Broken Ankle: How to get rid of crutches and walk again

Foot care
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Hi Everyone,My injury was 16 weeks ago, I broke my fibula and chose not to have surgery (the Doctor said it was my choice, but that it would take longer to heal if I did not have surgery).  I was placed in a splint cast for 6 weeks. After 6 weeks the X-ray showed delayed healing, and it looked almost the same as day 1 of the break. The Doctor gave me a Cam boot and wanted me to ‘toe touch’ the floor to hopefully stimulate bone growth for another 4 weeks.  After the 4 weeks was up (10 weeks total, since the break) the X-ray showed the bone had finally healed (almost 100 percent).  The Doctor said to keep the cam boot for another 2 weeks, then start transitioning to full weight bearing.

I kept the cam boot on for one week longer than what the Doctor said.  My ankle still felt weak and painful.  Now I am completely out of the cam boot (for 3 weeks) but I am still using crutches to walk. I can almost walk without the crutches, but just can’t seem to let go and get to 100 percent. Initially, if I put too much weight, the ‘bone’ area hurt a lot, so I backed off a bit.  Now, the ‘bone’ area does not hurt as much but I cannot seem to be getting my full range of motion back, or the tightness out.  Part of the problem is my Achilles – my foot was not placed in a 90 degree angle initially, and the Doctor said I would have to work very hard to get it back to normal. 

I am trying to do many stretches to get full range of motion, but it is swollen and very tight still after these weeks.  It also turns blue tinted if I keep it down too long, or press with full weight. 

I am afraid that I am not doing enough to walk on my ankle, and in being more conservative doing more harm than good.  Does anyone have any advice or similar situations? I hope that I can work through it - I am so worried that having avoided surgery for the break, I may have to have it to fix the tendons,

Greatly appreciate any tips or recommendations! Thank you so much.

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Dear Sarah

I suggest that you continue using BOTH crutches until such time that when walking you do not need to rely on them to walk strongly and with a good gait.   This will of course be progressive.

Good luck. Richard

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Talking from the experience I needed physiotherapy 3x week (for few weeks and continuing), tones of mental support and few weeks out of work. I looked for physio near my home and with experience with sports injuries. Expensive and time consuming but I somehow walk again without crutches now (short distances only). It is a great relive to walk again. I had anterior ankle ligament completely broken and posterior ligament partially broken some 9-10 weeks ago.

From your description I would think there is sth not functionally correct and would start from another MRI. MRI making doctor suggested for me dynamic ultrasound (? I have not tried and difficult in present remote location). X-rays are very limited. Also could make a difference to take an x-ray when putting weight on your injured foot.

BTW i would appreciate people with similar cases thoughts for my case. If I really need an operation for 100% recovery and if physio is a waste of time without reconstruction? The problem for me is still not resolved as my work insurance covered doctor does not want to operate and functionality nowhere close to what I expect Yes I do have lots of pain continuing but no swelling now. Another private doctor recommended immediate reconstruction (contrary opinion to the first one) but I had no private insurance or handy savings nor confidence to make that decision .

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Hello Sara,

I read your story with interest. I, too, was given a choice by doc whether to opt for surgery or not (mine was bimalleolar fracture)-- but there was no way I would choose surgery (unless my life or mobility absolutely depended on the knife).

Since your doctor gave you an option for surgery or not, chances are you made the right choice to forgo it (and saved yourself a lot of potential complications and suffering that might ensue from it). I wouldn't blame your ongoing tightness and movement restriction on avoiding surgery at all.

CAM boot you wore should have provided protection needed to both bones and any other damaged ankle parts.

Your difficulties in recovery are unfortunate, but take some consolation in fact that many ankle patients have distressful or eventful recoveries. Actually, I don't recall reading here about a single patient ankle recovery that was all smiles and roses.

Ankles are complicated and unforgiving things. To injure one severely is to find out the hard way how much we take them for granted.

I would hazard a guess that your struggles with swelling/tightness/restriction of movement has something to do with damaged ligaments or tendons (and you mentioned your Achilles tendon was involved). It can take a long time to resolve injured ankle soft tissues. They can be stretched or torn beyond normal limits. Also, excessive scar tissue buildup can be a factor in limited mobility.

An MRI or diagnostic ultrasound scan of soft tissues might reveal any damage that went unnoticed (x-rays are essentially 'blind' to seeing most non-bone damage).

If you are thinking about waiting to see if you might need reconstructive surgery on ligaments etc. please think again. If one lets their condition get that bad they can pretty much kiss chances of a normal ankle goodbye.

Remedial surgery should be considered a last resort after investigating all conservative treatment options.

Besides your stretching and range of motion exercise (keep doing them unless there is too much pain/discomfort) you might want to investigate deep tissue massage (such as myofascial release treatments, or Graston technique). This might help break down scar tissue adhesions, and otherwise mobilize ankle joint.

Some patients with ankle pain and stiffness have had success with injection  treatments like Prolotherapy and PRP.

Light treatments like LLLT (low level laser therapy), infrared and red light therapy can help in tissue healing too.

There are plenty of other healing modalities out there if you are willing to take time to research it.

I believe strongly that a vigorous physical therapy regimen is essential for most ankle patients to forestall chances of chronic ankle disability in future. And we all want a bright future where we can experience joyful activities using our feet

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You rock kpower... your responses are very helpful and I learn something all the Time!