Broken Ankle - time frame/how much is too much?

[Bisoux]

I broke my ankle (the little knob on the inside is not really attached any more, smooth joint surface, stable fracture, tendon/ligament damage, but no tears) 14 days ago. I’m back to weight bearing and using one crutch for any extended walking (college student, so I have to get around our campus). I’m in a walking boot (Velcro padded apparatus)

I am desperate for this ordeal to be over, and want a few more opinions than my crappy health center Dr.'s.

If it’s not hurting can I keep going? When should I start ‘rehabbing’ by stretching/exercising it again? Am I doing any harm by living life (ie walking around on it at home for short distances)? And what are some tips to get back on my feet sooner?

I really want to be back to normal because I bought a 5 yr old TB mare last winter who still needs basics to be fully instilled which I planned to do in the rapidly approaching summer. I won’t ride her if I’m not back to 100% because she’s still a baby and liable to buck/be silly and I know if I’m less than 100% I could come off/re-injure. I have a more well trained mare to do some rehab on to regain important muscles, but I need to get there first.

[twofatponies]

If after you do something (walk across room/campus) it swells and throbs or hurts, that was too much!

I think the basic structures need 6-8 weeks to do basic healing (still tender and prone to reinjury at that point, but stuff has grown back in place). Then you can start doing stretching, gradual more work, balancing exercises, etc. You can find all the rehab exercises online. (google physical therapy sprained ankle or similar).

That said, my badly sprained ankle still occasionally hurts and swells a bit if I do something unfamiliar (wearing dress shoes for an evening, for example), and that was 2 years ago I sprained it.

I started riding after eight weeks and only had to be careful when dismounting not to bring any weight down on it. Walking out in the uneven pasture to get my horse was the hardest thing for a while.

[Bisoux]

Thanks! I really just wanted to get a few opinions or personal experience and this was what I was looking for. Anyone else with suggestions?

I think I’ll try to keep taking it really easy, in order to be back to fully functional faster… I just hate being less than competent to do things like open a door for myself!

Walking out to my pastured mares will be tough! Their pastures are FULL of gopher holes etc to trip in. I’ll make sure to have special ankle braces for that for sure!

[KateandKc]

[QUOTE=Bisoux;4863053]
Thanks! I really just wanted to get a few opinions or personal experience and this was what I was looking for. Anyone else with suggestions?

I think I’ll try to keep taking it really easy, in order to be back to fully functional faster… I just hate being less than competent to do things like open a door for myself!

Walking out to my pastured mares will be tough! Their pastures are FULL of gopher holes etc to trip in. I’ll make sure to have special ankle braces for that for sure![/QUOTE]

Any way you can get an appointment with an orthpedic surgeon? Or even a really good sports medicine doc. Only 14 days and being back to FWB (full weight bearing) seems rushed to me, especialy since there was no surgery to make sure everything is in place and hardware to stabilize the fracture. Did the dr actually say that it was ok to walk on it? Have they xrayed it since you started walking to make sure the fracture is still stable/not displaced?

As an example- I broke my ankle and leg (broke the end of tibia and fibula- basically what you did X 2) and had a tibia/fibula fracture above the ankle joint. I had surgery and was finally able to be FWB at my 10 week post-op appointment. If I’d gone the non-surgical route, it would have been closer to 14-16 weeks of non-weight bearing.

I hope your recovery goes quicker than mine. I’m now at about 7 months post-break and am finally feeling like my ankle would eb stable/strong enough to ride again. I’m about 90% back to a normal life…still can’t run, have a bit more PT to do, and have pretty constant pain.

How is the pain and swelling when you’re walking (or at the end of the day)?
A great website is mybrokenleg.com Tons of good info and a great discussion group to talk about broken legs/recover/etc. Best of luck to you.

[imissvixen]

I had ankle surgery last year by probably the top ankle orthopedic surgeon in the US. The surgery was to correct a poorly healed broken ankle. Doc told me after surgery to be NWB for twelve weeks and to think of the situation as that he had planted grass seeds in my ankle joint and that they needed time and space to do their thing and grow.

I tried so hard to stay off of it. But after about 4 or 5 weeks I started climbing the walls. Walking on crutches is murderous on your shoulders – at least the way I did it. So I started gradually easing back and by 12 weeks I was pretty much full steam ahead. I didn’t ride at all though.

When I had my 12 week follow up I took my crutches so the doctor wouldn’t know how I had cheated but I broke down and told him. He didn’t seem too concerned but did say that I didn’t need PT because if I wasn’t having pain and was confident on using that leg that that was good. (I am 53.) He did tell me not to run for at least 6 more months and I have honored that completely. In fact it has been about 10 months and still no running.

Meanwhile through this entire ordeal I have had no pain except from my bad walking mechanics – overpronation.

[medical_mike]

“medial malleolus fracture”

Look it up on internet. That is your best source of information as you don’t seem to want referral to a specialist.

Granted there are many degrees, but it is still a fracture so 6 weeks.

My thought would be to try an access the colleges athletic training/PT program or a friend of a friend who is in either program. They will be able to lend you an excellent opinion and get you on a rehab program for both. Heck, maybe they can use you as a lab project!

Over pronation per se is not the worst problem to have. Your lack of a strengthening program is more a concern.
Without that, your problems are likely to cascade and your riding will start to suffer.

Best of Luck.
Medical Mike
equestrian medical researcher
www.equicision.com

[EasternMkt]

Gah… so close to home. I broke the end off the tibia and shattered my fibia, and dislocated the entire mess on 04/10, had surgery to bolt me back together the next day. I’m just 5 weeks into the ordeal and crawling up the walls, crutch wherever I can (to the store, to the coffee shop, etc.) but it do get horrible blisters on my sides, and it’s going to be at least 8-10 weeks NWB. Then I get to start PT and it will be a while before I get to ride and run. I’ll probably start w/ just working my friend’s old gelding bareback while she rides my 5 y.o TB mare (who really is a saint, but a green saint).

While I’ve had basically no pain since a few days after surgery, the entire thing is stabilized in a cast. It takes a minimum of 6 weeks for bones to start to knit, and you definitely want things to go well in that area as it has the potential to impact how you use the ankle in the future. I know it’s a pain, but I wouldn’t rush to use it.

[Sheila]

fell off and landed on feet- big mistake. bone came through, broke heel, shattered -dislocated ankle, broke tibia and fibia- one emergent surgery the next day - second surgery ended up twice as long as we were told as they had issues wiith the length of my leg and had trouble placing the plates into the ankle- …I was told 4 months no weight bearing. Using walker and wheelchair. Have a bivalve cast as I have 7 incisions- including where bone poked thru - so they can do dressing changes. The good thing with a bivalve- I can ice the leg and foot and check swelling.

My advise? listen to your body- keep track of how much you are doing and if you see swelling or have increased pain- back off. PLease try to see a Physical therapist- Medical mike is right on- your college insurance may cover you being seen by the Athletic trainers…can’t hurt to ask.

As far as riding your 5 year old- just remember, if the ankle is weak and you fall off, you may end up breaking something else in addtion to rebreaking the ankle. Please be careful. In the overall scheme of things, 2-3 more months won’t matter to a 5 year old.

[Hattie]

Sheila - I did the exact same thing except I did it to both legs!! 3 surgeries later and enough metal to build a new car - I was back riding at 4 months. There is nothing like being bed ridden for 2 months. I was given on ok from my doctor to start using the walker for one leg (but only going 10 feet to the rest room) - did I follow his instructions? No - I was out of the house when no one was around. Luckily, I had a physical therapist that started 2 weeks after my injuries and a nurse that came by daily to manage my wounds (from where the bones came out!) and give me my daily Lovenox shot (blood-thinner). My ortho doctor was wonderful - he understood how important it was for me to ride again and encouraged it. I did push myself but it was only after each dr appointment where you could see progress with my xrays (ie bone healing). Good luck and hang in there! I thought it would never end, but it does!

[wateryglen]

JMHO!!

Don’t do anything until you have your followup xray that says you’re healed. Broken bones don’t heal if they are constantly moving. NO rehab until you are cleared please!! The questions you asked should have been and can be answered by your doctor/doctors office. Ask there!! If you don’t heal right the first time; it can be many more problems. Keep your ambulating down…
JMHO!!!

[caper]

Sheila, Hattie same thing happened here. Doing a favour for a friend and exercised her horse for her. She neglected to say he was new to this barn and never in the indoor. It was a windy day with doors slamming and wind howling (you get the picture). I had the 9 second Calgary Stampede ride almost rode it out and he planted and I sailed over his shoulder and landed on my feet. I have very weak ankles due to very flat feet and having sprained each of them a multitude of times AND pulled ligaments. I guess I should feel lucky as I only had a hairline fracture but required a cast and was on crutches. I was given sort of a walking boot BUT was told to use the crutches. I can’t recall if it was 6 weeks or 8 weeks of having the cast. I think more along 8 weeks. When I returned back for my follow up appt to have the cast off and re-x-ray they said it looked good. I was so excited and said so can I just jump off the table and head off to the barn and resume my life. Nope not so fast…He handed me my crutches and said I should be using them for a week or two. I was so angry. He said the best exercise was walking to flex the ankle and my kids were little then. So I pushed the baby carriage while walking the 5 year old to school twice daily. So I basically waited out the two weeks like he said…I didn’t want any setbacks and make things worse. I am still to this day very careful on dismounting. I sort of slither down the side as both my ankles are toast. I’d say don’t be in a rush and listen to your body and give it the time to heal.

[PNWjumper]

I fractured my ankle and broke my fibula and probably tore the ligaments acorss the front of my ankle in the process (turned out I was newly pregnant when it happened so we couldn’t do the MRI to take a look) when a horse fell to her knees with me on the landing side of a fence (I flipped over her head and kicked the ground pretty hard). I got surgery to pin the ankle back together and was told to remain NWB for 4 weeks at which point I’d get a walking cast.

I think I lasted two weeks into the cast (so 3-4 weeks post break) before I was gimping around (it’s impossible to have a toddler and not use you leg at all!). When I went back in at 5 or 6 weeks post-break my orthopedic surgeon said to go ahead and do whatever I wanted as long as it didn’t cause any pain. He said that the minute something hurt it was my body’s way of warning me to stop.

I was back on the horse the day my cast came off, and I feel like I worked a lot of the stiffness out when I put my stirrup back on the saddle a few weeks later. My PT was surprised by the range of motion I had and suggested that I keep riding (no problem there!).

I held off on getting back on my green horses for a while. I was definitely worried about reinjuring if anything happened. But it was a bigger problem to walk around than it was to ride

Good luck with yours and I hope you heal up quick!

[Sheila]

Hattie- Both legs?! Good Gravy -I can’t imagine the pain.
Caper- I have cats and am having trouble withthe walker never mind little kids.
I have follow up and xray on Thursday so I am keeping my fingers crossed that he sees progress.
Thanks for the well wishes-

[Hattie]

Hey for everyone with hardware, the good news is, is that your same areas won’t break again - it will break above the metal!!!

I too, slide down my ever patient 3 yr old when I dismount. I can’t run very well anymore and I certainly can’t jump off my horse. However, I am thankful that I can walk, ride, and resume a normal life. Luckily, you guys are younger (I’m 52), so I’m sure you will heal even better.

[sk_pacer]

Getting into this late, but the bone is the least of the problems, the real problem comes with the soft tissue damage. You will find out why they recommend a horse with a bow or suspensory tears be given a year off. My bones heal fast, and so does soft tissue, but when I busted my foot, the ligaments and tendons still took a good 4-5 months before they felt kinda strong again; the bones healed in 4 weeks though. I kept that ankle wrapped for a many months after the cast came off.

[Bisoux]

I did get an x-ray 8 days post fracture and he said that it was staying stable all on its own. I asked a bunch of questions, told him that I could barely use crutches anymore because my arms were killing me so bad, and that I had been toe touching already just because I literally couldn’t hold my leg up all day (with 8-12 hrs of class on some days) I asked if I could start putting weight on it and told him that I had tried standing on it and it didn’t hurt. He said it was ok. Then he called me back two days later and told me that he should have said to keep toe touching with nothing else yet.

I don’t trust the guy because he wears bright purple button down shirts and rainbow-esque suspenders. My health center is also known to be less than perfect more than half the time. I don’t have insurance to go see someone else, but am willing to do so anyway if it means I heal right/quicker/best. I will give a call to ask for another doc and to see about PT because I know from experience that I need it. I just want the fracture to heal so I can go ride bareback!

I’ll keep the activity to a minimum until then, but crawling up the walls doesn’t begin to describe it…

[Sheila]

QUick questino- when you all went back to riding with your harware in your ankle- did you use safety stirrups? Do you think they would be a good idea with limited mobility?
Thanks for the input-

[JA1]

OP: On 2/21 I fell off and fracture my tibia and fibula. I had no displace fractures, the fibular fracture was oblique through the lateral malleolus and the tibia fracture of the posterior malleolus. I was in a NWB cast for 7 weeks, then a walking boot which I was only allowed to place 30% weight for 4 weeks (cleared to ride w/out stirrups). Next I was allowed to transition to full WB and riding with stirrups, well this was when the true extent of my injury came to light. An MRI on friday revealed I have a non healing oblique fracture of the fibula due to a disruption of the anterior tibiofibular syndesmosis (tore the ligaments stabilizing the ankle), marrow edema of the talus, distal tibia and fibula, joint effusion, and osteochondritis dissecans of the talus all of which will require surgery to fix. There is absolutely no way you should be weight bearing! Your ankle should be in a hard cast. Go to an orthopedist or a University hospital with a medical school to get the proper treatment. Most teaching hospital have programs for people without insurance because the students can learn from you. You will have to be a teaching case but you will get state of the art care.

I was a good patient, did exactly what the orthopedist said and because my ankle did not show signs (swelling, pain etc) I now have to go back to square one for healing. Ankle/ joint injuries are serious and need to be treated correctly. Your horse will be there when you heal. What is most important is to get the injury to heal.

Please take care of yourself