellar stabilisation operations. Not used routinely for ACL reconstruction unless combined with either meniscal repair or additional ligament reconstruction. Will typically be worn for 4 to 6 weeks & be used with crutches to limit weightbearing. May be removed in bed & when not weightbearing to facilitate cryotherapy (ice) but should be used at all times when up and about or weightbearing.
Non-Weightbearing Patients
For those non-weightbearing post op patients, the use of a device like this can make life a lot easier.
It allows you to be mobile without having the worry of having to balance on crutches or the inconvenience & size of a wheelchair. It allows patients to be independent without requiring the assistance of others for mobility.
The knee scooter is hired on a daily or weekly basis & can be delivered for a fee negotiated with the suppliers
There are other suppliers around if you wish to "shop around".
Click on the thumbnail for enlarged image
Rehabilitation Exercises for Insertional Achilles Tendonopathy
