Best rehab for an avulsion fracture in my ankle
October 26, 2022 6:53 AM   Subscribe

Rushing at the dog park. Slipped on some wood chips. Turned it hard. Assumed it was a sprain but after two weeks I got it check and I got the bone on the pointy part of my left inside foot popped off (WITH a sprain thrown in). What's the best way to recover from this?
posted by rileyray3000 to Health & Fitness (6 answers total)
 
Do you have access to professional physical therapy? Like, is it covered by your insurance or can you afford to pay out-of-pocket?
posted by mskyle at 6:57 AM on October 26, 2022 [1 favorite]


All due respect, but if you have broken bones and a badly sprained ankle, this is "see a medical professional" territory, not "ask the internet". Your doc should be able to refer you to an orthopedist and/or a physical therapist to help with the recovery - good luck!
posted by chrisamiller at 7:03 AM on October 26, 2022 [14 favorites]


IANYD, but oh hello. This was me eight weeks ago. I don't know if my break is like yours, but it was to that big outside lump of bone on my ankle.

I spent a few days in a splint (put on by the urgent care people) + crutches, then four weeks in a boot (via an orthopedist). I wore the boot all the time I was awake, and wrapped my ankle very snugly in ace bandages while I slept. Per my doctor's orders, the last week or two with the boot I would cautiously walk without it when at home, but always wear it when I went out. The good part about the boot, after the first few days, was that it let me do a lot of my normal stuff without too much pain.

Then I transitioned to a smallish ankle brace my doc told me to get + nothing while sleeping. Now, week eight, I'm using the brace only when I'm out in the world, and using nothing while at home.

Starting at about week four, I commenced physical therapy, once per week + doing the stretches and exercises religiously on my own. Both doc and PT are telling me "you'll make a full recovery!" but I'm not quite there yet. I have range-of-motion issues, am still experiencing some pain, and am unable to make those tiny adjustments that the ankle is always doing, so my balance is currently trash. I can walk up stairs without too much trouble, but going down is much harder.

But I'm seeing improvements all the time. Even two weeks ago, I had theater tickets and the sensation of sitting in a regular chair, with my ankle un-elevated for 2-3 hours, was difficult and painful. Now that wouldn't bother me very much. Last night I was able to walk very slowly on a treadmill, using each step to practice a normal walk (vs. a limp). It was under 1 mile per hour but it felt really good.

So I'm 8 weeks in and I wouldn't be at all surprised if I'm still working on my PT for another 8 weeks, or maybe even more. But I'm recovering.

It's not linear. Listen to your medical professionals. When it comes time for PT, do the work at home to enhance what the therapist is doing during your appointments.
posted by BlahLaLa at 7:56 AM on October 26, 2022 [1 favorite]


I had this same fracture back in 2012. I was able to recover after only 8 weeks in a boot cast - but ONLY BECAUSE I only waited two days before seeing a doctor. My doctor told me that if I'd waited 2 weeks, I would have needed surgery.

Please go to your doctor now.
posted by EmpressCallipygos at 8:11 AM on October 26, 2022 [1 favorite]


I had the exact fracture (with the addition to some massive stress to the tendons) and healing experience as described by BlahLaLa.

Get to an orthopedist and a physical therapist as soon as you can.
posted by theBigRedKittyPurrs at 9:05 AM on October 26, 2022


I had what sounds like the same fracture as BlahLaLa several years ago, an avulsion fracture of the distal fibula, in my case a Weber fracture type B2. If yours is on the inside of the foot then it would likely be a break of the medial malleolus of the tibia (the two pointy bone bits of your ankle are the extremities of your fibula (outside, baby toe side) and tibia (inside, big toe side) which run parallel to each other forming your lower leg.

I got a cast for four weeks (though I read a meta study that said air cast was just as effective) and then an air cast afterwards for another three weeks though by that time I was basically fine.

The game changer for me was getting a little knee-scooter thing versus crutches. So much more mobility. My insurance paid for this, which was a rental at ?50 bucks/month or so.

I went to a physiotherapist once the air cast was over, and the main exercise was extremely simple, and effective:

- stand on one foot (the injured one) with the tips of your fingers on a countertop for safety
- once you were good at this, stand on one foot on a rubber pad like a gardening knee pad, with fingertips as well
- after this, stand on one foot with a rubber pad and no fingertips and finally
- stand on two feet, then one foot on a wobble pad

I also spend about 20 minutes a day writing the alphabet in the air with my big toe

Then my own physio towards the end was to walk on a cobble beach every day.

Anyway, sounds like we had different fractures but the one-leg standing strengthens all the components of the ankle simultaneously and you can do it at home or work or wherever.

But this physio is only an option after enough healing, probably in a cast, has happened. Don't do this too early, or you will make your break substantially worse
posted by Rumple at 4:21 PM on October 26, 2022


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