After the cast comes off
September 16, 2008 11:26 PM   Subscribe

YANMD. Advice for rehab after a broken fibula, and life in a CAM boot? I'm going to get my cast off tomorrow and I'd particularly like to know what I should ask about when I see the doctor and the physical therapist, as well as any other advice you have. I suffered an oblique fracture of the right fibula just a couple centimeters from the lateral malleolus about six weeks ago, and am eager to get back on my bike before the winter.
posted by d. z. wang to Health & Fitness (2 answers total)
When I broke my tibia and fibula in much the same spot (three fractures total) a couple of years ago, I was on crutches for close to four months. I didn't get the boot because I had pins and plates put in. I had physio for a couple of months afterwards and have recovered 100% of my mobility. Such a recovery is unusual with implanted hardware, but not so unusual without.

Luckily for you, riding a bike is great mobility therapy, and I doubt you'll have any problem being on your bike by winter.

IMHO, the electrostim therapy is a waste of time. Concentrate on strength and mobility therapy. You'll be fine.
posted by ten pounds of inedita at 12:11 AM on September 17, 2008

I just came off a much less severe break of my fibula. I found when I wore the cam boot after the cast came off, the following unpleasant effects:

When I wore the boot, my ankle ached and swelled more than when I didn't wear it. So ask the doctor to be sure that it's the right size and that you really understand how to put it on. Further, the boot I used had a rounded sole so that I could not properly balance my weight on it, even with the crutch, and it forced me to limp, causing my opposite hip to ache. My doctor was not available to me-- his nursing staff simply would not let me talk to him, and answered every question with "the doctor told you to wear it, so wear it." Which I didn't, because not wearing it caused less pain, less swelling, and less discomfort. I have suffered no ill effects from this (he agrees, and was furthered annoyed that I called and the staff wouldn't connect me to him, so chalk one up for our side.)

I am now four weeks off the cast AND the boot, and am still experiencing the following-- a lot of stiffness of the achilles tendon in the morning. Going downstairs is a little bit of an adventure. I'm a figure skater, which means I do alot of weird things with my ankles; one of the weird things I still can't do very well is turn out (opening my hip so I can push with the side of the blade). Just mentioning it; this is not something most people are likely to have to deal with, but there it is. My ankle is still a little bit swollen, and in fact was *quite* swollen for at least two weeks after the boot came off.

The biggest effect was the loss of musculature in my foot. I actually lost 3 shoes sizes (7 1/2 to 6), and all strength in the foot (for instance, couldn't lift myself to the balls of my feet for many many days; because this is extremely important to skaters it has been the focus of my physical therapy).

Getting the cast off is AMAZING. The first time I got to drive I felt like a teen on her first solo drive-- yay! I'm a grown up I get to go out BY MYSELF. Plus, showers. hurray. So, congratulations. Welcome back to the land of the living.
posted by nax at 7:06 AM on September 17, 2008

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