foot drop, AFO and shortened heel cord

During a back surgery I sustained a nerve root injury at L4, L5 and S1. That was 8 months ago. I am now in an AFO that is hinged with dorsiflexion assist since I am getting some flexion movement of my toes but no dorsiflexion at all. I did physical therapy outpatient and they terminated my treatment after there was no further progress and said that maybe down the road a few months things might be a little better and I could come back for re-evaluation. We also have an excellent inpatient rehab center but they felt I could not do enough to participate in their rigourous program at this point. I had hoped to be released at least with a cane but the therapist said a walker was necessary because I still had frequent falls. What more can I do? I am doing some excercises at home, the rest of my body is strong and pretty sculpted, but it just seems that nothing I do will make my foot work or strenthen the little flexion I have in my toes...it is very weak and even with TID work it has not become any stronger.
I am 36 with an active husband and son and the degree of impairment I have (largely do to falling) is pretty large. I have heard nerve injuries can still heal up to 18 months post injury. So I have 10 months to go. I want to be jogging and playing with my family at the beach again and I am afraid because of insurance considerations (22 visits per year of physcial therapy) that I am not going to get the aggressive work that needs to be done to give me the highest level of functioning that I will be able to achieve. Also, I the AFO, but without it my foot rolls completely in on itself all the way to the medial ankle nearly touching the floor if I am barefoot and with just a shoe and no AFO my foot violently whips out laterally to the point that it swells up and bruises...thankfully I have no feeling because it looks like it would hurt pretty darned bad. It seems to me that the AFO is allowing my ankle to become very weak so that it will not support weight. Could the AFO be a bad idea as far as ankle stability in the future is concerned.
I am under no treatment for my foot now. I was turned over to physical therapy and physical therapy has released me. The surgeon who did my back surgery is a neurosurgeon and does not deal with peripheral nerve problems (although EMG did show it was a nerve root injury at those levels) So I have no doctor...I'm not sure how that happens that a patient is released to ..no one...just herself...yikes! I do not even know what kind of doctor I would make an appointment with? Podiatrist? Neurologist? Ortho? Another PT?

Posted By JK on June 18, 2007 at 19:34:37:

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