Friday morning is my 6 week appointment, so I am trying to prepare a list of questions so I don't forget to ask anything. For background, I experienced a Weber A ankle fracture (no surgery or reduction was required). I had 4 weeks of NWB, three of them in a boot plus two weeks of WBAT after that. I have been able to fully weight bear in my boot for one week at this point (no crutches or cane required). I have no pain and almost no swelling at this point. My ankle flexibility is at 85-90% in my estimation (I have a series of exercises I have to do daily).
These are the questions I came up with... if anyone has any I should add, please let me know:
1) When can I start to transition out of the boot? If I am permitted to begin this today, is there an approach to doing it that you recommend?
2) When can I start Physio Therapy?
3) When can I resume driving my cat (an automatic)?
4) What kind of footwear is recommended for daily wear/exercise?
5) What footwear restrictions are suggested and how long for (e.g. high heels, flip flops, slippers, etc)?
6) I want to start back hiking as soon as possible – will I need a special ankle support, or will good quality high top hikers provide sufficient support?
Good luck with your appointment. I think you have covered everything with your questions for the Dr. I feel sure that he will advise you of how to progress with everything.
Thanks for the good wishes! The appointment went very well - I could see on the X-ray that the bone is filling in nicely. The doctor seemed very pleased with my progress.
I thought others might be interested in the answers I received, so I came back to update:
1) I have been told to stop wearing the boot at home. Instead I am to wear supportive shoes while walking in my home (I am using a clean pair of high top hikers). I can also wear hiking boots outside, but I need to keep my walking boot with me in case I feel the need of it.
2) I have my first PT appointment tomorrow. I already have 100% of my range of motion back so I will be working on proprioception and strength. I am to have a home exercise plan set for me
3) I am to have at least two PT sessions before testing my leg to see if it is strong enough to operate the car break. My doctor advised me to go to an empty parking lot (with my spouse driving) and then take the wheel and practice emergency breaking there. I need to be able to do it without any pain.
4) High top hikers were approved as my footwear for now.
5) No specific dates were set for expanding my footwear options. I definitely will not try anything else prior to my next appointment in six weeks. After that, I will see. I will probably stick with safe supportive options for at least six months, but that's my preference.
6) Good quality high top hikers will provide sufficient support for me to resume hiking in... I will be going shopping tomorrow
I've been walking around without the boot all day and it feels a little weird. My knee is a bit weak and a little wobbly. About four times I have had a strange zappy twinge in the front of my foot (I think it is because my foot is going through the various flex positions, instead of remaining stuck in one as it is in the boot). I can go up stairs normally but need to come down slowly. It's an interesting stage, but I'm very happy to be moving on from the boot.
Me alegra saber que vas a FWB en el camino a la recuperación.
No fuerces demasiado a tu gato, el minino también necesita descansar.
No recuerdo si tu fractura de Weber A involucró el maléolo medial y daño ligamentoso. Si no es así, entonces estás años luz por delante de la mayoría de nosotros en términos de recuperación rápida y completa.
Has listado la mayoría, si no todos, de los aspectos importantes de tu recuperación en el futuro. Si no sufriste una lesión significativa de tejidos blandos (ligamentos, tendones, nervios, etc.), entonces tu trabajo es simplemente fortalecer y estabilizar esos tejidos blandos que se volvieron inactivos durante la no carga de peso.
Parece que ya has comenzado la terapia física en forma de ejercicios que mencionaste (presumiblemente ejercicios de rango de movimiento). Ahora solo sigue con más ejercicios para obtener más fuerza y estabilidad para poder reanudar tus actividades normales lo antes posible.
Personalmente, utilicé la tabla de equilibrio para trabajar en el equilibrio. El equilibrio sobre un solo pie con elevaciones de talones también se utiliza en el entrenamiento de equilibrio.
Me alegra que tomes en serio la recuperación segura en tu elección de calzado. De nuevo, si no se dañaron ligamentos ni tendones, probablemente estés en un buen lugar en cuanto a la condición de tu tobillo. Pero más vale prevenir que lamentar.
No debería ser mucho tiempo antes de que estés acumulando millas en los senderos de senderismo. ¡Mucha suerte!
Happily, my medial malleolus came out of this unscathed. I can't be so sure about the ligaments/tendons/nerves, but I suspect the low level of pain I've had with this injury probably means any injury to them is fairly minor. I know I am beyond lucky that it wasn't much, much worse than that.
My first set of exercises (not as advanced as the ones you listed) consists of:
1) Toe raises (both feet on the ground, rising up to demi point (tip-toe) and down). Once I've mastered this I have to move to single foot toe raises (I can't manage even one good single foot one on the injured foot at this point; I can do it fairly well with both feet on the ground). 3 sets of 10, 3 times a day.
2) Single foot balancing. This is to be done on a flat foot without hanging on to anything. I'm to see how long I can go without touching down my good foot or grabbing the railing in front of me. I am to keep trying for 5 minutes (also 3x per day). The longest I've managed to go without a touchdown is just over 2 minutes, but once it is a bit tired it doesn't last long at all... lol
3) The same exercise as #2 with the eyes closed. I am not very good at this one at all... it's quite comical. I can maybe get to about 20 seconds at best. This one tends to be a very long 5 minutes... lol
4) I have some theraband strengthening exercises that I do with the band tied to a pillar in the hall of my home. I pull my toes toward me, to the outside and to the inside. These are small movements, and this is the easiest exercise for me. I only need to do 3 sets of 10 three times a day, but I usually do more and go until I feel tired... I think I need to move to the next band level
I know she's going to move me on to the wobble board when I master these ones (since wobbly surfaces are what we have to deal with while hiking all the time, and she knows hiking is my end goal )... not sure how long that is going to take, but I look forward to getting to that stage
Deberías contar con tus bendiciones de que todo el drama traumático por el que pasan tantos pacientes, incluido el cirugía (con sus complicaciones y, especialmente, la cicatrización adicional de tejidos por el cuchillo del cirujano), el daño de tejidos blandos (mucho peor a largo plazo en la mayoría de los casos que las fracturas óseas), y los extraños y salvajes síntomas de dolor y hormigueo por lesión de nervios y tejidos, sin mencionar el edema persistente en el pie.
Estás bien informada sobre la fisioterapia adecuada y pareces muy seria en hacer todo bien. Sinceramente, desearía que cada paciente de tobillo fuera tan competente en cuanto a cuidados y tratamiento.
Una nota sobre los elevadores de talón (levantamiento de dedos) que mencionaste. Al principio de la recuperación no podía levantar el talón en el tobillo lesionado. Esto se debió a la disfunción del tendón tibial posterior (PTTD) posterior a la fractura y el esguince. Pero ahora está mucho mejor y puedo hacer levantamientos y sentadillas (aunque limitados, aún no sentadillas de pierna hasta los talones o es un poco doloroso). Bajar las escaleras con PTTD fue doloroso durante las primeras semanas de apoyo total de peso, pero ahora es normal.
Aún hago ejercicios de inversión/eversión de tobillo con bandas elásticas casi a diario, aunque probablemente estoy en un 90% de recuperación. Ayudan a fortalecer los ligamentos y tendones, y a tonificarlos para ayudar a prevenir futuros esguinces. Puede que continúe con los ejercicios de tobillo indefinidamente para tener un margen de seguridad.
El tablero de balanceo (equilibrio) siempre fue mi favorito y aún me subo a él. Proporciona un amplio rango de estiramiento y movimiento en todas las partes móviles del pie y el tobillo. Equilibrarse en el tablero de balanceo con los ojos cerrados aumenta la apuesta y realmente mejora tus habilidades de propiocepción.
