Hey everyone, 5.5 months post op here.
Regarding ballerina: After the distraction phase, I was super super tight. Every day during the end would be torture for my inner knee muscles if I kept them in an extended position. It quickly went away within a week after I had time to rest. My muscles were incredibly tight then, but are considerably less now, though still tight nonetheless. That was about 2.5 months ago. Today, when I stand up, my knees are still bent slightly, and my heels dont touch the ground. However, I was worse off before. I have gotten to a point where I can stand up and walk a bit, even though its a balancing act without proper heel placement on the ground. I can still get to the fridge if I have to. It's a different story if I have shoes on with a little bit of heel. I am much more centered. I'm going to give it a few months, I'm hoping two, and I'm sure it will resolve. -Side Note- Some people do not get ballerina, and they are not even using stryde. It depends on your anatomy. I suppose I was starting out with shorter and/or less flexible tibias? Although, I remember being able to flex 40 degrees before the surgery (highest setting on slant board).
Regarding Walking: About 6 weeks ago, I was just really making my first few unaided penguin steps. It felt dangerous to walk. Always kept assistive devices near. Lifts on. About three weeks ago, I would still have some heels on, ballerina was resolving more and more, and I could walk few short distances around the house before collapsing on my bed. My legs would get sore after every time I walked. Two weeks ago, I took my shoes & no additional heels, and walked to the park and back. I could barely walk on the way home. Soreness after the walk for 30 mins usually. A day later, I was determined to try jogging. BAD IDEA. Not only is it dangerous, the nail could break, and I could lose that height forever, as well as additional surgery, but it was PAINFUL on and off up until today. Throughout the past two weeks, my attempt to jog has created intense & reoccurring pain, mostly from swelling and inflammation it seems. It was a shin splint, I thought, and so much so I thought it could have been a stress fracture. The pain baffled my physical therapist. I went to my ortho doc in the states and an x-ray thankfully showed no signs of fracture. This leads me to my next point.
Regarding Pain: For the entirety of my post op phase, I was prescribed Tramadol, lyrica, and paracetamol. Perhaps they worked in the beginning, but towards the end, I feel as though the drugs provided little to no pain relief. Tramadol is a mild opioid, but its effects are varying. It doesn't works on your nervous system to block signals of pain, but it is a wild card and often is reported not to work. When I got off Lyrica, I didn't feel any different. When I took 1000mg of paracetamol, I didn't experience any pain relief. These are my experiences, though. I am told my Dr. Giotikas that I have more receptive pain receptors, and more pain in general. What won't work for me could work for you. I had a friend who reported Tramadol didn't work for him after a while. Dr. Giotikas does not advocate for NSAIDs such as ibuprofen. These drugs work to inhibit the actual inflammation, not just the signals of pain to your brain. The thing is, I've always suspected they help. My ortho doc here advised 800mg max a day. I tried one 200mg, and WOW I felt better. I discontinued it soon after, at the advice of Dr. G. Just yesterday though, was the height of my pain after running two weeks prior. I had such high pain I opted to go to the ER to get immediate pain relief, and an X-ray to see if weight bearing should stop due to a potential fracture. X-ray was clear, and they prescribed me hydrocodone. It's more potent that Tramadol. It didn't work for my pain that hurt with every pulse. Out of desperation I took an NSAID, and it provided such amazing relief, just a 200mg ibuprofen. I contacted Dr. Assayag who posts on this forum. He wrote to me that his mentor (Rozbruch) concluded in a 2020 study that out of 155 LL patients, NSAIDS did not negatively impact bone healing after osteotomy. It decreased opioid consumption, and funny enough, their understanding is that opiods have you worse off in regards to bone healing. In addition, he is right when he says that a combination of paracetamol and ibuprofen provides me the necessary pain relief to allow me to weight bear more (or at all)! This leads me to give you my unprofessional opinion that, NSAIDs w/ acetaminophen do the trick. Had I had that from the beginning, I don't think I would have needed anything else. NSAIDs are a life saver, and the only thing saving me from a ton of pain today, in fact I have virtually none at rest and aches are down to a minimum. I absolutely do NOT advise you to take my recommendation. Speak to your doctor. I'm sure Dr. Giotikas does not approve and it is not in my area as a patient to recommend to him to update his lit review. I do not know what he knows as a physician, and I do not know what his experience has yielded him in terms of recommendations. Side note: After distraction, I went months without taking any pain meds. It was more so just stretching and tightness that I had to fight than anything. This late in the game, the use of NSAIDs were simply to combat this inflammation from a silly attempt to jog early on. And aside from using meds to combat the aches after longer and longer period of walking, which happens as soon as your heels touch the ground, I don't typically need meds anymore, and haven't for a while. If you're one of the people who didn't have ballerina, you will likely not need pain meds for long because you will always have been walking more frequently from the start. When I build up a tolerance to walking normally, the aches will go away and meds won't be needed as much. It is only in this period that I seem to take them. Just wanted to add that to let you know that most of the time you won't be experiencing pain.
Regarding stretching: Slant board as much as possible in a strict routine. And for me, it simply takes time.
5.5 months later, I ran into hiccups very recently with pain. But as of yesterday, it was miraculously controlled with the right meds. I can walk short distances with tightness and a knee bend, but I can walk. I can pick stuff up off the ground. I can slowly get down the stairs, but faster coming up (no side-rail). In the next coming weeks, I will walk more and more. I foresee an exponential climb from this point on. I don't see much of a barrier anymore. Finally, this is not easy. If you plan to not tell anyone about this procedure, expect to wait half a year like me to get to this point. My thoughts of being great to walk around April/May were wrong indeed. Or not. You could be above average in terms of everything - from flexibility to pain tolerance. As a now 24 year old, I was below to slightly below average in the above. I would go as far as to say, this is one of the longer recoveries you'll find, one that is not yet resolved completely, but with hope for the future in terms of proper proportion, alignment, and tight yet progressing dorsiflexion ability. There will be bad days. It is so important to have friends and speak on the phone and be a human, while you hide your recovery, sometimes in isolation. Don't be fooled - there are bad days filled with boredom, physical, social, and mental pain. On days you feel bad, you don't end up posting on this forum. Don't be fooled at seemingly perfect threads that don't touch upon the struggle. When I'm standing without effort and run fast, only then, I can tell you it was worth it. This is only worth it if you get a recovery of 95% or more. I am very happy with the proportions, and I haven't been outside much to experience the height difference, so I haven't even gotten to experience the joy just yet. A lot of excitement in the future. I feel I am at the cusp of beginning my life again after this period of stagnation, and it feels great. Will update soon, and feel free to message me with any questions.