I had a modified Brostrom procedure 15 days ago (along with some bone removal and peroneal tendon repair). I am non-weightbearing in a cast. In 5 days (the 3 week mark) I can start weight bearing "as tolerated". What is everybody's experience with starting weightbearing? Can you walk on it a lot right away, or does it take days or weeks to work up to walking on it?
After having that procedure plus augmentation with a tendon graft, I was NWB for 6 weeks. I think sometime around the 3 or 4 week mark I started (very slowly) putting very small amounts of weight on it while standing still. So by the time I got to 6 weeks and the walking cast and permission to lose the crutches, I was able to put some weight on it, but not my full body weight (I didn't want to put that much on it, seeing as I didn't really have permission to be putting any weight on it, so I was very gentle). Once I got the walking cast, I tried putting my full weight on it and it hurt a lot. So I used both crutches that day, trying to walk on it with some weight but taking the extra weight through the crutches. By the end of the day I was able to put my full weight on it. The next day I was using either one or two crutches, I don't remember. The third day I was definitely down to one crutch (when you use one crutch, you use it on the side opposite your injured foot), and the fourth day I was walking with no crutches (but carefully, and definitely using the railing on the stairs!).
So take it slowly at first. Start with both crutches and just put some of your weight on it while you are walking (this will slow you down a lot, so be patient). Slowly increase the amount of weight you put on your foot as you can (let pain be your guide). When you feel like you are putting most of your weight on the foot and not really on the crutches, go down to just one crutch for extra support. Then when you aren't really putting much weight on that, you're walking!
It took me three days. I've read other people who said that it took them a week or two or even more. Just take it slowly, go at your own pace, and let pain be your guide.
Glad to hear that your surgery went well. Good luck with the rest of your recovery.
I had a modified bronston and repair of osteochondral lesion. I was NWB for five weeks. It took me two weeks to go from 2 crutches to none. I think that was because of the repair on my cartilege. What are you going to be in.. a walking cast, boot, aircast? I think that makes a different... the more protected you feel, the faster you can go. I was between a boot and aircast, mostly boot. Let us know how things work. Good luck!!!
I am in a fiberglass cast (blue) that I will begin weightbearing. At six weeks I get an aircast.
Over the last day or two I have put some weight on it (not full) and it feels ok at the time, but starts hurting a few minutes after I put weight on it. Based on that I am thinking that it may take a while to work up to walking.
I had that procedure done back in February, I was NWB for 6 weeks, (in a cast) and PWB to FWB in a boot for 4 weeks. It took me a long time to get rid of the crutches completly. Good luck, take your time if you need it.
I had a peroneal tendon repair and was in a splint and crutches for 10 days non weight bearing and have been in a boot for the last four weeks - weight baring as able - used the crutches for a few days - similar to others first two then one - then none - but have still used the crutches for distance walking. Take your time - it will slow you down - but it is worth it not to be in pain. I go to the doctor tomorrow - get out of the boot and into a lace up brace and I think get set for physical therapy. Good Luck.
Congrats on your walking Big Dog! I went to the doctor this morning - I got the lace up brace and will transition from the boot to the brace - a few hours at a time to start. I have been walking with it ,in the house and it definitely feels different. I go back to work part time the end of the week and start physical therapy on the 28th. Doctor says walking around at work will be like physical therapy!
I had the Modified Brostrom procedure 6 weeks ago. I got my cast off yesterday. Yeah. I was weightbearing in the cast for the past three weeks. I am in an aircast brace for 4 more weeks. During the six weeks time seemed to pass really slowly. Now, looking back it didn't seem to be that long.
I went straight from getting the cast off to the pool and swam laps. Did some light yoga this morning. It is so great to be getting back to normal life.
I am shocked at how good it feels. The repaired ligaments are pretty tight as is my achilles from being immobilized for six weeks. But, walking isn't that painful on the repaired ligaments. I am totally pleased and amazed.
PT starts tomorrow. We'll see how that goes.
Here's an interesting tidbit: I asked my Dr. how he knew how tight to make the ligaments. He said he cuts the ligaments and then puts the ankle mortise into position that he thinks is anatomically correct and then reattaches the ligaments. I thought that was interesting.
Big Dog sounds like you are making good progress. I started PT last week, had surgery on my tendon 1st week of Nov. Slow at first, but feels good to at least be able to move the ankle some - only up and down and out to the side, doc. does want it moved inward past 10 degrees till I see him again. Feels o.k. but gets tired easily. Please post how your PT goes.
I had it done in March. I was pretty sore for about two weeks. It slowly got better but I still sat in all my classes with my leg up on the table for maybe 4-6 weeks after the surgery. It wasn't as much of a pain issue toward the end of that time, but my toes turned the most amazing shades of purple when I let my foot hang down, so I kept it elevated pretty much all the time that I wasn't walking for the first 4-6 weeks. At 6 weeks I got the cast off and was in a boot. I was able to lose the crutches in 2-3 days. Pretty soon after that I was walking around my house without the boot and just wearing it to go out (I started that because I was having some issues getting part of my incision to completely heal over). I started PT as soon as I got into the boot. I think I was in the boot for 4 weeks or so, then into regular shoes with a brace to wear during risky activity. I continued PT for maybe 8-10 weeks total. By the end of June I was able to help people move (packing and carrying boxes). In August I was hiking on rocky trails.
The recovery seems long and hopeless at the point you are at right now, but hang in there. There were some nights where I was in pain and sick of the cast and I would cry and wonder why on earth I subjected myself to such torture. And it's a long time in a cast and on crutches, wondering if your leg is actually still in there. Once you get past that, PT is kind of slow, but I felt like I made pretty good progress from week to week. Once you get off the crutches, things speed up a lot; it's just waiting for the ligaments and tendons to heal that takes a long time and is frustrating. But I don't regret having the surgery at all and if I had it to do over again, I would. So try to focus on the end result and take advantage of the ability to send people to run your errands while you can. :-)
If they used a tendon to reconstruct the ligaments, then you probably had a Christman - Snook procedure, instead of what I had, which was a Modified Brostrom. What you had is more major and will take a bit longer to heal and you will have less range of motion in you ankle afterwards.
Yes, the crutches are a pain. With my procedure I found that I could go off the vicodin at about the 10 day point. I then took ibuprofin every four hours for about the next 10 days and then was able to get by without pain meds at all.
Just take it easy and be very patient. This is going to be a relatively long process. It may sound crazy, but try to enjoy and fully experience what you are going thru. Here are a few things I found were positive about the whole cast/crutches experience: (1) I got to relax more and read books, (2) I didn't drive (right ankle), so I had to be driven places - I found that my life slowed down and was a lot less hectic when I wasn't jumping in my car all the time and driving off, (3) as much as I missed working out (I mainly swim and do yoga), it was nice to take a break, (4) I appreciated the support I got from family, friends and co-workers - it really reminds you who your friends are and made me feel really good that so many people care about me.
I found that during the six weeks in the cast (and especially the three weeks on crutches) time seemed to move very slow (which isn't all bad). Looking back on it, it doesn't seem like much time at all.
I am in an aircast and doing PT now. Once again, things move slowly. There is improvement, but very slowly. I am encourgaged though. I had seen my PT a number of times before the surgery - so she was familiar with me. She said that I have gone from the loosest ankle that she has seen to having the best ankle reconstruction she has seen. That being said, I still cannot walk without a big limp and have pretty limited range of motion.
Most of my pain at this point is across the front of my ankle and top of foot (even more so than where the ligaments were repaired). DId you experience this? I am guessing its because that's where the extensor recalcanium (sp?) was moved and attached to the fibula?
Hi all. I had reconstructive surgery on my ankle on July 6th. I believe it was a modified Evans procedure, but they were reconstructing all three of the outside ligaments after multiple grade 3 sprains, so I am not positive.
Bigdog, I have been having pain in the same areas you are describing; across the top of my foot and at the base of my shin, where it meets the ankle. They are currently trying to address this pain with soft tissue work, electro stimulation, "shock baths" (soaking my foot in really hot water, then really cold, then really hot... etc. etc. etc.) They have also given me orthotics, but they are stil adjusting them to fit right.
It is nice to hear of someone else having pain in this same area, because I was starting to think I was going a little insane since no one can really tell me what is causing this pain.
I did experience more pain when blood would rush to my foot. That gets a lot better.
While the recovery does take awhile - you will improve. At each point its hard to tell what you will be able to do in the future. For example, a week after surgery I could not imagine being off vicodin, but a few days later I was able to move to ibuprofin. A week before I was supposed to go weight-bearing in the cast I tried putting weight on it and given the pain I thought there was no way I would be able to be weight bearing in seven days - but when the time came it was much better and I was able to move from being on crutches to full weight bearing over four days. I got my cast off six days ago. For the first two days I could barely walk. I thought, wow, this is going to suck! Yesterday I flew to Miami on business and was able to walk all through the airport without totally killing myself (yes, I am in Miami Beach right now preparing to go lay out at the pool). So, just because you are in a lot of pain and things are tough now, remember that they do get better.
Regarding going to class and pain meds - I went to work six days after my surgery. I thought I wouldn't be able to stay awake because I had been falling asleep a lot. But when I was at work I was ok. I wasn't real productive for the first few days (I spent a lot of time looking at www.explodingdog.com on the net and making inappropriate comments) due to being loopy on the meds, but I was surprised that I didn't fall asleep. So, it may turn out better than you think. Another thing you may try is skipping some class. You can get notes from friends. I have always thought that attending class is overrated - I skipped a lot and did really well - I bet you can miss some class and not have your grades affected too much.
Try not let this upset you too much. Try to look at this experience as being mildly entertainng and a great learning experience. I truely believe that we are here on Earth to learn and that everything we experience is a chance to learn. This injury will pass and it would be ashame not to have learned all you can from it and to have benefitted from it somehow. I had previously posted about 10 things I had learned from this experience, maybe I'll post a revised list.
How long are you in a cast? When do you start weight bearing? Where do you go to school?
My dad is 76 and finally admits to needing to do something about his ankle, either fusiion or ankle replacement. He was a construction worker and has essentially worn out his ankle/feet with intensive use and injury. He is strong but overwieght and the fear of being immobilized has caused him to endure intensive pain and severe limp for a decade. He has been to Mayo clinic, but their recommendation was "basically do what you want".
Is there a GOOD foot reconstructionist(?) or skilled surgeon in either the midwest or NJ/NY area that can be trusted to 1. make a great diagnosis, 2. unbiased with regard to treatment (e.g. isn't biased toward the more expensive treatment methodology), 3. a great surgeon with great results.
My concern is that if my father loses his ability to walk, even if his gait is painful and difficult, he will die or wish that he had.
Ron, I have heard very good thinks about ankle replacement at the Rothman Institute in Philly (I don't know if that fits your NY/NJ requirment). I had ankle ligament reconstruction there and have been very pleased. They have a website that can refer you to their ankle specialists. Let me know if you have any other questions.
Last edited by krbailey11; 01-09-2005 at 08:23 AM.
I can understand your concern about class. I had surgery on a Wednesday and classes started again that Monday. I had my mom helping me, so she would drive me to school for class and then straight back home. On the days that I had two classes, I would go lay down on the couch in the lounge and take a nap between them. I took a pillow with me to class and sat there in my chair with my foot up on the pillow on top of the desk. I definitely went to class drugged. My doctor prescribed percocet and vicodin. I didn't take the vicodin before classes, but I took the other one. I did try not to take too much and took it in 1/2-pill increments. But don't worry about it too much. Even if you do fall asleep, you just had surgery, so who cares? I got a golf cart ride through my school's disability resources center to my one class that was on the other side of campus. I also got a handicapped permit and was lucky enough that there is a handicapped parking lot directly behind my building, although with my mom driving me around I got door-to-door service anyway.
If you do decide to try going to class without taking any medication, be sure to carry the meds, a water bottle, and some food with you so you can change your mind and take some later.
I don't remember any pain on the top of my foot. I think most of my pain was on the lateral aspect. I do remember the top of my foot and the front of my ankle being stiff and having to do a lot of stretching to be able to point my toes and such. I don't really remember too much pain other than generalized achiness once I got into the boot and doing PT. Of course, I could just be blocking it all out... But with PT I mostly just remember pain associated with stretching.
I had a modified bromstrom with cartliege repair for a large lesion. I went back to classes just over a week after the surgery... My pain right after the surgery was not that bad... nothing compared to the original injury... but I do have a high pain tollerance. I was NWB for 5 weeks, PWB for 2, and then in a boot/aircast for the rest of the school year plus some (my surgery was last year, the beginning of March). For class, I just propped my foot on another chair, and only took OTC pain meds. I didn't like the drugged feeling, so I only took them when absolutely necessary (but I don't necessarily recommend that). To get from class to class, I either crutched or got rides from the safety guys. They were very nice about it. One thing I did find was I was very tired and took a substantial nap evrey afternoon until I was off the crutches. The only problem I had was in lab, where I was allowed to sit, but had no where to put my foot up. I would sit for about 30 minutes, then leave the lab and lay down on a bench with my foot propped to get the swelling down, then I would go back in. Most of my profs were very understanding and gave me some leway when I needed it. I did find that after my surgery my grades slipped a little... i tihnk it was because I was so tired all the time, and studying was hard because I usually do it at my desk, and that was hard. But I handled it just fine... Im sure you will be ok. Let me know if you have any more questions! Oh, and I have some pain over the front of the ankle, but I think it is from the scope to repair cartilege. The doc said that the surgery for that will help a little, but most likely I will still develop early arthritis. I think where they put in one of the scopes I have some damage which is causing some pain, but nothing I can't deal with. Adios!