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Post ankle surgery recovery ideas
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I'm having ankle surgery in a week and trying to research ideas to help speed up recovery and decrease pain. I don't have any races on the calendar so my only real goal is to maximize my recovery.

I have a bone chip (OCD) which will hopefully be removed arthroscopically (scenario 1) but if it can't be reached my tibia will be cut (scenario 2) to open the area further. If the tibia needs to be cut screws will be needed to reconnect the bone. I've been told either way its 6 weeks on crutches/cast but scenario 2 will be more painful.


Any ideas?

Ive been looking into proper diet and suppliments (Glucosamine), ice/compression systems (game ready or aircast Cryo/cuff) , lotions creams.

Any special boots or crutches I should be asking about.

I don't want to just wait and leave everything to my doc or PT.

Any suggestions would be helpful.
Last edited by: FdelPonte: Apr 13, 08 4:59
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Re: Post ankle surgery recovery ideas [FdelPonte] [ In reply to ]
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I really like the game ready system

Good luck!

____________________________________
Fatigue is biochemical, not biomechanical.
- Andrew Coggan, PhD
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Re: Post ankle surgery recovery ideas [rroof] [ In reply to ]
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After surgry the most important thing is rest and let the body heal. You are most likely a fast healer because you are young and fit. Talk to your doc and the PT to let them know that you want to get back as fast as possible. Remember that rest is just as important as your exercises that the PT will give you. Keep your nutrition up and make sure you are taking enough calcium with vitamin D. Vitamin D helps calicum absorbtion. I am not a PT but I do work with 6 other PT's daily so if you have any other questions feel free to ask me. Good luck!

http://www.MattRussellTri.com -Pro Triathlete -Tri Coach
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Re: Post ankle surgery recovery ideas [FdelPonte] [ In reply to ]
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In Reply To:
I don't want to just wait and leave everything to my doc or PT.[/quote]
Yeah they wouldn't know what they're doing ;-)

Seriously, best wishes for your surgery, and I hope they don't have to slice your tibia (*shudders at the thought).

love,
tc

maybe she's born with it, maybe it's chlorine
If you're injured and need some sympathy, PM me and I'm very happy to write back.
disclaimer: PhD not MD
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Re: Post ankle surgery recovery ideas [tigerchik] [ In reply to ]
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Just a word of caution...I basically had a similar surgery in June and I am still not right. At one point I took a chunk out of the cartilage on my talus bone. Microfracture surgery was done first a couple years ago. Last June an OATs was done. They took some bone and cartilage from my knee and put it in my ankle. To do this they had to cut off my medial malleolus and use screws to put it back on. Long story long it still hurts and there is no way I cold run on it. It could be the screws but I am working on that now with the doc.
Where are you having the surgery? HSS?

JW (on the comback trail)
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Re: Post ankle surgery recovery ideas [NYCTri] [ In reply to ]
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Thanks for all of the advice and well wishes.

I looked into HSS but it's not covered with my insurance so I'm doing it locally at Huntington Hospital. I haven't been able to run anything longer than a mile or two on it for some time (at least 10-12 months) so I'm not expecting miracles overnight. I also won't know if they had to put crews in until after I wake up.

My main goal is to return to work in two weeks, off crutches in 6 weeks, and maybe chase my two kids around by mid summer. If I could finish my local 5k turkey trot painfree in November I would be happy. I am a PE teacher and coach after school so I'm usually pretty active during the day so I'll have to change my approach at work for the next few weeks.

I've read about grafts online but as of now my doc hasn't mentioned it....yet.

For those who have had surgery, how was it living in a cast post surgery? Any tips in terms of sleep, driving (yes its my right ankle), or other post surgical help?
Last edited by: FdelPonte: Apr 13, 08 10:12
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Re: Post ankle surgery recovery ideas [FdelPonte] [ In reply to ]
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Best of luck with your surgery.

I had ankle surgery just last fall for a torn peroneal tendon and a gastrocnemius recession (procedure to lengthen the achilles). I also had a small piece of bone removed. So while our surgeries are different, I can help you with what to expect afterwards.

My surgery was also on my right foot. I was in a plaster/fiberglass cast for 6 weeks and then 2 weeks in an air cast. The first 3 weeks of the cast I was on crutches, the last 3 weeks I was given a boot that went over the cast so I could walk a bit. It took a few days to learn how to walk in the boot! Even then, I could not go far. You can get around the house, but you do not want to be up a long time on it. I still used the moter cart thing at the grovery store.

I was unable to drive for about a total of 9 weeks and after that I still let others drive if going very far. My surgery was 10/25/07 and I would say I would have felt OK driving a long distance at the end of Feb. Before that I kept it under 1 hour. I still am wearing a compression sock ordered by the orthopedic surgeon for swelling on my right leg only. I think my extended swelling has a lot to do with the gastroc recession procedure as that involved cutting thru the gastroc and soleus muscles and nicking the tendon. The doc said it would be 7-8 months for my calf to recover and it is still not strong enough for proper circulation yet.

I had PT start mid-dec and it went until the end of Feb. For the first couple of weeks I was not able to drive myself there.

I was pretty suprised with how ugly it was to manuever about the house after the surgery. I live alone which added some challenges. I had hurt my tendon earlier in the year and once I found out I needed surgery I hit the gym to gain upper body strength to help with being on crutches. Plus, I could not do much, so upper body/core strength training had been my only exercise for quite awhile. My only cardio was the arm bike as the regular bike and even walking hurt the ankle.

So what to plan for:

- If you live alone, cook like a mad man this next week and freeze the food for quick meal prep as you won't want to be up very long and cannot manuever to cook on the crutches. I would microwave my frozen food and steam veggies, eat soup. etc. I would put my meals in Tupperware and then put that in a plastic grocery bag so I could crutch my way to the table to eat. You cannot carry a plate/drink when on crutches!

- I borrowed a walker from a friend. I used the walker around the house a lot verses the crutches and used the crutches when friends would pick me up to take me to the store. The walker/crutch combo was great as arms did not get real sore that way. My hands got sore from the walker so I went back to the crutches for a bit. I really liked having both.

- I borrowed a Breg Polar ice maching thing from the same friend (her husband had had some surgery the previous year and had a lot of toys). It was awesome! You fill it up with ice/cold water and it circulates the ice water through a pad you wrap around the leg. The hospital sent me home with some freezer ice wrap things, but I used this instead. Yes, you do ice thru the cast! I iced every day for 9-10 weeks.

- I borrowed a handicap chair type thing for the shower. YOU NEED THIS! You will not be able to stand to take a shower at least while in the crutch phase. So I sat on this and bought a Water Pik handheld shower head as my shower head was fixed. I recommend the hand held shower head. Not sure what I would have done without this. For the first week or so I used a giant garbage bag around my cast to keep it dry and hung it out of the shower (I have a tub shower so could do this). This was a pain. I then got from the doctor a wonderful item called a Seal Tight cast protector. It has a rubber gasket thing at the top and totally keeps out the water so do not have to hang the leg over the tub. I would get this now so you have it. It is a pain to get on the first couple of times but then gets a bit easier. If your doctor does not have them, you can get at medical supply places or online. I had to buy mine from the doctor as insurance did not cover it.

- I borrowed a giant foam wedge shaped pillow. I used this for propping my legs up when sleeping so leg was above the heart when sleeping. For the first week I just slept on the couch with this and then eventually moved to the bed with it. I could not stand having sheets/blanker tucked in as the weight of it hurt my foot so I slept with the foot sticking out of the covers. Who would have thought the weight of bedding would lauch you into pain/no sleep! I also bought more cheap foam bed pillows to keep my leg propped up when sitting watching TV/eating as I discovered I did not have many pillows.

- I have stairs in my house. I just went up and down them on my butt. I was not going to mess with the crutches in my house for the stairs. The butt was much easier!

- As mentioned before, you cannot drive so friends/family will have to take you anywhere you need to go. I luckily have a job that allowed me to work from home verses the office or I would have had to go on medical leave as could not get myself there and was supposed to keep the leg elevated. Even a month after my surgery my toes would go purple and my leg felt like exploding if I had it down for more than 30 minutes. I went on a road trip that was about a 5 hr drive about 3 1/2 weeks post surgery. I had to be in back of car with leg up on pillows elevated or I would not have been allowed to go. Also had to get out every hour or so to move around to get the blood circulating to ensure no blood clots.

I had general anesthesia as a spinal freaked me out. I was very nauseous for a few days after. I had general before when I had a surgery and was in the hospital 2 days. I was OK with the hospital stay. With the general and the outpatient surgery it was a different story! I would throw up basically any time I moved much for the first day and a half. I would get up to go to bathroom and then throw up about 15 minutes later. So if you are having a general, get some saltines, chicken/veggie broth, jello to have on hand just in case!

Listen to the doctor and the therapist once you start that! Do not be a martyr and skip the pain meds. I am not sure what your surgery will be like, but I needed the Vicoden bad for what they did to my calf! Take them as prescribed. I was also on antibotics for a bit in case of infection and had to take an aspirin a day for blood clots.

I actually went to the gym for about 45 min - 1 hour each visit while in the walking cast. I would do the arm bike for a bit and do some upper body/core training. I would do the weights while sitting on a ball or a weight bench. I was not allowed to do things standing which would add weight to my leg. I went when I could get people to take me and bring me home. There was no need to go when on crutches as those are their own workout!

Once again good luck! The time does go by fast believe it or not! My ankle/calf still is not back to normal, but I do my post-PT exercises every day and it is getting there. I also walk, and now that it is getting warmer I have ridden my bike for a short distance each time. Getting back in shape is the worst part. I hope I can start doing more soon - gotta get the calf muscles built up!
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Re: Post ankle surgery recovery ideas [Bike Or Bust] [ In reply to ]
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Bike or bust,

Thank you, thank you thank you.

I just printed your comments and I plan on getting most of the items you recommended this week. I didn't even think about showering or walking with food/drinks.

My wife is home with our two kids (4 yo daughter and 1 yo son) so I'm sure she'll be a big help to have around. Not sure she wants another whining person around the house but I'm sure I'll make it up some how.

Good luck with your recovery and I hope your doing long rides soon.

I'll ask the doc how soon I can start icing, I never thought it could be used with a cast on.
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Re: Post ankle surgery recovery ideas [Bike Or Bust] [ In reply to ]
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I agree with most of what Bike OR Bust says. I had it a little better little worse. I was living in a 4th floor walk up in NYC. I pretty quickly learned to go up and down stairs as I had no choice. I did stay home for the first couple weeks from work and worked from home. When I did go to work it was a cab or car service. There is no way I would have been able to drive (right foot) for 10 or so weeks. I did "shower" myself by hanging one leg outside the tub/shower and using wash cloths extensively. I had a surgical cast for 2 weeks followed by 6 weeks of hard cast then a boot for a while. If you do get "screwed" you may be in for a similar fate.
One benefit I did have was NYC and the ability to easily order food (take out or groceries) to be delivered.
Good luck with the surgery and definitely take the recovery very slow. you have years to enjoy once you are fully recovered.
JW

JW (on the comback trail)
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Re: Post ankle surgery recovery ideas [FdelPonte] [ In reply to ]
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One last thing I forgot to mention - get a temporary handicap permit!

I am guessing it is the same in all states. In Michigan I needed a doctor's order for it. I got the form from my doctor and then took it to the license branch and they issued me one that was good for 3 months. It starts the day you get it so I went the day before my surgery and got mine. Even though you cannot drive you will want to get out and about some and this really helped.

Once again, good luck!
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Re: Post ankle surgery recovery ideas [FdelPonte] [ In reply to ]
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I had the same surgery on Feb 29th. I did not have any bone damage just cartilage damage. I had arthroscopic surgery on my left ankle. The first 2 weeks were the worst. Crutches 100% of the time and I couldn't get the incisions wet. (think sponge baths in the tub with my left leg hangin out of the tub balancing on one leg. It sucked. No cast though, just wrapped for the 1st 2 weeks.

2 week follow-up: Still had to be on crutches for 6 weeks but at least I could shower, just leaned against the shower wall. The good news was that at 2 weeks I was allowed (and fully encouraged) to swim as much as possible. My ortho. recommended it to keep the flexibility in my ankle. I was also allowed to ride a stationary bike after 2 weeks (easy spinning). The hard part was remembering that I couldn't push off of the wall with that leg while swimming.

6 weeks: off the crutches but told to take it really easy on the walking. I have my 6-week (really 7 week) follow-up tomorrow, so we'll see; but at least i can walk around with a hot cup of coffee now.

My ortho told my that he won't let me jog or run until 16 weeks after surgery (July). Kinda sucks but it's the only way I will heal. Also, he said that there's no guarantee that I will be pain free, but I had to clean out the damage in the ankle. Worst case: I do a lot of tri relays with my wife doing the run leg. I hoping he'll let me bike outside soon.

FWIW, my doctor gave me 3 options:
1. Stop running. (ha).
2. Arthroscopic surgery (what we did)
3. Your scenario 2 (cutting my tibia). This was a last resort if he couldn't get in there arthroscopically. I was lucky that he did.

He mentioned transplanting bone and cartilage from my knee but didn't wan to do that because the success rate was very low.

Good luck on the surgery.

Chris.
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Re: Post ankle surgery recovery ideas [FdelPonte] [ In reply to ]
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How about WiiFit? ;)

jk.. sorry to hear about your surgery. Can you get in the pool and do aquajogging? Its great when recovering from injuries.
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Re: Post ankle surgery recovery ideas [ In reply to ]
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Just a quick update to all of those who gave me so much great advice.

Surgery was last Tuesday (5 days ago) and so far so good. Doc was able to reach bone chip with scope and removed it without having to open me up any further....thank God. No screws, no cast, much less pain than expected. So far so good. Two hours after surgery I was able to leave on crutches and was even told to start basic range of motion movements when I felt I could. I've been using ice several times a day and started to get back most of the range of motion in my ankle. I can put weight on it without pain but haven't really pushed it. I found out the hard way when one of my kids tripped me up and I got off balance and I accidentally test it.

My next appointment is this Tuesday and Doc expects me to be able to get cleared for driving and maybe work a week or so later. Thanks again for all of your help and advice. It really put my mind at ease when I had questions.
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