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PT & Walking for a broken ankle & a sprained Ankle

Riders with Health Issues
#1

Had surgery on my left ankle almost 2 months ago (two screws put in), so I am finally in PT to help heal that ankle and the 2 Grade 3 torn ligaments in my right ankle… go me, I know! :lol:

I started PT last week, but I am trying to decide if I should stay or find somewhere else. My dad was in the military, so I have been going to the military hospital for PT (they usually only take on active duty members, but my surgeon said since he operated on me, I’m allowed to stay there).

So, first question:
I’ve never been to PT before I don’t know what to expect. What should I be looking for to decide if its a good PT clinic or if I should look for another? Honestly, I would like to go to a clinic that understands my needs as an equestrian, but my insurance is covering everything so I am not paying a cent for anything.

Second Question:
How long until others were able to walk after surgery? I am finally down to walking with just one crutch after getting the walking boot about 2.5 weeks ago. But of course Christmas and my birthday are coming up, so I have company parties and my birthday surprise that I really want to be walking without crutches for.
Any tips to help with the healing process?

I just want to ride!!! :slight_smile: I finally bought the horse I was leasing and this is KILLING me hahaha

#2

It really varries. I was NWB for 11 weeks, told not to let my foot touch the ground. It was that or more for my son but I really think his surgeon messsed up. t was another 2 months until was allowed to ride, so 5 months total.

PT’s often underestimate the range of motion we need. I was able to show my PT what my good ankle did. I sat on a chair with my good foot flat on the floor and slid forward until my knee was well in front of my toe.

Her eyes bulged.

I did PT for 5 or 6 months and have almost full use of my ankle though mornings can be ugly. I don’t jump any more though

#3

Since I only had chipped bones and sprains, and my OS is a huge fan of PT, I did PT from day one. About 4 months of it. I was beginning to think I was going to be at the office Christmas Party in a few weeks. :lol:

It started with a lot of partial WB stuff. I did all the wobble board stuff from a chair for about 3-4 weeks. Anything that I had to stand for, I did while carrying most of my weight in my arms, leaning on something. As I could carry more weight on my ankles, I did. Expect some strength training with a rubber band type thing.

As I progressed, I did a lot of stability work, standing on one foot on progressively squishier (??) foam pads. My personal most hated event is standing on one foot (later on the squishy pad) and picking up pennies. It just SUCKS. The first time I did it, I had the brace on, and it about scared me to death - my ankle was rolling all over the place, I think the only thing holding me up was plastic & velcro.

My PT isn’t a rider; however one of the other guys in the practice is. I found out by accident; I asked my PT, got the deer in the headlights look, didn’t trust him and asked one of the older guys. The practice I use is pretty deep; 2 of the 3 guys are DPTs and the 3rd has 30 yrs experience. If no one rode, I would have still stuck with them. I ride saddleseat, so I don’t think there isn’t quite the same angle needed through the ankle. They have let me ride for the last 2 months. I was more worried about it than they were.

#4

Thanks so much!! I am finally walking without the crutches but spend some time with one crutch so I am not over doing it too quickly :smiley:

Did you get a more one-on-one experience with a PT from day one? It seems my clinic has several patients (2-3) per session, so I am typically told what to do and then left alone to do. I have only been doing basic exercises at the moment… strength training with a rubber band, some weird sand machine with my ankles in it while doing the ABCs with my foot, and then leg press and calf press on my right ankle. I have an appointment with, I guess, the therapist on Dec 2. I’m going to bring her a photo of a rider’s position to hopefully get her to understand my needs, since I believe she creates the workout schedule and then gives it to the assistant who I see when I go to PT.

I actually think I want to switch clinics the more that I think about it, but it is going to have to wait until after Dec. 7 when I can get a referral from my OS :confused:

#5

Get thee to a sports medicine program

Do whatever you have to do to get to sports medicine. I will fight like ^^$$%& if they ever try to send me to PT again when I am hurt, well, until I’m 90 or so. PT appears to be for 90 years olds or really heavy people who never intend to move much. This is of course my experience.

I was attacked by a dog while riding my bike and broke three bones in my leg/ankle area. Had plates and I think 13 screws. Non weight bearing for 4 month s(extra month because I fell while on crutches…which are not my friend). Went to PT. Nice, but…I just didn’t feel like it was “Right” for me and the others at PT didn’t seem to have active lifestyles…I would say low expectations. 4+ years later I came off a horse, and in my infinite wisdom thought “I’ll land on my feet” - not the best…sprained the **&^ out of that ankle. DEMANDED sports medicine. Felt “at home” and thought I progressed very well. Of course, I know what to do and not do…most against Dr’s orders, but I knew that sitting around was bad…but, sports medicine seem to know that I was going to be active and so they best make a plan for that :wink:

Watch for swelling - if you have it, suspect lymphodema. There is great therapy for that. I went from a 10EEE shoe (my normal is 8M) in three treatments over a week…I had to wrap, use a compression stocking (still use that when I ride) for a long time after, but it was miraculous. Getting the swelling down really helped with recovery. The massage for it is a bit odd (and I not modest and am somewhat into holistic treatment, but it was a bit odd), but it works.

Good luck. BTW, I was about 40 when the initial break happened. I am sure age makes a difference.

#6

One amusing ancedote…when the surgeon visited when I was being prepped, he was explaining (as the drugs kicked in) to me that I would lose range of motion, but he would try to give me as much movement in what I call “ballet” position as possible, pointing your foot forward…I went nuts and basically begged him to set it the other way - “heel down” :lol: Glad I did…I do think that helped me after…

#7

I’ve had PT for my back at a sports oriented practice and hand, shoulder and ankle at the PT’s affiliated with my ortho. Both had similar routines, some"go off by yourself and do these exercises" and some one on one time with the PT.

My favorite (not) part of the ankle routine was with the PT who would try to break down the scar tissue in my ankle, producing some really spectacular cracking noises.

ETA: I think one of the best things I did on my own was spending hours in my pool just walking around in circles and side passing

#8

Now ankle surgeons have to remember to ask: are you more into ballet or riding?!

On your specific two questions, I can’t help, but I can offer the tip from many badly sprained ankles as you’re PTing, throughout your day: don’t limp. Letting yourself limp creates more problems. If you have to move more slowly in order to not limp, that’s fine, but the limp hoses up your strong side, your knees, your pelvis, your back. Limping is just bad for us.

#9

Lisa - good thing you told me that! I actually do start to limp at times but I guess I never realized it would be a bad thing.

Carol - when did you start the pool exercises? I have access to my school’s pool, the military pool, and I can pay to go to another pool by my house. I actually want to start swimming to get back in shape during the winter instead of running. But I just wasn’t sure when others started. My surgeon and PT know that I ride and have certain physical needs, so they are trying to get me back to where I need to be.

What is the difference between a “normal” PT vs. a sports medicine PT? What do they do differently from each other?

#10

Ditto on the limping screwing up the good side. I just got a second brace to prove it. Now I have a pair.:rolleyes:

Ask you PT about swimming. I got reprimanded by mine because apparently when he said I could swim, he didn’t mean 20 or 30 laps with a few sprints thrown in. OOPS. I’d been doing it for months before they found out the ankle was hosed. Ask specifically what they will let you do. I keep having to remind them that if my judgement was so great, I wouldn’t be in the mess I’m in.

#11

I started water exerecises as soon as I was weight bearing…but I wasn’t swimming. I was walking circles and side passes and doing calf raises and toe circles in the water.

Kicking …20 or 30 laps!!! might not be a good idea

#12

[QUOTE=carolprudm;5995622]

Kicking …20 or 30 laps!!! might not be a good idea[/QUOTE]

Have to remember, I’m the freak in this show that didn’t have surgery. It’s not like I was knocked out or completely immobile. I walked into the office, got handed a brace, here - have a nice day & walked out. Other than the brace, nothing changed; I swam that far a couple days before I got it, and had been doing it for months.

You can swim - medical folks -> person will do a few laps, float around some
You can swim - me -> hey great, I can keep doing what I’m doing

Just make sure you’re both on the same page, or at least reading the same book.

#13

Find a place with a pool that includes water therapy as part of the course of treatment

#14

Late in checking this thread…

RE sports vs. PT, not sure what the difference is in training, etc. In my area, they are separate areas, the PT room has things like stairs, beds, what looks like paralle bars, doors, normal stuff…thes sports medicine area looks like a gym, with a bit added equipment and “raised” beds. The people working in SM SEEM to be more educated about what sports use what muscles, etc. I felt more challenged in SM. The attitude is more, this person is going to be active so we best help them get back active. I felt like PT was more following x protocol no matter what my end goal was. PT focused on part that was hurt, the SM gave me a workout routine for a wider range of muscles, so say my arms didn’t waste away while I recovered…

#15

I went to PT in 2009 for an ankle syndesmosis and broken fibula that required surgery and 90 days of complete non-weight bearing. I was able to go to a PT clinic recommended by riding buddies. My experience was good except they kicked me out just when I was getting really fit!

Ask your riding buddies who they use–they’ll likely have had experiences to share–ouch! Do talk to the therapist, explain your needs as a rider.

Good news: my injured ankle, for some reason, is now my good ankle, perhaps because I never had therapy before for any of my sprains over the years. In lessons, my instructor is baffled because I can flex the “bad” one more and really get that heel down. Best wishes on your recovery.

#16

I think military PT should be good since they are used to treating basically pro athlete’s that must get back to their full athletic function ASAP or risk losing their job. They also work with a wide variety of athletes so they should be able to help you with riding specific stuff.
The more you put into PT the harder most therapists will push you. This is not the time to be a hot house flower,be a tough soldier type!

#17

[QUOTE=Kdash1228;5967130]
Thanks so much!! I am finally walking without the crutches but spend some time with one crutch so I am not over doing it too quickly :smiley:

Did you get a more one-on-one experience with a PT from day one? It seems my clinic has several patients (2-3) per session, so I am typically told what to do and then left alone to do. I have only been doing basic exercises at the moment… strength training with a rubber band, some weird sand machine with my ankles in it while doing the ABCs with my foot, and then leg press and calf press on my right ankle. I have an appointment with, I guess, the therapist on Dec 2. I’m going to bring her a photo of a rider’s position to hopefully get her to understand my needs, since I believe she creates the workout schedule and then gives it to the assistant who I see when I go to PT.

I actually think I want to switch clinics the more that I think about it, but it is going to have to wait until after Dec. 7 when I can get a referral from my OS :/[/QUOTE]

Hopefully the OP is healed in 5 years but in my opinion bad PT is do ten of these and ten of those etc. Good PT is hands on for at least a half an hour working on the body part themselves.

#18

[QUOTE=Laurierace;8596469]
Hopefully the OP is healed in 5 years but in my opinion bad PT is do ten of these and ten of those etc. Good PT is hands on for at least a half an hour working on the body part themselves.[/QUOTE]

Yes, 5 years later I am riding & running, and had a great PT who rode horses.

#19

duplicate, sorry

#20

Haven’t read all the replies…
But, I WILL NEVER NEVER NEVER EVER go to PT again unless there is just no way out.

Sports medicine only. The difference is so striking it amazes me that we are so brainwashed into PT…

I got attacked by a dog, 3 broken bones in the ankle/leg area, i was NWB for 4 months (had a set back). 2006, Still know it happened, but it taught me that PT is basically useless. If I knew then what I know I, I would have recovered faster with SM and would have been in WAY better shape than what I went through.

Had a couple of issues since with a rotator cuff strain and a stupid fall from a ladder where I hurt the ankle again, and sports medicine is where it’s at. They KNOW you want to be active and not sort of wither away. They give you things to do with the rest of your body to stay in shape, and strengthen the wounded area, and faster. I felt like PT just had a totally different focus - like on very overweight or out of shape people that didn’t have the same goals I did for future fitness.

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