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1617 Views 5 Replies Latest reply: Jul 28, 2012 7:33 AM by JamesJohnsonLMT RSS
NYhipster Amateur 8 posts since
May 26, 2011
Currently Being Moderated

Jul 23, 2012 7:44 PM

Foot drop/no ankle reflex post op

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? 

  • Damien Howell Legend 312 posts since
    Feb 27, 2008
    Currently Being Moderated
    1. Jul 24, 2012 6:59 AM (in response to NYhipster)
    Foot drop/no ankle reflex post op

    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

  • JamesJohnsonLMT Legend 1,160 posts since
    Aug 23, 2009
    Currently Being Moderated
    3. Jul 27, 2012 12:37 PM (in response to NYhipster)
    Re: Foot drop/no ankle reflex post op

    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

  • JamesJohnsonLMT Legend 1,160 posts since
    Aug 23, 2009
    Currently Being Moderated
    5. Jul 28, 2012 7:33 AM (in response to NYhipster)
    Re: Foot drop/no ankle reflex post op

    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.

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