FDL Transfer and Calcaneal Osteotomy Postoperative protocol

POST-OP DAYS 1 – 14

  • Immobilized in equinus and varus

  • Crutches – non weight bearing (NWB)

  • Active range of motion (AROM) hip and knee

  • Wiggle toes

  • Straight leg raises (SLR) x 4 directions

  • Short arc quad (SAQ)

  • Upper body exercises (seated or bench only – no pushups)

  • LE stretches – Hamstring, quads, ITB, hip flexors

  • Elevation

 

GOALS

-Pain management

-Prevent swelling

 

 

WEEKS 2 – 8

  • Short leg walking cast SLWC – Positioned more plantigrade

  • Crutches – non-weight bearing

  • Continue appropriate previous exercises

  • Isometrics x 4 directions

 

GOAL

 -Minimize atrophy

 

 

WEEKS 8 – 10

  • Cam walker – full weight bearing (FWB)

  • Continue appropriate previous exercises

  • Scar massage/mobilization with oil/cream

  • Ankle AROM – Calf pumping, alphabet, rotations 

  • Light Theraband ex x 4

  • Towel crunches and side-to-side

  • Steamboats (Theraband x 4 while standing on involved LE) in cam walker

  • Mini-squats, Wall squats, Total gym

  • Proprioception ex – Double leg BAPS

  • Gastroc/Soleus stretching

 

GOALS

-Full DF / PF

-No adhesions

 

 

WEEKS 10 – 16

  • Transition from cam walker to ankle brace

  • Continue appropriate previous and following exercises without brace

  • Strengthening ex, emphasize medial ankle mm

– Theraband with increasing resistance

– Elgin

  • Double leg heel raises – emphasize involved side

  • Leg press, knee ext, Hamstring curl, hip weight machines

  • Forward, retro and lateral step downs

  • Proprioception ex – single leg BAPS, ball toss, body blade

  • Stationary bike

  • Pool therapy

 

GOALS

-Normal gait

-Symmetrical ROM

 

 

MONTHS 4 – 6

    • Continue ankle brace and appropriate previous exercises

    • Single leg heel raises

    • Fitter, slide board

    • Treadmill – Walking progression program

    • Elliptical trainer

    • Stairmaster 

 

GOALS

-Normal strength

-Walk 2 miles at 15 min/mile pace

 

 

 

MONTHS 6 – 9

  • D/C brace

  • Continue appropriate previous exercises

  • Pushup progression

  • Sit-up progression

  • Treadmill – Running progression program

  • Agility drills / Plyometrics

  • Transition to home / gym program

 

GOAL

-Return to all activities

 

 

*NO CONTACT SPORTS UNTIL 9 MONTHS POST-OP*