Trimalleolar Ankle Fracture (w/ dislocation) - Progress Update
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Hi everyone!
Firstly, Thank you for everyone that has posted about their experiences regarding ankle ORIF surgeries! The unknown is not a comfortable place and everything has been put into greater perspective with so many experiences shared here.
I have read many posts here, and while helpful, often do not continue along the road of recovery and that is what my intent is with this thread. I will catch you up with where I am now and I plan to check in on a regular basis to hopefully help provide the injured with a timeline/expectation. Just keep in mind that everyone is different and nobody's healing path will be the same - never be disappointed if someone is doing better because there is also someone doing worse.
I am a 36 year old, healthy, athletic male. I suffered a trimalleolar ankle break on July 9, 2022 during a cycling race. I felt my right ankle twist on the way down and when I took a look, my foot was pointed at 2 o'clock when my leg was straight - not ideal. Amazingly, I was in very little pain. I thought it was the adrenaline but it turns out that I was just lucky (or tough as nails 😉) as it did not hurt until after my Surgery 5 days later. The surgeon wanted to wait that many days because when I saw him on July 11, I had severe swelling and my foot was covered in fracture blisters. Also not ideal.
I had my surgery on July 14. My fracture blisters were still there but the surgeon was able to work around it. I am thankful for that as I hated the fact that I was wasting days waiting as opposed to healing. I have seen many posts of folks having to wait longer so I am lucky in this regard. I have attached my operation report written by my surgeon so you can read to see what went down. There is also a before/after XRAY picture of my ankle.
I was sent home that same day and went right to bed to rest. The nerve block was in effect so I did not feel much pain. The next day, it was manageable as well. Actually, for the most part, when lying down with my foot elevated above my heart, I was fairly comfy. But for the first 1-1.5 weeks, when I would stand up, the blood would rush to my foot and the pain was wicked. I dreaded getting out of bed to do something as quick as taking a pee. TMI - I peed in bottles and my wife would empty them. It really was that bad.
At week 2 I had a follow up appointment. They were to take me from a backslab to a hard cast for another 4 weeks. I convinced my surgeon to allow me to have a removable boot instead. I figured that if I can use the 4 weeks to work on my mobility, it would only help speed up my recovery. Cycling is my life and I just want to do everything I can to help myself heal ASAP and get back to doing what I love. He was reluctant because I think many people take advantage of this, remove their boot often and become prone to reinjury. I assured him that I would only take it off for my mobility work, will stay 100% NWB and will wear the boot always (except during mobility). I highly recommend this to everyone that is able to be disciplined and not put them in a position to reinjure.
I am now almost at week 5 and things are better. I am not really in pain anymore. When my leg is down I do pressure/discomfort but am able to work at my office for the day. I still try to elevate and lay down as much as possible. My mobility is increased but would likely be better if I started to see a physio. I was hesitant just because my doctor didn't tell me to see one and I also thought it would be better to start once I can bear weight - in hindsight, I do with that I started then. Moving my ankle up and down has progressed a lot but the lateral work or spinning my ankle in circles is just so hard to get going.
Next up is my 6 week appointment on August 24. If all is well, I can start to put weight on my foot. I have my first physio appointment booked for August 25 so I can begin my journey to independence. I will keep you all posted and I hope this thread can serve some sort of purpose for someone out there.
Words of wisdom: Good luck. It's s**t but keep reminding yourself that this is temporary. I found that focusing on each day as opposed to looking ahead truly helped me keep myself sane. As an example: don't think about how it will be 10-12 weeks until you walk or drive again when you're in your first week of recovery, as that wont do you any good... so just focus on getting past the day.
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DannyLev
Edited
Week 15: I went on a 133km/~80mi bike ride with a fairly strong group. I was dead tired by the end but it was the best feeling to be out there with some friends. 2 days later I went for a 2 hour walk.
Week 16: On the weekend, I rode my bike indoors for 30 minutes and planned to go for a long walk (1.5-2h) after I showered up following the bike ride. After walking for about 45 minutes, it was hurting a lot and I finished the walk at around an hour, went home and laid around for the rest of the day to rest my ankle (my guess is the ride brought on some swelling which made the walk uncomfortable). Nothing is wrong, I just thought to share since it seems everything is going perfectly for me. It's going really well and I'm excited about it, however, I am still quite far off being normal. I still limp sometimes, in my opinion due to stiffness/swelling.
My plan has been the same... 45 minute walk every morning and daily strength training. When I am walking up hill, I try to really engage the calf on my bad foot to push me up for that stride - I am eager to get my calf size/strength back. My quad size/definition is coming back much faster than my calf. For strength training I am doing leg exercises, balance work, core and upper body muscles as well. I can now do a single leg calf raise! I can also balance on the bad leg wayyyy better. Winter is coming here in Canada and I will transition to 45 minute indoor rides every morning when the weather goes below freezing and kick the strength training up a notch. I am going to start doing some yoga in the mornings as well at that time. I had knee surgery in 2009 and my physio had me at about 90-95% ROM but I was stuck there - as soon as I began yoga, I got to 100%... so that is my plan now for my ankle. My physio thinks that it's a good idea and definitely safe to do now.
Until next time!
DannyLev
Edited
Week 20:
The cold weather ended my walking streak a couple weeks ago and I'm missing it. It was such a great way to start the day. There was a warm day this weekend and I went for a long one, 11km (6.5miles) and it took me a bit over 2 hours in light boots. I felt great during but that evening and the next day, oooooof, my ankle/foot was super swollen and a pain. I'm not surprised or concerned but it is definitely a good reminder that this is a long process and there is much work to be done.
Since my last post I have ramped up my full body strength training which has been great overall.
My range of motion is my limiting factor so as the morning walks ended, I began morning yoga/stretching. I searched youtube for "yoga/stretches for stiff ankles" or "yoga/stretches for ankle mobility" and I experimented with most that I found. My personal favourite and the one that I use almost exclusively (for now until I get more ROM and this is the one to get me there) is titled "Ankle Mobility Exercises!..." from a channel called "Breathe and Flow". If you search "breathe and flow ankle mobility" it will be the first one to pop up. Highly recommended.
I am considering signing up to a gym so I can use the treadmill so that I can get back to walking for long stretches on a more regular basis, to start "jogging" and to increase variety of strength exercises I currently do in my home gym.