This edition of my blog series on my experiences with a broken ankle will focus on the healing process. What happens once you can start putting partial pressure on a broken ankle? How long does it take to get back to “normal?” What exactly happens in physical therapy? When can you drive?
First, let me just state that at the time of this writing, it has been almost 12 weeks since I broke my ankle and 11 weeks since I had the cast placed. It’s been about two weeks since I totally stopped using crutches and the boot and I am probably only at about 75% of my normal ankle function. So I have not yet totally moved to “healed” but I am definitely a thousand percent better than I was when I heard that fateful “snap.”
Also, let me say that having a broken bone truly brings home the adage of, “if you don’t use it, you lose it.” Muscles and tendons that worked just fine for the last 51 years all of a sudden are totally useless after just two months of being immobile. They have to be slowly warmed up and stretched in order to get them to work again. They have to relearn their functions. So just because the boot is removed does NOT mean you will be able to walk immediately.
So to backtrack just a bit, at cast+7 weeks I was told I was not yet ready to wear shoes. I was instructed to start putting partial pressure on my foot, which was in the camo boot. My instructions were to continue to use the crutches, and to start putting one foot in front of the other while using the crutches and while wearing the boot. I repeated the instructions several times before I left the office.
Me: “So you mean I can start putting pressure on my foot? You want me to put pressure on it? On my foot?"
Medical Professional: “Yes, with the boot on and using the crutches.”
I repeated it twice because I wanted to make sure they were really saying I could put pressure on it. And the answer was “yes.” So I went home and immediately started practicing putting pressure on my foot, with the boot and crutches.
I’m going to say here, that I’m sharing MY story. You should definitely listen to doctor’s instructions and don’t take any of what I say as any kind of medical advice. Also, you may feel differently than I did. But this is how it felt to me.
Also, through all of the following, my ankle hurt. Not in a sharp way, but it ached almost all the time. At the beginning of this process, it hurt on the top of my foot, where the foot meets the leg. After those muscles started getting stretched out, it hurt on the side where I broke the bone. It was also tight the entire time. I have been working though those aches and didn’t let it stop me. In addition, it was (and still is) swollen. The swelling is dramatically reduced, but it’s still a bit swollen. So there were many nights I fell into bed with my ankle throbbing. Bottom line, each day the pain/aches were a little bit less, so I just kept going.
On the Road to Recovery – Week One:
So my goal was that in three weeks when I went back to the doctor, I would be walking in on my own two feet with no crutches. So every day for the first week after I came home, I walked all over the house with the boot on and with crutches. I only moved around with both feet on the floor. The boot actually makes it somewhat easy since you don’t have to put a lot of pressure on your foot to move it, since the boot is big and flat and relatively easy to move with little pressure. But I pressed my right foot into the boot so I WOULD feel it. The sole and heel of my foot were kind of tingly, like lots of little electrical pinpoints. I wanted to work through that weird feeling, so I walked around and around, from one end of the house to the other, making sure I pressed my foot down. The weird feeling was especially prevalent when I’d been sitting for a while. After the first few days, the tingly feeling was disappearing. Around the same time, I put on sneakers and walked with the sneakers and the crutches when I was in the house. I only used the boot if I had to go out. I also iced my foot about three times a day, trying to get the swelling down. After about 4 days I walked very slowly around the house with no crutches at all, but only for about 5 minutes. My leg and foot and ankle were very weak, but I was able to walk slowly. At the end of the first week, I decided it was time to get rid of my crutches and boot, and I placed them in the back of the closet where they remain.
On the Road to Recovery – Week Two
During week two, I continued to walk as much as I could, mostly in my home. I also went for my first physical therapy assessment, and I attempted to drive.
Physical Therapy:
Listen to your doctor on this one. Mine originally prescribed 3x a week therapy but when I indicated I was only going one time a week he said something to the effect that walking around will also help you heal, it just takes longer, and it’s fine not to use therapy. In my opinion, going at least a few times for formal therapy is great because you will get familiar with the various exercises you can use to strengthen your ankle, AND because it’s great to hear an objective, trained, person tell you what kind of shape your foot is really in.
The first time I went was for a 45 minute assessment. Both of my ankles and feet were measured. I was asked to attempt various feats, for example, I was asked to balance myself on my good leg for 30 seconds (which I did). Then to try it with my bad leg (couldn’t even balance). Then I had to raise myself up on the balls of my feet 20 times in a row. They wanted to see how much work was needed and where my strengths and weaknesses were. I left and made an appointment for the following week.
On visit #2, the work started in earnest. I’ve only been three times so far, but here is the general gist of what happens in therapy.
- Since I’m still swollen, we start with a massage of my ankle (ahhhhh). This lasts about 5 minutes.
- The massage is followed up by stretching exercises, which can also be done at home. Pull your toes toward you, and then away and do it slowly 20 times. Then bend your foot to the left and right (heel faces away from you and you’re trying to bend the entire left side of your foot up towards you, then the right side of your foot). Then circle your foot 20 times clockwise, and then 20 times counter clockwise. Sometimes we then stretch with a belt – i.e., put the belt under your arch, and pull the foot towards you. Sometimes we do the "abcs." Yes, that’s right. You use your toe and spell, in capitals first, then small letters, the alphabet. This makes you move your foot in many directions and because it’s kind of silly, it doesn’t even feel like exercise. Also, one of the biggest issues is calf muscles that are tight. So to stretch the calf muscles, you can put both feet on a stair, and drop your heels until you feel the stretch in your calf. Hold it for 30 seconds, then repeat 2 times. OR you can put your hands against a wall, bend your good leg, and keeping your “bad” foot flat on the floor, push your leg back as far as you can while keeping your foot flat. You should feel the stretch in your calf. Hold for 30 seconds and repeat 2 times.
- Stretching is followed up by harder exercises. I stand on both feet and raise my body on the balls of my feet 30 times, repeated 3x. This week I did this entirely with my weaker foot/leg, with my other foot raised off the ground. Then I might put both feet on a round blue mushy mat, and I have to push my feet front then back 20 times, then left and right twenty times. This week I did this with my weaker foot only. This week we added an exercise where I stood on my weaker leg for 30 seconds, repeated five times. That means I had to balance on that one leg with the other in the air. All of these exercises were followed up with 10 minutes on the treadmill.
- Those exercises are followed up with an awesome 10 minute ice wrap, sometimes with electrical stimulation (which are pads placed on the swollen areas to help scare the swelling away).
Most of the exercises are quite possible at home. I have been doing as many as possible every day, at least twice a day, and I also walk somewhere as often as possible. If I’m watching TV or reading a book, I do circles continuously with my foot. If I’m standing at the counter getting dinner ready I might push my body up and down with the balls of my feet. If I walk down the stairs, I might walk back up and then back down again just to get those muscles moving better.
Driving
When can you drive? Again, make sure you check with your doctor. If you broke your left ankle, you can probably drive anytime you feel comfortable getting to your car and getting in and out of the car. However, if you broke your right ankle, as I did, you have to be able to press hard on the accelerator, hard on the brake, and to be able to move your foot back and forth between the pedals easily.
In the middle of week two, I started sitting in the car and pressing the pedals, just to see. Quite frankly, I was so sick of not being able to go where I wanted when I wanted and I was anxious to be able to drive. But the first time I sat in the car, I knew by the pain in my ankle that I simply would not have fast enough reaction time, nor would I be able to come to a stop or accelerate safely.
The third day I tried it, I decided I would back down the driveway and stop, and then drive back up the driveway just to see how it felt. After doing that twice, without much problem, I said, “hmmmmmmmmmmmm. I bet I could back out onto the road and drive to the end of the road. That’s all I’m going to do is just drive that little way.” So I backed out, drove to the stop sign, and realized I was doing ok. I continued on to my local store, which was a distance of about 2 miles and required use of both brake and accelerator. I was sore, but felt firm on the pedals and realized that I was now FREE!!!!! I drove home and kept the trip short. The next day I went out again, about the same distance. The next day again, and then I couldn’t be stopped!
On the Road to Recovery – Week Three:
This is the week I find myself in now. I went to the doctor’s, and walked in on my own volition, although still with a limp. He pronounced me fit, set up an appointment in a month but told me to cancel it if I was still doing fine. I am continuing to exercise every day, usually starting before I get out of bed. I just stick my foot straight up in the air and do all the stretching before I rise, so when I stand up, I won’t have a problem walking. I walk down my road or elsewhere every day. I ice my foot daily. I am still slightly swollen and still slightly sore, but I can see a HUGE improvement. I’m not being called Gimpy anymore. I’m not limping. I can do stairs. I still cannot run and I have to be very careful to ensure I don’t trip. But my progress continues every single day. Three weeks after I was given the green light for partial pressure, I am using both legs and I am even dancing around my living room!
Overall thoughts to help the healing process:
The following may help you progress faster:
- Ensure you have a pair of sturdy sneakers that fit properly with any swelling. I purchased a pair of sneakers that were ½ size larger than I normal buy and they work great. I bought black so they’d look okay with my work pants. For you ladies, sorry, but heels or nice boots are simply out of the question until you're totally healed!
- Don’t miss your exercises, even when you start feeling better. Do them every day at least twice, but three or more times is even better.
- Put your foot up, higher than your waist when sitting, at least three times a day with ice. This should help reduce the swelling.
- Do not wear tight socks. Tight socks will not allow the swelling to dissipate. Ensure you are wearing socks that fit well.
- If you can, try formal physical therapy. This gives you great insight into how you’re really progressing.
That’s it for now! In my next (and final) part of this series, I’ll share my thoughts about difficulties maneuvering in public areas, and will also cover what kind of work I was able to do while injured.
Past ankle related blogs:
- Part 1 of 5: http://actvra.in/trr
- Part 2 of 5: http://actvra.in/tww
- Part 3 of 5: http://actvra.in/twJ
- Emergency Room Visit: http://actvra.in/p8h
- Lessons from Invalid: http://actvra.in/pdV
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