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Physical therapy

Posted by DianaJ on 7/30/01 at hrmin (054850)

Is anyone in physical therapy after having a TT release? I am wondering what exercises it is safe and good to do. I am sure athletes don't just sit around like I am and do nothing. Any ideas - I am icing and keeping it elevated like a good girl, but would like to start some movement if it is proper to do so. HELP all you PT's out there.

Re: Physical therapy

Ed Davis, DPM on 7/30/01 at hrmin (054872)

Diana--
You asked if 'anyone' is in physical therapy after a tarsal tunnel release.
I believe that the vast majority of patients who have had tarsal tunnel surgery have physical therapy after the procedure. There is no question in my mind that recovery is significantly hastened and results enhanced by physical therapy. The surgery involves the removal of pressure from the posterior tibial nerve by releasing the tissues which compress the nerve. New tissue will surround the nerve and you want that tissue to be as free of scar tissue as possible. Scar tissue starts building up during the third week after surgery so that is a good time to start PT.
Ed

Re: Physical therapy

wendyn on 7/30/01 at 22:20 (054882)

Hi Diana - I second Dr Davis' opinion....from what I understand Physio therapy is the norm after any type of surgery like this. It's going to take a while to regain muscle mass - and start to slowly get back to normal...I'd expect you to need some guidance from the experts alont the way.

Has your doctor told you that you don't need physio?

Re: Physical therapy

DianaJ on 7/31/01 at 13:32 (054972)

Doc hasn't said it is not needed, just hasn't mentioned it - but in these days of capitation and other wonderful insurance things, I am not surprised. I will contact him and get something started. Thanks for your reply.

Re: Physical therapy

Ed Davis, DPM on 8/01/01 at hrmin (055122)

Diana--
Your comments bring up a sad but true fact. 'Capitation' is one means by which managed care limits services to patients--it gives doctors a financial incentive to do less for patients. Patients, now more than ever, need to educate themselves about their care so they can learn what care is available, appropriate and if any care is being held back. I always thought that a doctor is a 'patient advocate' in the same way that an attorney is an advocate for his client. Not true any more with managed care. That aspect of managed care, more than anything else, really makes me sick to my stomach.
Ed

Re: Physical therapy

Ed Davis, DPM on 7/30/01 at hrmin (054872)

Diana--
You asked if 'anyone' is in physical therapy after a tarsal tunnel release.
I believe that the vast majority of patients who have had tarsal tunnel surgery have physical therapy after the procedure. There is no question in my mind that recovery is significantly hastened and results enhanced by physical therapy. The surgery involves the removal of pressure from the posterior tibial nerve by releasing the tissues which compress the nerve. New tissue will surround the nerve and you want that tissue to be as free of scar tissue as possible. Scar tissue starts building up during the third week after surgery so that is a good time to start PT.
Ed

Re: Physical therapy

wendyn on 7/30/01 at 22:20 (054882)

Hi Diana - I second Dr Davis' opinion....from what I understand Physio therapy is the norm after any type of surgery like this. It's going to take a while to regain muscle mass - and start to slowly get back to normal...I'd expect you to need some guidance from the experts alont the way.

Has your doctor told you that you don't need physio?

Re: Physical therapy

DianaJ on 7/31/01 at 13:32 (054972)

Doc hasn't said it is not needed, just hasn't mentioned it - but in these days of capitation and other wonderful insurance things, I am not surprised. I will contact him and get something started. Thanks for your reply.

Re: Physical therapy

Ed Davis, DPM on 8/01/01 at hrmin (055122)

Diana--
Your comments bring up a sad but true fact. 'Capitation' is one means by which managed care limits services to patients--it gives doctors a financial incentive to do less for patients. Patients, now more than ever, need to educate themselves about their care so they can learn what care is available, appropriate and if any care is being held back. I always thought that a doctor is a 'patient advocate' in the same way that an attorney is an advocate for his client. Not true any more with managed care. That aspect of managed care, more than anything else, really makes me sick to my stomach.
Ed