How to live & recover from a broken ankle?
May 18, 2011 6:07 AM   Subscribe

I've broken my Ankle need advise on how to live & recover from it

Badly broke my ankle resulting from an accident, requiring a metal plate.

The leg must be kept elevated and I can't put any weight on it at all.
Currently in a half-cast waiting for the swelling from the surgery to go down.

I am normally a very active triathlete and am very frustrated -
what exercise can I do in the cast for fitness and recovery?

Is it possible to fully recover from a broken ankle?
Any examples of sportstars

I am looking for basic tips on how to live with a cast
How do I shower?
How do I make a cup of tea?
How do I exercise?
How do I go up stairs?
How far can I walk?
posted by complience to Health & Fitness (23 answers total) 2 users marked this as a favorite
Man, I am sorry to hear this. I just got back from a weekend with my mother -- she's now walking with a cane after an ankle break at the beginning of March.

It takes a long time. Do you live with someone? You might consider hiring help. For probably won't be showering for real until the cast comes off. After 10 days my mom got a removable bootie so that at least let her get in the tub. Otherwise, she scoots around the house on in her wheelchair to do things like make light meals and get stuff done. As for exercise, she's done pulling exercises with those stretchy bands. I suggested one of those arm-bicycle things that you turn with your arms for cardio.....but it turns out she now has a rotator cuff injury from the moving the wheelchair and straining to reach things.

It's going to be several weeks until you can walk. As for stairs....once she scooted up on her butt one step at a time, but I wouldn't really recommend that since if she'd fallen or gotten stuck she'd have been screwed until her husband got home. She went up the stairs walking with her cane for the first time this week. Really, it's been more than two months after the break, so you have a long haul in front of you.

Please really consider a friend or even hired help to live with you for a while until you can at least put light pressure on with crutches or a cane. Don't over do it or else you might really never fully recover. Also look into a pool so that once you get a removable bootie you can go swimming for some exercise and to work the weakened muscles. My mom especially loves the salt water pool at a health facility near by, because it's bouyant enough to let her bear weight.

Good luck.
posted by motsque at 6:16 AM on May 18, 2011

I never broke my ankle, but I did have surgery on my ankle once that required me to keep it dry. I taped plastic grocery bags around it, completely enclosing the bandage, and took baths with my foot propped up on the side of the tub. I am lucky that we have a removable shower head, so I was able to properly wash my hair. I'm pretty sure that they make cast bags for this purpose that you can buy at the drug store, but I already had the grocery bags, so I figured why spend the money.

Crutches were no fun. When I was in the hospital, they had someone from physical therapy come by each day to make me practice on them, including on stairs. They tell you to put your weight on your hands and not on your underarms, but it's still not very comfortable doing it the correct way. When I was home alone and needed to get around the house while carrying something, I either shoved the thing in a bag and tied it to the crutches, or I rolled around in my office chair when I needed to get food or a drink.

Good luck. I was only crutching around for a few weeks, and I was so glad when I could just walk again.
posted by chiababe at 6:27 AM on May 18, 2011

If you end up getting the ankle recast after the swelling goes down, see if you can get a waterproof cast liner. You'll be able to shower without worrying about getting the cast wet. It takes a little while for the cast to dry, but it beats the plastic bag, one foot out of the shower routine.
posted by zamboni at 6:27 AM on May 18, 2011

I broke my left calcaneus about three years ago, but all the problems I now have are with my ankle. The human ankle is a pretty amazing and complicated piece of tech. Please don't give yourself unreasonable expectations about recovery time, because as I learned the hard way, it's probably going to take longer than you want it to. As to your specific questions.

Showering: I didn't have a removable shower nozzle, but I sort of preferring bathing anyway. What I did was sort of sit sideways in the tub with my legs draped over the sides and bathe until my doctor put me into a boot, which was a godsend because I could remove that and bathe like a normal human.

Mobility: Ask your doctor about getting a "rollabout." It's basically a scooter that use by propping the bad knee on the pad then using your good foot to roll around on it. It should be available at medical equipment rental places. Made a world of difference in self-sufficiency for me being able to do stuff for myself around the house when I was home alone. Also, please be careful with crutches. Crutches are a menace. I can't tell you how many times I fell on them while trying to get around, especially up steps, which are tricky. I suspect there are a lot of collateral injuries as a result of crutches. Which brings me to...

Stairs: If more than two or three, I would sit on a stair and use my arms help move my butt onto the next stair, using my good foot for leverage. Drag crutches up with to use on flat surface on upper level. Repeat.

Exercise and Walking: Your doctor will dictate. I'm assuming you're not doing any weight bearing activities right now; be prepared for the adjustment once the doctor clears you for putting weight back on it and you can start working with a physical therapist. I was surprised that I couldn't just immediately start walking like a normal person again. It took time to for me to relearn this and be able to walk again, and then another long stretch of time for me to be able to walk pain free. I actually used a cane for awhile. I felt like a cartoon supervillain.

Future: I don't know the circumstances of your break, but hopefully there was minimal joint damage. Because I fell from a high place, the impact messed up my subtalar joint, so I have chronic subtalar arthritis. I had some pretty severe ankle pain that really limited my weight bearing activities, including walking for a long time. Three years later, I'm just now getting back to the point where I can run again [for at least short stretches - my poor stamina prevents me from seeing how long or how far I can push the running].

I completely sympathize with your frustration. Give yourself permission to heal, and give yourself sufficient time to recover, because it's probably going to take longer than you want or expect it to. It will happen, though.
posted by Dr. Zira at 6:39 AM on May 18, 2011 [1 favorite]

How do I exercise?
How do I go up stairs?
How far can I walk?

Don't, or at least not until you get explicit instructions from your doctor on when you can and how much you should do. And even then you should take those instructions to heart. From what I've seen of acquaintances who didn't follow instructions to the letter, the consequences are severe, if not permanent. At the very least, you'd make recovery take much longer (we're talking months, with at least one stretching into 1-2 years), and at worst you could do some damage that will never heal. I have no doubts that it's going to be extremely frustrating going from triathlete to couch potato, but it's better for it to be a temporary setback.
posted by zombieflanders at 6:41 AM on May 18, 2011

I suspect that this will be antithetical to your nature but I'm not sure that makes any difference to reality, which is: while you were once spectacularly able, you are now temporarily disabled and it is going to suck for a good long time. Which double sucks because every task you try to accomplish will now take three times as long.

When I tore my ACL and had similar surgery, I spent months and months in a similar situation both pre and post-op. You need help. You need help for everything. At an absolute minimum, you need someone to come in for an hour each day to make meals, help you bathe, do laundry and deal with groceries.

Showering: Plastic garbage bag over the cast. You need help because the getting in and out is difficult and because the danger of falling is high.

Cup of tea: you can make one but not carry it. Get a tray. Make the cup of tea, put it on the tray, put the tray on the floor and slide it, step by step, to where you need to sit.

Exercise: Later there will be lots of physio but right now, whatever you can do sitting is what you are restricted to. There will be significant muscle wastage but physio will help you regain and it will be OK later. For knee injuries there's a mechanical bender to maintain range of movement but I don't think there is for ankles; check with your orthopedist.

Stairs: Avoid, avoid, avoid. The risk of falling is your #1 concern right now. I know you think it is staying fit but it is not. It is avoiding a potentially huge setback and additional surgery from a fall. Stairs are your mortal enemy right now. Move your life to a single floor if at all possible. You are poorly balanced and have odd new appendages and you will eventually trip over your crutches. Do not compound that with stairs.

Walking: Aside from being exhausting, you are at this phase of post-op recovery supposed to be sitting with your foot elevated approximately 23.5 hours a day. You will maximise your chance of a full recovery by giving your body the very best chance of rest and healing after significant trauma. The time to push is when you get to physio; the time to sit the hell down with your foot elevated is now.
posted by DarlingBri at 6:43 AM on May 18, 2011 [1 favorite]

I have never broken my ankle, but I had knee surgery a long time ago, and that required a long time in a cast (3 months?). I had a huge plastic bag I taped over it, then I used a flexible hose shower head to wash the rest of me. I rigged up a stool of some sort -- you can buy a shower stool, but even a good sized bucket can work in a pinch. Going down stairs was slow and rather hellish, going up stairs, I lifted the good leg, pushed up, and dragged the bad leg after me. If there was a railing, I used that and held both crutches in my other hand, using them as a cane/staff for balance. Having a light bag that will keep out of your way is critical when using crutches. Otherwise, you can't carry anything.

Basically, assume everything will take twice (maybe three times) as much time as it did before.

Talk to your PT about how to handle some of the details. They will have useful advice.

Understand that not resting will prolong healing.

The good news is that you eventually will heal. Your disability will likely be largely temporary. Try to live as much in the moment and avoid, as much as possible, comparing your current abilities to your peak health abilities. This will make the whole process much more bearable.
posted by GenjiandProust at 6:44 AM on May 18, 2011

Climbing stairs: Could you sit on the step and scoot your bottom up from one to the next, using your arms to just pull yourself up? You sound physically fit enough to have the arm strength to do that, and I think you would be in much less danger of falling down the stairs than trying to balance on your good ankle!
posted by misha at 6:56 AM on May 18, 2011

Broke my ankle six years ago. Because I was active and wanted to remain so I talked carefully with my orthopedist about treatment to make sure I could continue to play soccer post-break. I was significantly impacted by the break for about a year and I think that's not unusual - younger people, elite athletes heal faster so your mileage may vary. I no longer cross country ski because I lost a fair amount of lateral movement in the joint from the ligament and tendon tears that happened at the same time - so now I snow-shoe instead. I still do back-country hiking but gave up soccer two years ago after other (soccer) injuries - I broke my ankle while hiking. Charlie Davies is a soccer player on the US national team who broke a boatload of bones in a serious car accident ~a year ago. He's back playing competitively.

Stairs - do you have a sturdy railing on one side? If so what you do is crutch on the non-railing side and hold the rail. Your physical therapist will work with you on this before you get out of the hospital post-surgery. Until then up and down on your bottom is safer - especially if you're taking heavy duty pain meds. I would NOT go up and down alone in the house. I went down in the morning and stayed down until bedtime - minimal movement. In terms of fitness for the moment you're limited to sitting down stuff - small free weights and maybe an arm cycle or speed bag. I ended up crutching pretty long distances eventually - I was on crutches for months given my particular injury and that's a good workout.

A small daypack to carry your essential around helps. A little wheeled table /tea trolley type of thing can help for the hours you're alone in the house and need to move food/drink. Set up the place you're going to spend most of your time with computer, tissues, water bottle, pain meds, snacks etc - it's a nuisance to not have stuff within reach, especially before and just after surgery. For hot drinks a thermos is key to avoid getting burned.

You'll be horrified at how thin and atrophied your leg will look when you get the cast off but muscle rebuilds pretty quickly. I found it harder to regain flexibility than strength post surgery. I was 44 at the time so that's some benchmark.

Good luck - it will improve but it's a long haul and can be lonely too.
posted by leslies at 7:01 AM on May 18, 2011

Response by poster: Thanks for the advice - I don't intend to move from the sofa until im in a fullcast at least.

I'm most worried about running, cycling specifically afterwards.
Also has anyone any experience of swimming with a cast, I've heard you can get casts made of special material that is waterproof and then swim with a pullbuoy

also in a cover
posted by complience at 7:27 AM on May 18, 2011

I broke my foot three years ago and the hardest part was not being able to shower. If you have a shower over a bathtub, it;'s easy to wash hair, but I needed help to be able to actually shower. You might have to get a sponge and wash in the sink. The first thing I did after getting the cast off was a long bath and scrubbing my leg to get all the nasty dead skin off. The other hardest part was finding clothing I could wear as my jeans wouldn't go over the cast! For about six weeks I was very smelly and scruffy as only tracksuit bottoms would do. Obviously this isn;'t your main concern but if it happened again I'd try and deal with both better as you feel low enough when you're incapacitated without feeling grim as well.

One of the best things I did was get my shopping done online. If you don't have someone who can go for you, order from Tesco etc. Order things you can stick in the oven, microwave or dump onto a plate - it doesn't have to be processed food, but you don't want to have to stand chopping/frying etc.

2nd the thermos idea. You do not want to burn yourself. I have a two year old burn scar from trying to carry two mugs at once, and that was without juggling a crutch as well.
posted by mippy at 7:55 AM on May 18, 2011 [1 favorite]

I broke my ankle just shy of a month ago! I have a plate and a screw and a few other things going on right now. It's pretty rough no doubt.

Stairs with crutches are easy.

Showering... plastic bag. Thick rubberbands. Lawn chair. Works for me.

I'm in a hardcast right now for the next three weeks. I hate it. I've started doing girl pushups. Ha. It's about the only thing I can think of exercise wise to do.
posted by lakerk at 8:02 AM on May 18, 2011

I'm also a triathlete and swam a lot with my broken foot to maintain some semblance of fitness and not go insane. I started swimming as soon as I was cleared by my doctor and put in a removeable boot.

I recommend spending the money for a second boot. They are waterproof, but they still stay squishy and damp for awhile after a swim. I hated putting my boot back on after drying off.

Using the pullbuoy all the time was very frustrating. Do not expect to swim nearly the distance or speed you are used to. The buoy keeps your legs floating, but the drag from the boot is unbelievable. This is a good time for lots of form drills.

Be *very* careful pushing off the walls. You'll either forget you can't use both feet or not center your good foot behind you and go rocketing off at an unexpected angle.

Good luck and try to get as much rest as you can stand. Your body is working very hard even if you can't feel it!
posted by the_shrike at 8:07 AM on May 18, 2011 [1 favorite]

With any broken bone, take calcium.
posted by PJMoore at 8:42 AM on May 18, 2011

I swam with the fiberglass cast and waterproof liner. My arm was broken, so I can't speak to how your ankle will feel... but there is a lot you can do in a pool. Even if it's just bouncing along on your good leg, or wearing a float belt and pulling yourself along with your arms. It helps a lot in terms of Getting Out and Doing Something. You might need to agitate at your doctor a bit to get the fiberglass cast and waterproof liner, not all doctors really think about them for adults, and it might be more expensive.
posted by anaelith at 8:54 AM on May 18, 2011

Everyone's little tips has brought back some memories and I just remembered a good one: put a stool with no-slip feet in the shower so you can sit! Trying to balance well on one foot in a wet tub is perilous.
posted by DarlingBri at 9:54 AM on May 18, 2011

First of all, do NOT fuck around with the recovery. Make sure you have a referral to a good physical therapist who is used to working with athletes, and then follow her recommendations to the letter. If they give you stretches to do every day, do them EVERY DAY -- not occasionally, not twice a day. Do not push yourself thinking "eh it only hurts a little." Really, seriously, it will drive you mad, but don't.

As for exercise? Try an arm bike, like one of these. You can get your heart rate up pretty far pretty fast with one of these. It won't be the high-impact workout you're used to, but it will help you not lose as much fitness while you're laid up. I have a friend who used a rowing machine with only one foot while recovering from a badly sprained ankle, and that worked out well for her too, but consult your PT.
posted by KathrynT at 10:02 AM on May 18, 2011

I haven't used one, but I've found the iWalkFree an interesting replacement for a crutch. It's something like a peg leg with a platform to rest your knee on. It keeps your foot off the floor while being able to walk somewhat normally without crutches.
posted by ShooBoo at 10:21 AM on May 18, 2011

Hi there, I just got back on my feet after fracturing my tibia up by my knee. I was non-weight bearing as well.
Stairs were tricky for me. The PT showed me how to go up and down, which is basically leaning on the stair bannister with your good side, hopping up or down, then using the crutch to push up or lean down on the injured side. It was too tricky for me to master, so I went up and down on my butt, using my arms to stabilize.
What I did to keep muscle tone in my legs was isometric exercises, which are just targeting muscle groups (quads, hamstrings), squeezing them, holding for 5 seconds, then relaxing. I also did straight leg raises and side-lying hip abduction. YouTube videos here, here and here.
As far as showering goes, it was tricky because I could only bend one knee. I sat on the tub edge and leaned into the shower spray. I don't have a detachable shower head, which would have made things much easier.
Hope this helps. Feel free to MeMail me if you want someone to commiserate.
posted by blueskiesinside at 10:35 AM on May 18, 2011

A pee bottle is a great accessory for cutting down on the number of times you need to get up, especially at night.
posted by doctord at 11:44 AM on May 18, 2011

I has a pretty horrible comminuted fracture of my ankle back in 2005 (booze and tree climbing are a poor combination!) It was plated and pinned pretty extensively at the time. The bad news is that I was about 6 months totally non-weight bearing on that leg, followed by another 3 months on at least one crutch. The good news is that, apart from the loss of some motion, which has no effect, it is perfectly good these days. I run regularly, at distance, with weight, and it is fine.

In short, it will take time, and that sucks, but it will get better. Stick to whatever physiotherapy you are given totally religiously. That is what determines how much motion you get back.

Stairs, btw, are very easy once you get used to crutches. Stand next to bannister.. Hold bannister with one hand, crutch in other (probably also holding crutch 2 in fingers). Take step with crutch, slide hand up bannister, take step with leg. Repeat. Its actually safer than walking with crutches normally, because you're holding onto the bannister. The same technique works going down, but sliding on your bottom is easier, if less dignified.

Good luck - the hardest bit I found was being patient...
posted by prentiz at 4:19 PM on May 18, 2011

Seconding the advice to look at a rollabout or similar knee scooter. There are lots of websites out there with many different models (Google search "knee walker" or "knee scooter") and you can rent them in weekly chunks. Typically they are much more expensive to buy. Talk to your insurance and see if they will cover some or all of the cost if your doc writes you a prescription for one.

I broke my ankle last October and was very fortunate to be partial weight bearing after just three weeks (small fracture in my tibia only, no pins or plates, no cast, just the boot). I was getting tendonitis in my elbows from using my crutches the "right" way and was on the verge of getting a knee scooter regardless of whether my insurance would cover it or not when my doc said I could start to walk on it minimally. I've seen a few folks out and about with them and they seem like they make life SO much easier with the limited amount of mobility you have. You can carry things--which seems like such a normal thing to do that you don't even notice it until you can't do it anymore.

Recovery is a long process. Even when you're "completely healed" it will take months to feel even somewhat back to normal. I think around the six-month mark I finally was able to walk around the office without having random pangs of pain for no apparent reason, and that was with a fairly minor break. I didn't have any kind of rehab or physical therapy since my break was minor, but you probably will. Definitely look into water therapy if given the option.

As far as stairs go, I always felt they were harder on crutches. I went up and down on my knees, keeping my ankle bent out of the way but don't know if that's an option for you.

Good luck!
posted by miratime at 4:58 PM on May 18, 2011

I broke my ankle and tore tendons back in high school. Back then the consensus was to keep it in a cast for months until the tendons healed (I understand now that getting movement to the tendons as soon as possible is the preferred treatment). The gist of it was that I was active with a non-walking, and later a walking cast for about 3 months.

While in the non-walking cast, I hopped everywhere. Hated crutches, so I hopped around the house, stood on one leg in the shower, hopped to quickly get between point A and B whilst on crutches. The problem was, when I finally got the cast off my left leg, it had atrophied terribly and my right leg look like Schwartzengger's. It took two years to even out. So, be cautious on the unbalanced exercise.

One tip that did work great was using a rolling desk chair around the house to push myself backwards with my good leg.

Once I was in the walking cast (hard cast with a heel, not a soft cast), putting in a lot of walking miles sped the bone healing process along. The tendons, not so much, as they were immobile. I did notice a problem with my cast getting funky due to sweat. Frequent changes might be in order if you are active.

It took several years until I didn't notice a twinge and had all my strength back in my ankle, but many years later I'm very active, running 60k a week. Don't have all the original flexibility back, but the ankle is just as strong as the other.
posted by qwip at 4:40 AM on May 19, 2011 [1 favorite]

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