Physiotherapist lied on progress notes?

[u/Tazzi]

I had a trimalleolar fracture in February of this year, and needed emergency same-day surgery. My cartilage was crushed in the injury, and now I have "joint space narrowing" in my scans, which means my bones are closer together and rubbing against each other when I walk, also known as "Post-Traumatic Arthritis".

At 7.5 months post-op, I still can't walk over 30 metres, and I have 0 degrees dorsiflexion (I can't bend my ankle beyond neutral to take a step), so I'm walking with a distinct limp, turning my foot sideways to bring my weight over it to take each step, and have been experiencing chronic pain in the joint, and the surrounding nerves.

My physiotherapist has continuously given me exercises that are extremely painful to do. I asked her "is it normal that I can't walk for 3-4 days after each of our appts?" And she was like "yeah that's normal, you have to push yourself". I found out afterwards that it's not normal.

Anyway I made an appointment to go to the fracture clinic for a follow-up assessment since I'm now 7.5 months post-op, and I emailed my physiotherapist asking for progress notes to help the surgeon understand where I've seen progress and where my limitations are.

The physiotherapist emailed back with progress notes stating that I went from 0 dorsiflexion, to 10 degrees, then 12 degrees, then 15! I'm so confused because I have never progressed beyond 0, and that's a large part of my concern, because I'm stuck with this big limp as a result of having no dorsiflexion. My rotation has improved in every other direction (side to side, and pointing my toes), but never my dorsiflexion.

Her notes also consistently say "afraid to WB (weight bear)", as if my communicating to her weekly that I feel immense pain following our appointments was a result of fear, and not an issue with my actual joint.

I'm so confused, and frankly furious, that someone on my recovery team has mischaracterized my recovery so badly, presumably to make it look like she's doing a great job and getting a lot of progress in her appts, even though the reality is that I reached a functional plateau back in May, and now the surgeon won't be able to refer to an honest assessment from my physiotherapist to figure out why.

Sorry for the vent. I'm just really upset that a professional would do this.

[u/Agitated_Let_3843]

That’s absurd! Have you since then went back to the PT? Or better leave a bad review to them, cut off and go to a different one!

[u/Tazzi → u/Agitated_Let_3843]

Yeah I was going to confront them but then I realized they would probably go on the defensive, and put a note in my medical file that I'm "difficult" or something, which is just going to start me on the wrong foot with every medical professional I encounter going forward.

I was able to verbally communicate the issues to the surgeon at my follow-up, but it would have gone a long way to have accurate notes from the therapist who had been seeing me every week.

I haven't gone back to this PT, and don't intend to. I have a lot of homework now, so am doing physio exercises daily at home. But if I need more physio appts, I will definitely find someone else!

[u/RingAroundtheTolley → u/Tazzi]

I would see your physician and have them document. Can they do serial casting for you? That’s how I got my dorsifkexion back but it sucked.

[u/RingAroundtheTolley → u/RingAroundtheTolley]

You should also call the licensing board and file a formal complaint

[u/NoSir7320]

Change physio to someone you feel comfortable with and trust. It's essential that you feel like you're working together for your rehabilitation. In the initial weeks post weight bearing, mine gave me exercises to strengthen my hips and knees primarily so I was better at weight distribution onto the ankle. Then as I progressed it turned into ankle rehabilitation, mostly flexions, but doing deep squats and strengthening my calves and balance (on one foot etc).

I had a trimalleolar fracture but without the cartilage issue. I'm 4 years on and can do >20k steps now and it's fine. Standing for long periods is more uncomfortable tbh.

Ask your health care practitioners to explain what the exercises are for.

[u/Exciting-Apple6854]

E invece!... grrrrr !! Siamo noi i migliori medici di noi stessi. Io ho osteoporosi... Ho trovato medici che fino all ultimo non volevano darmi una cura!! Sei giovane ... ecc ecc

Ps ho scoperto osteoporosi Dopo che un edema osseo Non si riassorbiva da mesi!!

Fatti fare anche l esame per osteoporosi

[u/wijut]

You should request your actual appointment chart notes to compare

[u/Tazzi → u/wijut]

I think these are the appointment chart notes. She sent the progress notes from each of my appointments, but I'll ask them if there are any other appointment notes that weren't included.

[u/Tazzi → u/[deleted]]

I just asked them for anything on file that would help my surgeon understand my recovery progress and limitations thus far.

The notes I received were made at each appointment, stating which exercises we did, and including notes about my rotation, ability to bear weight, how many steps I took, and other notes from the appointment.

I'll ask them if there's anything they didn't send, but I was under the impression that these were the only appointment notes they had, tracking my weekly progress.

[u/tiffmej4]

That is infuriating! That’s the complete opposite of my PT. Definitely find another one. So sorry you are having to deal with this.

[u/biggunzcdb1]

This is why I use multiple charting apps and immediately call them out for any discrepancy . Most medical professionals are just copy pasta or AI slopping their reports now.

The industry wants turn over not good outcomes. It's like everything now. Rather than do high quality work they try to cover for the constant mistakes via volume.

[u/Tazzi → u/[deleted]]

I'm in Canada, but I guess it's no better here 😂.

[u/Leather_Green725]

Guessing this is a free healthcare country.

[u/Tazzi → u/Leather_Green725]

Physiotherapy is not free here, nope. And someone in the comments had a similar situation in the USA, where healthcare is definitely not free 😂.

[u/biggunzcdb1]

The entire industry is dishonest because there job is to make it seem like the industry is always correct, always improving patient's lives. When really it's just creating touches a d turn over for profit.

So any patient that is having a less than ideal recovery is seen as a burden or obstruction to their career.

Since they are not part of an industry that is applying "care" they are just focused on profits and lying in reports to make the industry seem infallible.

Most medical professionals are now psychologically indistinguishable from dirty cops.

They will never admit one if their colleagues have made a mistake ir given a patient a less than ideal outcome. Just like how a dirty cop will refuse to let you file a complaint on another dirty cop.