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PT after ankle Injury

Original Post
T. William · · Avon · Joined Oct 2008 · Points: 80

One month ago today I dislocated my left ankle and fractured my fibula in a "parkour" accident... and yes drinking was involved. 6 pins, a plate and a screw, three months non weight bearing.
Anyway I'm trying to get a timeline from people with similar injuries. So.. the first two weeks I did nothing but lie in bed, foot elevated, eating goldfish and streaming movies. Third week, the staples came out, I was back at work and pretty much off pain meds. PT was prescribed by the physicians asst. for 2-3 times a week for 6 weeks. Does this seem early to anyone?

Robert Buswold · · Northglenn, CO · Joined Jul 2010 · Points: 80

I don't claim to know anything about this type of thing, but last year I broke my ankle (the talus) in late January while skiing (I'm a terrible skier).

I was back to running slowly (and carefully) on it 2 months later, climbing easy stuff shortly after that. I wish I would have had the benefit of PT, but no insurance = no real medical care besides the initial visit to the emergency room. :)

It all turned out fine though, but individual results may differ!

MegaGaper2000 James · · Indianola, Wa · Joined Apr 2011 · Points: 20

I hope you are seeing a real sports medicine trained/oriented PT, not just a physician's assistant.

I can't comment on the recovery schedule, but the thing to know about ankles is that they take a long time to fully heal, and that the main focus of any PT regime in addition to strength building should be preservation of ROM.
A moderate ankle sprain takes 8-12 months to fully recover. A bad one can take 18 months. During that time, you are at a much higher risk of re-injury. The main reason the muscles of the lower leg (calf/hamstring tears, too) take so long to heal is that they are in almost constant use.

If you're interested in taking a (hyper)active role in your recovery, a book can be a good place to start. This one is a great all-purpose layman's reference that will help you understand the muscles and bones involved and build/modify/understand your own re-hab program long after your insurance-covered PT visits have run out.

Comes from: I spent a lot of time in another discipline where ankle injuries were pretty common.

Jim Davidson · · Fort Collins, Colorado · Joined Nov 2006 · Points: 20

I have had not your injuries, so my comment is general: get all the PT you can. Do all the Pt excercises you can. I cracked a tibal plateau and trashed my ACL a year ago.

At first, I did not understand why the PT & doc were hyper-focused on range of motion. 15 months later, i now understand. You need to get back every scrap of movement, range of motion and strength that you can, as early as you can. Other wise your body will just "settle in" the loses can be almost permanent. Also scar tissue forms if you do not break it up with frequesnt movement early on. So listen carefully to PT and get after it like you are training for the biggest climb of your life. Good luck Brother!

andyedwards · · OR · Joined Aug 2009 · Points: 205

I broke my ankle right after Thanksgiving, bouldering at the gym (ouch). Had surgery a week later, couple plates and some screws. No weight bearing for 10 weeks.
Just getting used to walking again, with a slight limp. I've been going to PT for a month and a half or two, mainly working on range of motion stuff. Doc said yesterday no climbing for months yet.

This is probably pretty conservative, but I definitely don't want to re-injure it.

Gaper and Co. have it right on following PT, and doing as much as you can. Get a hangboard too!

xray

Woodchuck ATC · · Unknown Hometown · Joined Nov 2007 · Points: 3,280
aed wrote:I broke my ankle right after Thanksgiving, bouldering at the gym (ouch). Had surgery a week later, couple plates and some screws. No weight bearing for 10 weeks. Just getting used to walking again, with a slight limp. I've been going to PT for a month and a half or two, mainly working on range of motion stuff. Doc said yesterday no climbing for months yet. This is probably pretty conservative, but I definitely don't want to re-injure it. Gaper and Co. have it right on following PT, and doing as much as you can. Get a hangboard too!
Hey, looks like my ankle & pins, screws job. Definately take as much PT as your insurance will let you. I slacked off after 6 or 7 weeks and it really never got as strong again as I think it could of. Keep the flex and tension exercises up each morning when you awake, at a minimum do that.
crankenstein · · Unknown Hometown · Joined Dec 2005 · Points: 0

Looks a lot like my ankle too. I had surgery 6 weeks ago and just started being partial weight bearing. Doc says crutches for 5 more weeks then PT and move toward full weight bearing. Do all the ROM exercizes and PT strengthening exercizes you can do. Ankle often do not ever recover fully from my previous experience.

Evan S · · Denver, Co · Joined Dec 2007 · Points: 510

I broke my talas in half about two and a half years ago now. I was back to work within a month, and within two months I could ride an exercise bike and after about three months started climbing in the gym with the boot on. In all likelihood it will take about six months before you feel like it's solid enough to use in any serious fashion, and close to a year before it feels anywhere near "normal" again. My foot is perma-screwed, it always hurts, I don't have full range of motion, and did I mention it hurts? But...at this point it doesn't stop me from doing anything, you just learn to live with a joint at 80 or 90%. Do as much PT as you can, actually going in to see someone is a lot more effective than trying to do it on your own, no matter how motivated you are. And just remember, you can exercise just about every part of your body other than your lower leg, no real excuses to get lazy and too out of shape, at least that was my mentality, although I gained 20 pounds.

Don't do this.

T. William · · Avon · Joined Oct 2008 · Points: 80

The physicians assistant was just there to take the staples out and tell me I couldn't bear weight for 3 months and to do PT 3x/week.
My Physical Therapist is awesome and has extensive experience with athletes of all kinds. Anyone ever been dry needled? I haven't yet but he talked a little about it.
Hangboard and rock rings in the living room and I've been one legged bouldering (traversing) indoors once a week. It's my favorite night of the week!
So, it sounds like it could be while till I'm climbing again.
Crankenstein, what was your injury? Have you done any PT yet or still 5 weeks away?

JCM · · Unknown Hometown · Joined Jun 2008 · Points: 115
T.Dailey wrote: Anyone ever been dry needled?
Whoa there.
Mike G · · Unknown Hometown · Joined Jan 2011 · Points: 0

dude, i suffered the same injury playing football in law school. didnt have the benefit of pt, but after the pin came out, in my case one month, I was ok'd to put weight on the leg and started rehabing my self. each evening i would go out and walk 50 paces, then run 50 paces. the leg healed great! at my last orthroped. appointment, the doc asked me to bend and rotate my ankle, I did, he asked me if it hurt and i said no, his reply was thats amazing, I have patients who are limping 6 months after this injury. Agressive rehab, pt is definitely the way to go

andyedwards · · OR · Joined Aug 2009 · Points: 205
Woodchuck ATC wrote: Hey, looks like my ankle & pins, screws job. Definately take as much PT as your insurance will let you. I slacked off after 6 or 7 weeks and it really never got as strong again as I think it could of. Keep the flex and tension exercises up each morning when you awake, at a minimum do that.
Recently or long ago?
If long ago, how long was it until you were comfortable jumping and landing on it? Any pain from long hikes, or backpacking, if you do that stuff?
T. William · · Avon · Joined Oct 2008 · Points: 80
Jon Moen wrote: Whoa there.
It's like acupuncture I guess. I'm curious to see myself , but my PT says it does wonders.
andyedwards · · OR · Joined Aug 2009 · Points: 205

Anyone else have any ankle injury recovery stories?

Woodchuck ATC · · Unknown Hometown · Joined Nov 2007 · Points: 3,280
aed wrote: Recently or long ago? If long ago, how long was it until you were comfortable jumping and landing on it? Any pain from long hikes, or backpacking, if you do that stuff?
hard to believe it's been 4 years already almost to the day. I had to cancel my late March trip to Red Rocks Rendevous but had to use the plane ticket up within 8 months. So did Red Rocks in Nov. and was fine for climbing and long hikes in to canyons. But did not hike , backpack long distances ever again due to constant weak days in ankle for years after. First tried some climbing after 4 months, but no jumping down or landing more than 2 ft. high. I should have kept up the extreme flexing and PT work for months instead of just weeks. But I'm old, and not expected to heal back 100% at age I broke it.
andyedwards · · OR · Joined Aug 2009 · Points: 205
Woodchuck ATC wrote: hard to believe it's been 4 years already almost to the day. I had to cancel my late March trip to Red Rocks Rendevous but had to use the plane ticket up within 8 months. So did Red Rocks in Nov. and was fine for climbing and long hikes in to canyons. But did not hike , backpack long distances ever again due to constant weak days in ankle for years after. First tried some climbing after 4 months, but no jumping down or landing more than 2 ft. high. I should have kept up the extreme flexing and PT work for months instead of just weeks. But I'm old, and not expected to heal back 100% at age I broke it.
Thanks!
I've done some fun trips in the last few years, like hiking into the Winds, Tetons, Beartooths, etc, and hope that I heal up well enough, so that type of trip isn't a thing of the past.

Also, a bit worried about leading, etc, and landing on it.
In time I suppose I'll find out, good to hear that people heal up though.

Also curious if anyone has ever had their hardware taken out?
T. William · · Avon · Joined Oct 2008 · Points: 80
aed wrote: Also curious if anyone has ever had their hardware taken out?
I'm curious about that too. They told me my plate would stay in but the one long screw will come out in a few months. Anyone had this done?
crankenstein · · Unknown Hometown · Joined Dec 2005 · Points: 0

T. Dailey my original injury was a severe sprain/dislocation which basically destroyed all of the soft tissues in my ankle 30 years ago. I had bone spurs removed once about a year later and then it was pretty good for 15 or so years before arthritis started setting in. I went to multiple ankle docs and they all wanted to fuse it but I figured I was walking and climbing and wasn't ready for that. My latest doc is a foot and ankle guy and said he could make my ankle better if he realigned bones in my leg and foot, so here I am recovering from a distal tibial osteotomy, calcaneal osteotomy, ligament replacement, peroneal tendon reconstruction and more bone spur removal. Almost 7 weeks now and am partial weight bearing, but PT and full weight bearing are a few weeks out yet. I'm doing some range of motion excercises and trying to take it slow and easy in order to maximize my recovery. Good luck to you. Parkour looks so fun as I was a gymnast and would love to do that. Though I don't think I'll ever be doing a lot of jumping again.

Woodchuck ATC · · Unknown Hometown · Joined Nov 2007 · Points: 3,280
T.Dailey wrote: I'm curious about that too. They told me my plate would stay in but the one long screw will come out in a few months. Anyone had this done?
My hardware was a thin 1/2 inch wide titanium plate and 4 tiny screws. They will stay with me for life I'm told. A year or so after the swelling finally went down, that area is now as thin skinned as the rest of ankle bone areas are. There are 4 distinct bumps where the screw heads kinda poke out. Thankfully they don't rub against my hi-top hiking shoes or winter ice boots. So far no wicked knocks to that area either, or sprains to the ankle.
Guideline #1: Don't be a jerk.

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