Friday, February 4, 2011

Physical Therapy--No Pain, No Gain

I'm now 10 weeks post-surgery.  At about four weeks out, Dr. B had looked at my toe and said, "You need to start working that toe--it's going to freeze up on you."  So he showed me how to do my own physical therapy, stretching it downward at the joint at the base of the toe with my hand.  I've been trying to do this for weeks now.  When I first started, I would sit there stretching, with tears running down my face, because it hurt so bad, even on pain meds!  Poor Jon, sitting across the room from me, felt horrible.  In time, it became less painful, but not much more flexible.  Finally last week, I called Dr. B's office and asked for orders for physical therapy.  I had a feeling I didn't really know what I was doing, and also wanted to have someone else look at the fourth toe, which is still very sore (hurts with every step) and pretty swollen.
Today, because we got a snow day from school, I was finally able to make a call for a PT appointment. The receptionist said, "Can you come in now?"  Craig, the physical therapist I had seen a few years ago, happened to have an opening.  
I'm so glad I went!  When he evaluated the foot and took his measurements, it was clear I have a long way to go to restore an acceptable range of motion to my toe.  And Dr. B had only told me to flex the toe downward, but Craig pointed out that it's the upward motion (like standing on your toes) that I need in order to walk correctly, because I should be extending through and pushing off that toe with each step.  Right now, my toe doesn't even extend enough to allow for that.
So he had me do four things, all of which hurt immensely, even though I had taken a precautionary hydrocodone!  
1) Stand and lean my hands against a wall for support, then lift the heel of my foot so that the foot was positioned like standing on tiptoes (although no weight was on it, just being in that position caused lots of pain), 
2) spill a cup of marbles on the floor and pick them up with my toes and put them back in (ouch),
3) put my foot on this device he had with a spring-loaded lever, and flex my toes to pull the lever back (yep, ouch),
4) then Craig spent about 15 minutes manually stretching my toe both ways.  He got busy doing this and then started chatting with one of his regular patients who had come in and started her exercises.  So he's mashing away on my toe, pretty oblivious to my wincing and breathing, and squirming in pain (or just pretending he wasn't noticing).  When he looked back up at my face, he gave me this questioning raise of the eyebrows.  So?  I just expelled all that breath I had been holding, and said, "I can assure you I have NOT been doing any stretching of that sort at home."  I thought he was going to just go ahead and snap the toe right off, he was pushing and pulling it so hard!  It was so red when he finished that I had to take a picture for the blog.  And here's a pic of the deceptively cute little pink marbles--demons!
I'm really glad that I'm going to PT now . . . it makes me feel more confident that I'll be able to have full function of that toe when I'm done.  And I talked to my therapist about the fourth toe as well, since it is still so painful, and I showed him the one on the other foot to get his opinion about whether it had been a good idea to get it done.  He said yes, and it will eventually heal well and not bother me anymore, which was a relief to hear.