Broken

Hi Jay,

You went to A&E (what we in US call the emergency room) and they took x-rays, found some fracture(s), and put you in an air boot.

Did they not give you explicit instructions on non-weight bearing status until further instructions on your follow-up visit? I'm astonished. Truly dismayed I am.

An ankle fracture usually requires a period of immobilization and non-weight bearing (NWB) to allow broken bones (and any damaged soft tissue collateral damage) time to mend properly and be strong enough to handle stress of weight bearing and ankle movement.

Now, if broken bones are displaced (when bone fragments are separated from each other) NWB is absolutely crucial. Putting weight and movement on injury in this condition can wreck body's bone mending process-- the results could be bones that knit out of place (causing arthritis and/or ankle instability later), or not at all (that's called a non-union).

Don't be deceived by lack of pain when you walk or stand in boot now. That doesn't mean much because nerves that signal pain may be out of order (from injury), or boot may provide just enough support that masks pain.

I hope you get some competent specialist medical attention soon.

STOP!!! Get that boot back on (if it's off now) and follow your doctor's orders!... OK, enough of me using my "mommy voice"! LOL  

It is an old wives tale that you cannot walk on a fractured ankle and that there has to be a ton of pain. You totally can walk on some of the more stable ones. I did it. After breaking my fibula (stable Weber A) in the back woods I walked 3 kilometers on a hunter's trail (very rough, unstable, even walked on loose rotting logs). I was aided only by a single walking stick. I spent the rest of the day in my kayak (6 hours or so) and then I walked nearly another kilometer up a muddy hill, in the dark. Then I drove my AWD out on a 4WD rutted,dirt road (cue the Jeep commercial ) and finally drove myself about 3 hours on regular paved roads before reaching home... did I mention that the injury was to my driving foot? Yup... that one... The next day I WALKED into the ER and was astonished to discover that I had a fracture. I was told by the doctor that I was lucky it never displaced on me during my walking adventure, but I had no choice as there was no way I was getting an air ambulance in to where I had injured myself and I was miles from roads.

I was given a boot on the 6th day and told to be NWB for 5 more weeks. I called back at 4 weeks (2 weeks early) and managed to get permission from my doctor to transition to weight bearing as tolerated in the boot (WBAT) due to my excellent progress with my ROM exercises, minimal swelling and lack of pain (there is a danger of calcification and poor healing even with a stable fracture if weight bearing is started too early according to my ortho doc). I was able to lose the boot entirely at my 6 week check-up. I'm 9 weeks now, going to physio once a week and doing home exercises. I'm walking pretty normally now, and even went on a short gentle terrain hike last weekend (I was cleared by my PT for that). I'm also driving again (have been for two weeks).

I am guessing you are likely in the UK and may already be WBAT in the boot. If so, consider yourself lucky as your progress will likely be faster than those in the NWB category... if you follow your doctor's instructions.

And back to the pain. I've never really had much myself... just achy sometimes (especially after I do my home PT exercises because I am doing some challenging ones now), but it's always been tolerable. I only ever used Ibuprofen to bring down the swelling, never for pain. So don't use a lack of pain as an indicator of a lack of fracture either... just consider yourself very lucky... I know I do

Just get your list of questions ready for that follow-up appointment. You don't want to jeopardize your recovery by getting ahead of your doctor's recovery plan.