Why I Chose to Have Surgery to Cure My Foot Drop
After being in a wheelchair for 31 years I've learned a few do's and don'ts about how to sit in your wheelchair properly. If like me you use a wheelchair permanently then your body will get used to being in the same position every day so it's very important that your wheelchair is the right size and it set up properly to accommodate your posture and leg position.
The purpose of this specific blog post is to talk about how important it is to make sure that your feet are sitting properly on your foot plates. It makes me wince when I see people wheeling around with knees sticking high up in the air because they've set their footplates far too high. Alternatively, you see people with legs and feet dangling in midair because they've either got no foot plates, or the foot plates are set far too low.
When I first became disabled I would wear trainers on a regular basis. However, once I moved back home I started to leave off my shoes during the day and my feet were not being supported properly by the footplates because obviously they had been adjusted when I was wearing footwear. Because there wasn't any support my feet my feet were not sitting at or past a 90° angle like they normally would if I was wearing shoes. The Achilles tendon started to shorten and within a couple of years without me really noticing. It was only in the last couple of years that it became apparent that this form of foot drop could have contributed to some of the problems I've had with skin problems on my backside. When the Achilles tendon shortens to this extent your feet just don't sit flat on the footplate. This then makes it very difficult when you are adjusting the footplate in order for your thighs to have equal pressure with your backside on the cushion. It's very important that the pressure is spread evenly over the whole sitting surface in order to maintain the best pressure levels. As soon as you raise your legs slightly reducing contact between thigh and cushion then all of the pressure is redirected to your backside, especially the lowest prominent bones which is where pressure sores can occur. One of the problems I have experienced more than once is having a pressure sore on the underside of my right foot. I'm almost certain that this is due to the fact that my feet were resting on the ball and a lot of pressure was redirected to the bony prominence just underneath the foot behind the little toe. So this is yet another reason why it's so important for your feet to sit evenly on the footplate.
Unfortunately, my condition was far too severe for a physio to manipulate my Achilles tendon so surgery was my only option. In my case, the operation was fairly straightforward and could be carried out at day surgery. It took less than an hour for the surgeon to make three or four very small incisions which didn't even require stitches. It now means my feet sit nicely at a 90° angle and will even go past the 90° angle upwards if need be. I'm having to wear some special boots for a few weeks in order to make sure that my feet stay at a 90° angle while the Achilles tendon heals properly. I can't tell you how satisfying it is to see my feet sitting properly on the footplate. Obviously, the boots have to come off for showering and getting dressed, however, I keep them on in bed when I'm sleeping at night to make sure that the Achilles tendon has the best chance to heal properly and at the right length. Even in bed without any boots on my feet look normal which makes the operation completely worthwhile. If you're in the same position then go and see your doctor and they will discuss your options. Just remember that any operation involves a risk because they are creating open wounds. However, it's not something that even came close to stopping me from having the operation carried out. I should add that I did speak to a friend in great detail about the operation which he has also had. It's always best to get somebody else's opinion who had the operation as they can give you a detailed description of exactly what will be done and what to expect in the following weeks after the operation.
I hope that my story will hit home with anyone who is sitting in a wheelchair wearing no footwear and letting their feet dangle in midair. It's very important that you adjust your foot plates so that your feet are fully supported. Use my story as inspiration.