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

    I had ankle joint fusion 2 weeks ago and really have felt great ! Pain has not been bad at all.

    I had post -op appt 2 days ago and went out of splint into cast and have been aching and hurting . Has anyone else noticed having more pain when they put cast on . This is my 4th surgery in two years from what started as a trimalleour ankle fx . 

    • Posted

      Hi Amie, it sounds like your cast might be too tight.  But it does also feel different when you first get the full cast on because of the swelling.  If you get a lot of pain you should probably  contact the hospital so they an check it. Good luck! 
    • Posted

      I got my cast on straight after opp got it changed after two weeks and then on for 3mths.  I had discomfort at first but once I kept it elevated the swelling went down.  Cast was ok then
  • Posted

    Hi Tessa and all

    This forum helps me to understand the aftermath of ankle fusion which doesnt really get talked about when you are prepped for ankle fusion surgery, so thank you it is very informative and gives a realistic picture. My dad is due to have ankle fusion and I understand results and outcome will vary from individuals. Just a change of topic slightly, our closest hospitals are in London, he is trying to decide which surgeon to go with, either with Mr Sam Singh based at Guy's Hospital or Mr Andrew Goldberg at the Royal national orthopaedic hospital. Just wonder whether anyone has had experience / opinion with them to help him decide?

    Thanks

    • Posted

      Hi yes this forum is definitely a life saver when it comes to talking about recovery post op, which is just not talked about realistically enough before you have the surgery.   I had my ankle fusion done at the royal national orthopaedic and although it wasn't Andrew Goldberg that did it, I know he is very highly regarded, and the RNOH is a centre of excellence so I think a good option, (although waiting lists are quite long there  - I waited about 8 or 9 months for an initial appointment).   I don't anything about Mr Singh I'm afraid.  I hope your dad gets on well whichever he goes for.  

  • Posted

    Thank you Tessa, glad to know that there's someone who had the operation at RNOH. I am hoping for a good outcome.  I wonder whom your surgeon was if you dont mind me asking, although completely respect this is very personal.  As my dad also has osteoarthritis in all the other lower limb joints, I am guessing after the fusion, his other joints are going to take quite a toll, not to mention that he will need both his ankles done at some point. He is not overly fond of having a 'non-curative' operation, but the idea is to help with pain right ? (eventually after a long period of rehab )

    • Posted

      Hi, my surgeon was Matthew Welck, who was fairly new to RNOH at the time. He's very nice, and I think all the surgeons at RNOH are very good as it's a specialist hospital.  Yes after fusion the other joints do take the strain and you can have problems longer term because of that.  The more immediate problem is the 3-6 + month stage when I had a lot of pain in the foot once I came out of the aircast boot (although more in the muscles/tendons than joints I think). Also a long period of time on crutches / in aircast boot does take its toll on the whole body.  The idea of the op is to be pain free, but from my experience it does take a very long time to get to that point (I still haven't completely after 9 months, although after 8 months was a bit of a turning point for me).  I saw Mr Welck the other day and he said I was doing well but that it takes a year or even more to totally be happy you had the op done.  I'm now walking unaided and in normal shoes without painkillers, so that's better than life before surgery, however I still get discomfort so I wouldn't say totally pain free yet).  At least from having read the forum your dad will know more what to expect.  It's tough but hopefully worth it in the longer term.  I wish your dad luck! 

  • Posted

    Thank you Tessa. The information I learn here with regards to rehab is invaluable!  I shall certainly pass that on to my dad. I wonder whether you could give me an idea of how often you would need to attend for follow up at the RNOH? As it is quite a journey for us! Will need to take into account the practicalities and logistics (especially when I will need to be doing the ferrying and have a toddler and a baby!)
    • Posted

      Yes of course.  Initially you're in for 2 nights. Then there's a check up after 2 week  - they put you in a half plaster for the first 2 weeks because of the swelling, then after 2 weeks you have a full cast put on (and I think stitches were taken out at that stage too). The next check up is at 6 weeks, (although I did go at 4 weeks too as I had some abrasion on the skin under the plaster which they wanted to check on). Then 12 weeks when the plaster comes off and if all's well you go into an aircast boot.  Then after that there's a check up at around 6 months.  Then I think it all depends on how things are going. I've also had check up at 9 months, and also I've had an orthotic insole made so I've had separate check ups for that.   And now I'm waiting till 5th January when I'm going to have the screws taken out! So it's quite a lot of to-ing and fro-ing - I spent a lot on taxi fares initially until I was able to drive again (which was around 7 months).  I hope that helps give you an idea of the process!

       

  • Posted

    I'm so glad to have found you all. I'm 5 months post ankle fusion and have been so worried about the level of pain I still seem to be in. I've ditched the boot this month as I don't actually feel it's helping, it felt more of a hinderence if i'm honest. The worst pain I have is just below my ankle bone on the outside of my foot, the outside part of my ankle and also across the bend part of my foot and ankle. When I first get up after sitting for a while well all I can say is Omg. It takes a while to get moving. Like most of you I've have had little to no expectations given to me in regards to recovery before or after the surgery. Until I found all of you I was begining to think I was never going to heal. I feel like I have some hope now.

    • Posted

      I’m getting a little discouraged too. I had ankle fusion 10/27/17 and it’s been 2 months and my 3 little toes and the left side of my foot is numb. After surgery I was placed in a plastic cast and from the removal of that cast I wasn’t placed in anything so I’m a bit nervous. I have tried to stand on my own but it feels so funny because I can barely feel the left side of my foot and it also feels and if something is stabbing at the bottoms of my foot is that normal
    • Posted

      How long was you recovery time frame? I’m going to physical thearpy but I haven’t made it to the machines as of yet 
    • Posted

      Hi -I was 6 weeks non weight bearing then around 5 weeks in boot with gradu all weight bearing. As soon as the boot came off I was sent to physio and started with very low weights at the gym immediately -the physio had me on leg extensions and leg press on my first visit. I have been gradually increasing the weights since then. None of this actually directly fixes the foot -but the physio said that building up the legs and doing exercises to improve walking is the best aI'm and it does seem to be working. Now 6 months post op I still do the gym work. My ankle still swells but my walking is much smoother. (When I was in the boot I bought a pair of platform flats so that the good leg wasn't shorter than the bad leg).

      All the best

      Brigid

    • Posted

      Hey Bridget

      I'm almost 5 months post OP and started to walk without the moonboot last week and Friday. Swelling is a lot but next morning its down. Did some of your nerves/joints also pain after you took the boot of and fwb?

  • Posted

    Hello all,

    I had an ankle fusion on the 2nd August - boot came off after 11 weeks. I have been attending physio - the primary focus has been on building up the legs to improve walking and it has helped me a lot. I have been through various stages of foot pain - initially the outer side of the foot hurt horribly, then it suddenly eased. I got back on my bicycle in November - a bit tentative, but it was actually a lot easier than walking.  Over Christmas and New Year I did a lot of walking (probably a little too much) - the longest around 7 miles, including up some hills. It was wonderful to be able to walk - because the arthritis in the ankle before had been excruciating and really limited what I could do. The ankle and foot have swelled since then and the discomfort in the foot is now across the middle. I know that it can take up to a year for it all to settle down so I am keeping hope that the aftereffects of walking will ease in time. Having said that, the pain in the foot now is much less than the previous pain in the ankle so it was all worth it. The rehab takes a lot of time, I do all the exercises the physio told me to do everyday, and I do some weight work on the legs in the gym. I never liked gyms before so this is a new discipline, but it certainly feels as if all the boring stuff is worth it to be able to do the outdoor stuff again. I had to buy some cheap and wide trainers and can only really wear them, so I have three pairs the same, all very dull but they are the only thing that can accommodate the fatter foot just now and allow the flexibility for the foot. I don't know if it would be helpful to try special inner soles, they have not yet been recommended to me, and I don't know what the research says in best. I thought it might be best to just let the foot get on and adapt to the new bending it has to do - but I will ask the surgeon when I see him in a couple of weeks. It has been helpful to read about other people's experience because I have not yet met anyone else who has had an ankle fusion as it seems to be relatively rare.

    Thanks

    Brigid

     

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