Rehabilitation after ankle fusion

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I had an ankle fusion 14 weeks ago and after 12 weeks in plaster, progressed to an aircast boot.  The surgeon told me to walk around the house without the boot from 14 weeks, so I've just started doing that,  but am finding I have lots of pain in the foot - below the toe and along the left side of my foot when I attempt to walk and roll through the foot.  Am walking with crutches now without the boot, and trying to roll through the foot as much as possible, hoping that the muscles will relax.  The hospital told me very little about what to expect at this point and haven't referred me for physio so I'm feeling a bit lost. Is this foot pain normal? (I don't have pain in the actual ankle, it's just everywhere else, including my opposite hip and knee too!).  

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  • Posted

    Yes this pain is normal and it gets better as the muscles and tendons strengthen. I'm 18 weeks and the side of my foot still hurts and my plate pinches when I rock thru, so plate will removed in one month. I walk with a cane or walker. Very slow and hurts more if I go unaided. Good luck!

    Margie

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    • Posted

      Thanks, it's reassuring to know that the pain is normal and to know it gets better eventually! I've now been in contact with the hospital who told me to stay in the boot for a bit longer as it takes time for the muscles to strengthen.  I'm just surprised about how long it's going to take to get back to 'normal', and how little they tell you about this stage before you have the op.. Good luck to you too and thanks for your reply. 

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    • Posted

      I had my operation in Nov 2016 and my cast was removed in Feb 2017. Been walking on my moon boot eversInce . Went to my doctor on the 28 April 2017. And he told me it's time to walk without the moonboot. I tried it for about 2 days Omw was it painful. I'm back in my moonboot and I don't know what todo. The pain is still there everyday, and my foot is swelling alot when I don't elivat it.

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    • Posted

      Sorry to hear you're still in your moonboot.  I spoke finally to someone at the hospital and they said to ease off the boot slowly. So have maybe one or two hours with the boot off, then have the boot on for 2 hours, etc. and slowly build up the time without the boot to let the muscles and tendons build up.  I'm trying that now - doing a couple of hours without the boot with one crutch, then putting the boot on when it gets too much.  The muscles in my foot all feel very sore but hopefully they'll get stronger.  Fingers crossed! and good luck!

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    • Posted

      I am at the stage of walking in cam walker boot. I am going to try the shoe and no boot but I thought I would start gradual with my crutches or walker for support until it gets stronger. I know it will hurt as my plate is right up against the bone Nd won't let my foot go past 90 degrees. I will have thatout June 6 yuck, I hate the thought of surgery again but it must be done. I think the slow approach to let those muscles adjust and strengthen will be less pain but prob take a bit longer.

      Good luck!

      Margie

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  • Posted

    Hi Tessa,

    It took me a long time to be able to stand weight on my foot.  Some of that was because of nerve damage, but as others have mentioned it also takes quite some time to just get used to it again, loosen things up, etc.

    I would recommend seeing if you can get a physio referral.  They can help you understand what's normal at what stage, but also have techniques for doing it in a way that may be less painful.  And more important, they can help you in gait monitoring because if you start trying to overcompensate for the loss of ankle motion, you can mess up your knee and/or hips.   

    You mentioned fusion with an internal rod.  Do you know what type/brand was used?  In my case, I have two rods for complete immobilization.  There's one vertical rod through all of tibia, talus, and calcaneous, and the other one is a horizontal rod running the length of the calcaneous and locking into/through the vertical rod).   

    I bring this up because you specifically said some of the pain was when bending the foot or trying to roll through the foot.  Maybe it's just getting used to it as already covered.  But in my particular case I had a similar pain which continued fairly long term.  I went back and got xrays done when bending the foot and we found that one of the screws going through the talus had its tip sticking out just enough that it would punch into the midfoot navicular bone when trying to bend the foot.  Once the surgeon was sure the bone had fully firmed up around the rods I went back in for one more surgery to get that screw removed. 

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    • Posted

      Sorry, I just realised that first sentence could be confusing.  It would have been better worded as, "It took me a long time to be able to tolerate weight  bearing on my foot.  "

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    • Posted

      Hi thanks for the advice. Yes I think I'll try to get a physio referral as I notice that i feel quite lopsided after so many months of being on crutches then walking with the boot, and am indeed getting knee and hip discomfort on the other side.   The foot pain is still there when I walk but it's reassuring to know that this is to be expected and will hopefully get better as things loosen up. I'll ask the surgeon to check the xrays next time I go back too.  Thanks!

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    • Posted

      "and am indeed getting knee and hip discomfort on the other side."

      Since you're just now starting to walk without the boot, I would guess this may actually be boot-related.  I was almost 2 years from the initial accident to recovery and had a boot on a lot of that time.  The height mis-match between the boot and regular shoes was part of the issue, and just the un-naturalness of the gait while in the boot.  Getting a shoe that matched the sole height of the boot helped.  

      But nothing was like the day I was finally able to get rid of that darned thing forever!  :-)

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  • Posted

    I have been in a boot for 16 weeks and agree my hip is starting to protest a little too much, forgot to mention this to the doctor on last visit. I have taken a couple of anti inflammatories which I hope will help. So looking forward to getting the boot off and being able to walk again.
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    • Posted

      I here you I'm 19 weeks in the boot. Chiropractor really helps with the adjustment of the hips! Yes I can't wAit to throw away the boot!!!

      Margie

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  • Posted

    Hi

    I am 7 weeks in the boot and its driving me insaine i demented stuck in the house. I swear l am gonna burn the boot when l am.finished with it. I have been so depressed stuck in the house constantly. I am totally struggling with it. And l had 2 hip replacements and a knee last year and it was so much easier.

    Lors

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    • Posted

      I here you, I had many thoughts of burning the boot and still do lol. I am 20 weeks and still in the boot , but now I can drive walk with a cane I went to the bookstore and Starbucks the other day. They have lots of chairs around. It will help when you can get around better in a few weeks and you are not so house bound. Can you wb yet! I ne we thought it would be this long but ankles are the slowest to heal.

      Hang in there!

      Margie

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  • Posted

    I am starting to get around a bit more, slowly slowly, and need to rest after about an hour. Yesterday I vacuumed and mopped the floors, happy with that, however not much else got done. Have made an appointment to see Chiropractor on Friday maybe he can sort my right hip out. Left ankle in boot, I am afraid to burn my boot in case I need it again. I have already had 6 operations for my dodgy ankle hope this is the last one. Work are starting to ask when I am coming back, I will go back when I am ready. I don't want to go back fall over something and be back to square one. I do get down sometimes, when you feel like that phone a friend, read the post here. If you can drive, go for a drive, you don't have to get out of the car. Go through the drivethrough at Macdonalds and order a drink or an icecream.

    Have a great week everyone.

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  • Posted

    I had a double ankle fusion of my right foot and am 5 weeks out of my boot. This is my second foot surgery in two years. I am still having a terrible time with walking and having pain while doing so. I still have quite a bit if swelling. If resting the pain is very minimal if exist at all. Walking seems to be my only issue. My foot was repositioned as well because I have prolapses arches so now in my right foot I feel like I am walking on the right side of my foot only and it feels so odd and painful. I am told this is all normal and my progress is on point. I feel like after 5 week post boot almost 4 months post surgery walking should be getting easier and less painful. I have searched all over looking for stories and progress of others during this same type of recovery to see if how I am feeling is normal and when I can expect some relief. My physical therapist and doctor just say it will take time but my frustrations grow daily. I never healed after my last surgery and was in pain until this one so I can't even try and compare my progress. Please I need some feedback from people who have been through this and understand?!?

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    • Posted

      Hi Laura, I'm now 23 weeks post fusion and still have pain in my foot and at the back of my ankle when I walk. I'm still walking very slowly and with one crutch. I'm also walking more on the outside of my foot so have been referred for orthotic insoles to correct this. Like you I've been really frustrated ever since I came out of plaster and the boot at how slow my progress has been, and have also been told it all takes a long time to settle down and that I need to be patient! The nurses keep telling me it can take between 12 to 18 months to feel completely happy with having had the surgery. I'm trying to stay positive but it's hard. I can feel some glimmers of hope as every week there is a slight improvement but it's very slow. Keep going and be patient is all i can say!! Good luck!

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    • Posted

      Tessa- thank you so much for the message. Its nice to know what I am feeling is not crazy and my progress is where it should be. It does get very discouraging but having people who understand is very helpful. I should probably use my crutch more and not be so stubborn to help with easing the pain when walking but I felt I shouldn't. Please keep me updated on your progress. I see my doctor again in another 3 weeks.

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    • Posted

      Good luck when you see the doctor. I'll keep you posted abt my progress. I'm off on a beach holiday next week, booked back when I thought I'd be fully recovered by 6 months post op. That was obviously very over optimistic, but I'm hoping that swimming in the sea will help, despite the fact that having a crutch on the beach is not going to be very stylish!!

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    • Posted

      Im in the same boat Tessa,

      29 weeks out with 2 surgeries and still with one. Rutch and sometimes came but walk very slow as well, my calf and achilles very tight and my foot balloons up after all the excercises I have to do for my Physio. It is a slow and ago izing road so hang in there. I sure know my patience had run out but I too see little improvements.

      Keep your chin up!😊

      Margie

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    • Posted

      9and half months after subtular hindfoot fusion that isnt completely fused so Just under 3weeks ago they removed the top screw as to aparently allow impact of bone onto bone to help with fusion process but after stitches remove just over week ago l spent sun til thurs in hosp with infection and am not spending enuff time walking so unsure if screw removal has had effect or night although i do feel its given some much needed length to R leg which was greatly shortened during fusion surgery

      ###CANTGETMUCHWORse

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    • Posted

      Kevin I am really sorry to hear what you are going through! I can't imagine how tough that is. I will pray your healing continues please keep me updated on your progress. Hang in there and good luck!

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    • Posted

      Kevin......has your ankle fused after removing the screw?  I, too, am having problems with my ankle fusing. Iam 7 1/2 months post sub talar fusion, and my ankle is still not fused. They gave me a bone stimulator which I am now wearing 3 hours a day. However, i went to the market today to go food shopping, and even though I leaned on the shopping cart....I have a lot of pain after 45 minutes.....Although I am 68, and I have osteopenia ....which is something before osteoporosis
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    • Posted

      I had my operation 3mths ago no weight bearing at all during this time now I have a boot on  and told to leave this on for 5 weeks.  I go back to see consultant in 2mths am using two crutches but people are telling me I should be only using one and that’s only one week after getting boot on.   If I use one crutch my foot hurts like mad on the top where it feels tight.   How long did you use two crutches.
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    • Posted

      i was in cast for just over 3mths now told to keep boot on for 5 weeks am using 2 crutches how long before you reduced to one crutch. Please help as my family think I should be using one crutch only.   I am 66 so I didn’t think I was doing bad.
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    • Posted

      linda,its a long time since you posted. was the pain at the top of your foot from one side to the other of your ankle bone? How long did it take to feel better? My pain in that area....i believe called the cruciate ligament is what is holding me back its really painful on weight bearing.

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