Drop foot & neuropathy

Bones, joints and muscles
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    I was hit head on by a drunk driver in 1988 and had to have a total hip replacement and steel plate put in my pelvis. I had that replacement for 26 years and it wore through the plastic insert and the bone got diseased around the pelvis and one day the whole joint and pelvis broke and went up inside my pelvic cavity. I walked on crutches for several months while a search was on for an orthopedic surgeon that could patch me back together because the original surgeon who did me was retired.

​      So at 53 years old I had my second replacement with a tri-flange joint that wires to the outside edge of the pelvis. I told the surgeon my only request is that you get my bad leg the same length as my good leg because I live to be barefoot all the time. Well after he stretched my leg back out 1 1/2 inches I now have a paralyzed foot and ankle. It's been over a year since surgery. Had a month and a half of physical therapy in the beginning. I have to take massive doses of neurotin and had to be fitted for a AFO brace to be able to walk. I walked for so many years with old replacement with a crooked pelvis, I am now level and it is pinching nerves on my right side. I have 4 lumbar prolapsed discs and right leg (good leg) is going numb. So now they are scheduling me for a BurstDR stimulator to shock the nerves on my spine to deaden the pain. I was active, but now I'm not and really at a loss as to what to do. Trying to wean myself down for 3 doses a day of 1200mg neurotin. I can push down with my foot but can't lift it and have no muscle movement on outside of leg from knee down,  so without a cane I can easily get overcentered and fall to the left. I have trouble sleeping. Can't lay on my back or sides and could never sleep on my stomach, but Dr prescribed sleeping pills leave me groggy. It's been 14 months and I'm getting depressed and don't know what to do to help my situation. I feel I need more physical therapy with foot and ankle but insurance won't pay for that anymore and with only wife working now and medical bills rolling in. I can't afford 3rd party physical therapy. Gonna try to get back to bicycle riding to try and strengthen that ankle. Feet and toes swell and the color of foot is different from my good one and toes are starting to look a little deformed from always pushing down. Oh the foot cramps in the arch of the foot. The leg right above the ankle looks like skin over bone with not much muscle. Can't walk without the brace, but the brace causes alot of swelling. So what can I do? I can't give up, but it sure is tough!

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Hop for the best for you I have a ? You suit the person ?

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Hi Lonnie

i am guessing  you hale from America,  where your health service is different to UK s.  I too had a similar experience in so much as had an accident, broke femur,  had to have a full hip replacement during which in the operation the perineotal nerves  on both sides of my left leg below the knee was severely damaged. The difference  is I was in Spain at the time where  physiotherapy is so much cheaper, so I stayed here and had daily physio Monday to Friday for five months. This journey took  me from paralysis and only the slightest movement in one tone to eventually walking again after  five months with a cane.  Have you taken any form  of exercise for your legs toes and foot in the last 14 months? Perhaps if you answer to see if there are still a few similarities I can give you some idea of the exercises you can do. I to wore a foot brace 24 / 7 for seven weeks and I hated it every minute of the day however I found with the physio, exercises, I finally found my foot stopped dropping. Wait To hear from you and I will reply

Regards Dot

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Hi Lonnie, your story and outcome sounds worse than mine, I too had an accident a year ago next week, I fractured hip and pelvis and didn't have surgery due to site of pelvic fracture and because hip fracture was/is impacted, I chose the conservative route, you couldn't have had that option due to possible internal bleeding/damage.

I too can only walk with crutches because I'm shorter on injured left side than right side.

1.5 inches, does make walking difficult even with crutches, don't know that it has any bearing on the pain though.

I do physio once a fortnight now and hydro twice weekly, it helps build muscle tone which had atrophied badly, 50% improvements, cycling is excellent and pushing, so laying on bed and pushing wall or wife LOL

My heart goes out to you, whatever people say about UK health service I would disagree, without there continued support I would still be bed/chair bound.

Any advice is freely given even if I have to pick my physio brain for you

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Dear Lonnie

How absolutely horrible for you. Have you considered swimming for exercise?

Best wishes Richard

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Hello Dorothy. Thank you for your reply. After the replacement I left the hospital and went directly to a rehab center with intense physical therapy 3 times a day for a week. Then I went home on a walker and had outpatient physical therapy 3 times a week for around 6 weeks. Then at that point the insurance wouldn't pay for any more therapy and it would have cost around $1000 out of pocket per week to continue, so I had to stop. After around 10 months the doctor sent me to be fitted for a custom AFO foot drop brace. From that point it has been 7 months more for a total of 14 months after surgery. Up to this point I could push down with my foot and even the toes wiggle a little towards the floor and return to the neutral position. I have gained the ability to twist my foot in but nothing on the outside edge.Just in the past 2 weeks I am able to ever so slightly twitch my foot up from the neur\tral position, so I sit and work on increasing that, but I have no lifting of the toes. The doctor says it could take up to 2 years, so 10 more months of that time frame. But I think I need physical therapy right now to capitalize on the slight foot lift. But there are 2 things against me right now. One the insurance will not pay for anymore physical therapy.  Second I am going for outpatient surgery in about 2 weeks to have a Burstor stimulator implanted on my back for lumbar prolapsed discs that is causing my good leg to go numb. So I guess I'm gonna be delayed a few months. I stay as active as possible. I mow 2 acres of yard which alot of is hillside. I weed eat, trim and cut trees, work on cars on the side. I do electrician work and I play full time in a band. On top of that the doctor released me to do low impact activities so I have just began bicycle riding which is a passion of mine. So I am not a couch potato. My first week home I rebuilt the engine in my Smart car sitting on a roll around stool. But I just wonder what specific things I should be doing to work on and stimulate my slight lifting of the foot and trying to stimulate those toes to lift. Thanks.

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Thank you Alexandria for your reply. Certainly most people would think the less obvious your body damage is, the less you should hurt, but we that are going through it know better. I am glad that you were able to ressurect your muscles that are atrophied. That is my biggest worry from the knee down. The calf muscle is working and fine, but the rest is shrunken badly. So trying to lift foot more than a twitch and getting my toes to lift is my problem now. Little toe seems to move the most and the big toe barely twitches. I am glad to hear that atropihied muscles can be restored. The neuropathy feels like I have a weight pressing down on my burning foot. Neurotin helps but it takes huge doses to abate the feeling. It's evening now and after a busy day it is driving me nuts.

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When I was a kid I was a horrible swimmer, but I was able to float on my back. When I had my first hip replacement and steel plates on my pelvis back in 1988, I found that it changed my buoyancy and I could no longer float in a relaxed state.I always end up sinking at my waistline. So I gave up on trying to swim years ago. Bathtub only. LOL.

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Hi Lonnie

 

It was explained to me that the nerves grow at approx. one inch per month, measuring from the base of my spine to my ankle and then round the ankle again (!) would mean 2 years possibly before it would start to work again, partially work again, or give up at that point.

 

You do need the help of a good physiotherapist, without doubt, but in the meantime, some of the exercises I was given were to be carried out three times a day, three repititions of 10 each time, and I still do them but not so regularly.  All you need is one of those long elastic bands that look like 3” wide ribbons, wrap it once round your foot, then holding both ends in your hand and sitting on a bed, pull your toes and foot towards you and then try to push them back.

Measure your success with your good foot, see how far it bends towards you and then bends back to where your toes almost curl under your foot.  (do not wear brace while doing these)

 

Still using the band (until you have the strength to do this yourself) turn your foot slightly left and pull again towards you, then turn your foot slightly right and pull again towards you, then (use your good foot to illustrate what you are trying to do with the bad foot) slightly twist your foot at a greater angle and pull your foot towards you and again with a right movement.

Then try to swivel your whole foot in a circle from the ankle, then swivel it the opposite way in a circle.  Then placing two feet together, without the band, move your feet to the left as far as possible and then to the right as far as possible, the aim is to touch the bed with your left side of foot and as you move to the right touching the bed on the right. (I do not mean move the whole leg, just the feet/foot)  Every movement 10 x 3, three times a day.

 

Then standing up – in a confined area – so you do not fall.  Holding on to something (I have a galley kitchen and stand between work surfaces, holding on to one surface, but if I fall, I just hit the other side first.  Anyway, stand on tiptoe (even now it is my good foot that supports the weight) and do this 3 x 10.  Then go back on your heels holding your weight (this is the one that can unbalance you) just as far as you tiptoed up, then you lean back purely on your heels.

 

Then start to try to stand, balanced on your bad foot, bend your bad knee slightly and try holding on to transfer all weight to bad foot and hold for a few seconds.  As you strengthen increase this time but do not hold for more than 5 seconds.   Is your hamstring weak, then look up on the internet for exercises for hamstring, that muscle running down the back of your leg operates every muscle and that is the one to first go and cause weakness throughout.

My physio even after a year tell’s me I have a dolls leg – no real muscle – but cycling will help you.  Also you must concentrate on butt clenches – to strengthn the core of muscles round your pelvic girdle, again check out you tube for those exercises.

 

Also do not forget you must work through the pain but if it is too bad, then there is no harm in concentrating on getting back use as opposed to how much pain killers you take.  Pain is your worst enemy to beat this so try to mitigate the pain with the assistance of your Doctor.

Pity you are not in Spain where I could introduce you to Encarnie my physio.  Hope this helps.  Regards Dot

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Hi Lonnie. Any type of hydro would be great. Walking in the pool. No brace. Hold the pool side at first. Weightless. Get blood flowing. Help cramps. Lol the list goes on. Give it a try. You don't need to swim. Even do yr physio in the pool.

Good luck.

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Thank you Denise for your reply. You have given me good advice.

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Thank you Dorothy. I appreciate your guidance. I will try the exercises as you described and I will report back to you about my progress.