Out of cast into brace! Maybe light at the end of this journey!

Foot care
1

Hi everyone!

Today I went and had my cast off. After 4 and a half weeks.  Doc said surgery site looks good. And I had the option of going back in a  boot w/ air cast or a brace for support. I opted for the brace. I can take it off for showers! (thank God for that!! ) And also, can take it off for bed... problem is the pain is crazy! 

I assume its from the doc moving it around and having me stand on it, but damn.... can't they be more gentle? So back in the chair/ doing some movements now and ready to rock and roll! Time to get life moving again. 

My surgery was a tendon repair and a ligament repair/ some pretty extensive cleaning up of the ankle from the fall. But thankfully no arthritis. That I'm happy about. 

Just writing to let everyone know that even though there is still quite a bit of pain, there does seem to be some light at the end of this awful journey! Another 5 weeks and back to the doc! 

Good luck everyone!

Rose

2

Hi Rose,

Congratulations on passing the first stage of recovery. Now comes the challenging part of rehabilitation.

Since your injury involved tendon and ligament damage you have your work cut out for you. I know from experience that tendon (mine was the posterior tibial tendon) injuries can be difficult to recover from.

Key to getting back normal ankle function in these cases is an aggressive rehab program to heal those soft tissues, and then strengthen them so they can do their job to support ankle joint and normal movement biomechanics.

Besides ROM and other gentle beginning exercises, you should be incorporating appropriate  physiotherapy tailored specifically to ligaments and tendons. And likely you will need to have an ongoing maintenance program forever to keep ankle in good shape and avoid sloppy ankle joints caused by lax ligaments and tendons. And yes, unfortunately, that could lead to chronic ankle instability and eventually arthritis if it progresses unchecked.

Don't forget to do the ankle/foot pump exercise as frequently as tolerated. That exercise also activates the calf muscle pump and helps keep good blood circulation going down there in that healing foot/ankle.

3

Hi KP,

Thanks for the reply. I am still quite sore. I guess I got baffled because the doctor and his nurse looked at me like I had two heads when I said I still had pain. I mean, its it just six weeks today so yes, I still have pain in my ankle. Literally feels like a ton of toothaches in there, but I'm hoping this will pass soon enough! 

  I have started my exercises. I can't go to a PT because they no longer take my insurance and when she called me, she let me know it was over 100 dollars for one visit. So, doc said that most of the rehabbing is done at home anyway unless you have stellar insurance. 

I've been doing my towel crunches, Toe pulls back and forth with the towel and just generally moving it. 

I was able to be on it for 40 mins today with out sitting but for only a few minutes, which I thought was a huge thing for me! LOL 

  I am scared of what is to come with this injury. It has been a year since the fall. I had a Cheilectomy first on my left toe for the post traumatic arthritis and a bone fracture from the fall On August 2nd and then Nov 13th was the Tendon and Ligament reconstruction and clean up in the ankle. I feel like its never going to be perfect at this point.  And scared of that aspect of where I can be. 

Can I ask you if your 100% healed? 100% no pain and can walk quite a while on the foot/feet?

I'm so curious of what is to come. 

Thanks so much, 

Rose

4

Hi Rose,

I'm happy to share my particular details with you.

About a year ago I suffered a bimalleolar fracture and severe sprain to medial right ankle-- no surgery.

I did the moon boot thing for about 6 weeks (NWB), then PWB for 2 weeks in boot. Then walking again.

The bones of course healed very nicely on schedule, and deltoid ligaments bounced back with gusto even after the atrocious sprain. My limiting factor was posterior tibial tendon-- it was clobbered and severely stretched by injury trauma and its damage caused post tibial tendon dysfunction, or PTTD.

For the first few months PTTD caused slightly painful walking, and difficulty going down steps (post tib tendon does many things, and acts as a pulley in joint action, besides providing main support for foot arch). My post tib stayed slightly inflamed and sticky in its sheath-- it runs from mid-calf to its attachment under foot.

At about 6 months things were looking good, with virtually no pain or impediments. Now, today I'd say I have perhaps 90% of my remembered healthy ankle function back, and I'll get it all back fairly soon.

Lucky, you say? It was no cake walk.

I aggressively pursued every option I could to regain tendon/ankle health-- but especially ankle rehab exercises-- like using elastic band for inversion and eversion work on ankle, wobble board, and particularly using a PEMF device to stimulate tissue healing.

I'm very sorry to say it, but too many patients whine and complain about their ankles but won't do the necessary work to strengthen and stabilize the ankle joint.

Human ankles are a miracle of engineering and deserve the best support we can give them.

So please don't neglect rehab therapy and go for the gold of a healthy functioning ankle. You can do it.