Partial Achilles Tendon Injury/FCEM

[Robin2006]

Hi There,
I have a lovely patient who has really bad luck.
At the beginning of last year he suffered a partial achilles tear on the R hind. Based on what I see now (dropped hock, flexed toes) his SDF is intact, there is a small knot in the achilles just above the hock. The gastrocs is really weak.
At the end of last year, he experience an FCEM and was paralyzed (worse in the L). He is a trooper and with laser, stretches, exercises, swimming he is ambulatory. He has a mild CP deficit in the L hind and weak hamstrings.
To date, his R hind is weaker than his left but both are weak.
My question is about E stim and orthotic braces. I was thinking of a toe up shoe for his left hind and didn't know whether you think I should get an orthotic made for his achilles injury to support him while we try to get him stronger along with gastrocs e stim.
I'm new to rehab, so just wanted some advice as this is a big case but I think we can really help him. I feel like his ability to gain now is limited by his R hind.
Thanks so much
First post to the forum:)
Robin

[lehughes]

Hi Robin,

Thanks for posting!
So, my first caveat is that it's hard to be 100% of what to so without seeing the dog... but based on what you describe (R is limiting recovery, and L just has some weakness & mild CP deficits) then I would proceed as follows:

1. Look into some sort of hock support brace, and in this case, because it's a permanent issue, I'd go with one of the orthotic companies (and Hero offers a discount to FourLeg members - so that might be somewhere to start investigating!)
2. Maybe don't encumber the left foot just yet. While sticking a bootie on the foot could help with foot placement, it also diminished a certain degree of body awareness for conscious foot placement I find. So maybe hold off on that... or 'create' something using a sock or some tubing as a cheap / temporary solution (There's a video on that).
3. Realistically, there will be a ceiling as to how much better you can get his 'gastroc's strength' because of the tendon tear. So I'd focus more on the overall limb strengthening (i.e. neuro rehab / active exercises / weight bearing activities) over E-stim to the gastrocs.

I hope this helps to direct your focus with this dog! Best of luck!

Laurie

[Robin2006]

Thanks. I have made a cast impression to get a hock brace for his right leg and then start doing some strength building.
Thanks for the advice
Robin

[lehughes]

Totally welcome! Let us know how it goes!
Laurie

[KKelly]

Hello,

I have a patient with a partial achilles tear also and am wondering how you got on? Any tips would be much appreciated.

Thank you