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Sunday, July 10, 2011

Email Activity Followup: An Excellent Method in Helping to Treat Some Injuries

Joe had severely injured both feet several years ago. For 2 years he hardly walked, and this is when I first met him. He had injured his big toe joints and walked on the heels only of MBT shoes. It was a fantastic adaptation of this shoe. First thing I needed to do was to see if he could begin to walk on his full foot. This took many months to accomplish. It was also hard to wrap my fingers around his problem with our monthly followup visits. The monthly ups and downs of his pain levels based on what he did was hard to follow. So, March of this year, I had Joe email me a activity report based on the standard pain level . I will have a post just on the pain scale. It is based on a scale of pain from 0 to 10. As Joe began to walk, stand, bike, etc I wanted to follow his pain to understand it better. I told him we want to keep him in the 0-2 good pain area, but occasionally drifting to 3 or 4 is okay. Joe had kept his pain level between 0 and 1 for 2 years by not walking, but his muscles and bones were atrophing terribly. The golden rule of foot is if it takes 2 years to heal something, it will take 2 more years to rebuild the strength. I knew Joe and I had a long haul together. We had to do it right. This daily activity log with pain level during really keeps us honest and on the right course. EOD stands for End of Day. PL stands for Pain Level.

This is what Joe sends me and I respond only when I think necessary.

July 1 Walking 45 min Standing 40 min PL1-2 Biking 50 min PL1-2 EOD PL: 2-3

July 2 Walking 40 min Standing 25 min PL 1-2 Biking 25 min PL1-2 EOD PL: 3

July 3 Walking 15 min Standing 30 min PL: 1-2 EOD PL: 1-2

July 4 Walking 1 hr Standing 3.5 hrs PL: 2 Biking 45 min PL: 0-1 EOD PL: 3-4

Here I sent Joe an email to increase his icing and decrease his activity.
July 5 Walking 30 min Standing 1 hr PL: 2 Biking 45 min PL: 0-1 EOD PL: 3

July 6 Walking 25 min Standing 40 min PL: 1-2 Biking 35 min PL:0-1 EOD PL: 1-2

July 7 Birks Walk: 25 Standing: 35 PL: 1-2 Keens Walk: 5 Stand: 5 PL: 1 Biking 45 min PL: 0-1 EOD PL: 1-2

Joe has been walking in Birkenstock sandals without bending his foot to push off the ground. We are introducing Keen enclosed shoes as a step forward towards normalcy. Joe awaits some new tests to see how he is doing. I am ordering a new MRI (last one 6 months ago) and a bone scan. Yet, I think the activity and pain scale log may be giving us a great picture of how well he his doing.

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Thank you very much for leaving a comment. Due to my time restraints, some comments may not be answered.I will answer questions that I feel will help the community as a whole.. I can only answer medical questions in a general form. No specific answers can be given. Please consult a podiatrist, therapist, orthopedist, or sports medicine physician in your area for specific questions.