Broken Ankle - help with rehab

[Alistair Tucker]

Dear Kit,

I hope you don't mind me contacting you via the forum for some advice on rehabilitation of a broken ankle. I have been doing Stretch Therapy daily since May 2020. This journey started when I had a bad back and wanted to change this. I have also embraced barefoot shoes, Vibram five fingered shoes and have been making good progress with the Stretch Therapy starter course.  I have also purchased the Mastery series but this is proving mostly too difficult for me at this stage in my stretching journey. I am 52 years old, a keen cyclist, and before Stretch Therapy I was very inflexible. Unfortunately I managed to break my ankle falling off my bike on black ice at the very end of November 2021. I had surgery on the 6th of December to repair a broken tibia which was plated and tight-roped above the plate to join the tibia and fibula together. I also fractured my fibula just below the knee. All of these can be seen in the x-rays below. I was in plaster from the 6th of December until 17 January.  I am now in a moon boot but only partially weight-bearing. I am having physiotherapy with short wave diathermy into the top fibula fracture but not lower down because of the metal work. I have been doing gentle stretches, non-weight bearing, and trying to move the ankle as much as possible in circles and as far as I can get it in plantar flexion and dorsiflexion, and also inversion and eversion movement. I would be very grateful to know if you have any experience of rehabilitating this kind of injury and if so what advice you could offer.  

Many thanks for your time,

Alistair 

 

[Kit_L]

@Alistair Tucker: Welcome to the Forums.

It's clear that your ankle and foot are still considerably swollen, so you'll need to wait until the swelling has gone down, and you have progressed to weight bearing capacity. As you are in the care of the physiotherapist presently, please be guided by what she/he recommends for now. Are you planning to have the screws and associated hardware removed at some time?

The short answer is that a lot can be done, but in my view it's too early in your rehab. to start exploring these. Let me know about the hardware.

[Alistair Tucker]

Thanks Kit. Re hardware in the ankle. The surgeon so far has only said that it could remain if it presents no problems to me. I get the impression I will have to push for it to be removed on the NHS or go private. In your experience and opinion is it likely to restrict my movement/flexibility? 

[Kit_L]

@Alistair Tucker: It really is case by case, and I feel it's still too early to start testing this. Please do report back once you are in the weight-bearing phase, the swelling is down, and you feel you can start to do some gentle work. What sort of time frame does the physio have in mind to that stage?

As well, your left ankle pronates more than your right (this explains the deviation of the big toe away from the midline of the body, too, and the shape of its nail). This definitely can be optimised once you can take the body's full weight. Some light reading in the meantime:

https://kitlaughlin.com/forums/index.php?/topic/33-flat-feet-pronation-in-response-to-a-q-from-coach-sommer/#comment-76