I am experiencing numbness in my foot and ankle following surgery for sciatic nerve decompression, hamstring repair and hip labral repair and revision. All this repair has impacted my entire leg, which I never had a problem with. I was recently told my Achilles might be the problem and might require lengthening.
I'm challenged to find two docs who agree on a diagnosis and next steps to get me back walking more than 1/4 mile w/o a need for crutches and w/o pain, numbness, swelling and discoloration.
Any recommendations for a foot/ankle orthoped. in NY?
In my experience Achilles Tendon lengthening surgery on the long term is not a good option. As you are doing get second and third opinion on whether this elective surgery is a good option. If you have not already done so, explore a Ankle Foot Orthosis. A smart PT can help you figure out if there are non surgical options. Go to Find a PT. An friend of mine who is an Orthopedic Surgeon say "going to a Orthopedic Surgeon is like a chicken going to Colonel Sanders.
Damien Howell PT, DPT, OCS
AGREED on all fronts. Ive been to and left six PTs since I had these two surgeries. All haven't understood the procedures I had and several were completely unprofessional. I wont elaborate, but use your imagination. I did recently find a quality and knowledgable PT who I am happy with. I have an AFO brace for the 'foot drop;' problem is it is causing havoc on my knee and hip, and Im now told it might not actually be a tru foot drop. I was also told that the brace is freezing up my ankle so the muscles there wont have a chance to start working. (Ive been on crutches 8 months this year.)
I think surgeons feel pressured to view multiple surgeries as more efficient (as if these were car repairs), but it removes experimental controls and makes troubleshooting complications much more difficult. I hope a nerve has not been inadvertently cut, but assuming you are neurologically sound, muscles respond to surgical trauma in neighboring tissue even when not incised and systemic anesthesia has been administered. All calf muscles, particularly Tib. A. and antagonists, should be trigger-pointed to ensure the foot drop is not due to unresponsive muscle tissue or common neuromuscular dysfunction. There may also be residual inflammation near the deep fibular nerve or contributing branches such as the peroneal.
Even if nerves are cut or traumatized, all is not necessarily lost. Some research into post-sciatic injury reinnervation prognosis to follow up on...
Regarding the achilles I agree with Damien. Have the surgeons considered tonus of the Gastroc and/or Soleus instead of the achilles they tension? I would put my money on evaluating and regulating tonus in these muscles before messing with the achilles. The dosiflexors are always at a disadvantage in such a scenario and can fatigue to the level you describe..
Message was edited by: James Johnson LMT
The first time I got out of bed post-op in the hospital, I had no dorsiflexion. I did, however, have alodynia in my foot, calf and ankle, and numbness from hip to foot. I've been working my foot/ankle a lot in PT from the get-go and no change in six months to the 'foot drop.' My EMG this week shows some mild improvement in terms of axonal regeneration, which is good, but the pain remains the same...it's just awful and is really ruining me. I'm pushing myself to get stronger being ever so mindful not to irriatte the nerve w/ hammstring rehab work. My hip is still a major pain in the a-s and continues to grind when I climb stairs, and snap when I sit. I can get it to only 90 degrees flexion so far w/o pain.
I will ask my OS when I next see him about your nsight about the achilles, which I so very much appreciate!!!
I hope their follow-up procedures are good enough to rule out surgical complications. Certainly, the consistent demand from the PT is key to regeneration, though painful. Please stick it out; Rome wasn't built in a day.
I'm going to hazard an optimistic guess that the Sciatic surgery was such that it gets worse before it gets better. At least we have the first part down. You'll have developed one helluva pain threshold when all this blows over!
Best of luck.. Your body is going to require time to completely heal, no matter what.. but don't give up hope. Resignation is the first step to failure. At the same time, find a way to distract yourself from the pain. Take the time to browse this site on the subject by Dr. Jonathan Kuttner, which explores the mind-body and muscular connections to pain.