Happy Holidays Friends,
This Christmas marks ten years of stroke rehab for me. At ten years out, I refuse to be complacent about my recovery and to accept that I have plateaued. Praise God, I have come a long way and I continue to make significant gains even at this late stage.
My spastic hemiparesis only affects my leg and foot. Gone are the days of acute rehab when I could not use my arm and hand. I have been told that the symptoms that I experienced first will be the ones that I will overcome last. This explains why my greatest struggle remains regaining strength and range of motion in my foot. Specifically, dorsiflexion (ability to lift foot up) and eversion (ability to turn foot out) remain my greatest challenges.
This fall, I started getting ultrasound and EMG guided Botox injections in my posterior tibialis and gastrocnemius. These injections have made a positive difference for me. Although the effect of Botox wears off after several weeks, with continued hard work in physical therapy, I have made permanent gains.
A recent evaluation with a physiatrist at a prominent rehab facility revealed a diagnosis which I never received before. My loss of strength and range of motion are due as much (and perhaps more so) to a foot contracture as they are to spasticity. This news came as a surprise to me, as I have had previous consultations with many other physiatrists. Although I have likely had this contracture from the start, this is the first I have heard of it.
Apparently, there is a foot surgery which can correct this problem. I was told that a tendoachillis release and a split anterior tibialis transfer would give me improved range of motion and allow me to have better foot mechanics.
For the time being, I’m going to continue with Botox and physical therapy to see how far they can take me toward my goal of a complete recovery. I would love to hear from anyone else who has foot drop. Have you used Botox? Have you heard of surgery for releasing tendons?
May God’s peace, healing, mercy and grace be with you all.