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Rehabilitation

Recovery after triple arthrodesis

02/24/2009

Question:

I am 60 years old. I had triple arthrodesis and tendon repair of my right foot eight months ago. From several months in a succession of casts and walking boots, my right calf muscle atrophied to about half its normal size. I had PT but it was terminated 2 weeks early because of a scheduling conflict. I am trying to keep exercising on my own, but the muscle is still much smaller than its counterpart on my left leg and I can`t walk normally (unable to push off with toes of right foot). How long does it usually take to recover full muscle size and strength? How often and how strenuously should I exercise the muscle? Also, my toes are still "pudgy-looking" and curled under. The DPM said the middle one might never straighten out, but the others should. How do I encourage that? Thanks.

Answer:

It takes a very long time to make a muscle bigger. It can take a couple of years.  Normal activities help but so do the right exercises.  Your previous therapist should have shown you exercises to develop calf muscle strength.  You should keep doing them and continuing to progress the repetition and speed. Usually three times a week is enough because you need some recovery time.  You should push the muscle to fatigue.  If it does not get tired or sore from exercise, it is not getting stronger or bigger.

Getting the toes to straighten out can also take time.  Try straightening them out every night with your hands to stretch them for as long as you can commit. (Most people might go 2-5 minutes.)  Also make sure the toe box of your shoe leaves lots of room for your toes and that your shoe is long enough.

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Response by:

Tammy S Wadsworth, PT MS OCS Tammy S Wadsworth, PT MS OCS
Sports Medicine Team Member
Clinical Instructor at The School of Allied Medical Professions
College of Medicine
The Ohio State University