Questions to ask at my six week appointment... am I missing any?

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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?

Thanks smile

Carolyn

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6 Replies

  • Posted

    Oops... that should be "driving my car" not "driving my cat"... eek 

    Neither of my cats like to go for a drive... razz

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  • Posted

    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.

    Regards

    Paul

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    • Posted

      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 smile

      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 smile

      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.

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  • Posted

    Hi Carolyn,

    It's good to hear you are going to FWB on way to recovery.

    I wouldn't drive your cat too hard-- kitty needs to take it easy too. biggrin

    I don't recall if your Weber A fracture involved the medial malleolus and ligament damage. If not, then you are light years ahead of most of us in terms of speedy and full recovery.

    You have listed most if not all of important aspects of your recovery going forward. If you suffered no significant soft tissue injury (ligaments, tendons, nerves, etc.) then your job is just to strengthen and stabilize those soft tissues that went dormant during NWB.

    It sounds like you have already started physical therapy in the form of exercises you mentioned (presumably range of motion exercises). Now just continue with more exercises to get more strength and stability so you can resume normal activities as soon as possible.

    Personally, I used the wobble board to work on balance. Balancing on single foot with heel raises is also used in balance training.

    I'm glad you take a safe recovery seriously in your choice of footwear. Again, if no ligaments or tendons were damaged you are probably in a good place right now with regard to ankle condition. But better safe than sorry.

    It shouldn't be too long before you are racking up the miles on hiking trails. Good luck to you.

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    • Posted

      Thanks kpower smile

      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 wink

      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 smile )... not sure how long that is going to take, but I look forward to getting to that stage smile

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  • Posted

    Hi Carolyn,

    Thanks for your response.

    You should indeed count your blessings that all the trauma drama that so many many patients go through-- including surgery (with its complications, and especially the additional tissue scarring from surgeon's knife), soft tissue damage (far worse long term in most cases than the bone breaks),  and the weird and wild pain and tingling symptoms from nerve and tissue injury, not to mention lingering foot edema.

    You are well-informed about appropriate physiotherapy and you seem very serious on doing everything right. I sincerely wish every ankle patient was so competent about care and treatment.

    A note on the heel lifts (toe raises) you mentioned. Early on in recovery I couldn't lift heel on injured ankle. This was due to post tibial tendon dysfuntion (PTTD) injury subsequent to fracture and sprain. But it is much better now and I can do lifts and squats (limited though- no leg squats down to heels yet or it is a bit painful). Going down stairs with PTTD was painful for first few weeks FWB but now it is normal.

    I still do ankle inversion/eversion exercises with elastic bands nearly daily although I am probably at 90% recovery. They help strengthen ligaments and tendons, and tone them up to help prevent future sprains. I may continue ankle exercises indefinitely to afford a margin of safety.

    Wobble (balance) board was always my favorite and I still get on it. It provides a wide range of stretch and motion in all moving parts of foot and ankle. Balancing on wobble board with eyes closed ups the ante and really advances your proprioception skills.

    Keep up the good work.

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