1-Week Post-Ankle Surgery: When will I be able to lower my leg without massive swelling and pain??

Foot care
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I (34 yrs old) am now 9 days post-ORIF surgery on my left ankle (plate/screws for spiral fracture and repair of torn ligaments) for a Weber C fracture/dislocation (surgery was one week post-injury). I now have a splint-type cast and go back to the surgeon for my first follow up next week (2 weeks post-op) and will be in a removable cast for 4 weeks, and then in a boot. I am non-weight bearing until I am in the boot.

I have been off pain meds for several days now and have minimal pain when my leg is elevated. When I put my leg down to get up to use the bathroom and shower, etc, my leg and ankle immediately swell from what seems like blood/fluid going down there by gravity. Putting my leg down results in almost unbearable pain within seconds, and is only relieved by elevating the leg again.

My question for those who have gone through similar ankle procedures is: how long should I expect until I will be able to be upright without this massive pain from lowering my leg?

I am not able to use my knee scooter yet and am now in bed with leg elevated 99% of the time because of this. I know that once this stops (or at least the pain is reduced) I can be more mobile and upright, which will certainly lift my spirits. Any advice folks can give based on similar experiences would be most appreciated.

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Hello Andrew

My heart goes out to you , on this!

It is a long journal ahead, to be honest with you.

The pain, may not be better, until the cast comes off. Keep taking your meds!! .they help alot. Keep it

Elevated as much as you can. I have to still keep

Mine elevated every day! You can read my story

I listed here, for advise and help! I'm still trying to get well. It's been now 16 months for me. I hope you get better soon! Thank you Veronica 34189

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Keep elevating Andrew you are early days. Crutical for a few weeks. Even when you get your boot this will be ongoing until the foot adjusts to healing and new normal -  you are young you will heal well I suspect. Do what your surgeon tells you at two week checkup. Bones still healing and not out of the water until re- crated to see how bones are knitting at six weeks usually. I'm much older that you but had same injury basically as you. Take good care....

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That's re- X-ray to see how bones are healing......

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I think it probably took about six weeks for the blueness and pain to disappear when standing. I hope yours is quicker, I don't think everyone gets it, but it is extremely painful.

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Hi Andrew,

I'm 5 and half weeks post op ankle surgery on both of my ankles. I've got my 6 week check up this Wednesday and hopefully should be in boots from then on.

I do keep my legs elevates 75% of the time but I have found that once the swelling goes down. As the weeks have past that I have been able to lower my legs and the pain isn't as bad. I haven't been taking any pain relief for the past few weeks. Which has allowed me to start doing seated work out and has help when I've been going out the house for a few hours.

The only think have had problems with casts were they have been rubbing on my heels, from where I've been keeping my feet elevated. I was advised by the nurse to keep my heels free from resting on anything and place a cushion behide my heels.

I hope this is some help.

Thanks Gemma

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Sheepskin insoles in boot help so much with comfort & rubbing......

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Hi Andrew, I broke my ankle (tibia and fibula) in February, had orif surgery in March ( plates and screws) . I think is important to rest your leg as much as possible the first two weeks after surgery. Don't try placing any weight on it. After they remove the staples the leg should feel better. The swelling will last a long time. I am walking without any aid now, and even now the ankle swells. Sitting up with your leg down will cause a lot of swelling, so try lying down with you leg elevated all the time. Take your meds as prescribed, don't wait until the pain is unbearable before taking them. It is a long road to recovery but you are still young and this should be in your favour. Be patient and remember to rest and elevate your leg as much as possible. Good luck with your recovery and please keep us posted.

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Hi Andrew- I'm 16-1/2 weeks out after ORIF, 56 yrs old, and super active before ankle break. I had a trimalleolar break, so it may be worse than yours, but I haven't really had any complications, as unfortunately some people on the site have had. My doctor and PT are saying I am healing very well to give you an idea re. timing, at least in my case. Everyone's injuries and healing will be different. I too was totally off pain meds at your stage, and casted for 7 weeks vs. your 4, but the boot is just like the cast (they're pretty much interchangable), so you will need to add that time in for immobilization. The immobilization causes your ligaments to shrink, which is the second, longer phase of repair you will need to go through. I couldn't WB until week 7, so that slows things down a bit compared to you. I agree with others that the longer you are immobilized, the longer your eventual recovery time will be, because the more frozen everything gets in your foot. It took me about 4-5 weeks to be able to be FWB and get rid of the crutches, walker etc. That is such a nice feeling btw!! Once you get to that phase you have PT, and that's when pain meds come back to play. I suddenly needed two Motrin a day to take away my overall aching pain. The stretching exercises you can see online, to get an idea of what you will need to do (stretching your foot right, left, forward back etc.). Unfortunately, I have found the stretching exercises hours later to cause a lot of pain. There's no way around them, as you need to get your ROM back (range of motion). I do push with my exercises to try to speed up recovery, but then that means more pain that night and there is only so much pain you want to push yourself through. Your foot will be pretty frozen when it comes out of the cast and boot. I hate to tell you, but I still need to sleep with my leg up in the air 4 months after the surgery, but I know several people in my position that have gotten past that several weeks ago. The good news, is that life really improved for me at 4 months out, and I am walking all over (just not at a very fast pace). Most people wouldn't know I had an ankle injury by looking at me, except I walk a bit slower than some people. I can do most anything walking related, but only find going down stairs in a normal fashion a bit hard still, because I still need to get more toe strength back to do it right. My PT thinks by month 6 I will be in really good condition. I have heard it takes 12 months to get everything back (in some cases 18 months), unless there are big complications and delays due to healing problems (nonunions etc.). If you don't smoke, are young, eat well, and are fit, that will help to decrease some of the chances of complications.

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Hi Andrew, I meant to say in my earlier post - when I queried that sensation with the doctor, he said that the pain was due to damaged blood vessels and it is, as you quite rightly say, blood rushing down to the foot.

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You're very early in your recovery. I suggest inclined rest of the foot as often as possible!!! My injury was 07Feb & surgery 16Feb, if I was not inclined my ankle was swollen and painful- it was the main treatment I used. 2 weeks after surgery I was no longer using pain med's & at 9 weeks I was released to walk unaided. I had fibula break with a ligament damage.... I am doing better than I ever imagined 4 months later. I don't think I would do a long walk or run yet but I'm not hurting too bad either!! I do think everyone is different based on each individual's break and damage. Good luck!!

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Sorry to hear of your accident.On January 30th I had an accident which resulted in an injury called a Maisonnueve Fracture.Something similar to the Webber C with syndesmotic injury and interessous muscle tearing and a high fibula spiral break. I was in a non weight bearing cast for 7 weeks before being able to partial weight bear for the next 3 weeks and then full weight bearing as pain allowed.At present my foot stills turns purple if I am sitting,the consultant said this is due to the massive trauma caused when the ankle came out of the mortise and the energy transferred up through the ligaments and up through the muscle and out through the break.He said it could take up to 2 years for that to settle.At present I am still walking with the aid of crutches for stability as the ankle is very weak and catching my bone.He said I maybe looking at another operation to clear that up.I am 54 years old and my job as a postman involved walking 12/14 miles a day,now I have gone to limping about on crutches with still a good bit of swelling whilst on my feet.I am still attending Physio and trying to use the wobble board but I feel it is aggravating the joint and I am in pain for a good few hours after it.My days as a postman are numbered as my work want to get rid of me on ill health retirement as it's taken to long to recovery from the injury which happened in the course of me doing there job.Buts that's loyalty for you.Like yourself my leg /ankle causes no pain when elevated but you can't be sitting all the time.Its frustrating when you have been on the go all the time and then this happens.You need the calf muscle to get moving as it pumps the blood back to the heart.Even when resting keep wiggling the toes as this helps to get the blood moving.I had to self inject blood thinners for 5 weeks due to the inactivity with the cast, boy was I glad to get shot of those.At present I am wearing a home made modified trainer to let the swelling disperse as normal trainers keep the fluid gathered round the ankle making it stiff and tight.I still think my ankle will improve given time but it will never be the same as before.Wishing you a speedy recovery,but these sort of injuries are slow the consultant said.My screws will be staying in as he doesn't believe in taking them out.

    Regards Chris From the UK

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My Physio told mecto tell you to get an elbow frame walker for mobility.

@(*+"wink#

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Similar injury for me. 8 months so far for me.4 months non union, over 4 months ago I had bonegeaft, plates and surgery.

Yours sounds worse. Getting over surgery will take several weeks to start with. Yes its a very slow process. Sift tissue injury swelling can take months.

There is light at the end of the tunnel. I can verify that with Drs care and up and coming Physio, you will improve.

Don't be a hero and go off meds. Use them as directed . I stopped codeine but kept on anti inflammatories and panadol.and vitamin C.

I got very down about my swollen sore foot . purpley red blotchl mess.

Stayed in bed for 2 weeks. Hated shower. I have a shower slide. More stable than a stool. Your knee scooter may come in handy soon. Short bursts with pain medication on board. Take it easy. I drove mine out of hospital. Slow speed at your stage. From memory every thing was a pain in but. I ate lying down. Couldn't sit or stand easily, but you have to make regular efforts to prevent blood clots. Try to lightly wiggle toes. Ask Dr about that.

Get a hobby. Ps4, books, movies?

Hard I know. But very very gently do a bit more each day under medical advice.

This forum gave me sanity.

Good luck!

©{°$°}©

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Good advice from everyone as always. What is a shower slide? 

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Hi Patti, shower slide is a long bench with a back and suction adjustable legs. Most of bench goes in shower, , part with 2 legs goes outside shower. Have at good height. Get on seat outside shower and sorta slide yourself along bench to water, then exit same way. I couldn't do without it. I kept falling off shows stool. This is a very handy gadget.I'm big on getting right took for job!

®{°÷`}®

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Gutter frame walker I think.:+)

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Wow! It is so nice products like these have been developed to help people! I found a picture online. Never heard of this one before you mentioned it. So glad you found this to help you!

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Hey Andrew, I had RT lateral malleolus ORIF & ligament repair one week after my accident as well, plate 10 small screws, 1 large syndesmotic screw.  In splint like you for 2 weeks, then he skipped the removable cast and put me in boot (all doctors different).  Then had to wait 7 weeks from that point till 2nd surgery to remove synde screw before I could even PWB.  The boot was NOT for walking, only stabalization at this point in my case.

Not sure why your not in knee scooter yet, I was using from day 2.  Your surgery worse then mine or doctor's order?  When using my knee scooter, leg responded as when elevated.   

Swelling = inflammation = pain.  My swelling improved significantly at 2 weeks by keeping foot elevated and icing, anti-inflam meds like you.  Doc gave me prescription anti-inflam as well as pain meds.  Are you taking anti-inflammatory? Help tremendously!!  After two weeks, only took pain meds when needed (like 1X daily when getting in shower vs the 8 daily preseribed), but I continued with anti-inflam. pretty much daily, elevation (mainly for discoloration), but need for icing reduced. 

Although swelling became a non-issue for me soon after 2 week mark (maybe anti-inflams?) and almost literally no pain when foot elevated, ONCE FOOT DOWN still had bad achy pain within seconds due to those blood flow issues you mentioned. in addition I had much annoying pins & neeedles, burning and red, blue, even purple discoloration. So foot up 100% except when bathing, dressing, bathroom and some unavoidable situations. 

I was so frustrated not to be able to sit at my desk or the dinner table.  I used walker with a seat as a knee scooter, not as good as the real thing but I coped.  So by week 3, couldn't stay in bed or the recliner anymore all day, was going crazy.  Reading books & watching TV just not my thing.  So started to literally lift my leg up on my desk to work on computer (working on computer helped keep me keep sane). At dinner time I rested leg on the seat of walker.  Had to twist back and forth to take bites but liked being able to sit with family. 

These sensations most probably will continue till you start weight bearing, then will slowly decline.  Can scare the @*#$ out of you at times - after bathing with chair in shower it was almost black when I came out.  But it's all normal. 

I finally started to walk in book at week 10 from accident and significant improvement on the lowering of the leg issues, still happens but way less.  However, WARNING, once weight bearing, your swelling and pain will increase significantely again, and a whole new phase of questions.  So be sure to get pain med refills when they put you in boot!!  I'm at week 12 and just walked unassisted today.  Remember I'm behind due to my 2nd surgery so you may be up and about sooner. You have your youth on your side ;-)  I'm 56, was not in good shape and had many other health issues working against me.  

It takes hard work and much paitence is needed to get through all this. Never imagined the recovery process would be so tough.  Keep your mind busy, get adult coloring book if have to :-), read book, get a tablet, keep in touch with friends and family frequently, have visitors if you can to sit with you for a while, don't be afraid to call doc or his nurse with ques, take one day at a time and don't hesitate to ask for help from friends and family.  

This is a great site for support.  If you have Facebook, another good support is the page that will show up when you search for "Broken / Ankle / Foot / Leg Recovery - On a Quest for Normal."  Join, it's a closed group but another great resource while you recover, you will have many more questions.  Just a caution on comparing you healing time to others with same surgery.  Some take 8 weeks, some 16 weeks, some lot's longer.  So many factors come in to play regarding when.  We are each unique and will heal based on our individual situation. Best of luck to you!! 

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We should start a thread with useful devices tried and tested lol.@(*+"wink#