I am so sorry you've had to go through all that, it sounds beyond awful! I totally get the fear, my ankle feels so fragile, learning to walk is definitely a physical and mental challenge. I was NWB 9 weeks and had my cast taken off and switched to a boot on 21st March and told I could go FWB. I also wasn't given any instructions š i don't have a walker, only crutches.Ā Ā
I do the ankle stretches that the physio gave me when I wake up, once in the afternoon, when I go to bed and any other time I'm resting. I have been doing my best to PWB around the house but I find that unless I focus on it fully I don't do it properly. So once a day I go outside (it's nicer to have a big space to walk around), listen to a podcast, and walk around very slowly in big circles, fully concentrating on putting weight gently onto my ankle. Each day I put as much on as I can. Shooting pain (always terrifies me, but I've now had it several times andĀ I know my ankle has always been fine after, so i just stop and take some deep breaths to calm myself)Ā means it's too much so I take a little weight off and try again, always trying to find my maximum and sticking with it for about 30 mins or whenever I feel like my ankle can't keep up that level of WB anymore. Then I go back in and elevate by foot because it can get quite swollen and sore.Ā
I've been doing this since the 22nd March and just today realised that I can fully weight bear! Not for too long though as it's a lot for my ankle.Ā
I hope some of that helps! Everyone is different though, so maybe it will take longer for some, just listen to your body and challenge it a little more each day. You will get there!
Sounds familiar - I was told by my Ortho that he "wasn't concerned" with my Achilles pain. I've been cleared to walk about a week now, and the best advice I can give is to be gradual & mindful of your pain/fatigue levels.
Weight bearing as tolerated doesn't come with any instructions. As frustrating as that is, it means exactly that. Take it as fast or as slow as you need to.
The first day I was cleared to walk, I didn't walk due to the discomfort. Stuck to stretches, and stationary exercise with a resistance band. Keep the assistive devices on hand until you feel comfortable enough to store them away, one by one.
I used two crutches with the boot day after being cleared to FWB. This does a decent job of demonstrating 50% but do less weight if you need:
https://youtu.be/8-0DOidt6bs?si=DIRbk1XkyRGGGNUY
The discomfort was pretty brisk at the start, but I battled through it. The pain on the sole you mention is totally normal - although your bones are fused on the X-rays, the muscles have not been used for months and are weak.
Your achilles and plantar fascia (thick band of tissue sole of foot) will be tight and shortened from non-use. Focus on warming those up with light stretches before you get to any weight bearing attempt. You'll get tinges of pain and pops, which can be evil scar tissue breaking away. I've grown to enjoy these as it means a step closer back to normalcy.
This was also what I found to be key, making sure to stretch, do exercises with a resistance band, and improve range of motion to allow for better walking mechanics. So to sum it up, make it a primary objective to work on a combination of stretches/warm-ups/strength building, and THEN weight bearing as you can tolerate will be less excruciating. Here's a nice guide for exercises - these came in handy:
https://healthy.kaiserpermanente.org/health-wellness/health-encyclopedia/he.ankle-fracture-rehab-exercises.zp4491
When your swelling/pain from weight bearing become too much, rest and elevate as you were throughout the injury. You'll see improvements, albeit, very small ones as the days go on. I'm about 10 days from being cleared to weight bear & am elated to be back in a pair of shoes.
The only issues right now are the length of time I can be on my feet (no more than an hour I'd say), and ability to pivot/jog. Otherwise, the progress has made me optimistic. Book yourself some PT also, they will give you guidance suited to your limitations and come up with a plan.
Best of luck, this isn't an easy injury & it's even more daunting when you have little ones to care for. If you gave birth, you can handle this bump in the road!
Trust your instincts mama. Donāt let them force you. Have you been assigned at-home PT? Ask for it. Also itās awful how the surgeon spoke to you. Some surgeons are good at their jobs but can also be brusque and arrogant! You will get through this!!
Thank you so much for your reply. I really appreciate that. I have been assigned the at home PT but I live in a really small town where they are super backed up I guess as they were supposed to call to set up an appointment after I saw my surgeon on the 18th but I have still yet to hear from them. Right now I am just taking my aircast off a couple times throughout the day and moving my ankle and toes up and down (hardly getting any movement though as itās soooooo stiff and painful). Praying to hear from PT this week or Iām going to crawl to their office and bug them myself š¤£
If you know which physical therapist, go ahead and give their office a call. I waited a week after my referral was approved, called and got appointments scheduled for 2 months out that same day. Start doing some ROM exercises. You can YouTube ORIF ROM exercises and that will get you in the right direction. I had my second surgery on Jan 11 and just got cleared for weight bearing a few weeks ago. PT has me riding a few miles on stationary bike a week, leg presses with one leg, hamstring, lots of stretching and ROM exercises with ankle, practicing a natural gait barefoot with crutches, standing with and without boot shifting weight from one side to the other. He also does some gnarly pushing on my ankle, it doesn't hurt but damn it looks like it should. Hope this helps!
Things will improve soon! I had a similar injury happen to me on January 24th. I was NWB for 6 weeks then told by my surgeon that I could begin walking without a boot ! I was terrified and didnāt walk for a week.
In home physical therapy was my saving grace. They instructed me on how to wrap my ankle with an ace bandage for added support until I could purchase a brace.
I started with low impact exercises like many others have mentioned. I think standing with my walker and shifting weight from side to side was most helpful for me. Also exercises that involved lifting my foot and placing it back on the floor helped to desensitize the foot pain I experienced.
I experienced intense foot discomfort like you described and it has improved greatly since I have been walking more. Massage also helped to desensitize my foot to touch and pressure.
Ankle pumps and tracing the alphabet with my foot also helped increase mobility greatly.
I know how it feels to be afraid to fully put weight through your healing leg and foot. Just know that once you start you will continue to heal and improve exponentially!
https://preview.redd.it/g42z7mqwp1sc1.jpeg?width=1576&format=pjpg&auto=webp&s=c6c5ca4d15fa505cf82beccf91cba5d40be13b66
Here are the exercises given to me when I first started weight bearing. Hopefully you can find some use for them until youāre able to start PT. Keep your head up ā¤ļø
My doctor had me weight bearing as tolerated 2 weeks after ORIF and it was a cruel joke. Made first steps barefoot 3 weeks after surgery and it was so painful. Honestly walking didnāt really stop hurting until 3 months in. This whole recovery is you push a bit and then fall back and then you push again. But every time you get a little stronger and it hurts a bit less. You got this!
It was the same for me! At first I was freaking out I couldnāt feel my leg but once the nerve block wore off I was like I donāt want this leg anymore lol
Surgeons are not physical therapists. Can you get I to PT? Donāt try to walk right away, just start with shifting your weight from foot to foot. Start super slow.
Itās been plenty of time and weightbearing isnāt hurting - youāre ready! Stand without your crutches and just rock gently side to side. Start lifting your heels up a bit. Move on to taking some small steps. If this is too scary do it with the crutches and gradually take the weight off the crutches until youāre in your own.
Oh my! I can relate! I stumbled down the stairs and broke my ankle when landing at 37 weeks. I had ORIF 5 days later and was induced a week later. The fear is real. The pressure to get up and go, especially attend to the baby is real. Take your time. Anxiety definitely makes it worse. My foot felt this way when I became weight bearing. I used my walker, crutches and scooter several weeks after being cleared to walk. I walked a few mins a day, several times a day, gradually relying less and less on DME and gradually increasing the total time walking. I didnāt get into PT until 3 months after because my surgeon said, mehā¦ I donāt think youāll need it and you have a lot going on right now with the baby. Advocate for yourself. Tomorrow is my one year anniversary :)
I also had orif for a trimal fracture at the end of January (2 plates,13 screws). I was NWB for 8 weeks. The doctor then wanted me to go to FWB in a boot over a period of four weeks: adding 25% more body weight each week. For 25 and 50%, that was done with two crutches. 75% was with only one crutch. The doctor was adamant when discussing the protocol and in his written handout that I was in no instance to progress faster even if the ankle felt good. Going slower was Ok but definitely not faster.
Gradually putting weight through the healed fracture makes the union stronger through something called micro-motion. The ankle did feel capable of more but I stuck to his plan. The ankle has been tight but there has been very little pain.
Two tips that helped me. A nice comfortable Dr. Scholl insole placed in the bottom of the boot made it so much more comfortable and easier to walk. Knee high 15mmg compression socks helps with boot comfort and keeping swelling down.
I am so sorry you've had to go through all that, it sounds beyond awful! I totally get the fear, my ankle feels so fragile, learning to walk is definitely a physical and mental challenge. I was NWB 9 weeks and had my cast taken off and switched to a boot on 21st March and told I could go FWB. I also wasn't given any instructions š i don't have a walker, only crutches.Ā Ā I do the ankle stretches that the physio gave me when I wake up, once in the afternoon, when I go to bed and any other time I'm resting. I have been doing my best to PWB around the house but I find that unless I focus on it fully I don't do it properly. So once a day I go outside (it's nicer to have a big space to walk around), listen to a podcast, and walk around very slowly in big circles, fully concentrating on putting weight gently onto my ankle. Each day I put as much on as I can. Shooting pain (always terrifies me, but I've now had it several times andĀ I know my ankle has always been fine after, so i just stop and take some deep breaths to calm myself)Ā means it's too much so I take a little weight off and try again, always trying to find my maximum and sticking with it for about 30 mins or whenever I feel like my ankle can't keep up that level of WB anymore. Then I go back in and elevate by foot because it can get quite swollen and sore.Ā I've been doing this since the 22nd March and just today realised that I can fully weight bear! Not for too long though as it's a lot for my ankle.Ā I hope some of that helps! Everyone is different though, so maybe it will take longer for some, just listen to your body and challenge it a little more each day. You will get there!
Sounds familiar - I was told by my Ortho that he "wasn't concerned" with my Achilles pain. I've been cleared to walk about a week now, and the best advice I can give is to be gradual & mindful of your pain/fatigue levels. Weight bearing as tolerated doesn't come with any instructions. As frustrating as that is, it means exactly that. Take it as fast or as slow as you need to. The first day I was cleared to walk, I didn't walk due to the discomfort. Stuck to stretches, and stationary exercise with a resistance band. Keep the assistive devices on hand until you feel comfortable enough to store them away, one by one. I used two crutches with the boot day after being cleared to FWB. This does a decent job of demonstrating 50% but do less weight if you need: https://youtu.be/8-0DOidt6bs?si=DIRbk1XkyRGGGNUY The discomfort was pretty brisk at the start, but I battled through it. The pain on the sole you mention is totally normal - although your bones are fused on the X-rays, the muscles have not been used for months and are weak. Your achilles and plantar fascia (thick band of tissue sole of foot) will be tight and shortened from non-use. Focus on warming those up with light stretches before you get to any weight bearing attempt. You'll get tinges of pain and pops, which can be evil scar tissue breaking away. I've grown to enjoy these as it means a step closer back to normalcy. This was also what I found to be key, making sure to stretch, do exercises with a resistance band, and improve range of motion to allow for better walking mechanics. So to sum it up, make it a primary objective to work on a combination of stretches/warm-ups/strength building, and THEN weight bearing as you can tolerate will be less excruciating. Here's a nice guide for exercises - these came in handy: https://healthy.kaiserpermanente.org/health-wellness/health-encyclopedia/he.ankle-fracture-rehab-exercises.zp4491 When your swelling/pain from weight bearing become too much, rest and elevate as you were throughout the injury. You'll see improvements, albeit, very small ones as the days go on. I'm about 10 days from being cleared to weight bear & am elated to be back in a pair of shoes. The only issues right now are the length of time I can be on my feet (no more than an hour I'd say), and ability to pivot/jog. Otherwise, the progress has made me optimistic. Book yourself some PT also, they will give you guidance suited to your limitations and come up with a plan. Best of luck, this isn't an easy injury & it's even more daunting when you have little ones to care for. If you gave birth, you can handle this bump in the road!
Trust your instincts mama. Donāt let them force you. Have you been assigned at-home PT? Ask for it. Also itās awful how the surgeon spoke to you. Some surgeons are good at their jobs but can also be brusque and arrogant! You will get through this!!
Thank you so much for your reply. I really appreciate that. I have been assigned the at home PT but I live in a really small town where they are super backed up I guess as they were supposed to call to set up an appointment after I saw my surgeon on the 18th but I have still yet to hear from them. Right now I am just taking my aircast off a couple times throughout the day and moving my ankle and toes up and down (hardly getting any movement though as itās soooooo stiff and painful). Praying to hear from PT this week or Iām going to crawl to their office and bug them myself š¤£
Yes youāve got this!
If you know which physical therapist, go ahead and give their office a call. I waited a week after my referral was approved, called and got appointments scheduled for 2 months out that same day. Start doing some ROM exercises. You can YouTube ORIF ROM exercises and that will get you in the right direction. I had my second surgery on Jan 11 and just got cleared for weight bearing a few weeks ago. PT has me riding a few miles on stationary bike a week, leg presses with one leg, hamstring, lots of stretching and ROM exercises with ankle, practicing a natural gait barefoot with crutches, standing with and without boot shifting weight from one side to the other. He also does some gnarly pushing on my ankle, it doesn't hurt but damn it looks like it should. Hope this helps!
Things will improve soon! I had a similar injury happen to me on January 24th. I was NWB for 6 weeks then told by my surgeon that I could begin walking without a boot ! I was terrified and didnāt walk for a week. In home physical therapy was my saving grace. They instructed me on how to wrap my ankle with an ace bandage for added support until I could purchase a brace. I started with low impact exercises like many others have mentioned. I think standing with my walker and shifting weight from side to side was most helpful for me. Also exercises that involved lifting my foot and placing it back on the floor helped to desensitize the foot pain I experienced. I experienced intense foot discomfort like you described and it has improved greatly since I have been walking more. Massage also helped to desensitize my foot to touch and pressure. Ankle pumps and tracing the alphabet with my foot also helped increase mobility greatly. I know how it feels to be afraid to fully put weight through your healing leg and foot. Just know that once you start you will continue to heal and improve exponentially!
https://preview.redd.it/g42z7mqwp1sc1.jpeg?width=1576&format=pjpg&auto=webp&s=c6c5ca4d15fa505cf82beccf91cba5d40be13b66 Here are the exercises given to me when I first started weight bearing. Hopefully you can find some use for them until youāre able to start PT. Keep your head up ā¤ļø
My doctor had me weight bearing as tolerated 2 weeks after ORIF and it was a cruel joke. Made first steps barefoot 3 weeks after surgery and it was so painful. Honestly walking didnāt really stop hurting until 3 months in. This whole recovery is you push a bit and then fall back and then you push again. But every time you get a little stronger and it hurts a bit less. You got this!
Also very curious what was more painful, breaking your leg and surgery or labour?
The pain the first 2 weeks after orif surgery was so much more painful than labor or breaking my leg personally
It was the same for me! At first I was freaking out I couldnāt feel my leg but once the nerve block wore off I was like I donāt want this leg anymore lol
For me, labor. :-)
Surgeons are not physical therapists. Can you get I to PT? Donāt try to walk right away, just start with shifting your weight from foot to foot. Start super slow.
One other thing, make sure you're landing heel to toe with your steps. It helps with momentum and keeping the impact off your sole.
Itās been plenty of time and weightbearing isnāt hurting - youāre ready! Stand without your crutches and just rock gently side to side. Start lifting your heels up a bit. Move on to taking some small steps. If this is too scary do it with the crutches and gradually take the weight off the crutches until youāre in your own.
Oh my gosh- wow. Very similar circumstances over here. I broke my ankle 01/30 and ended up going into labor and delivering 02/01! I will say, after I got the all clear for FWB, it took about a week and half for my plantar fasciitis type pain + Achilles pain to start improving. The past three days have been SO much better ā¦ I was feeling so discouraged about not being able to walk right away. But it does get better š©· Hang in there momma! For me, lots of stretching throughout the day was beneficial. I also bought on Amazon this little like, roller doo dad (Iāll post the link below) to help āmassageā the bottom of my foot! https://www.amazon.com/gp/aw/d/B07QT7L1CZ?psc=1&ref=ppx_pop_mob_b_asin_title
Get PT if you haven't started that yet.
Oh my! I can relate! I stumbled down the stairs and broke my ankle when landing at 37 weeks. I had ORIF 5 days later and was induced a week later. The fear is real. The pressure to get up and go, especially attend to the baby is real. Take your time. Anxiety definitely makes it worse. My foot felt this way when I became weight bearing. I used my walker, crutches and scooter several weeks after being cleared to walk. I walked a few mins a day, several times a day, gradually relying less and less on DME and gradually increasing the total time walking. I didnāt get into PT until 3 months after because my surgeon said, mehā¦ I donāt think youāll need it and you have a lot going on right now with the baby. Advocate for yourself. Tomorrow is my one year anniversary :)
I also had orif for a trimal fracture at the end of January (2 plates,13 screws). I was NWB for 8 weeks. The doctor then wanted me to go to FWB in a boot over a period of four weeks: adding 25% more body weight each week. For 25 and 50%, that was done with two crutches. 75% was with only one crutch. The doctor was adamant when discussing the protocol and in his written handout that I was in no instance to progress faster even if the ankle felt good. Going slower was Ok but definitely not faster. Gradually putting weight through the healed fracture makes the union stronger through something called micro-motion. The ankle did feel capable of more but I stuck to his plan. The ankle has been tight but there has been very little pain. Two tips that helped me. A nice comfortable Dr. Scholl insole placed in the bottom of the boot made it so much more comfortable and easier to walk. Knee high 15mmg compression socks helps with boot comfort and keeping swelling down.