# Broken Ankle Advice.....



## jabert (May 1, 2006)

In early May I was ran off the road by a car and broke my right ankle..
Officially called a Distal Fibula Fracture. I got a cast and just had it removed last Friday after 6 weeks in the plaster. Doc says the bone is healing at his anticipated schedule. I am now in boot for at least 3 weeks, but at least I can now take it off and go swimming, shower without a garbage bag around my leg.. So my doc said I could start walking on it, but it is still to sore and painful to do so yet. Still on crutches.

Any Advice on how to rehab from here? Any and all advice would be surely appreciated! Prior to this I rode 100 plus miles a week as a commuter and hit the dirt on the weekends! I am in AZ so plenty of riding I am missing out on! Driving me nuts!:madman: If anyone has been thru this I would love to hear how you rehabed:thumbsup:

Jabert


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## mtnbikej (Sep 6, 2001)

It's going to be sore and painful for a bit. Remember for the last 6 weeks it has been in a cast and non-weight bearing. Work on the range of motion, and you will find that once that begins to come back some of the pain will go away.


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## clo (Nov 25, 2010)

no visits to a physical therapist?? that would be my next visit...


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## jabert (May 1, 2006)

clo said:


> no visits to a physical therapist?? that would be my next visit...


No Insurance... This is already going to cost me 8K out of pocket. My Doc said I can do most PT at home or in my pool, and on the bike. I found on line some at home stretches with towels to start my range of motion stuff...

Jabert


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## jabert (May 1, 2006)

mtnbikej said:


> It's going to be sore and painful for a bit. Remember for the last 6 weeks it has been in a cast and non-weight bearing. Work on the range of motion, and you will find that once that begins to come back some of the pain will go away.


Each day I put a little more pressure on it, not full body weight yet. Doc said it might take a week or two for that.

Jabert


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## pwrtrainer (Oct 23, 2005)

Where in AZ? I am a PT in Ahwatukee and I know we offer free consults for a 15 minute assessment that would probably be a good start...Many PT clinics do the same. Plus AZ is a direct access state where you can simply show up, pay a hundred bucks and get a good start on rehab. No script required. 8k is a lot to spend and not be at full function, so what's a few hundred more for a better outcome?


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## jabert (May 1, 2006)

pwrtrainer said:


> Where in AZ? I am a PT in Ahwatukee and I know we offer free consults for a 15 minute assessment that would probably be a good start...Many PT clinics do the same. Plus AZ is a direct access state where you can simply show up, pay a hundred bucks and get a good start on rehab. No script required. 8k is a lot to spend and not be at full function, so what's a few hundred more for a better outcome?


What part of Tukee? I have lived in there for the last 8 years. I am now in S Tempe but my office is at 48th and Elliot.

Jabert


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## pwrtrainer (Oct 23, 2005)

Haha! Figured as much. Check your PM's


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## jabert (May 1, 2006)

pwrtrainer said:


> Haha! Figured as much. Check your PM's


I know exactly where you are! I will call you to see if you can help!

Thanks Bro

Jabert


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## Bernina (Apr 17, 2011)

Just saw your post, jabert, and thought I'd chime in. I broke my ankle in an mtb'ing accident almost 2 years ago. Here is some info that might help you:

+1 on the physical therapist. You don't necessarily have to go twice a week. They can teach you many good exercises that you can do at home. Pay close attention to learning proper form. You should probably visit the same therapist every few weeks so that they can recheck your form and teach you more exercises as you progress.

One vitally important piece of info that I didn't get until almost a year after my injury is that virtually all broken ankles include significant injury to the tendons and ligaments. It's likely that much of your discomfort from here on out will be attributable to soft tissue damage. Tendons and ligaments can take a couple of years to fully recover.

Easy cycling was the only time that my ankle didn't hurt during the first couple of months of weight bearing. Check with your therapist to see if your ankle is ready to ride. If so, remember that your foot and ankle are "stupid" right now. They've lost proprioception, (knowing where they are in space), and your balance will be off. Stick with wide, flat trails for your first several rides.

I was riding less technical mtb trails and doing easy trail running by 4 months after my injury. I was competently riding all of my favorite mtb obstacles 3 months after that. Almost 2 years out, my ankle is still a bit stiff but I rarely notice it anymore.

Best of luck. The healing and rehab may sound a long way off now but you'll be able to resume your favorite activities long before your ankle is fully recovered. Luckily, time passes much faster once you can start doing what you love again.


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## Optimus (Apr 14, 2012)

pwrtrainer said:


> Where in AZ? I am a PT in Ahwatukee and I know we offer free consults for a 15 minute assessment that would probably be a good start...Many PT clinics do the same. Plus AZ is a direct access state where you can simply show up, pay a hundred bucks and get a good start on rehab. No script required. 8k is a lot to spend and not be at full function, so what's a few hundred more for a better outcome?





jabert said:


> What part of Tukee? I have lived in there for the last 8 years. I am now in S Tempe but my office is at 48th and Elliot.
> 
> Jabert


Small world. I'm in Ahwatukee also, run a machine shop up by Broadway/52nd. I just so happen to also be nursing an ankle injury, took a fall up at the waterfall on National last weekend. Bad sprain, multiple fractures of my navicular.


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## mtnbikej (Sep 6, 2001)

Bernina said:


> Just saw your post, jabert, and thought I'd chime in. I broke my ankle in an mtb'ing accident almost 2 years ago. Here is some info that might help you:
> 
> One vitally important piece of info that I didn't get until almost a year after my injury is that virtually all broken ankles include significant injury to the tendons and ligaments. It's likely that much of your discomfort from here on out will be attributable to soft tissue damage. Tendons and ligaments can take a couple of years to fully recover.
> 
> Best of luck. The healing and rehab may sound a long way off now but you'll be able to resume your favorite activities long before your ankle is fully recovered. Luckily, time passes much faster once you can start doing what you love again.


^^^^This:

My Ortho just about guaranteed that I would have eventually get arthritis in my ankle when I got older......but I didn't expect it to flare up only 3 years later.

Granted, when my ankle was broken, I also dislocated the foot back nearly 3/4"....so the tendons and ligaments got stretched out and I damaged the cartlidge in the joint pretty bad.

I now know when the weather is gonna change....my ankle tells me so.


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## jabert (May 1, 2006)

Bernina said:


> Just saw your post, jabert, and thought I'd chime in. I broke my ankle in an mtb'ing accident almost 2 years ago. Here is some info that might help you:
> 
> +1 on the physical therapist. You don't necessarily have to go twice a week. They can teach you many good exercises that you can do at home. Pay close attention to learning proper form. You should probably visit the same therapist every few weeks so that they can recheck your form and teach you more exercises as you progress.
> 
> ...


Thanks for the info... my Dr said no tendon or ligament damage that he could see. He see's this as a stanard break of the Fibula. I still cant put full weight on the ankle, but it has only been 10 days since the cast came off. I go back in July 12 to get my last Xray and he said maybe a brace at that time. I commute to work so that should be plenty of rehab once I can do that again. It's only about 5 miles to my office, so my Dr said that will be the best rehab I can do. I am hoping to be there again by Sept 1. My break happened April 27, so that would be 4 months... Does that sound realistic?

Jabert


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## Mr. Lynch (Jun 11, 2010)

When I snapped my fibula a few years back i had a non-weight bearing cast for 6 weeks. It wasnt completely healed so they gave me a brace. I used that for a few weeks but the ankle was stiff for awhile. The one exercise i found that worked the best to regain strength and range of motion was calf raises. Id do then at work at my desk. Once i could do them on flat, i started used a ream of paper to elevate my foot and get more range. I was shocked by how fast i regained my strength and range of motion. By 12 weeks i was lightly jogging and back to riding.


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## jabert (May 1, 2006)

Mr. Lynch said:


> When I snapped my fibula a few years back i had a non-weight bearing cast for 6 weeks. It wasnt completely healed so they gave me a brace. I used that for a few weeks but the ankle was stiff for awhile. The one exercise i found that worked the best to regain strength and range of motion was calf raises. Id do then at work at my desk. Once i could do them on flat, i started used a ream of paper to elevate my foot and get more range. I was shocked by how fast i regained my strength and range of motion. By 12 weeks i was lightly jogging and back to riding.


You were riding in 12 weeks from the cast being removed? I would love to be on the bike in that time frame... giving I had the cast removed June 14, that would put me in that Sept time frame. I found online a bunch of stretching of the ankle that can be done at home also. I also work at a computer so I can do those calf raises at work also. I am gonna go see PT-ist to see what he has to say also. Thanks for the encouraging words Lynch... I really needed them. This has been very emotionally as well as physically difficult thing I have ever been thru. Biking is my life as I need to to do the miles for my heart... got a pre-existing congenital problem I am dealing with and the excersise I am sure is keeping me alive longer.

Jabert


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## Bernina (Apr 17, 2011)

I wore my boot for 6 weeks. I did my first ride 2 weeks after I got out of the boot. It was probably only 2 miles on a wide, flat, empty trail. Based on my experience, I think that you will be plenty able to commute 5 miles by 4 months, post injury.

Strengthening exercises are excellent but don't neglect the range of motion exercises, like writing the alphabet in the air with your foot, picking up marbles with your toes and dropping them in a tall, narrow mouthed container, and towel scrunches with your foot (do a You Tube search for that one). The range of motion exercises will also help you regain your proprioception, a necessity for getting your feet off the pedals and planted on the ground quickly and steadily.

I totally understand the emotional component of dealing with this injury. It changes your life for at least a few months. Are you still taking pain meds? They're depressive and I blame much of my emotional instability while I was non-weight bearing on the pain meds. I broke my humerus 8 months ago and took as few pain meds as possible. I got through the initial healing phase with much less stress without the pain meds affecting my emotions.


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## Mr. Lynch (Jun 11, 2010)

jabert said:


> You were riding in 12 weeks from the cast being removed? I would love to be on the bike in that time frame... giving I had the cast removed June 14, that would put me in that Sept time frame. I found online a bunch of stretching of the ankle that can be done at home also. I also work at a computer so I can do those calf raises at work also. I am gonna go see PT-ist to see what he has to say also. Thanks for the encouraging words Lynch... I really needed them. This has been very emotionally as well as physically difficult thing I have ever been thru. Biking is my life as I need to to do the miles for my heart... got a pre-existing congenital problem I am dealing with and the excersise I am sure is keeping me alive longer.
> 
> Jabert


12 weeks after the injury i was trail riding again. 6 weeks in a cast, 2 weeks in boot, then 4 weeks of rehab and indoor spinning on a trainer.
5 months after the injury I was playing soccer and flag football and running like it never happened.

Like posted above, writing the alphabet with my big toe was very helpful. I'd lay on the floor and watch a movie, prop my calf up in the air and write the alphabet over and over emphasizing the movement of my ankle.


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## Bernina (Apr 17, 2011)

I got so bored writing the alphabet so often that I started writing family and pet names. My MIL's and my dog's names had the most interesting combinations of letters. My daughter's and mother's names were a pain because they both have 2 n's next to each other in their names. I hated m's and n's:madman:


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## jabert (May 1, 2006)

Bernina said:


> I wore my boot for 6 weeks. I did my first ride 2 weeks after I got out of the boot. It was probably only 2 miles on a wide, flat, empty trail. Based on my experience, I think that you will be plenty able to commute 5 miles by 4 months, post injury.
> 
> Strengthening exercises are excellent but don't neglect the range of motion exercises, like writing the alphabet in the air with your foot, picking up marbles with your toes and dropping them in a tall, narrow mouthed container, and towel scrunches with your foot (do a You Tube search for that one). The range of motion exercises will also help you regain your proprioception, a necessity for getting your feet off the pedals and planted on the ground quickly and steadily.
> 
> I totally understand the emotional component of dealing with this injury. It changes your life for at least a few months. Are you still taking pain meds? They're depressive and I blame much of my emotional instability while I was non-weight bearing on the pain meds. I broke my humerus 8 months ago and took as few pain meds as possible. I got through the initial healing phase with much less stress without the pain meds affecting my emotions.


I have had the boot almost 2 weeks now. I found the youtube excersises online you mentioned. Should I start the towel pulls yet? The range of motion excersises are hard but I do have some ability to move my ankle. Or should I wait til I get the boot off. I still cant put weight on the leg and still use crutches. I do take the boot off when I sleep and that seems to work with out pain. My doc said keep it on while sleeping. What did you do while sleeping?

I took pain meds the 1st week on the cast then stopped, I didnt like the way they made me feel. I just toughed it out so to say.

Jabert


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## Bernina (Apr 17, 2011)

My experience may have been different from yours because I had surgery with a bunch of hardware implanted. The medical assistant at my ortho's office insisted that I sleep in the boot but the doc never said anything about it. I couldn't sleep with it so I used an OTC ankle brace and wrapped it over with an ace bandage. Seemed to work fine. I was non-weight bearing for only 6 weeks total. Once I had permission to bear weight again, they told me that I could toss the boot. I considered burning it instead.

My doc said that I could move my ankle as tolerated but not to bear weight on it for the first 6 weeks after the injury. That meant alphabet writing, picking up marbles with my toes, and towel scrunches. After 6 weeks, he told me that I could do anything that my ankle would tolerate, and I did. It sounds like my doc is less conservative than yours.

Towel scrunches are different than towel pulls. Here's a link to the scrunch exercise How to do a Towel Scrunch to reactivate foot, arch, and ankle muscles - YouTube The marble and scrunch exercises get your foot and toes working again, which improves your balance and takes some of the stress off of your ankle and calf muscles.


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## jabert (May 1, 2006)

I guess I am just getting impatient. I need to take easy. I will probably be in the boot til August. That would be 6 weeks. Then hopefully 4 weeks on a brace and rehab and maybe try to road ride by Sept 1. My doc said not to start PT till after the boot is off.
I just want this to end and get back to my life. Very frustrated right now.

Jabert


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## Mr. Lynch (Jun 11, 2010)

I feel your pain. I have a cast on my left hand (shattered pinky) and it comes off on July 10th. I booked a trip to whistler for July 20th months ago. I'm goig there with 8 riding buddies and all I may get to do is start the bar tab early.


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## jabert (May 1, 2006)

Mr. Lynch said:


> I feel your pain. I have a cast on my left hand (shattered pinky) and it comes off on July 10th. I booked a trip to whistler for July 20th months ago. I'm goig there with 8 riding buddies and all I may get to do is start the bar tab early.


Yeah I saw that... ouch.... I could barely look at the pics.
Sucks your trips is toast. At least you can enjoy the scenery!

Jabert


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## jabert (May 1, 2006)

Yesterday, at the office I ditched the crutches and walked! My Knees hurt more
than my ankle! Now I am walking around the house! What a milestone! I am beginning to see the light at the end of this dark tunnel.... Now going in the pool to rehab and move the ankle around for an hour.

Jabert


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## BigSteve in CO (Sep 12, 2009)

Man, I just broke my ankle yesterday in a DH wreck. I was hoping you guys would say you were back on the bike within a week.


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## jabert (May 1, 2006)

BigSteve in CO said:


> Man, I just broke my ankle yesterday in a DH wreck. I was hoping you guys would say you were back on the bike within a week.


How bad is the break? Cast? Surgery?

Jabert


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## jabert (May 1, 2006)

jabert said:


> Yesterday, at the office I ditched the crutches and walked! My Knees hurt more
> than my ankle! Now I am walking around the house! What a milestone! I am beginning to see the light at the end of this dark tunnel.... Now going in the pool to rehab and move the ankle around for an hour.
> 
> Jabert


So, been walking in the boot for a week now, no crutches. Can stand in the shower and in the pool on the foot. Still tender, not body weight, but can definatly balance on it. Go see the Doc on Friday for Xray and next steps...

What should I expect? Ankle Brace? Stay on the boot for a while? Gonna ask him about PT and when I can start that process..

Jabert


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## BigSteve in CO (Sep 12, 2009)

jabert said:


> How bad is the break? Cast? Surgery?
> 
> Jabert


Pretty clean. Original ortho said no surgery, but I wasn't too comfortable with some of his info. Got a second opinion today, and I'm getting a plate and 6 screws on Friday. Same recovery time.


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## jabert (May 1, 2006)

*No Mo Boot!*

So saw the Ortho Doc yesterday and he took my final pics... Said looks good and no more boot! Start using Tennis shoes, maybe a brace, and start PT. He said as soon as Aug 1 I should be able to start back on bike, just road work for a while and see how it goes. Ankle is still stiff, but can walk barefoot and with Teva's and sneakers is much easier. So my goal is to stretch like crazy for the next 2 weeks and start commuting to work in August. Hopefully I can get some AZ Trail in Flagstaff in by Sept or Oct.

Now out to the pool for heal stretching for an hour!

Jabert


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## 749800 (Jul 14, 2013)

I broke mine on Jan 1st of this year.









I started getting back on the bike in March while still on crutches -- on a fluid trainer. I'm still in PT 6.5 months later and now riding 10 or 12 miles on hilly roads but in the lowest gears. I quit PT for a month after I started walking, decided I could rehab on my own, but had to go back. I'm paying out of pocket now.

It still hurts a lot to stand up on the pedals or to walk on uneven surfaces. A gift that just keeps on giving.

Also, I used to ride with SPDs. I got a pair of high-top Impact 5-10s and flat pedals with a bunch of spikes on them. I don't know yet if that will be a permanent change.


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## mtnbikej (Sep 6, 2001)

wgscott said:


> I broke mine on Jan 1st of this year.
> 
> View attachment 815854
> 
> ...


I had a very similar break.....but I got a 2 plates/14 screws on both bones.










Happy F**kin' New Year-Palm Canyon

The pain goes away after a while. It will still get swollen for some time.

I went straight back to riding SPD's.....took a little while to get the twisting action back into the joint. 3 years later, it's not a problem. I skipped the PT and just started walking and riding.


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## 749800 (Jul 14, 2013)

That definitely looks worse than mine. Congratulations. 

What is it with New Year's breaks? 

(I was knocked over while barefoot on ice by the pup in the avatar and her brother, just getting out of the hot tub following my annual bath and looking forward to a peaceful morning ride.)

Glad to hear you can ride with SPDs. Did they contribute to the injury?


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## jabert (May 1, 2006)

I got off without surgery. My doc said it was a good call to just cast it up for 6 weeks. After looking at the pics yesterday, he was even more confident in his call. Said in 3 months I will be back to my 150 mile's/week again no problem.. So I got lucky. Bones are fusing and placed well. The swelling is still too much to put my spd biking shoes on, so I might do the flat pedal/tennis shoe thing for a while like wgscott... I guess I will see how the swelling goes down for a couple of weeks.

Jabert


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## jabert (May 1, 2006)

Any of you guys get a ankle brace? My doc said I might get one to help out with Stability. He said Aircast has some good braces for less than $50.

Jabert


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## mtnbikej (Sep 6, 2001)

wgscott said:


> That definitely looks worse than mine. Congratulations.
> 
> What is it with New Year's breaks?
> 
> ...


I was clipped in when the injury occurred. Don't know if they were the cause or a contribution.


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## mtnbikej (Sep 6, 2001)

jabert said:


> Any of you guys get a ankle brace? My doc said I might get one to help out with Stability. He said Aircast has some good braces for less than $50.
> 
> Jabert


Never needed a brace.....just the act of walking and riding eventually strengthened the joint.


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## jabert (May 1, 2006)

mtnbikej said:


> Never needed a brace.....just the act of walking and riding eventually strengthened the joint.


Did your swelling go down after a while? I am still swelling pretty bad.

Jabert


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## Bernina (Apr 17, 2011)

My ankle is still swollen almost 2 years after the break. It gets better every month but I think that it will take another year for the swelling to completely dissipate. Then again, I had surgery right after the break and a second surgery to have the hardware removed last December. Your swelling may go away sooner because you didn't have the additional surgical insults, but I'd still plan on some swelling for at least a year.


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## 749800 (Jul 14, 2013)

My swelling took 5 months to go away.

I'm not using a brace, apart from the metal screwed into the bone. My quack said if he did his job correctly I would not need one. I spent a couple months walking in leather Asolo hiking boots.

The 5-10s I am biking with look like this:









I just turned 50 and am a bit of a wuss about this, so calibrate accordingly. I never had anything worse than a crown on a tooth before this.


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## mtnbikej (Sep 6, 2001)

I had swelling issues for about 6 months after I became active again.


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## 749800 (Jul 14, 2013)

Just some random thoughts for DIY physiotherapy:

Walking barefoot on sand at the beach really helped regain some mobility (and hurt like hell). My hiking boots eventually started inhibiting my recovery, so I switched to Ecco sandals (get something better than Tevas).

Stepping down from a step on the stairs leading with the non-injured foot is important. 

Working on symmetric gait is more important than speed (and was why my quack sent me back to PT -- he said I was "walking like a pirate with a peg leg" and I couldn't afford a macaw). One crutch (or a cane) on the side opposite the injury can really help at first.

Working the ankle with a "wobble board" (you could put a half tennis ball on the underside of a round cutting board) really helps with gaining strength and mobility.

Re-learning to balance on the injured leg is very important (and for me really hard).

Realize your good leg also atrophies when you are on crutches. You need to work it out too.

Every day you don't do all the tedious stretching and excersizes sets you back several days. I keep learning this the hard way. Don't let it happen to you.

Say no to people. The world really doesn't need you that badly.


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## jabert (May 1, 2006)

OK, so last night after work my ankle was very swollen.. Iced it most the evening and went to bed. Woke up, all swelling down? Both right and left ankle look identical in size. My buddy at work broke his ankle and had surgery. He said this should be the case for 2-3 weeks, each day getting a little better, less sore, more movement. Doc said last friday same thing. Should I do my stretching multiple times a day? In the AM and at Night? I found a bunch of home PT on youtube, so I will start that tonight. Also
doing calve stretches in the pool in the evening.

Jabert


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## 749800 (Jul 14, 2013)

Elevation is probably the single most important thing to do when it swells. I actually hate icing it, so didn't do that enough, but you can do both simultaneously. Swelling like that, in my experience, is normal and will be the case for 2 or 3 months. Rehab in the pool would be ideal. I only did it once, but it really helped.


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## jabert (May 1, 2006)

OK.. got most of range of motion back with stiffness. Still walking peg-legged but
can move pretty well. So I got some stretching bands from my friend. On line, I found a bunch of resistance stretching to work the muscle's, tendons, and lig's. So that starts today.. Anyone do these type's of stretching with resistance for rehab? I have a bunch of different tubular bands measured in LBS? 5, 7, 13, 19, and 23 lbs
bands. Do I start with the weak or strong bands 1st? 

Jabert


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## BigSteve in CO (Sep 12, 2009)

In general, you start with the lightest/easiest bands first.


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## 749800 (Jul 14, 2013)

Start with the weakest, and move up. Do it several times a day. Practice stepping down stairs leading with the good foot, as soon as you can. I still have trouble with that.

Consider going to a physical therapist, even if you have to pay out of pocket. That is what I am doing now (the new place isn't covered my shitty HMO). It was $100 for the first evaluation and then $75 per session after that. Even if you only go once or twice, it probably would be worth the money. They can help you identify where your deficits are and how to work on them.

If you can find a stable trainer, try standing up on the bike pedals when you pedal. I can now do it, almost 7 months after the injury.


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## jabert (May 1, 2006)

wgscott said:


> Start with the weakest, and move up. Do it several times a day. Practice stepping down stairs leading with the good foot, as soon as you can. I still have trouble with that.
> 
> Consider going to a physical therapist, even if you have to pay out of pocket. That is what I am doing now (the new place isn't covered my shitty HMO). It was $100 for the first evaluation and then $75 per session after that. Even if you only go once or twice, it probably would be worth the money. They can help you identify where your deficits are and how to work on them.
> 
> If you can find a stable trainer, try standing up on the bike pedals when you pedal. I can now do it, almost 7 months after the injury.


Yeah, I did some stiff bands the other night and my foot blew up and I had to Ice it. So I went down a few notches last night and it felt better, not so swollen. I think I will see a PT in August. I found a couple local clinics I might check out. Free Eval and all. Gotta good commisssion check to help pay for it.:thumbsup: No insurance so the last 3 months have hit my wallet hard. My Doc said I should try and ride my bike around the block on August 1. Said that will bethe best PT I can do for mobility and strenght. I have a Turner Dual so I 
can soften it up big time. I want to be riding
to work by Sept 1 if possible. I am walking better each day and the ankle is not even swollen in the morning when I wake up. So day by day....

Jabert


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## pwrtrainer (Oct 23, 2005)

The one thing I always tell my patients post op is that with tissue recovery you have a window of efficacy that narrows rapidly after about 6-8 weeks post surgery. After that point the amount of time and energy needed to get a good return on a rehab investment increases. Wait too long and it'll take too long and cost more. My usual rehab for this condition consists with gentle manual therapy initially progressing to what the patient can tolerate. At this point in rehab I don't want to trigger pain in an already sensitive site creating a bigger issue. Balance exercises are important but not paramount but they do a great job working the muscles of the feet as well as the lower leg. They get extra credit for some "core" work ( hate that word). If you are weight bearing, take a walk and pay attention to the rhythm of your steps then how long you walk before it gets uncomfortable. Peg leg is a normal abnormal and is pretty easy to fix. The reality is when I see someone for an "ankle" I end up treating from the neck down about 80% and the neck up 20%. After a few months the mind makes issues harder than they need to be.


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## 749800 (Jul 14, 2013)

pwrtrainer said:


> The one thing I always tell my patients post op is that with tissue recovery you have a window of efficacy that narrows rapidly after about 6-8 weeks post surgery. After that point the amount of time and energy needed to get a good return on a rehab investment increases. Wait too long and it'll take too long and cost more.


I found this out the hard way.



> "core" work ( hate that word).


Me too. It seems almost a cliche -- everything requires "strengthening your core". My core is composed almost entirely of adipose tissue.



> 80% and the neck up 20%. After a few months the mind makes issues harder than they need to be.


For me, it is probably 20%/80%. My quack said it was the scar tissue that had accumulated between my ears.


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## BigSteve in CO (Sep 12, 2009)

Went from a cast to a boot yesterday, and my plantar fascia was feeling super tight (cast was a slacker angle). I just spent 10 minutes rolling my foot on a tennis ball, and it helped tremendously. I do that regularly when I'm healthy, but it was really noticeable this time.


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## jabert (May 1, 2006)

BigSteve in CO said:


> Went from a cast to a boot yesterday, and my plantar fascia was feeling super tight (cast was a slacker angle). I just spent 10 minutes rolling my foot on a tennis ball, and it helped tremendously. I do that regularly when I'm healthy, but it was really noticeable this time.


How long were you in the Cast? I didnt have surgery but was casted for 6 weeks and in the boot for another 4 weeks. Been walking out of the boot for 3 weeks tommorrow.

Jabert


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## BigSteve in CO (Sep 12, 2009)

Only had a cast for 8 days, but was in a dressing before that (after surgery). I have a month left in the boot. Are you progressing well?


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## jabert (May 1, 2006)

BigSteve in CO said:


> Only had a cast for 8 days, but was in a dressing before that (after surgery). I have a month left in the boot. Are you progressing well?


Pretty good I guess. Gotta buddy who is a PT and he is helping me at my house. Day by day Bro... Every day I am a little less swollen. I broke my right ankle, so doing the peg leg. Forcing the big toe inward when I walk. Stretching in the pool in the AM. Doing ankle raises and mobility stretches while I work at my desk. At night I do resistance band stretching excercises while I watch the tube. Do that for at least an hour. Then ice and heat.

I have a couple of buddies who have had similar ankle injuries. One broken with surgery and another with just torn tendons and ligs. They say I am looking better each day as they have been thru this crap before. My goal is to be on the bike by Sept 1. Gonna do road work to my office to start and take it from there. I live in PHX so I want to be ready for the winter riding Season.....

Jabert


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## 749800 (Jul 14, 2013)

I rode the 10 or 12 miles to work yesterday. I found the biggest challenge was going downhill, especially a tight turn on a 10% grade and then off-road, on a (slightly) challenging but steep downhill trail. It was 99% psychological, but absolutely real. I am now wondering if I need psychotherapy instead of physical therapy. It has been 7 months now.


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## 749800 (Jul 14, 2013)

BigSteve in CO said:


> I just spent 10 minutes rolling my foot on a tennis ball, and it helped tremendously. I do that regularly when I'm healthy, but it was really noticeable this time.


This is huge. Keep doing it. The sooner you can get full range of motion, the better your recovery will be.


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## 749800 (Jul 14, 2013)

My P.T. suggested I revisit my quack and ask about the possibility of having additional surgery.

I think I would rather thread a treble fish-hook through my eye-ball and staple my tongue to the redwood deck that I slipped and broke my ankle on using a croquet hoop and mallet.

Perhaps it is now time for DIY physical therapy.


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## Stevebiker (Feb 17, 2004)

wgscott said:


> My P.T. suggested I revisit my quack and ask about the possibility of having additional surgery.
> 
> I think I would rather thread a treble fish-hook through my eye-ball and staple my tongue to the redwood deck that I slipped and broke my ankle on using a croquet hoop and mallet.
> 
> Perhaps it is now time for DIY physical therapy.


I had a Triple Arthrodesis done on each foot when I was a kid. Slightly club footed. The second foot didn't turn out so well. The Dr gave us the option but didn't get it corrected. 32 years later and it got to the point I couldn't stand it anymore. Now I'm recovering from having the joints broken back open and reset properly with 2 plates in the front of the foot and 2 scews throught the heel. Had to also cut the bones over the ankle to realign the joint 20 degrees (2 more plates). I was using a peddle extension and even with that some of the newer cranks wouldn't work. If it's gona take more work, better now then later. Just sayin.


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## BigSteve in CO (Sep 12, 2009)

Stevebiker said:


> I had a Triple Arthrodesis done on each foot when I was a kid. Slightly club footed. The second foot didn't turn out so well. The Dr gave us the option but didn't get it corrected. 32 years later and it got to the point I couldn't stand it anymore. Now I'm recovering from having the joints broken back open and reset properly with 2 plates in the front of the foot and 2 scews throught the heel. Had to also cut the bones over the ankle to realign the joint 20 degrees (2 more plates). I was using a peddle extension and even with that some of the newer cranks wouldn't work. If it's gona take more work, better now then later. Just sayin.


Gnarly! Can you post up how your recovery goes, and maybe some x-rays?


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## 749800 (Jul 14, 2013)

Just to clarify, in my case, there is nothing going wrong to correct.


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## Stevebiker (Feb 17, 2004)

I will see if I can post a pix tomorrow. A total of 4 plates and 23 screws... First op was about May 23rd and the second was the end of June. I just got the cast off Monday and am in a boot for 4 weeks gradually putting weight on the foot. Started PT too. I work 12 hr swing shifts and started back on light duty. Long night and of course I spent too much time up and about. Foot swelled like a stuffed pig. Tonight less mobile and an ice pack along with laying on the carpet with the foot elevated every 3ish hrs for about 15 minutes. Before I elevated, I would do a few minutes of PT work.


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## jabert (May 1, 2006)

Stevebiker said:


> I will see if I can post a pix tomorrow. A total of 4 plates and 23 screws... First op was about May 23rd and the second was the end of June. I just got the cast off Monday and am in a boot for 4 weeks gradually putting weight on the foot. Started PT too. I work 12 hr swing shifts and started back on light duty. Long night and of course I spent too much time up and about. Foot swelled like a stuffed pig. Tonight less mobile and an ice pack along with laying on the carpet with the foot elevated every 3ish hrs for about 15 minutes. Before I elevated, I would do a few minutes of PT work.


Yikes bro... I have been out of the boot for 4 weeks now. Been walking in Tennis shoes at work. Doing stretching bands for PT at home. Starting to walk straight and the swelling is almost gone. My foot is starting to look like my old foot again! Just got done mopping the floor in my house!

Hang tough bro. My foot did the same thing in the boot. I was also in it for 4 weeks after 6 weeks in a cast.

Jabert


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## Kdowg65 (Jul 14, 2013)

mtnbikej said:


> I had a very similar break.....but I got a 2 plates/14 screws on both bones.
> 
> 
> 
> ...


Man I feel lucky! I only have 3 screws and one plate but it took 2 surgeries (for now). No rehab, doc said just start walking on it! After the dam boot came off it took me a few weeks to even try to put any weight on it.



mtnbikej said:


> ^^^^This:
> 
> My Ortho just about guaranteed that I would have eventually get arthritis in my ankle when I got older......but I didn't expect it to flare up only 3 years later.
> 
> ...


My biggest problem is with arthritis, some days I limp on the ankle until it loosens up. I slipped on some ice and fall backward onto my left ankle and when I got up, my foot was rotated 90º counterclockwise. The tendons and ligaments was messed up real bad and it took me over a year before things got better. I rushed my recover after my first surgery and that's why I had to have the 2nd and maybe why 4 years later still might have to have another surgery!!! DON'T RUSH YOUR RECOVER, and don't try to rehab yourself. I should have not listen to my doctor and "just walk on it", it's changed my life and I thought (at the time) every thing is OK. If your young, you don't know the problems you'll face down the road.

Go to run, I think the weather is going to change. lol


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## 749800 (Jul 14, 2013)

I somehow got lucky and didn't have to teach between January and the last week of March, and then only a small graduate course where I didn't have to do much except show up and turn on a projector for 12 PhD students (not very needy types). There is no possible way I could have gone right back to work. I couldn't even leave the bedroom for 10 days. My research took a big hit, however.


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## jabert (May 1, 2006)

OK, so my buddy from work brought me a floor pedal machine for me at my desk while I work..... gonna do this for couple of days, actually started this morning. I think I might be back on the bike here in a couple of days. Gonna try toe clips vs my spd shoes to start and see how it goes. Maybe around the block this evening for a trial run.

Jabert


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## jabert (May 1, 2006)

*Back in The Saddle.....*

Spun the bike tonight in front of the house for about an 15 minutes. Felt better than walking! So the road work starts in the morning! To the office and home should be about 10 miles a day, with a little climbing involved! Going with toe clips and tennis shoes for a while then going back to spd clipless on Sept 1!:thumbsup:

Jabert


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## chris9888 (Feb 27, 2011)

*Road to Recovery*

Ride trainer *one week* after ankle surgery.

Ride around neighborhood *4 weeks* after surgery.

First XC ride on trails *5 weeks* after surgery.

Back to normal activities *12 weeks* after surgery.

You may want to read my blog on Road to recovery.

Hope it helps! Speedy recovery mate :thumbsup:


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## jabert (May 1, 2006)

chris9888 said:


> Ride trainer *one week* after ankle surgery.
> 
> Ride around neighborhood *4 weeks* after surgery.
> 
> ...


Nice!

No surgery here. 6 weeks cast, 4 weeks boot.... 4 weeks off boot and now on the bike! 4 miles this morning to work, less than 20 minutes! No Problem!

Jabert


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## 749800 (Jul 14, 2013)

chris9888 said:


> Ride trainer *one week* after ankle surgery.
> 
> Ride around neighborhood *4 weeks* after surgery.
> 
> ...


This does make me wonder if we take a too conservative approach in this country (US). My doc mentioned in Europe I probably wouldn't have a cast. I had it splinted for 10 days after surgery (two incisions), then three weeks in a cast, and an additional four weeks in a boot brace that really made it impossible for me to re-learn to walk. I was told not to put any weight on it for the first month, for fear of re-injury. It does take 6 weeks (min) for the bone to heal, fwiw. Your incision looks better at two weeks than my larger one at 7.5 months.


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## jabert (May 1, 2006)

wgscott said:


> This does make me wonder if we take a too conservative approach in this country (US). My doc mentioned in Europe I probably wouldn't have a cast. I had it splinted for 10 days after surgery (two incisions), then three weeks in a cast, and an additional four weeks in a boot brace that really made it impossible for me to re-learn to walk. I was told not to put any weight on it for the first month, for fear of re-injury. It does take 6 weeks (min) for the bone to heal, fwiw. Your incision looks better at two weeks than my larger one at 7.5 months.


My concern also Scott. I rode 10 miles this morning before work, and when I got to work I am still doing the peg leg, but not as drastic as yesterday... Gonna force my right foot "toe in" until I walk straight again I guess. My doc said the best PT I can do is the road miles. I have not been on my bike since late April and now in the last 2 days have done 20 miles. By Sept will be back back to 100 miles plus per week and hope that everything straighten's out walking wise. And I didnt have surgery, so my initial healing process required the full 10 weeks of cast/boot for the fibula to start meshing. I am pretty sure surgery shortens that initial healing process.....

Jabert


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## chris9888 (Feb 27, 2011)

wgscott said:


> This does make me wonder if we take a too conservative approach in this country (US). My doc mentioned in Europe I probably wouldn't have a cast. I had it splinted for 10 days after surgery (two incisions), then three weeks in a cast, and an additional four weeks in a boot brace that really made it impossible for me to re-learn to walk. I was told not to put any weight on it for the first month, for fear of re-injury. It does take 6 weeks (min) for the bone to heal, fwiw. Your incision looks better at two weeks than my larger one at 7.5 months.


Apparently, there are 2 school of thoughts. Some OS are in the opinion that exerting pressure will stimulate blood flow and increase healing process. Others take more conservative and safe approach. No right or wrong, depends on preference and circumstances. Whatever you do, as long as pain is tolerable it should be ok. I always believe this "you will lose it if you don't use it".


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## 749800 (Jul 14, 2013)

The less conservative approach has you use it sooner, which is why I wonder if I would have benefited from that. 

On the other hand, I broke both bones, which meant it wasn't at all weight-bearing, and I guess I broke it pretty badly -- they did emergency surgery on me New Years Day. I was also very paranoid about screwing it up and having to have a second operation, turned 50 a couple of months after the break, etc.


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## 749800 (Jul 14, 2013)

So should I ride in Moab next week?


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## chris9888 (Feb 27, 2011)

Wgscott, the above x-ray belongs to my riding mate. He broke his ankle 3 weeks before I broke mine. His is worse, broke 2 bones and required external and internal fixations in 2 separate operations. He opted for aggressive approach as well, and healed really fast. He recently completed one of the most challenging MTB trails in Malaysia.









This is my x-ray. Broke fibula and ankle, not as bad but required surgery as the whole foot misaligned quite badly. I adopted aggressive approach as well. Mine was unionized in less than 12 weeks. So far, I have completed many trail rides, and planning for an overseas ride soon.

Whatever you do, stay safe and ride within your limit. Avoid aggressive jumps and drop. Choose your lines. As long as the pain is tolerable, I think it should be fine.


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## chris9888 (Feb 27, 2011)

BTW Wgscott, I am only 4 years your junior. My ridding mate is equally young too. Age has no barrier, only mind has.


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## mtnbikej (Sep 6, 2001)

chris9888 said:


> View attachment 824119
> 
> 
> Wgscott, the above x-ray belongs to my riding mate. He broke his ankle 3 weeks before I broke mine. His is worse, broke 2 bones and required external and internal fixations in 2 separate operations. He opted for aggressive approach as well, and healed really fast. He recently completed one of the most challenging MTB trails in Malaysia.
> ...


YOu also broke the smaller of the 2 bones......it seems as though those who break that bone heal quicker and are back to everyday activities.

Those that break the larger bone tend to require more non-weight bearing time/surgery/recovery time.


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## Stevebiker (Feb 17, 2004)

BigSteve in CO said:


> Gnarly! Can you post up how your recovery goes, and maybe some x-rays?


8-10
I had a Triple Arthrodesis done on each foot when I was a kid. Slightly club footed. The second foot didn't turn out so well. The Dr gave us the option but didn't get it corrected. 32 years later and it got to the point I couldn't stand it anymore. Now I'm recovering from having the joints broken back open and reset properly with 2 plates in the front of the foot and 2 scews throught the heel. Had to also cut the bones over the ankle to realign the joint 20 degrees (2 more plates). I was using a peddle extension and even with that some of the newer cranks wouldn't work. Wish I had this fixed a long time ago..

I will see if I can post a pix tomorrow. A total of 4 plates and 23 screws... First op was about May 23rd and the second was the end of June. I just got the cast off Monday and am in a boot for 4 weeks gradually putting weight on the foot. Started PT too. I work 12 hr swing shifts and started back on light duty. Long night and of course I spent too much time up and about. Foot swelled like a stuffed pig. Tonight less mobile and an ice pack along with laying on the carpet with the foot elevated every 3ish hrs for about 15 minutes. Before I elevated, I would do a few minutes of PT work.

8-17
I'm at 50% weight on the foot now and PT 3 times a week as well as doing my own at home and work. This morning I got on the trainer without the boot for the first time. Fairly tender, did about 10 minutes of very light peddling and will see how it feels. May double it tomorrow! I haven't posted pix, it comes up asking for a URL thingy, what ever that is.... Still fairly swollen and not much movement. Up and down motion was at 4 dgrees down and 2 degrees up from 90 to start with. Now I have 8-9 degrees up... With my foot up and rolling it as if you wanted to walk on the outside of your foot, my wife can't tell which way I'm trying to move it at this point.

The (not so) funny part is, I bought a Spech Carbon Camber Expert EVO this spring with upgraded wheels. It's sitting in the basement colecting dust. 50 miles on it.


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## 749800 (Jul 14, 2013)

chris9888 said:


> View attachment 824119
> 
> 
> Wgscott, the above x-ray belongs to my riding mate. He broke his ankle 3 weeks before I broke mine. His is worse, broke 2 bones and required external and internal fixations in 2 separate operations. He opted for aggressive approach as well, and healed really fast. He recently completed one of the most challenging MTB trails in Malaysia.


Yeah, that's the kind of break where they put a screw between the two bones. You either have to snap the screw during physical therapy or they have to go back in to pull it out.


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## jabert (May 1, 2006)

chris9888 said:


> Apparently, there are 2 school of thoughts. Some OS are in the opinion that exerting pressure will stimulate blood flow and increase healing process. Others take more conservative and safe approach. No right or wrong, depends on preference and circumstances. Whatever you do, as long as pain is tolerable it should be ok. I always believe this "you will lose it if you don't use it".


I am taking the aggressive approach at this point. 1 hour of road work on the bike every morning before work, and then ride home at night, tho only 3 miles. Gradual climbing thru my hood and staying in my front 2 ring unless I am going downhill then go big 3. Never go to the granny gear! I actually feel no pain in ankle while on the bike, but still feel the ankle "nag" when I walk and the slight peg leg still going on. Then at night, 1 hour of resistance band stretching. I am gonna be on the trail no later than Oct. At least that is my goal.:madman:

Jabert


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## jabert (May 1, 2006)

*Recovery Update*

Back on the bike full time.. ride to work and home with extra miles when I can. I did 30 road miles last weekend with no problems. Walking better each and every day and step. I was hoping to be back on the bike by next week, so this is huge! 2 weeks earlier than anticipated!

I am starting to get out of the saddle and put more pressure and force on the ankle. I think when I get back to my clip in/spd's, that will be much easier. Still in tennis shoes and toe clips for now.

Wanted to thank everyone for their advice and encouraging posts!
It all really helped thru this very trying time!

Jabert


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## 749800 (Jul 14, 2013)

I managed to pound 45 miles without the ankle hurting much. My feet hurt a bit, but I suspect it is the 5-10s, which are less rigid than my previous bike shoes. I can bike better than I can walk now (although still managed a hike up angel's landing in Zion a couple weeks ago).


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## 749800 (Jul 14, 2013)

Fairly late into the game I bought a wobble board, and even now it has really helped with range of motion.










I would strongly advise anyone reading this and who wants to speed/extend recovery to buy one to use as soon as they are out of a cast. It is about $80 and worth every penny, but you can make one with an old cutting board and nail a rubber ball to the center of it.


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## blizzard_mk (Feb 19, 2006)

Thanks to everyone who has contributed to this thread. I broke my leg three weeks ago, and it helps a lot to hear how others have coped with similar injuries. I'm sure I will also find some of the stretching and strengthening exercises useful when I get to that point. It was especially good to hear that pedaling a bike is good rehab! I hope you are all healing well and enjoying some time back on the bike.

Here are xrays of my leg pre and post surgery:








I slid out on the landing of a jump. My leg got caught between the bike and trail and just snapped. I was alone with my dog and about a mile from my house. Luckily the trail home was mostly downhill and I was able to sit on the bike and scoot with my good leg. The real pain didn't set in until the car ride to the hospital.

I am now three weeks post-surgery. The doc says it is healing well, and I should be able to put weight on it at six weeks. I was in a cast for the first week and a half, and am now in a boot. The doc hasn't said much about what to expect for rehab after six weeks.


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## Sofakinold (Dec 17, 2005)

^^^That's a lot more of an injury than a broken distal fibula. 

I spent 40 years as an imaging specialist, specializing in Ortho/OR.

Jabert's issue with his ankle has been primarily connecting tissue (tendon and ligaments) injury and atrophy from wearing the cast, which by now should be getting much better. Most distal fibula fxs are not load bearing issues but it sounds like the ankle mortis was compromised. We would have used stabilized the mortis with a screw if the ligament was gone.

Blizz has a classic spiral FX of the tibia and fibula. The old skiing FX. The fact that the fibula fx'd means the ligament held. Fixation with the IM nail has become standard and decreases healing times with a much better reduction. Bad news is the surgery increases chances of old age arthritis and leaves a hell of a scar on the lateral side. Good news is you can have it removed at some point it the screw cause problems.


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## blizzard_mk (Feb 19, 2006)

Sofakinold said:


> ^^^That's a lot more of an injury than a broken distal fibula.
> 
> I spent 40 years as an imaging specialist, specializing in Ortho/OR.
> 
> ...


Thanks for the analysis! 

Since posting here I've done quite a bit more reading in these forums and on mybrokenleg.com. Didn't realize how common my injury is. I've read a few unpleasant stories about bones taking a long time (many months) to fuse together. Hoping that is not the case for me. At three and a half weeks post-op I'm surprised how little pain there is. I'm tempted to do some easy spinning on the trainer with my boot on, just to loosen up the knee a little bit and flex my upper leg muscles a bit. I should probably consult my doc first, but anyone here think that's a dumb idea?


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## 749800 (Jul 14, 2013)

I think asking your doc first is a great idea.

That is an impressive fixation. I'll quit whining. Good luck with the healing, and assuming your quack agrees, moving it sooner rather than later can only help.

I'm at the point now where I am overall a better mountain biker than before my break. However, I still am a woos (sp?) on single-track. It is all psychological at this point (well almost).


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## mtnbikej (Sep 6, 2001)

wgscott said:


> I think asking your doc first is a great idea.
> 
> That is an impressive fixation. I'll quit whining. Good luck with the healing, and assuming your quack agrees, moving it sooner rather than later can only help.
> 
> I'm at the point now where I am overall a better mountain biker than before my break. However, I still am a *wuss* (sp?) on single-track. It is all psychological at this point (well almost).


:thumbsup:


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## 749800 (Jul 14, 2013)

wgscott said:


> I just turned 50 and am a bit of a wuss about this, so calibrate accordingly. I never had anything worse than a crown on a tooth before this.


That is frightening. I used to be able to spell wuss.


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## blizzard_mk (Feb 19, 2006)

My therapist also recommended a wobble board, so I ordered one. Thanks, wgscott!

I am almost at nine weeks since the surgery. I am done with crutches and walking in a boot. I've been working on ankle range of motion and starting to increase the intensity on the trainer. I will hopefully be out of the boot at ten weeks. Can't wait to be able to do a little snowshoeing or cross country skiing as we have about three feet of snow on the ground.


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## boomvader (Nov 27, 2006)

blizzard_mk said:


> Thanks to everyone who has contributed to this thread. I broke my leg three weeks ago, and it helps a lot to hear how others have coped with similar injuries. I'm sure I will also find some of the stretching and strengthening exercises useful when I get to that point. It was especially good to hear that pedaling a bike is good rehab! I hope you are all healing well and enjoying some time back on the bike.
> 
> Here are xrays of my leg pre and post surgery:
> View attachment 849468
> ...


How is your recovery? I suffered almost an identical tib/fib fracture as you on Nov 29. No plate on the fib and a shorter plate on the tib with 10 screws. I go in for my 6 week follow up next week and should start some weight bearing and PT. I am also hoping to start driving and to begin spinning on the trainer.










I hope everyone who posted is healing and progressing!


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## blizzard_mk (Feb 19, 2006)

boomvader said:


> How is your recovery? I suffered almost an identical tib/fib fracture as you on Nov 29. No plate on the fib and a shorter plate on the tib with 10 screws. I go in for my 6 week follow up next week and should start some weight bearing and PT. I am also hoping to start driving and to begin spinning on the trainer.
> 
> I hope everyone who posted is healing and progressing!


Sorry to hear about your injury! How did it happen?

Hopefully you'll be driving soon. I guess I was lucky to break my left leg, so I was driving about one week after surgery.

My recovery is going well. I've been full weight bearing in a walking boot since six weeks, and without crutches since about seven weeks. I'll be done with the walking boot at the end of this week (ten weeks). I've been doing PT for a few weeks now. Initially I was just working on ankle range of motion, now I'm getting into some strengthening. I've also been riding my trainer since about four weeks. I took it pretty easy for a while, spinning lightly for 15 to 20 minutes. Now I'm pushing fairly hard for 35 to 45 minutes.

I'm no doctor, but I assume our recoveries will be a little different given the method of fixation (IM nail in my tibia vs. plate and screws on yours).


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## blizzard_mk (Feb 19, 2006)

manbat said:


> Had a fractured ankle about twenty years ago after a motocross accident it was itchy as feck while the cast was on (needed a knitting needle to scratch it) and looked like a skinny scab when the cast came off but it didn't take long for the muscle to build back up and its never bothered me since
> 
> Hope you guys heal up quick


I was lucky to only be in cast for a week and a half. I've been in a removable walking boot since then, so no major itching or discomfort.

Glad you had no lasting effects. I hope I'm the same!


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## boomvader (Nov 27, 2006)

blizzard_mk said:


> Sorry to hear about your injury! How did it happen?
> 
> Hopefully you'll be driving soon. I guess I was lucky to break my left leg, so I was driving about one week after surgery.
> 
> ...


Thanks! You too.

I planted my foot on a turn and twisted it. Was not a compound fracture, luckily.

I didn't realize that was an IM nail. I thought it was a long plate!


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## 749800 (Jul 14, 2013)

I got out of the bedroom for the first time after a week. Sometimes I think the painkillers were to get me to sit still for a week between the surgery and the cast. I hope your recovery is quick and painless.

But I dropped in to give one more retrospectively obvious piece of advice:

*Put new knobby tires on before you start back on gravel trails.* Don't do this six months later like I just did. The amount of self-confidence you get from not sliding around is huge. If I had only known ...

Schwalbe Kojack for the trainer, but go the opposite extreme for the trails.


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## jabert (May 1, 2006)

I started back on the bike in the middle of August and started riding to work. Easy commute of only 3 miles each way. Gradually moved up in miles and climbing. By mid Oct I hit the dirt on South Mt. Now I can do almost anything I used to do. Have done T100, Gold Canyon, and climbed O and B on Javalina last sunday. And I do close to 100 miles a week on the road... And my doc wanted to do surgery and I said no! I hope this summer to do Sedona and Flag like before! It's been a hard slog but it can be done!

Jabert


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## boomvader (Nov 27, 2006)

jabert said:


> I started back on the bike in the middle of August and started riding to work. Easy commute of only 3 miles each way. Gradually moved up in miles and climbing. By mid Oct I hit the dirt on South Mt. Now I can do almost anything I used to do. Have done T100, Gold Canyon, and climbed O and B on Javalina last sunday. And I do close to 100 miles a week on the road... And my doc wanted to do surgery and I said no! I hope this summer to do Sedona and Flag like before! It's been a hard slog but it can be done!
> 
> Jabert


That is fantastic news! I am at 10 weeks non weight bearing. Tough times, but could always be worse. Able to spin with light resistance on trainer. Hope to be able to start PT and drive in a couple of weeks!


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## Whitewater (Nov 17, 2012)

Just read this full thread after posting my own. Man, I feel like a baby now after looking at some of these breaks. I start PT tomorrow and am glad to hear that time in the saddle appears to be good rather than bad. Best wishes to all those healing!


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## boomvader (Nov 27, 2006)

Whitewater said:


> Just read this full thread after posting my own. Man, I feel like a baby now after looking at some of these breaks. I start PT tomorrow and am glad to hear that time in the saddle appears to be good rather than bad. Best wishes to all those healing!


No worries! Everybody's injury is unique. Good luck with PT and i wish you a speedy recovery!


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## snowgypsy (Jun 5, 2011)

So much good information and positivity in this thread! I suppose I have to add to it.

Shattered my ankle while practicing for a DH race. This year was just my year to take one for the team. :thumbsup:

The force shattered my talas and shifted everything a good inch away from where it should be. According to my ortho, I should have fractured both my tib/fib and had both sticking out of my leg, but luckily, they just spread out to accomodate the force. There is nothing more terrifying than looking down and seeing your bones pressing up against your skin, where they _should_ have popped out of your leg... I'm one lucky gal. It could have been a lot, lot worse.

I'm almost 4 weeks post surgery (a few screws, surgical wire, and buttons?!? I had no idea they were using buttons now) and it's been a painful process. In my imagination, I'll take the cast off in late august and be ripping down trail that took my leg the next day...but that's wishful thinking.

I will say that my surgeon is amazing. Dr. Griggs and I have an awesome relationship. He just gets it. Another doctor that I spoke to had said that I probably wouldn't be able to ride competitively again. Luckily, I went out for a second opinion. Griggs has promised to do all he can to get me back up to race shape as soon as possible - better than new, he said, and added that there just aren't enough women in DH out in CB as it is. His daughter wants to get into the sport and well, "she needs someone local to look up to."

He is ordering some kind of ultra sound machine thingy (lots of medical terms) and giving it to me pro-bono. It's supposed to spur bone growth and help speed up the healing process by up to 40%. My insurance denied the treatment, but he just shrugged and said "I guess we'll just eat the cost. You need it." Seriously. This man is amazing.

I'll give some updates once I get it hooked up and running on Wednesday. Fingers crossed that its everything he thinks it might be and more.

The goal? Swimming, hiking, strength training all of September, Moab trip in October, Sedona in November - and riding with the boys like it never happened next year.  It's going to rock.


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## ladljon (Nov 30, 2011)

*Ankle Surgery*

Severely torn Pereneal tendon and a piece of broken bone floating around between the nerves in my ankle. Got the bandages off in two weeks. Started riding with this boot cast.


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## jabert (May 1, 2006)

Whitewater said:


> Just read this full thread after posting my own. Man, I feel like a baby now after looking at some of these breaks. I start PT tomorrow and am glad to hear that time in the saddle appears to be good rather than bad. Best wishes to all those healing!


Since I started this thread last year, I shall chime in on my progress...
Back to full time commuting to work. Dirt on the weekends. Have been to Flagstaff and Sedona and feel good. SM Mormon and Javalina runs are no problem. Did my own PT with stretching bands and ankle stretching in the pool. My Doc said the best PT is getting back in the saddle. Hang tough WW and ride as soon as physically possible. Best of luck!

Jabert


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## 749800 (Jul 14, 2013)

ladljon said:


> Severely torn Pereneal tendon and a piece of broken bone floating around between the nerves in my ankle. Got the bandages off in two weeks. Started riding with this boot cast.


That's awesome.

That also looks a wee bit like the bike I am now riding on the trails.


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## ric426 (Jul 13, 2007)

This thread has been a huge help. I busted up the end of my right tibia on 5/4/15 on my first ride in almost a year and wound up with (only) 4 screws and a good prognosis from my surgeon. I've had 2 weeks in a big splint, almost 2 weeks in a cast and will switch to a boot in a few days. The first two weeks booted will be non-weight bearing but with some exercises, then PT and gradual return to activity. My goal is to get at least one full mountain bike ride in before I turn 63 in October. I hope that's realistic. My cervical fusion happened much faster than expected, so hopefully that'll be the case with my ankle as well. I get the impression that the PT and recovery will take a lot longer though.
I appreciated reading some of the comments about the mental aspect of recovery from this because that's been at least as hard for me as the physical part of it. I haven't been able to ride for almost a year because of cervical disk problems, then cervical fusion surgery in December and then hernia surgery in March. Seems like I've been recovering from one thing after another for the better part of a year. This is the longest I've been off a bike since 1986 and now that the prime riding weather is here it's been depressing to have to just sit and look at it.
For a while I was unsure about returning to riding, but it's been such a crucial part of my life for so long, I know I won't be able to stay away from it. Plus, at my age there's no telling how many more years I'll be up to serious riding and I want to make the most of what's left. I just hope I'm not too gun shy when I do get back on the trails. It's never good to be tentative when mountain biking.


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## 749800 (Jul 14, 2013)

Push as hard as you can in PT. My only regret was not being aggressive enough early on. Also get that wobble board (assuming it doesn't mess with your back). Best of luck with the recovery. If you have a trainer (or can buy one), put the bike on that in the house. For me, the psychological issues were probably my primary impediment (at least after 12 weeks).

The other thing I did was I ordered a custom frame road bike, which gave me a goal to work up to.


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## ric426 (Jul 13, 2007)

4 weeks post surgery and I got my cast off yesterday. I'm now in a boot that looks like something a Star Wars storm trooper would wear. I can take it off for working on range of motion, sleeping, and showering (it felt *so* good to be able to wash off the stank!) and start PT and gradual weight bearing in two weeks. The doc said that I could start riding an exercise bike with zero resistance now if I want, though i don't have access to one, and could conceivably be walking without assistance in as soon as a month. It just depends on how the ankle feels once I start the weight bearing. I'm gonna work hard on the PT, but i'm not gonna rush my return to riding until I can build my leg strength and stability back up. I've been off the bike for almost a year now because of the cervical problems that hit me last summer, so I'm gonna approach it like I'm starting from scratch as a rookie. Strength training -> exercise bike -> road riding -> mountain bike once I get sufficient strength and stamina to hit the trails safely. The hardest part will be maintaining the self discipline to keep building up without jumping too far ahead too soon.


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## Spec44 (Aug 17, 2013)

If it's anything like mine was, putting weight back on it was VERY painful and occurred gradually over weeks. The nerve endings were firing on all cylinders.

That being said, after 2 years of daily swelling discomfort resulting in my avoidance of being as active as I should have been, I decided to start pedaling again (on my exercise bike at first) which got the blood flowing to it really well, and reduced the swelling and all the ghost pains started to go away. (When I broke it, I was a whole week into getting back into biking after a 15 year hiatus.)


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## ric426 (Jul 13, 2007)

So far the most painful thing has been sudden movement of the joint when I had the boot off and accidentally bumped my heal as i was lowering my leg, and again today when my crutch slipped out from under me on our deck after a hard rain and I went down. No damage done though.

My doctor said the same thing about moving my leg on an exercise bike just to get the blood flowing to reduce the swelling. I'm gonna look into setting my road bike up on a wind trainer in the house if I've got some old platform pedals. I don't think this this storm trooper boot will work well with SPD pedals and I know it wouldn't feel too good if it slipped off unexpectedly.

The thing that has me the most bummed out is how emaciated my leg is after not being used for over 6 weeks. I can't believe how much muscle mass I've lost. I hope it doesn't take too long to build it back up. It looks pretty pathetic.


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## Spec44 (Aug 17, 2013)

Oh, I have stories. I live alone, so had lots of challenges being a 40 year old, overweight smoker at the time, with a broken, tib, fib, and dislocated foot/ankle, especially since we were in the middle of a heatwave (13+ days over 100 right after it happened).

I went back to work a week after my surgery, which was WAY too soon. All I had on my foot was a bunch of fluff wrapped with an adhesive ace holding it on. Anyway, had to go to the bathroom at work, so went in the handicapped stall, and of course the grab rail was on my bad side. The crutch slipped and I put that foot down...let out a nice scream...kinda ruined the moment.

Shut my aircast in the car door one time, didn't have it all the way in. That twisted my ankle really nice before I realized what was happening.


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## ric426 (Jul 13, 2007)

3 months since injury and surgery. Finished a month of PT (during which I weaned myself from the boot and worked hard to get flexibility and strength coming back) a week ago and started road riding. I'm actually more comfortable riding than walking except when a I hit a sharp bump with weight on that ankle. Each ride has been better and I was finally able to pedal standing a little bit yesterday. The only assist I use now for walking is a cane when things are really sore. The most surprising thing is the cramping I get along the outside of my leg in my upper calf. It's really painful if I try to raise up on my toes with that foot. I suspect it'll be a while longer before I have the strength for that.


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## ric426 (Jul 13, 2007)

wgscott said:


> Push as hard as you can in PT. My only regret was not being aggressive enough early on. Also get that wobble board (assuming it doesn't mess with your back). Best of luck with the recovery. If you have a trainer (or can buy one), put the bike on that in the house. For me, the psychological issues were probably my primary impediment (at least after 12 weeks).
> 
> The other thing I did was I ordered a custom frame road bike, which gave me a goal to work up to.


All excellent advice. I worked hard at PT and at home, started riding on the trainer as soon as I could, made myself a wobble board, and I'm back riding on the road and hope to be ready to hit the trails by the end of the month, but only if the ankle feels strong and stable enough.
The main head game that was holding me back was being discouraged at how far I still have to go to be back where I started, instead of looking at how far I've already come in a relatively short time. It took an astute physical therapist and a caring wife to shift my point of view on that.


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## ric426 (Jul 13, 2007)

Well, it just keeps getting weirder and doesn't look like I'll be back on the mountain bike as soon I'd hoped. Went back to see the surgeon today because I've been having various pains a few inches below my knee and it really hurts if I squeeze the sides of my legs together up there. Turns out that it's very common to damage the upper fibula when the ankle is injured the way mine was. He said they assume that there will be some stress and/or damage up there, but unless it's a complete fracture and things are way out of line, they don't take any corrective measure and just let the fibula heal on it's out. 
An x-ray showed that I did have a break a few inches below the knee, but it's healing well and may give me some discomfort for a while longer. I was kind of relieved to find out that that's what's been causing the pain and that it's no big deal. The doc said careful road riding will be ok, but to stay off the trails until the ankle feels solid enough that if I have to put it down hard, it won't hurt. Basically once I can stamp my foot hard without pain I can hit the trails again.
Damn, more delays...


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## bcipam (Nov 8, 2006)

Ric... I am responding to your post last week... the reason I am posting is because you are describing a Maissoneuve Fracture... I sustained the same injury April 18 and had to have surgery where my ankle was pinned with two large screws. The upper fibula was broken just below the knee, but that was not an issue. If you "google" Massioneuve fracture you will see the classic broken fibula - blown out of busted ankle. 

I just had the screws taken out last week. I started physical therapy yesterday. I have been walking around without a cast or boot since last Wednesday. I am doing OK but have difficulty walking normally. I repeatedly ask the doctor if I can at least sit at a spin bike. The answer is "no" because the tendons and ligaments at the ankle take a really long time to heal. He wants me to wait another 4 weeks at least (he told me 6 mos total and apparently he means it. I wish I had your doctor - he allowed your return much quicker).

So I have been off a bike since April 18; really no exercise at all. I've gained weight and lost alot of fitness. PT was difficult even though by olden day standards it was easy. Take it easy and follow docs advice. It is a very serious injury (lucky us) and if not properly healed, will cause problems later on. PS I am 64... 

Good luck on your healing... I just counting down the days to returning to some sort of bike...


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## ric426 (Jul 13, 2007)

Thanks for your concern, but I was lucky(?) in that I didn't tear the tibiofibular syndesmosis ligament, the fibular fracture was simple rather than spiral and damage to the interosseous membrane was minimal. Instead of tearing itself, the tibiofibular syndesmosis ligament tore the attachment point on the tibia off with a good chunk of the tibia and joint cartilage with it (an avulsion fracture). The doctor said that as long as he was careful to line up the cartilage properly, the two horizontal screws would hold the piece of tibia in place and it would heal much faster than if the ligament had torn. Because of the angle, the two horizontal screws look like they go through the distal end of the fibula, but they don't.
I was able to start spinning without resistance on a wind trainer while I was still in the boot and while it wasn't weight bearing, it got the circulation going to reduce the swelling. Once I'd been through the PT and was able to put weight on my foot, he gave the ok to start road riding the beginning of August. He said the everything was healed enough that I can put as much pressure on the ankle as I can tolerate. 
My ankle was still tender at first and even bumps hurt, but the discomfort i was having at the fibula subsided within a few days of seeing the doctor, even though he didn't do anything to it. I decided my criteria for getting on the mountain bike again would be when the bumps didn't bother me and I was able to pedal standing. Between working hard on the home exercises and riding progressively harder on the road bike I was able to do three mountain bike rides last week and felt better with each one. I still need to gain a lot of muscle mass back, but I'm able to ride pretty comfortably now.
It felt really good, both physically and mentally, to be able to mountain bike again, even at my current limited level. I figure that with riding however much of the season is left and enough gym work over the winter, I should be back to where I was before all the surgeries and the year off the bike.
I hope your healing keeps progressing, and like you say, follow the docs advice.


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## 749800 (Jul 14, 2013)

Coming up on 5 years now for me. How are folks doing?


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## ric426 (Jul 13, 2007)

wgscott said:


> Coming up on 5 years now for me. How are folks doing?


I'm at around 2 3/4 years and my ankle is good and the least of my problems. I never really got all the muscle mass back in that leg and the physical therapist told me that at my age (65) I'm not likely too, but I'm not that worried about it. I've had several unrelated surgeries to other parts of my body, some of which didn't turn out as well, so my mountain biking has been limited. I've had 32 good years of mountain biking, so I can't complain. I still do as much road riding as I can (pedaling a fairly strange machine) when the weather permits, but that's not likely now for another couple of months.


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## Ktom300 (Feb 29, 2012)

Hate to revive an oldish thread, broke my fibula last Thursday and I'm searching all over the internet for info on what to expect. One question I had was did anyone feel like being clipped in contributed? I hate to ask but it's been playing through my mind ever since the events that lead to the "click!" I felt in my ankle. Basically getting off line and riding up against the side-hill. Regardless I still feel like clips have probably saved me 100 times to every one time they maybe hurt me.
Ortho appt is tomorrow, what questions should I ask him?

Main report from ER radiologist below but leaving out a lot or words, I think it's enough.

-Acute Oblique/spiral fracture through distal shaft extending to the level of the syndesmosis.
-There is widening of the lateral ankle mortise space suggesting possible ligamentous injury.
-Multiple osseous densities with no apparent donor site.


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## yeti0200 (Mar 28, 2019)

Hi all, this is a good thread and i'm glad people are recovering well. i'm bumping this to see if anyone has advice for improving dorsiflexion? 

I broke my ankle last Nov, had the syndesmotic screw removed early Feb, have been weight bearing since then with weekly PT visits. I've been able to walk normally (no limp) for maybe 6 weeks but still working on range of motion. 

I can dorsiflex my injured foot to nearly the same angle as my non injured foot if i'm seated in a chair with my legs straight out (after a bit of stretching). Problem is dorsiflexing with weight on the injured foot. I still can't go down stairs as normal for this reason. If I have my foot up against the base board of a wall and push my knee forward, after several stretches i can get the tip of my knee to roughly the tip of my big toe. Seems to be improving very slowly, better when i get help from the PT with ankle mobilizations.

I would appreciate any ideas or exercises i should try to help improve dorsiflexion. Thanks


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## mnpikey (Sep 18, 2017)

Bumping this thread because I joined the party just over a week ago. Riding my favorite gravel trail with friends; same trail I've put thousands of miles on over the last 2 years. We went for our normal Thursday ride, gonna do a quick 40 miles (20mph avg) and grab a beer at a brewery the trailhead. I was in the lead and saw a "damp" spot in the gravel. Thought to myself "ride straight through this and don't turn". I have 27 years of riding experience, figured I was a good judge of trail/road conditions at this point.

I hit the damp spot and my tires started picking up mud. Rear wheel started sliding out, I started to unclip, as I was doing that I hit the ground and heard a SNAP. looked down and my ankle was 90 degrees off from my leg and hanging loose. I estimate we were doing 25mph in this spot as it was a fast section and a bit of a downhill. Happened in the blink of the eye.

Friends called 911 and local fire dept came out. They wanted to remove my shoe so it wouldn't be cut off by the ambulance crew and I agreed. As they were doing that it sort of set the ankle back into place and felt much better. But I was in shock and knew I was FUBAR at that point.

Ambulance ride with lots of Fentanyl. trip to ER for xrays and cast, trip to ortho doc the next day, surgery 2 days later.

They installed a Tightrope device to fix syndesmosis injury. Right ankle open repair to fix deltoid ligament tear. Right ankle anterior tib-fib ligament reconstruction. Also broke my fibula up high from the twisting. Guess it's called a Maisonneuve injury.

Had to cancel a bunch of gravel and endurance MTB events for the summer. Thankfully most refunded me and so did the hotels. Hoping for 4-6 weeks off the ankle then starting PT and back on bike by fall?


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## Ktom300 (Feb 29, 2012)

I had a displaced spiral fracture of my lower fib that required 2 tightropes and a plate with 8 screws. Your ligament damage sounds worse than mine as I actually got up and tried to walk it off. Then road the bike out. Adrenaline I guess 
I had to wait 2 weeks for swelling to go down before surgery. The 6 weeks no weight bearing is horrible but that’s how long bone takes to heal. Ligaments and tendons take longer. Your ankle will be pretty useless, stiff, painful when you do start weight bearing. 
i couldn’t walk well in the boot so I pedaled around the neighborhood a lot and did my PT.
No sugar coating it’s a long process. I’m 2 years out and still have some pain running but I’m pretty much 100% on the bike so there’s that. Stick with PT and do what they say. You’ll be back 👍🏻


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