6 months post- ankle injury, and I need help!
August 4, 2016 10:45 AM   Subscribe

In January of this year, I suffered a really, really severe 3rd degree sprain of my left ankle. I asked this question back in March, and y'all gave me a bunch of great advice. Hopefully you have some more, because I'm struggling to adjust to my new weak-ankled life.

It's now been a little over 6 months since I took a tumble and jacked up my ankle. I was on crutches for 6 weeks, in a walking boot for 12 weeks, and did roughly a zillion hours of intense physical therapy. Things are better, but I'm still dealing with pain, weakness, stiffness, unintended weight gain, and a serious lack of shoe options.

The long story short update is: I'm finally done with PT and no longer wearing my hefty support brace on a daily basis. Latest doc visit shows that I still have a lot of weakness, stiffness, and probably the onset of some arthritis. The long-term hope is that I can work with what I've got and avoid surgery to rebuild the ligaments (fingers crossed!). I do my ankle exercises and stretches at home every day. I started walking about a month ago hoping to both strengthen the ankle and get some badly-needed exercise. I can do a very slow mile to mile-and-a-half around the neighborhood. before my ankle revolts. If I can't get the pain and stiffness under control soon, doc is suggesting cortisone shots (yikes!).

Here's where I could use some help. I need to exercise, badly. I've put on 15 pounds since this injury, and I feel like a lazy slob. The walking is nice, but I need more options. Before the injury, I took a couple of dance classes a week and was training to run a 5K. Now all I do is meander around the neighborhood catching pokemon and practice lifting glasses of wine on the sofa. Doc doesn't want me doing anything too strenuous yet, so dance and jogging are still no-goes for a while. Swimming is the only other real exercise I can think of, but would require some significant effort (buying equipment, joining a gym that has a lap pool, etc.). What else can I do that will really make me feel active but doesn't require two working feet?

Second question: because my ankle is still so damned weak, I've been given a shoe insert to wear to keep my ankle from rolling inward all the time. It's nice, it seems to help, but it's huge. It's fine for when I'm wearing tennis shoes, but I typically don't live life in athletic shoes. It's hot all the time here, and pre-injury I mostly wore sandals or converse. I don't think I need to have the orthotic in 24-7, but I definitely can't be taking trips to the grocery store in flip flops. Do you have any suggestions for good, supportive shoes that are good for hot climates and won't make me look like a 75 year old nurse?

Lastly, if you know where I can just get this foot replaced by a cool robot foot, hook a girl up. :)
posted by tryniti to Health & Fitness (22 answers total) 3 users marked this as a favorite
I would definitely talk to your doctor before beginning any exercise regime, but it seems like weightlifting might be a possible answer for you. Also, in advice you probably don't want to hear (sorry), since you might be looking at an extended time where you're burning fewer calories than you once did, take a careful look at your diet as well. You likely need fewer calories. Those extra pounds are probably not helping your ankle either.
posted by backwards compatible at 11:03 AM on August 4, 2016 [1 favorite]

I have a hip issue that has meant changes to my routine.

One thing I do is the kind of dumbbell routine that does not require standing - I sit on a bench while doing a detailed arm workout, lie on the bench for chest press and flies, kneel on the bench for certain back exercises, etc.

Another thing - what about adding some fast floor work that doesn't put pressure on your ankles? Lots of different leg lifts, for instance - I find that I can work up quite a sweat if I do a bunch of different leg lifts while lying on my front, sides or back. Also, you can do reverse crunches and any exercise that you do on hands and knees without lifting from the ankle (like bird dogs, for example). You could do the Hundred from pilates.

Provided that you can stand, you can do all those arm-waving standing core exercises, too.

I bet forty minutes of vigorous floor exercise would be a good supplement to your other stuff.
posted by Frowner at 11:04 AM on August 4, 2016

I had a significant ankle sprain several years ago (although not this bad!) and I think I was told to try cycling - your ankle doesn't have to do too much work since it's not landing on anything. Ask your doctor if that will work for you. If you're nervous you can start out on an exercise bike.
posted by the agents of KAOS at 11:09 AM on August 4, 2016 [4 favorites]

You need to take it easier and slower than you want to in order to let your ankle truly heal. Ligaments take a long time to heal. This was a sprain, not a muscle strain. 6 months is not long enough. "Doc doesn't want me doing anything too strenuous yet" YES. Listen to your doc!

Stop walking until your ankle "revolts". Stop when it first starts telling you to stop.

Swimming is recommended for a reason. You can get good cardio exercise and some resistance without putting bodyweight on your ankle. Don't reinvent the wheel. Swim. It's not as inconvenient as you're making it out to be, and certainly not as inconvenient as re-injuring your ankle doing something it's not ready for.

Think about yourself 20 years from now. Which feels better: having a usable ankle, or unrelenting dysfunction that you could have prevented? Was it worth pushing it and doing too much too soon?

Stop trying to push it. Accept that you need to take it easier and slower than you want to, for a while, so that in the long run you have a usable ankle.

a person who sprained both ankles and broke her right foot over a decade ago, didn't get proper medical care, and is jealous of your opportunity to actually heal properly, and hopes you don't blow it!
posted by mysterious_stranger at 11:13 AM on August 4, 2016 [15 favorites]

Hiking shoes are supportive and ventilated.

Some sandal models (Teva? No link, sorry) are supportive and are shaped almost like an orthotic.

Not clear what you mean by a "huge shoe insert." Is it bigger than a normal orthotic? Also, after your injury, wearing athletic shoes seems pretty reasonable. What's the objection?
posted by JimN2TAW at 11:14 AM on August 4, 2016 [1 favorite]

That sounds horrible! For exercise, weight lifting would be a good substitute, but I think the low impact cardio workouts from Fitness Blender would work for you too. No jumping, no fast movement and lots of strength work. These are my favorite right now: https://www.fitnessblender.com/videos/low-impact-cardio-and-total-body-toning-workout

I guarantee you will be dripping sweat by the time you're done.

They even have one where you sit in a chair!

For the weight gain, you might consider adjusting your diet. In my experience, I only lose weight by eating less food and making sure that every meal includes lots of vegetables and fruits. I also have had to avoid alcohol and sugary things. YMMV.

Shoes-wise, I wish I had recommendations! I have my own foot and insole issues and buy a lot of wide width shoes (despite not really having a wide foot) and returning most of them. When you find something that works, buy at least two pairs!
posted by purple_bird at 11:15 AM on August 4, 2016 [2 favorites]

You don't need to by equipment and join a gym to swim. All you need is a swimsuit, goggles and a municipal pool.
posted by monotreme at 11:23 AM on August 4, 2016 [1 favorite]

After I broke my ankle I joined a gym for the pool but mostly for the concept 2 rower. Such a good workout.
posted by Sassyfras at 11:33 AM on August 4, 2016 [1 favorite]

I broke my ankle 15 years ago - complicated healing and lots of ligament/tendon issues so spent much of a year on crutches and or in a boot. I needed an ankle brace for several years afterwards for anything strenuous. For hot weather I wore Keens which could accommodate a brace. A pair of lace-up ankle boots (LL Bean) did the trick for non-hiking day-to-day stuff. Part of my post-PT exercise routine was swimming and part was just walking in a pool. Lots of pool workouts out there - lower impact but will help you burn calories.

It will get better - I thought I'd never get back to where I was but I backpack, hike, workout, played soccer for years after. It takes a lot longer than you think - 1-2 years to get fully healed. Don't overdo it and set yourself back.
posted by leslies at 12:07 PM on August 4, 2016 [3 favorites]

I've had really good luck wearing shoes/sandals from The Walking Company. Their in-house brand Aveo is made from a built-in orthotic (which I think is actually Vionic) and the arch support (as well as the overall quality of the shoe) is impressive. The price point is a little steep (around $125 USD) but nothing out of the ordinary for a quality sandal/shoe.

Nthing the suggestion to take it slow. I had surgery for compartment syndrome on both legs in January, and am STILL healing, STILL swollen in places. While my situation is very different from yours, keep in mind that you may take longer to heal than everyone estimates. The surgeon and PT both told me I could run after 3-6 months. It's been 7 and I can't walk for more than an hour, and I've been doing everything to the letter in terms of icing, no exercise, rest, etc. Everyone is different. You need to let your body heal on its own timeframe, and not let impatience dictate that. Personally I've started swimming and while I don't like it as much as running, it's a great workout and works muscles I didn't even know I had. Might be worth a shot for you, at least to try?

Might be irrelevant to you, but I'll throw it out there - have you tried seeing a chiropractor who specializes in the Active Release Technique? IANAD but I know they've done wonders for my situation, and identified problems that only a professional could. I'm healing faster and seeing results. Less stiffness, more mobility, less swelling. Who knows if that will translate to getting back to running, but ART helps move fluid from the site of the surgery (because, y'know, gravity) back up through your lymphatic system. Again, IANAD and I don't know if it's appropriate for you, but it may be another option to look into.

Best of luck. There's a huge emotional component to losing mobility (even if it's temporary) and I hope you have a strong support network for all you are dealing with! MeMail me if you'd like : )
posted by onecircleaday at 12:27 PM on August 4, 2016

2nd mysterious stranger, big-time, and 2nd cycling and rowing.

Shoes: perforated suede oxfords; sandals with a behind-the-heel strap (adjustable straps everywhere). Should be stable and sturdy, with flat soles that distribute weight well (lots of contact with the ground) - nothing too high off the ground (would cap it at 1", and not as any kind of pronounced heel, either, a smooth 1" slope or flat) - no platforms or kitten heels that will make you wobble. Would even stay away from clogs. Also, would stay away from anything too heavy (e.g. Dankso). Flats, go for ones that are actual shoes, well-constructed, not little ballet slippers. Positively framed - think light, supportive, stable, low, strain distributed sort of around the foot, not just on one area (e.g. with thongs or flipflops, you have to grip with your toes a bit). If the sole curves *slightly* upwards at the toe, that might help reduce strain as you walk (bc your foot will slightly roll off the ground as you walk).

Sandals - I've had luck with Tevas and Joseph Seibel. Wearing Taos right now. I know some people like Keens and Vionics. I know Naot and Finn Comfort have styles that will actually fit your orthotics.

Flats, gotta just try stuff on. You will need a better fit than you would with adjustable sandals or lace-up styles. Mary janes aren't too bad for a compromise, fitwise. (I can't make myself wear them, stylewise. T-strap or bust.) Brands have different basic footbeds, something to be aware of. (I have feet like Fred Flintstone and need a big toe box, also pronate, Clarks never work for me. Fryes tend to be too small. Just gotta try everything, really :/) May have luck with Cobb Hill or Cole Haan. Mostly, shop at "comfort shoe" stores, maybe attached to chiropods' offices.

In cold weather, oxfords and lace-up boots are most supportive. Some are cute; I find it easier to find decently stylish footwear in cold vs hot weather.

Good luck.
posted by cotton dress sock at 12:32 PM on August 4, 2016

I also have a problematic ankle from an old injury, and my best luck with sandals has been:
Ecco makes some good "T-strap" options that accommodate my orthotic and still look reasonably dressy: 1, 2
Generally, gladiator sandals are also good as they typically have a solid back that keeps it in place (example)
And Chacos work for me, but don't accommodate an orthotic so may not work for you.

Agreed with cotton dress sock on getting lace-up shoes whenever possible.
posted by veery at 1:26 PM on August 4, 2016

6 months is still really, really early in the process. Take it easy and listen to your doc.

I did weights for a bit. I found things like kettle bells where I was keeping my feet still worked for me (I was working with a trainer).

I had a cortisone shot in my ankle at about 6 months out because I couldn't bend my foot at all. The shot helped me but I don't know if I was lucky, a lot of people were a bit horrified by it (??)

Agree with lace up shoes. Sandals (can't suggest brands, I'm in Oz) needed to have a strap for support.

But really, it's time. A couple of years before I stopped feeling like it was going to snap like a twig. I'm now 4 or 5 years out and I don't feel like a person with bad ankles. But for a long time, that was who I was. You're now in the bad sprained ankle club and it's one you're stuck in for quite a while. Broken bones pfffft, they don't know what they are complaining about.
posted by kitten magic at 5:53 PM on August 4, 2016

just as an aside, there is nothing "yikes" about cortisone shots for injuries. maybe people hear "steroid shot" and assume terrible things akin to anabolic steroids, or idk what else, but it's literally just a powerful antiinflammatory. and it's great, far better overall than taking prednisone tablets, which ARE in fact kind of yikes wrt side effects.

if you're still not doing better after all the physical therapy you've done you might want to look into someone who specializes in injury rehab for professional dancers. i've done enormous horrible amounts of PT over the past 6-7 years for various injuries and the best results i've had are from people who worked specifically on actual pro dancers and/or athletes as opposed to with the general public.
posted by poffin boffin at 6:20 PM on August 4, 2016 [3 favorites]

I went through this a few years back and now I'm able to wear chaco's sandals and feel like I'm getting decent support.

For a while, when I couldn't really stay off it enough and really didn't want to wear sneakers, I wore a very high-quality lace up brace with other (flat, stable) shoes.

I also second the ideas of swimming and finding a PT who specializes in athletes.
posted by mkuhnell at 6:57 PM on August 4, 2016

Oh, and 6 months isn't very long for this type of injury. Super severe ankle sprains take forever to recover from. I realize that it's very frustrating and feels like it's taking forever, but you are going to have to be patient. The ankle strengthening exercises do work.
posted by mkuhnell at 6:58 PM on August 4, 2016

Agree with a lot of the advice above. Background: I have severely sprained one of my ankles twice now. Each time it took way more than a year to "heal" and it has never been the same (my last time it took me probably close to 2 years and it's still messed up). The last go around I even gave myself a bone bruise down there to boot. It has not been a fun recovery.

First - cortisone injections aren't really a "yikes", as mentioned above. I had to get them both times I messed my ankle up. The shot hurts, and for like the first 24 hours for me my ankle felt worse but then afterwards it starts to help you feel much better. Think of it as putting strong anti-inflammatory stuff right where it needs to be.

Regarding exercise - listen to your doctors and don't push it. I was told to consider swimming and biking, but you should check with your doctor first before trying those. It's so frustrating, I know, when it takes a year or more to heal, but the more you fuck with your ankle and push it, the more you are risking making your ankle never heal properly at all, and then you will be like me: with a crazy unstable ankle that I can easily re-sprain at any time, one that hurts after mild walking even though it's been ~3 years since my last injury, one that can tell me when it's going to friggin rain because it will hurt with the barometric pressure changes. You don't want any of this if you can help it!

Regarding shoes - unfortunately you may need to make some lifestyle changes, at least until it fully heals. Since my ankle is basically permanently messed up, I was told to never wear high heels or flip flops again. I cheat every now and then (doc said as long as I'm not walking for long I can wear those kinds of shoes briefly), but I mainly use athletic hiking shoes, with custom-made orthotics that help reduce my on-going ankle pain. Things like Columbia or Merrell. I've also been able to wear some ballet flats from Clarks that I can fit an orthotic in. But, yeah, sandals have been the hardest for me to adapt to and I haven't found a solution to that. I basically never wear them now.

P.S. If you find that cool robot foot, hook me up too. I've been wishing for a new foot since 2006 haha. Feel free to memail me if you have any other specific questions. Been dealing with annoying ankle shit for 10 years now.
posted by FireFountain at 8:34 PM on August 4, 2016

Oh whoops, just realized I totally commented in your other Ask with a lot of the same. Sorry for the repeat, been a long day!
posted by FireFountain at 8:42 PM on August 4, 2016

Try pilates on the reformer. My studio requires 5 private lessons before joining small group (max 4 people) classes. This was awesome for rehab.
posted by crazycanuck at 9:00 PM on August 4, 2016

I think you might benefit from taking some yoga classes. Lots of the poses don't involve standing or using the feet. I've found that most instructors are very willing to help you modify poses to accomodste injuries of you let them know in advance what you are dealing with. However, yoga is done barefooted, so possibly that would be a concern, and I would not start any exercise with out OKing it through your doctors first.
posted by WalkerWestridge at 11:15 PM on August 4, 2016

I had a similar injury in 2004 and Fitflops became my staple footwear. Despite the name they aren't all beach shoes, they do pretty much any style you can imagine, but with flat, stable, comfortable soles. Oh, and it seemed to take forever, but it did get better and I'm running a marathon this year.
posted by intensitymultiply at 5:32 AM on August 5, 2016

I had a severely sprained ankle about 20 years ago. My entire leg swelled up and was black and blue up to the knee all around. At the time I did the crutch thing, the boot thing and all that for most of the summer. Swimming was the absolute worst for at least three years after, it was just a limp appendage grinding against whatever was broken and what was not. I also had a couple ganglion cysts on the torn tendons. It was ugly.

For the next 5-6 years it was all right I guess, I just powered throuh. I never felt safe or sturdy on it. I squatted 450 lbs on it and that ankle was my weak point. I had no problem standing or walking on it, but it hurt like hell when no weight was on it, like relaxing. Or sleeping.

Finally I couldn't take it any more. It KILLED me when I was trying to sleep. The cortisone shots did nothing, and I went to an actual ankle surgeon who worked for an NBA team and had an MRI. He was like, yeah, you have a couple torn tendons. I can reattach a couple and that should fix it.

So I went though with it. And I did the crutch and boot thing all over. And the PT. Oh man all the PT. But he was right. I have 3 screws in my ankle and they reattached a couple tendons, and now it's better. The only one I remember is the Peroneal tendon, that was the big issue for stability apparently.

My Doctor was right. It's been 12ish years now? And I have absolute confidence in that ankle now. I have had no more pain from it ever. My other foot and knees, well, it's a crapshoot. But getting the surgery I needed was literally the best thing I have ever done.

So now I wear hightop boots every day. Timberland White Edge I think. They have wide sizes, and go large. So I have 14w ones. They wear well and only wear out when the soles do. That takes about 2 years by my estimation of wearing them every single day.

When they "wear out" I use them for fishing boots.
posted by sanka at 7:21 PM on August 5, 2016 [1 favorite]

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