Stupid Broken Ankle: Week 10

The mucous sheaths of the tendons around the ankle. Lateral aspect. (Photo credit: Wikipedia)

Things progressed really well for me this week in terms of walking again with much less limp. I went all week sans boot. I was rather depressed at the end of last week when I was without the boot a few days and had a pretty severe limp.  It's gotten much better this week, which makes me happy.

 I saw the OS (orthopedic surgeon) today.  Probably won't be the last time I see him, but he said he didn't see any reason to book a follow appointment with him unless (until) my ankle bothers me.  He highly predicts that in a year I will need to have the plate and screws removed, which will involve surgery and holes in my bones that will have to heal again.  I pointed out that I have a tendon (peroneal tendon) that is popping over my outside ankle.  He said I would likely have to have surgery to fix it.  It would involve deepening a grove behind my outer ankle bone and attaching a sheath to hold it in place.  Since I will very likely, in his opinion, need surgery to remove the plates and screws he suggested taking care of both at the same time.

He also thought I should start physical therapy to get my range of motion and strength back.  He let me pick my own place/PT and I suggested one with an Alter G treadmill so I could maybe get to running again sooner than I would otherwise.  He thought that was a wise idea. :-)  But I can't run until I can flex my ankle toe to shin and have enough strength in my calf to push off. Crossing fingers the peroneal tendon resolves itself on it's own, or I might not be doing much running next year.

I think I'm ready to sign up for AXS Moab 30 hour race October, 2015. Maybe I should wait a little while before committing.

Stupid Broken Ankle: Week 9

I seriously have no idea where this week went.  Once I started working again these weeks have FLOWN by.  Next week I go in for my 10 week appointment.  I was told by my doctor he expected me to be in shoes by that time, and I have been diligently working towards that.  So much that I started going to work in shoes 3 days ago.  No boot.  I gave the boot the boot! Ha-ha!  I wore it to work 2 days, then it was the weekend and I wore it a few hours each day, an the past 3 days back at work have been w/o the boot all day long.

Bimalleolar fracture and right ankle dislocation on X-ray (anteroposterior). Both the end of the fibula (1) and the tibia (2) are broken and the malleolar fragments (arrow: medial malleolus, arrowhead: lateral malleolus) are displaced. (Photo credit: Wikipedia)

I don't walk very well.  My ankle doesn't have enough mobility or strength to allow me to walk normally, so I walk with a ghastly limp and get asked all the time if my ankle hurts.  Surprisingly it hurts very little, it's more of a dull uncomfortable sort of pain, not a sharp hurting pain. I know I look like I am in pain when I walk, but I don't walk funny from pain, simply the lack of joint mobility.  It gets sore as the day goes on, primarily the outside ankle where the plate is.  Unfortunately today it was more sore than the previous two days. I'm guessing because I got unexpectedly thrown in the lab for most of Monday and Tuesday - so lots of standing and walking. It also meant I didn't even have time to take a lunch.  I had not planned on this, but I guess when you show up to work in shoes you are suddenly normal and expected to work normally. Unfortunately I am so slow and walk at a snails pace everything takes 2x or 3x longer and eats away your lunch hour and hour breaks.  To make up for it I left an hour early today.  I also resorted to using my crutch during the morning hours today.

I get asked all the time about physical therapy, and I keep telling them my doctor doesn't think I need it at this time.  I'm not sure he'll ever suggest I go to physical therapy. I'm not sure if it is because he thinks I'm active enough to rehab on my own, or if he just doesn't ever suggest it for people in general.

I still get body aches most days.  It comes and goes most days, some days are worse than others. And occasionally I have no aches.  Today was a body ache free day, but my ankle made up for that.  I take naproxen and loratadine every morning.

My ankle is super stiff first thing in the morning, but after my workout it's fairly loosened up for the rest of the day.  And by fairly loosed up, I mean I can move it about 2".

I feel like I'll never walk normally. It's strange to not be able to move your ankle because it just won't move. I'm losing hope that I will race next year.  I just got an invitation to do an indoor triathlon in Mid February and I know that's a lost cause.  It's so disheartening.  I won't be adventure racing either.  I'm going to have to find a new hobby.

Stupid Broken Ankle: Week 8

Bloody Mary: (Photo credit: Wikipedia)

Week 8 (days 50-56 post-op) has come and gone.  Since starting work I find that I no longer have much free time to sit on the couch with nothing to do Writing/updating this blog has taken a back seat to everything else.

Day 51: This past weekend we hosted our belated annual Halloween bash.  A murder mystery party – and I was neither murdered nor did I murder anyone.  It was such a fun time, and I spent a good portion of the night on my feet with just 1 crutch to assist me.  I limited myself to 1 beer and 3 small Bloody Mary’s over the course of the evening, which amounted to about 1 drink/hour, plus a couple of waters thrown in for good measure.  Let’s face it, a Bloody Mary is really a health food drink, so it doesn't even count as alcohol.  I managed to stay upright all evening. J

I have managed to just use 1 crutch this week, and on occasion, perhaps a short trip across a room I would go w/o the crutch in just the boot.  In the evenings I would spend most of the time with just a crutch and no boot so as to strengthen the muscles and loosen the tendons and ligaments in my foot & ankle.  Weekends are spent most of the time w/o any boot and I would only put it on if we would be leaving the house.  I can’t bear as much weight without the boot as I can with the boot, but that doesn't matter, it’s the moving of the joints that matters most.

I hit the weights pretty good this week before work and even did some squats and dead lifts with 60 lbs of added weight.  Squats are difficult without much flexibility in the ankle joint, but a sort of decent squat is better than no squat.  I was pretty sore the 3 days following squats and dead lifts.  Otherwise I've pretty much focused on upper body work and warm ups on the bike.

Oh, I nearly forgot.  I made an illegal outing on my mountain bike for 8.3 miles midweek.  I was outside.  Riding my bike - in a running shoe – no boot.  Outside!  It was great.  I was breathing hard, not race hard, but I had the heart rate up. The wind was in my face. The sun was out. The temperature was cool enough so that I broke just a light sweat.  I felt human again.  Now it’s covered in snow outside with patches of ice.  Glad I took that opportunity when I had it!  I did skip out on work one day when it was super icy out.  I was still using 1 crutch and I thought it to be very unwise to be on crutches on solid ice.

And now the best news regarding the healing of my ankle, by the end of week 8  (day 56) I was able to walk in my boot without a crutch all day long.  All Day Long!   In a nutshell I went nearly 1 week walking with 2 crutches, then a week with 1 crutch, and now no crutch.  Perhaps I’ll be out of my boot completely before Thanksgiving.  The thought makes me smile.

Stupid Broken Ankle: Week 7

Ligaments of the ankle. (Photo credit: Wikipedia)

"Fractures also can occur in individuals with unstable ankle joints and a history of recurrent ankle sprains." Aha, I suspected that the fact I had rolled my ankle the morning I broke it probably played a roll in the fact it broke that evening.  Plus I had a pretty good sprain on that same ankle during an adventure race about 2 months prior - I rolled it on a rut in a trail.

"most women experiencing ankle fractures are over age 50"  Hmmm...I'm not that old. I wonder if most are caused by slipping on ice, or falling on stairs?  Anyone want to take a bet?

The mucous sheaths of the tendons around the ankle. Lateral aspect. (Photo credit: Wikipedia)

I have the OK to start bearing weight on my foot this week.  This first week I'm supposed to use 2 crutches, then work my way to one crutch and then no crutches.  This is 2 crutches week, and trust me, I need 2 crutches as putting weight on my foot is rather painful.  Not the ankle, but the foot.  Why the foot you may wonder? "Yes, please tell me, why the foot if you broke the ankle?"  Well, let me tell you. The tendons and ligaments in the foot essentially shrink/tighten up from not being stretched for 6 solid weeks.  Plus there is tons of swelling.  When you step on a swollen foot, it hurts.  When you step on a swollen foot and stretch all the tendons and ligaments, it hurts more.  It's like stretching past your stretching limit - think of touching your toes, but add another 5" past your toes.  Now spread that pain all over your foot.  My right foot is about 1/2 size shorter and narrower than my left, but it's much thicker.  I liken it to a cooked hamburger.  You put it on the grill thin and big, but by the time it's done cooking it's thicker and the diameter much smaller. That's my right foot, a cooked hamburger. 

I have to push through the uncomfortable pain in order for it to get better.  I also have to start doing exercises to increase muscle strength and flexibility.  Both suck.  I notice obvious improvements in the amount of movement by day 4 of this week.  And get this: I can do squats now! I did 20 just fine - well sort of fine. Guess that means it's time to start doing some sort of workout routine again. My calf cramps up on simple flexing exercises. That will hopefully work it's way out by the end of this week.

I forgot to mention that my legs insist on stretching all the time while I'm in bed. Must be from all the laying/sitting around, but if I start to straighten my legs in bed they instantly start to do a full on stretch.  Rather annoying and strangely odd at the same time. It's like being possessed.  But this has been going on for weeks.

I returned to work all of this week.  I played it conservative and only worked 5 hours each of the first 2 days.  I was pretty worn out by the end of the day and slept pretty well. It has created a nice improvement in my sleep cycle.  It also causes my ankle to swell to twice it's size by the end of the day.

I've added a photo of how great the ankle looks first thing in the morning when nearly all swelling is gone.  Trust me, by the end of the day it looks nothing like this.  In fact, with in a few minutes of getting up it looks nothing like this.