Trimalleolar Ankle Fracture (w/ dislocation) - Progress Update

Things have been great since being allowed to start walking with no crutches 7 days ago. I can now walk rather smoothly whereas I was very choppy in the first couple days. It did hurt for the first 5 days, and it was more of a dull/achy pain rather than the intense pain we feel in the first couple weeks after surgery. Very manageable, I'd rate the pain 3/10. The first couple days I did use 1 crutch in the last hours of the day to get some relief and I also would use 1 crutch for the first 10 minutes of the day. But now, 1 week later, I am not in pain from walking on it. My physio was reassuring and reminded me that it is normal pain due to being non weight bearing for so long - so don't get down if it gets sore, especially in the early going.

I have done a few outdoor leisurely bike rides and an harder effort on my stationary bike the other day - boot on of course. It felt amazing to get my heart pumping again and I was gassed after 20-25 minutes of effort. Through my injury I have continued to eat like an athlete although I wasn't exercising like an athlete so needless to say I am looking forward to losing some weight that I've put on in the last 2 months.

My physio said that we may look to ditch the boot on my next appointment this coming Tuesday. I feel like I am ready and can handle it. I expect more of the same soreness and am here for it.

oh Danny, that is so awesome. I keep looking to your progress and praying I have the same. I have one more week of nonweightbearing, I go back on 9/19. i have been doing small circles with my ankle for ROM and it doesnt hurt so im hoping its helping. WHEW So happy for you!!

Update @ 9 weeks:

I have been off crutches, still in boot since week 7 and feeling stronger everyday. Last Saturday, 8 weeks + 2 days, I went for a walk around the block with my kids and it was super sore about halfway (5 minutes in) and I was in a lot of discomfort by the end. It didn't hurt before that during walks but before never included a steady walk of distance. More so walking around the house, walking around my office, all walks that quickly had a break, standing or seated, just by nature of the destination. Today at 9 weeks, I was able to walk my daughter to school (in my boot) absolutely pain free and this walk included going up hill on the way home carrying my 35lbs (~20kg) son and I think it was a 15 minute walk in total. The body just needs time to adapt to new stressors like increases in distance and the like.

I had physio yesterday and hit another milestone. We took off the boot and with the support of my PT being the equivalent to 1 crutch, we walked up and down the hall. I was beyond excited. All the staff were really happy to see it and I kept yelling silly things like "and they said id never walk again!!!" the whole time lol I was absolutely shocked that there was ZERO pain with this. The physio thought I was maybe being deceptive in hopes to be allowed to do more but nope, it truly felt AMAZING. Of all the milestones so far, this one means the most to me. It now feels like "normal" life is on the horizon.

I am now allowed to walk without my boot, using 2 crutches for 1-2 minutes, 5-6x a day. He said that if it feels easy and is 100% pain free after 3 days that I can progress to 1 crutch with the same time/frequency protocol. With a few of these walks under my belt, absolutely pain free, I am certain that I will be on 1 crutch in 2 days.

He also allowed me to ride my stationary bike without the boot. He told me to start at 10 minutes and increase my time by 3-5 minutes each session if the previous felt good. I did 10 minutes last night and felt like I could keep on going! Tonight I will go for 15 minutes and maybe push the watts a bit as I was conservative on yesterdays spin.

Pennie and Jacqueline - you have a big week coming up! I am looking forward to hearing how your appointments go and am sending positive thoughts your way.

Update @ 9 weeks + 4 days:

I intended to do weekly updates but things are moving fast so I will keep the updates coming when anything notable occurs. I went to 1 crutch yesterday and immediately had a normal full length, smooth stride. No pain. Today, while I am at my office and I put down my crutch, I was completing a task when I needed something a few steps away... I walked over without the crutch to get it and noticed no pain in those small short strides. Curious, I tried to see how it would feel to walk without any crutches and it is easy. My ankle is stiff laterally but my dorsi/plantar flexion is good enough that I can actually walk quite smoothly without any crutches. I have been doing short, 2-3 minute walks for the past couple hours and there is no pain during or after. I have a physio appointment tomorrow and will likely just walk in unassisted. I hope that I am not pushing too much too soon but it really feels quite good. I will immediately grab my crutch if it gets sore later today.

I am also going to do a 30 minute ride on my stationary bike after work. I did 20 minutes yesterday and felt like I could go a lot longer.

Getting there.

Update at 10 weeks:

I got the all clear to start walking without the boot+crutches in safe controlled environments which is pretty much anywhere except my house when the kids are around. I am limping, not really in pain, just going slow and concentrating on proper walking form.

I have also progressed to 40 minutes on the bike. The bike work has been improving despite me not actively "pushing" it. I am just trying to ride steady and keep decent pressure on the pedals. Here is how my 4 rides have gone since I've been allowed to ride without the boot:

1st - 10 minutes at 151 watts

2nd - 20 minutes at 167 watts

3rd - 30 minutes at 203 watts

4th - 40 minutes at 207 watts

Update @ 11 weeks:

I am still walking without my boot and am progressing well. My walking form is poor unless I walk slowly and focus my efforts. I do a few slow, focused walks each day to make sure I help strengthen the proper muscles and hopefully speed up walking properly.

My last cycling effort was 1 hour and 15 minutes. Tonight I will go for 1hr30m. I am able to ride in my former Z2 power for these durations which is nice. That last ride had 5 10-20 second seated sprint efforts that didn't seem to bother the ankle.

I am starting some calf raises, straight leg deadlifts to my gym work and it feels outstanding to finally work towards putting some muscle back into the leg. My physio allows me to squat, acknowledging that it wont be a full squat, but on my last attempt it just didn't seem possible due to limited ROM. I will try again this evening.

Next week I have my 12 week appointment with the surgeon. My physio is eager to hear about my progress as he wants to become more aggressive in my treatment.

Update @ week 12:

Walking is coming along really well. I limp but it has improved tremendously as this week went on.

I had my 12 week follow up with the surgeon yesterday and he was happy with my progress. I no longer need to see him and have the green light to "do anything". Physically I cannot do anything but am looking forward to becoming more aggressive in getting back to 100% so that I can.

My ankle/foot is still very swollen. I wear diabetic socks on the injured foot and highly recommend them.

Week 13:

This was a good week. Once my surgeon gave me the "all clear" my physio responded accordingly with some new homework. Complete a 40 minute walk, ride my bike outdoors for 1 hour and he gave me more exercises such as practicing balancing on one leg... which is surprisingly difficult. I am also doing squats, deadlifts and calf raises to rebuild my strength. I am trying to progress to single leg calf raises but I cannot do it just yet. He also reminded me not to forget to do my mobility work, specifically the side to side movements. He also said that I only have to see him once a week now down from twice a week.

On Saturday I rode my bike on paved walking paths for 1h50m at a slow pace while getting used to everything again. It felt great. So on Sunday I went for 4h on a ride with my wife on hilly gravel roads. We took lots of breaks (the fall colours are stunning at this time of year). On Monday, I ended up completing a walk of 50 minutes my ankle was a bit sore by the end which made sense given it being my longest walk which was the day after a 4 hour bike ride. On Tuesday I rode my bike to physio and rode for 2 hours with a friend after. I can't put into words how amazing all this felt for my soul.

My focus now is on strength training mainly trying to get some size/strength back into my right leg and also to lose some weight that I put on during the rest period. My friend took a picture of my legs from behind that shows the discrepancy in size at the moment.

Week 14:

I will start posting when developments happen or every 2 weeks as I am having less appointments and less to share.

This week I have been waking up early and starting my days with a 45 minute walk. It has gotten better with each passing walk. The first couple had intermittent pain or pain at the start that faded as I trucked on. I record my walks and today my pace was faster than the previous walks and I felt that I was walking quite smoothly. I am at the point where I sometimes do not limp but I think that I limp more often than not. Sometimes my ankle is stiff/sore for the first few steps after sitting for a while but I don't pay much attention to that.

I am working hard on mobility and doing full body workouts with weights. I still cannot do single leg calf raises but am getting stronger and closer. I can balance much more now than I did last week on my single leg balance exercise.

Progress is such a great motivator. My tip to anyone reading is to keep your focus on your progress. It doesn't matter if you are recovering at a slower/faster rate than anyone else, this journey is your own. As long as you progress and get better at whatever it is you are doing, that is what matters. Stay positive. A negative mind doesn't promote a healing atmosphere.

I am still very swollen but my physio is not concerned about it.

I was super excited to find this conversation when i was researching how long the discoloration of my foot would be after ORIF surgery on my right ankle.

About a month ago, I slipped on some gravel going down some steps and suffered a trimalleolar fracture as well. I had to wait almost two weeks for my surgery and am now 2.5 weeks post-op. It's been great to see everyone's recovery schedule!

My schedule seems to be a little accelerated so I've had to google a lot to get some answers since Kaiser isn't great at getting me answers. I was in a splint after surgery, and then in a hard cast one extra week before they removed my stitches two weeks after surgery. My Kaiser surgeon hasn't informed me about the needing a PT outside of the exercises he told me to work on at home, and has told me to return to wearing shoes ASAP which seems a bit soon. I waited a few days before starting the ankle exercises as I was feeling some pain, but day by day, I'm able to move it more and more. My surgeon said I can switch to WBAT on 11/6 which will be about 4.5 weeks post op, but I don't have my next appointment with my doctor until 11/21. It seems everyone had an appointment with their doctors at certain important milestones, but mine is more spread out which worries me since I'm mostly doing PT on my own.

I'm excited to see all the progress everyone has been making and I cant wait for the day I can start walking without crutches and driving again. I try not to count the amount of near slips and falls I've had with crutches and I can't wait to stop relying on them.