Weight bearing after ankle surgery

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I posted a few weeks ago following my post surgery check-up (ankle ORIF) and you were all really helpful with tips on range of motion exercises.

I was due to go back for my 6 week check on 10th January but ended up going back yesterday instead as my surgical wound wasn't healing. I also talked to the surgeon in more detail and it turns out it is the posterior malleolus that was the worst part of my fracture (as well as repair to medial and lateral malleolus) - must have been the shock or medication or lack of understanding that missed that part and as my doctor referred to it as a "nasty fracture" that's probably why! Anyway, silver lining being my doctor saved me the trip back next week and said from looking at my x-rays all is healing well and I can gradually start weight bearing in my walking boot.

The question is, how do I go about this without limping on to my good foot and keeping weight on my hands? I expect it's all in my head with the fear of putting weight on the bad foot but any advice you lovely people have would be much appreciated! Also, how much should I be "walking" around to help my recovery? Thanks in advance smile

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  • Posted

    Vicky,

    With your bone breaks now healed enough for some weight-bearing activity, go ahead and proceed with confidence-- your bones are not in peril (unless you do something really foolhardy that might cause re-injury). Just don't overdo it starting out.

    It seems to vary with doctors, but standard weight-bearing protocol dictates a graduated approach-- several weeks at partial weight bearing (for example 50%), and then full weight-bearing in boot for a few more weeks. Then you are in your normal shoes and walking as usual again.

    Crutches or walkers are invaluable aids in getting partial weight bearing activity correct (not too little or too much pressure and stress on ankle). In full weight bearing you may find a walking cane helpful as you work on getting balance and gait back.

    How much pain and difficulty you have in recovery and weight-bearing depends a great deal on what associated soft tissue injury you sustained in your accident. Surgery introduces another variable of complications due to tissue scarring, and possibly nerve damage.

    So you see that while there are certain benchmarks to look for on your recovery path and timeline, it will vary from patient to patient depending on their circumstances.

    You should walk and move as much as you can without too much pain or discomfort. If ankle is screaming bloody murder it's best to back off and try more later. With time, you will improve.

    Adopt an ongoing program of physiotherapy to strengthen, stabilize, and heal all soft tissue (ligaments, tendons, muscles, etc.) that were compromised by your injury and subsequent enforced inactivity while you were non-weight bearing. That is probably the most important advice I can give you.

    All the best to you.

     

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    • Posted

      Hi kpower,

      Thank you for your advice. I have started walking in the boot using just the one crutch today and seems to be working fine so must be getting a bit of strength back. I've been doing 10 minutes a day on my exercise bike and have walked round the block a couple of times to try and get my bad leg moving again so hopefully that's helping.

      Going to physio on Wednesday so looking forward to that. I have a bit of a limp at the moment but not sure if that's mostly because of the height of the walking boot.

      Onwards and upwards and I can't wait to have 2 shoes on and no crutches!

      Take care too smile

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  • Posted

    Hi Vicky, it's nice to know someone's in the same position as me!

    I went back for my cast off yesterday and have been given the moonboot, told to bear weight as is tolerable. It's so nerve-wracking isn't it?! Luckily, apart from obvious stiffness in my ankle I don't seem to experience any pain when I put my foot flat on the floor, so I have found it helpful to alternate wearing my boot and practising the motion exercises.

    In terms of bearing weight, if I use both crutches it's quite easy to practise putting my foot down, but I think a lot of it will be in our heads; even though my foot doesn't hurt I am so terrified about putting weight on it. This morning I have managed to make it to the kitchen and back on one crutch (same side as my bad foot), but letting the boot take the weight. Yes I look ridiculous and the limp is slow and awkward, but I think it's important to establish your pain level to determine whether you can push forward or take a rest.

    I find myself imagining that my ankle will just snap again if I stand on it, but our ORIFs will stop that happening so I hope you feel able to start trying. The only thing my doctor said to me was to make sure that you put the heel down first and really pay attention to not 'flat-footing' with the boot on- that may feel safer but it won't do anything to help the muscles and ligaments stretch and relax. In terms of how much time; I'm aiming to be walking around the house as much as I can (for at least an hour or so), practising stairs twice a day, taking the boot off and flexing the ankle 3 times a day, and standing with crutches and stretching whole leg a couple of times.

    I'm going back to work on Monday after 9 weeks, which is why I'm trying to hurry things along, but just listen to what your foot is saying to you. I do personally believe that you have to push through some pain as stopping straight away may just be putting off the eventual recovery, but obviously take care and don't push too far.

    All the best, let me know how it goes!

     

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    • Posted

      Hi Nat, 

      Thanks for your reply and it definitely helps knowing you're not the only one going through it. How are you getting on now?

      I've started using just the one crutch today so that's progress! I agree, it is nerve-wracking and it's the fear of undoing any of the healing but it seems to be getting easier. I have been told to stop doing my range of motion exercises for a couple of weeks as my surgery incision wasn't healing so have just been trying to walk round the house, round the block a couple of times and on my exercise bike...every little helps I hope! I have a limp too, my other half has said I'm walking around like the elephant man, ha ha

      How is it being back at work? I can't wait for that but I think it's going to be the first/second week in February for me and it can't come soon enough!

      I'm looking forward to my physio appointment on Wednesday, I think that should help me with knowing how much I should be pushing myself and what exercises to do.

      All the best smile

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