Recovery

Hi.

I had the same rotten injury and my surgeon told me I was at the worse end of the spectrum regarding ankle breaks. They do differ tremendously in injury. 

I'm over 2 years in. I was not walking unaided until 5 months POST OP. I had a job on my feet, which I am unable to do now. I still have pain when walking or standing for periods of time. I'm also 61, so if you are young you will probably be much better off. I have 2 screws inner ankle bone which I can sometimes feel and in cold weather I can feel all the metal. I must say it has shown a little improvement over two 2 years and still believe it's healing. My ankle will never be the same , but this doesn't mean yours will be like mine. I get pain in my foot and leg at times. I also have days where I'm fine. I can't judge one day to the next. I don't now get much swelling, but then again I also rest a lot. I also had physio and hydrotherapy but don't do the exercises much now. I do have plenty of movement in my ankle , so keep up with the exercises. I used to be very stiff in morning but this also has improved but I still get some stiffness some mornings. Also I find if I'm walking inside without footwear I do get pain but in footwear I'm fine apart from the pain I get from time to time. You are still in early days and you will improve. It has affected me mentally and get somedays where I'm down. Keep strong you will improve over time. It's a long road. I have 2 plates with screws and 2 long screw inner ankle bone. My metal can't be removed. The 2 long screw are the most problem. 

Gosh! 

I’m 9 months down the line, had over 30 PT sessions and continue with them, still on the single crutch, when I’m walking I  cannot get my knee in line with the end of my toes so this has a knock on effect all the way up to my hip, apart from my lower leg break my ankle was shattered and I have tendon issues, the two plates an over a dozen screws could be a contributing factor for lack of mobility, I get my results from the MRI for my knee and results from the  CT scan on my ankle tomorrow so hoping to get some clarity, I’m 48 and I’ve really up the exercise regimes in the Gym, bike work, mobility classes I start in the pool next week, I’m trying to exhaust all things to do all I can to get as much flexibility in my ankle as possible, however doc did warn me that I’ll never run again and it could possible take 2 years to get to some kind of normality. So I’m agreement with other comments it’s so important to adapt and stay positive, I had 8 weeks Healthy Minds Therapy which is very advisable  and I’m now on a health eat program, I read a lot and I find I do things I had no time to do prior to my injury, family stuff mainly. Keep positive guys  

Hi Rita,

I wish someone could tell you with some certainty what your recovery timeline will look like, but that would take a crystal ball. You see, each recovery journey is a unique and individual one.

That said, there are some general comments that would apply in many ankle injury scenarios.

(1) First, if the breaks were bad and surgical intervention was required then that usually means a more difficult and prolonged recovery (remember, I'm generalizing here-- YMMV (your mileage may vary).

In my case, it was a bimalleolar fracture with a honking big ankle sprain and tendon damage. I skipped out on surgery although my orthopedist suggested it might be necessary (I did just fine, by the way).

(2) Age and general health do most definitely impact outcomes. You're young so you have that advantage-- the downside is you have many more years to watch and take care of that ankle because, although you may recover close to 100% pre-injury state, your ankle is now compromised and susceptible to future injuries, like sprains. So be careful and don't, repeat do not take your ankle for granted anymore.

(3) Diet and lifestyle choices make a measurable difference in healing rates and completeness. A poor, inflammatory diet (carbs and sweets for example) will slow down the healing. In recovery, you needs lots of nutritious food and can benefit with supplementing diet with antioxidants, collagen/silica/msm/hyaluronic acid (to rebuild shattered connective tissue like ligaments and tendons). Deleterious habits like smoking, excessive alcohol, and relying on narco painkillers will hinder success, too.

(4) Broken bones usually mend right on schedule (there are exceptions, of course). Limiting factor in many ankle fractures/sprains is soft tissue damage. That's where most of patient drama and grief comes into play. In my case, it was mainly a damaged post tibial tendon (PTTD).  Fortunately, I'm close to fully recovered there, but it hasn't been easy. That leads to another crucial factor:

(5) Physical therapy, or physiotherapy (PT) is absolutely crucial to stabilizing and strengthening an injured ankle and preventing an incompletely healed ankle from ruining a patient's life further down the road (through chronic ankle disability).

PT regimen should be tailored around the severity and type of ankle injury. A competent physiotherapist is your best bet if you are clueless how to go about it (although some patients like me are DIY and learn from internet and YouTube).

Goal of PT is strengthen and stabilize all soft tissue components (muscles, nerves, ligaments, tendons, fascia) that got damaged in injury AND also all the bits that went dormant and flabby when you were non-weight bearing.

PT is a lot more than wiggling your toes and moving your ankle in little circles. That will help but it won't get to the level of full recovery you deserve.

PT should now be an ongoing part of your life to keep ankle supple and strong. Many patients believe it is a 'one and done' practice, but that is an error.

(6) Don't forget general physical fitness to complement ankle PT. Everything is connected to everything else. So it often happens that ankle patients in recovery go on to experience hip, ankle, and foot aches and pains. Move that body and get your flexibility and circulation back in order. The pelvic area in particular needs attention because the nerves and muscles there control a lot of what happens in the nether regions.

(7) Proper footwear (sandals, flip-flops, flats, and flimsy shoes are just like begging for more trouble, at least initially) and support can make a crucial difference in how long you suffer and long term outcomes. If you sustained tendon/ligament damage like I did then a temporary ankle brace may tide you over (especially if your income depends on standing and walking). An orthotic insert, if needed, may make difference between walking pain and being relatively pain-free. Get good professional advice if you need it.

(8) Above all, keep a positive attitude. Promise yourself (and your ankle) that you will do whatever it takes to get back to a normal, active life. You deserve it. 

This is what I wanted to hear! Thank you very much. I know I will be keeping a close eye on my ankle more than likely the rest of my life but you covered my concerns about PT and after 20 sessions I felt like I wasn’t getting much out of it anymore. I will keep a closer eye on my diet also. Not that I eat bad but you can always eat better. I’ve never taken any pain meds so I’m not worried about that but right now I’m just working on trying to loosen up my tendons since they are so tight from the recovery road. They gave me a ankle brace since I am very active, having that piece of mind where I have some extra support really helps. Being that it was a trimalleolar fracture I knew it would be a long road ahead but I’ve always had a positive mindset that I can only get stronger from here! Thanks again so much