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Foot & Ankle Problems Message Board

Foot & Ankle Problems Board Index

Initially after the injury (well 6 months after) I was on crutches, then in a walking boot for 16 weeks, but I had messed much more by that point on both sides by the time I saw a doctor who realized what was wrong.

The whole time I could walk. After the boot whixh cane with daily PT I wore lace up ankle braces with figure 8 straps. I wore those until I was twisting my ankle in those and asked for a stronger brace. At that point I got another walking boot for the 3 months until they could schedule my surgery. The whole time I could walk, and even sprint if I needed to for short periods, like when one of the kids decided to run into the street. Everything obviously caused pain and a risk of greater injury. It wasn't ideal, but you do what you have to.
I tore my AFTL, CFTL, peroneal tendons, achilles and mildly tore my deltoid ligament (which healed fine) in 2009. I did not have surgery until 2014. I wore lace-up figure 8 braces for a few months but I was inverting so badly that I was wearing one out every 3 weeks which was expensive. I also needed more support because I was lifting people as part of my job.

I was prescribed (but you can buy it yourself) the Donjoy Velocity brace. I had the ES version. They are more expensive but only worth 3 lace-ups :). I wore it until in March 2014 I stupidly went outside for "just a minute" without a brace and re-tore my AFTL, CFTL and Peroneal tendons. They continued to partially re-heal and tear again until I had surgery in June 2014. I should have been in a boot but because of misommunication I was in a stirrup brace for that time. (My Velocity brace happened to wear out about then and I wasn't replacing it so close to surgery and I think that I couldn't handle the movement at the joint that the brace allows. I think I was too unstable but it may have been pain?. In April 2014 I was doing PT and my AFTL ruptured. Loudly. So that was the end of PT and the beginning of a really difficult 6 weeks until surgery; the peroneals gave out whenever there was weight on them, the AFTL was useless and hurt and the CFTL was also useless although at least semi-intact.

The surgery was one of the best things I've ever done for myself. It's not a fun recovery but it was completely worth it. A year ago I wasn't able to go outside when it was icy (I was still regaining stability after surgery) and this year I can do whatever I want if I wear a brace if there is ice or too much snow that could cause an ankle turn.
I would have much, much rather been in a boot than the stirrup from my last injury (if there was one; from my last sprain to surgery I hurt it over and over and over again). The stirrup wasn't enough to keep it from turning under (and this with orthotics too) and walking was so painful and felt dangerous. I had to chase my niece who ran into traffic once and the whole time could feel my peroneals tearing. But even walking it was so clear things were very, very wrong in there and I fell a lot of times between that injury March 17 and surgery June 14. I fell down the stairs while carrying my laptop which flew into the air, landed on my mouth and broke my tooth. I stood on the sidewalk outside waiting to talk to the neighbor and it gave out and I fell so that he was stunned and asking "um, did you just fall?" (while standing still was implied) and the only answer was yes and now I've skinned my knees too.

I used a boot after my original injury in the winter. It happened to be a very bad one and the particular boot I had was crappy in the snow. However it was crappy in many ways. I dreaded going into a boot for 10 weeks of casting post-op because that boot was so awful and then my post-op boot was so comfortable and had traction and things (I had it August-October so not in snow but certainly on wet ground without problems. My first boot would have been slippery on wet ground too. In fact it was slippery on just wet floors). So a good boot is important this time of year (mine was an Aircast and while I think Aircast makes higher quality boots this was their bargain basement model and it was awful in so many ways. The air wasn't integrated so every time I sat down or stood up I had to use a pump to adjust the boot's tightness, which was my biggest complaint. My post-op boot was a top of the line boot and it was soft and padded inside, had integrated air and after a couple of weeks I didn't even adjust the air much, just a totally different experience.)

I had been seeing a podiatrist between my 2 injuries and thank God had to have surgery where he didn't have OR privileges so I had a foot/ankle ortho; I didn't know to seek one out and avoid podiatrists with scalpels. I saw him after my March 17 injury and he talked about putting me in a boot and then decided the lace-up was enough. I don't know why although he seriously under-estimated the damage I had in there so maybe he didn't realize that I was not able to walk safely in the lace-up he recommended. (I think he actualy had me do stirrup for a week then lace-up and when I kept falling I went to the stirrup b/c it beat the lace-up. I had thrown my boot out the year before when I moved or I'd have put myself into it.)

I had almost my entire joint lining removed because it was so damaged for the years of instability. The podiatrist said I could wait on surgery until I was ready as long as I did it before I had severe arthritis. He was not accurate that no more damage would come of this.

But the good news is that I did heal and while my ankle is different than the anatomical one and I've learned that as my surgeon warned it can still be injured and I need a brace for some activities or when it is icy out or otherwise risky (like doing yardwork on the steep hill I live on) it is a million times better than it was 2 years ago. I'm 100% glad I had surgery.
Wow, I can't believe that. Your injury must have been really bad! I also can't believe you still had to wait so long for surgery. I think if I were falling just standing my surgeon would try to bump me up the list.

I tried every pair of shoes I own and none of them really fit with my brace (even some slip on runners). I have pretty small feet though, so I think my shoes are just too small. Hopefully I can get this boot that you said was so good. My injury is from falling on the ice last year, so I'm really timid on the ice now.

Can you tell me a bit about the recovery? I'm a bit worried about that too because I'm likely going to have the surgery in March and I'm writing final exams beginning of April and then starting a new job in June. I'll have a lot going on while I should probably be resting.
Peroneal tendons collapse when they are torn. It's not pretty.

My surgery could have been sooner but I had to schedule it after vacation, both so I could go on vacation and so I'd have help. I think it was nearly a month later than it could have been. I also had to wait longer b/c of a medical condition that required me to have surgery at the hospital instead of the outpatient center. My ortho is only at the hospital once a week so it took longer to schedule that.

The thing with the boot would be to be sure you are taking it off and moving as much as you can and keeping the ROM and strength up. I went into surgery without much strength and while rehab went fine it was so weak at first. Some of that was my surgeon's recovery though.

My surgeon is very conservative so you will probably go through stages faster than did, sometimes much faster and those peroneal tendons can add some healing time too. I was in a surgical cast for 5 days with a take home nerve block that could have been in all 5 days but I was ok to remove it on day 3. On day 5 I got a hard cast. I was on bedrest and in hard casts (they changed them every 2 weeks) for 6 weeks with non-weightbearing. At 6 weeks I got a walking cast and was allowed partial WB for 4 weeks with crutches. At 10 weeks I got a boot and gradually weaned off crutches during the day. I was in a splint at night and not allowed to put down any weight at all without the boot so the crutches continued at night for 6 weeks. I started PT at 10 weeks. I eventually could walk into PT but needed my crutches to move around with my boot off so I had to carry them into PT which was weird. At 16 weeks I started wearing a brace and shoe and gradually worked up to doing that all the time. I finished PT 5.5 months after surgery and was cleared to walk without my brace at 6 months. But then we had a horrible snowy, icy winter so I was really in the brace for 3.5 months more.

They say you are fully recovered at year. I added those extra months because I did all my PT at home but wasn't getting to walk without the brace and I really needed to practice that after being braced for 4.5 years after my injury (and really the injury started with a push and fall in a cross country meet 23 years before surgery; my ankle was fractured and I didn't know and kept running on it until it gave out and tore up my knee. The fracture was found in xrays after my fall in 2009 and I had been through a lot of sprains between so had been doing damage for a long time). I had to re-learn normal stepping and rolling my foot heel to toe. So I really felt I was pretty much fully recovered by about 15 months. I've had a few twists and one small sprain but have learned more and more what I can handle and what I can't. It's mostly amazing and what isn't is easily corrected with a brace.
Honestly I don't think there is any way you could not elevate constantly at 6 days. Ideally it is in bed and higher than your head. It actually will hurt if it is down at all b/c the blood will get trapped in the foot and it gets uncomfortable. I have elevated a new sprain by propping it on my trash can in my cubicle but that only works so much since elevating less than over the head doesn't really reduce the swelling.

Some doctors treat this much more seriously than others. Mine was very strict and had many rules to follow. I wound up completely happy with my ankle so it worked out well. Having just the AFTL done may make some difference. I haven't seen a ton of difference between people just getting ligaments and people getting ligaments and peroneal. I had most of the joint lining removed via scope and that's the part most likely to be noticed now (hurts when the weather changes).

Since it is just an AFTL you really do have the option to delay if that makes things easier. I waited 5 years from badly tearing everything to surgery. I did have to wear a brace through that period and I ruptured my AFTL while in PT preparing for surgery (it was already in bad shape and just let go with an ugly noise). I don't know if i'd recommend my waiting thing to anyone though. It had it's drawbacks for sure. But it is an option.

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