Broken Ankle Update

A Surprise

I went upstairs with Doris today, came back down again then I needed to go to the toilet again and went to find out where I had propped her this time; looked at the bottom of the steps, propped against the sofa, under the sofa, in the fridge (well you never know). I couldn't find her anywhere, by now I am desperate for the loo, so I think I will have to go up without her and work out how to get back down again once I have relived the pressure.

totally unrelated picture - but I do love it, one day I am getting one

I get upstairs close the bathroom door, and what should I see, yup you guessed it, Doris! I had somehow managed to walk down stairs without her and hadn't even realised.  This may seem a small thing but it is the first time I have been down stairs without a stick or crutch in 5 months and I didn't even think about it.

Ankle Classes


I have been going to 3 physio classes a week for a couple of weeks now, 2 in the gym and 1 aqua.  They vary in intensity but the gym classes are basically a simple circuit training routine, something normal people would manage without any problem but for us cripples can be quite hard.

Typical Equipment includes: 

Wobble Boards
Wobble Cushions
Rocker Boards
Trampets
leather medicine balls
ropes
beanbags
cones

The exercises are mostly balancing on one or both feet, squatting, walking heel in front of toe, side stepping, stepping up and down off steps.

But is it working?


I know I am walking better but there are still days when it hurts and I feel like I have done something to hurt myself.  The process is so slow, I am getting impatient with it.  This morning I was running late for my class and as the hospital car park is really busy I parked up the road, a good 5 minute walk away at a normal pace. I was trying so hard to walk quickly but it hurt so much, I just had to slow down, it took me 10 minutes and I was late.

Breaking something really does slow you down, you have to be much more organised, you have to know if you are walking far before you set off and if there are steps or not.  I might have made it down the steps on my own at home today but I still wouldn't manage to climb any without a handrail and anything more adventurous than one flight terrifies me; this means that the stick still comes out with me on a regular basis, I usually leave her in the car if I am going somewhere flat like hospital or the supermarket, but a trip to the seaside for example is a definite Doris day.

The look of leg

Swelling is intermittent, on bad days it can be like a ball above my foot but if I sleep with it raised then it goes down again.  I still haven't got all my muscle tone back in the left leg but it is getting more shape, lucky me I will have two huge calves again!

Pain relief

I am trying to avoid painkillers unless I am in agony, I have only had Tramadol twice since I have been back home.  The first time I threw up, despite weeks of taking it everyday it didn't agree with me after not taking it for a while.  The second time  I had so much pain in my leg that even the Tramadol didn't touch it: I had been aching all day at work and then because it was tired I didn't lift my foot high enough as I walked and I wobbled my ankle on a stone in the car park, I caught myself on a car bonnet (good thing the owner wasn't in it) and stopped myself rolling it further, still the pain travelled up my leg and I honestly felt like I had broken it again, I was in agony all  evening. It is fine now but I am still so scared that I am going to do it again!!

Hydrotherapy Ankle Class Session 3

Another week has passed on my journey to recovery.  I have walked lots this week, I'm not talking marathons,but I have been out shopping and when we went out for tea I walked from the car to the restaurant.  Yesterday I drove to the supermarket, it was the first time I had been out in the car on my own for 18 weeks, I was scared but I had to do it, not least because I hadn't got my mum anything for Mother's Day (I am such a bad daughter)!

I am definitely moving more fluidly than I was before I started 'Aqua for Cripples', The limping is only apparent if I try to walk too quickly or if I have been at it for a while.  Regarding pain I have good and bad days but definitely more good than bad now.  I am still using Doris but only because I can't go downstairs without her, I am getting better at it but, I still feel like I am swinging down instead of stepping. I can at least get up stairs with just the rail now .

I have set myself a target to move home on 15 April, this coincidentally happens to be the same day that my other half's parents are planning on returning to France after taking over my house for what will be three months.  I love them and all but I want to move back to experience normality not to feel like an intruder in my own home.

So back to today's class, today's exercises were;

Warm Up

Walk or swim up and down the pool.

Exercise 1

A). At the edge of the pool rise up onto the toes and down (repeat 10 times)
B). At the edge of the pool rise up onto the toes and down and onto the heels (repeat 10 times)

Exercise 2
A).Stand on one leg, cross your other leg over the first leg and touch the pool floor with the outer edge of your foot, repeat with the other leg (repeat 10 times).
B).Stand with your feet slightly apart and shift your weight from one foot to the other putting your weight as far over on your foot as you can do comfortably.

Circuit Training

1). Square kick Float

A).Place float under foot and step to the front with second foot, back to the centre and then behind.
B). Step to the side with one foot then the other.
C).Repeat with opposite foot.
(Repeat for 2 - 5 mins)

2). Small inflatable ring

Place your injured foot in the hole of a small inflatable hoop, push it down in the water and then lift it up using your leg. (Repeat for 2 - 5 minutes)






3). Penny floater/foam football

Put the ball between your legs and rise onto your toes, return to your flat feet and then sqaut down. (Repeat for 2-5 minutes)

4). Flipper

Put a flipper on your injured foot and standing at the edge of the pool slowly lift your leg up and then down in the water, lift your leg as high as you can comfortably before returning.

5). Woggle or Noodle

Sit on the Noodle and float in the pool using your legs like you are cycling.
(continue for 2 - 5 minutes)





6). Move a none floating ball around the bottom pool with your good foot while standing on your injured foot, try to keep control of the ball.

Hydrotherapy Session 2

The second session in the pool took place on Monday.  The exercises different, the result was that my ankle started to hurt during and definitely ached afterwards, I had some pain in my calves on the evening but my thighs this time were fine. 

In addition to walking in the various ways mentioned in my previous entry, we also did some smaller more focussed exercises:

Warm up

Walk up and down the pool, or swim.
At side of pool rise onto your toes and down again.
At the side of the pool, feet together and squat down.

Exercise 1

Stand in the pool with the float under both feet
step forward with your bad foot to the pool floor just in front of the float, return to both feet on the float
Put your bad foot to the side of the float, return to centre
Put your foot behind the float. return to centre
Repeat with bad leg on float and good leg moving forward, to the centre, to the side, to the centre, and then to the back.
Repeat on both feet 10 times.

Exercise 2

With the float on the floor beneath your feet shuffle to the front edge of the float so that your toes are on the pool floor and heels on the float,move around the edges of the float in this position.
Repeat 5 times (change direction on each turn to prevent you going dizzy).

Exercise 3

With the float beneath your feet shuffle to the back of the float so that your heels are on the pool floor and toes on the float, move around the edges of the float in this position
Repeat 5 times (change direction on each turn to prevent you going dizzy).

Exercise 4

Walk up and down the pool as if walking on a tightrope, putting the heel of one foot directly in front of the toes on the other.

Exercise 5

Stand in the pool, make a small step to the side with your bad foot, return to the centre, make a slightly bigger side step, to the centre, repeat until you are stepping as wide as you can.  Repeat 10 times from the start.

Cool Down

Walk down the pool, with each step lift your foot and move it in a small circle.
Continue the small turns stood at the end of the pool.

Disclaimer
I am not a trained physiotherapist, if you choose to do these exercises you do so at your own risk, I am not responsible for any harm you do to yourself, there is no substitute for professional help, and if at all possible you should contact a trained physiotherapist to help you with your rehabilitation.

Hydrotherapy - OMG I ache all over!

Today was my first session in the hydrotherapy pool, me and 3 blokes all with poorly ankles were put through our paces by 'Alexander the Great' sorry that should be Alex the physiotherapist (his bloody minded determination for us to push ourselves is very reminiscent of the famous military leader).

I figure we walked about a mile up and down that pool today, forwards, backwards, side steps, knees up, jogging, with float under bad foot, with float under good foot in all three directions.  It was actually really good fun, I forgot how much I enjoy exercises classes, it has been so long since I have been to one.  However my thighs think they have been set on fire and I am having to force myself not to limp as the evening draws in and I realise how out of shape I am.

I was warned by one of my fellow privates in the army of Alex, that it will hurt and I will probably wonder what on earth was wrong with me.  This bloke was blatantly in a lot better shape than me to start with so I imagine my pain will only be getting worse, if he felt it there is no hope for me.

I would like to say just how great the new Pinderfields' hospital is in Wakefield, it seems to be getting a bit of stick in the papers but my experience has been really positive.  The hydro pool is fantastic, although showers in the changing rooms instead of the pool side would have been a good idea.   The place is bright and airy seems to be kept really clean and is generally very welcoming.

On a side note I once read that old people don't become more angry when they get older the angry ones were always like that.  If that is true then the old lady behind me at the rehab reception today must have had a lot of tantrums as a child.  We were only waiting a minute before she had a total rant about how it was just not good enough that there was no-one on reception, I admit it is a bit odd that there are three people at the desk but only the relevant one will help you, surely they could cover for each other.  Anyway the poor receptionist, who wasn't covering physio, didn't know what to do with herself as the woman started what was likely to be a full blown assault if the actual receptionist hadn't turned up to cut her short.  Blimey some people are just scary!!!

I thought I would take this opportunity to introduce you to my best pal Doris, she is a real support to me, keeps me up when I feel like falling down, holds my hand through the bad times and takes whatever I throw at her.

Don't she look pretty in her new bow! 

Shopping, shoes and a swollen foot

I have a new laptop, I am very excited.  It is a tomato red Acer Aspire 5742, I collected it from PC World this AM. 

Next stop on my trip was shoe shopping, the biggest problem I have had with recovering from a broken ankle is that my foot is so swollen none of my normal shoes fit,  I have been living in trainers for weeks. 

In order that I could dress in something other than jeans and tracky bottoms I decided to invest in some really comfortable shoes, unfortunatley this meant a trip to a 'granny' shoe shop; you know the ones I mean, you expect comfort over fashion, usually full of old ladies with bunions and replacement hips. 

The shop I visited was a small independant store in Wakefield called Earnshaws, yes there was limited choice of shoes that a self respecting 30 year old would wear, but the staff were young and friendly, they were really attentive and actually helped to properly fit the shoes on my feet.  There was a real difference in the customer service compared with some of the bigger more mainstream shops, it was a refreshing change.

In the end I bought a pair of  Hotter shoes in the sale and a pair of Rieker shoes at full price.  The Hotter shoes have removable insoles meaning that the swollen foot would fit in the same size as my other reguarly wide foot.  The Reiker ones are a wide fitting anyway and I managed to get both feet in quite comfortably, I may need to add an insole to the normal foot to make it a snugger fit but they generally looked pretty good.

I had my third physiotherapy session this week, I am now down to a stick. Can't say that carrying a stick does much for the street cred, I feel like an old lady, what with the comfy shoes and a stick I just need a blue rinse to complete the look.  The stick is a lot less supportive than a crutch, I can't imagine going up and down steps is going to be easy and I don't fancy long distance walks.  I know it is all about confidence - but the thought of falling again... it doesn't bear thinking about.

The physio manipulated my ankle today, no idea if it helped but it really, really hurt. She was pressing it, twisting it and moving it back and forth, at times it felt like it was going to break again which was really scary and wierd.  

Additional exercise this week were:

1.)Step up and down with the bad foot on the bottom step of the staircase. (repeat 10 times)

2.)Make a small squat movement (bend your knees so they extend over your toes hold and return to standing).You can use a worktop for support. (repeat 10 times)

3.)Balance on your bad leg holding the pose for as long as possible.  (repeat 10 times)

4.)Put you bad leg on the bottom step keep your good leg behind you and lunge forward, repeat on the other leg.  Intensify the movement by using the second step again.  (repeat 10 times)

Physiotherapy for Ankle Rehabilitation Session 2

I apologise for my previous entry I realise I never finished adding the exercises  so I am attaching the full list at the bottom of the post.

I attended my second physiotherapy session today.  It was a learning curve and felt quite productive.  Firstly, I was advised that I could walk better if I took larger steps with my good foot; as I was taking little ones so I spent less time on the bad leg.  Then I was also told to stop looking at my feet and look forward when I walked, as looking down makes you stick your bum out.   See this proves that confident people look thinner because they draw less attention to their bottom.

I had a go at  using steps with alternate feet.  By far the hardest thing so far, don't think I will be doing this much for a while, I was definitely swinging down the steps as opposed to walking, my shoulder is really hurting now (not sure if that is related or not but thought I would throw it in for sympathy).

Other than feeling quite stupid that I don't know how to walk correctly I am pleased with the help I am receiving, I can't urge anyone in the same position enough, get yourself some physiotherapy - I feel so much more capable now than I did a week ago, I have more confidence because I know I am doing the right things.

Disclaimer

I am happy to share the exercises I have been given, but I won't take any responsibility for what happens or doesn't happen if you try them. I am not a trained physio and what is prescribed for me, may not be right for you.  There is no substitute for a professional watching you and advising where you are going wrong so get in touch with one if at all possible!!!

Physio Session One

1.

• Lying on your back or sitting.
• Bend and straighten your ankles briskly.  If you can keep your knees straight during the exercise you will stretch your calf muscles.
• Repeat 10 times

2.

• Sitting with your feet on the floor
• Alternatively raise the inner boarder of your foot (big toe) and then the outer border (little toe). 
• Repeat 10 times 

NB I find doing the exercise with both feet at the same time helps you to compare what normal range of movement should be so you know how far you can push yourself.

3.

• Lying on you back with a cushion under your back (or sitting on a stable chair). 
• Put a towel under the ball of your foot and hold an end with each hand. 
• Bend and straighten your leg slowly.
• Repeat 10 times

4.

• Standing with the bad leg behind the other leg, in front of a table or wall.  
• Bend the front leg, and press the heel of the bad foot down to stretch the achilles tendon.
• Hold for 5 second
• Repeat 10 times

Physiotherapy Session Two

1.

• Sit so you can have your legs up (on a bed or sofa). 
• Place a towel around the bad foot.  Take the one end of the towel in each hand.  Keep this start position for the next 3 exercises. 

a) Push your toes up as far as you can towards your body.  With the towel pull your foot a little further until you feel a stretch.  Hold for 2 and release.

b) Raise the inner boarder of your foot (big toe) as far as you can then with the alternate hand to the foot (my left foot was injured so I use the right hand) pull the towel against the foot to stretch it further in the same motion. Hold for 2 and release.

c) Raise the outer border (little toe) as far as you can then with the corresponding hand to the foot (my left foot was injured so I use the left hand) pull the towel against the foot to stretch it further in the same motion. Hold for 2 and release.

2. 

• Sit so you can have your legs up (on a bed or sofa). 
• Place a theraband or exercise band around the bad foot.  Take the one end of the band in each hand
• Pull the band with both hands up towards your body against the foot. Push against the band with your foot pointing you toes away from the body as far as you can.  If it is too easy, next time pull the band closer to your body before you start the stretch. 

Standing exercises

1. 

• Stand against the kitchen worktop or other table (use the table or worktop for support throughout).  
• Find your centre of gravity.
• Lift up onto your toes with both feet, go only as far as you can on the bad leg.
• Repeat 10 times

2. 

• Stand against the kitchen worktop or other table (use the table or worktop for support throughout).
• Roll back onto your heels lifting the balls of your feet off the floor, go only as far as you can on the bad leg. 
• Repeat 10 times

3. 

• Stand against the kitchen worktop or other table (use the table or worktop for support throughout).  
• Walk on the spot, lifting each leg as high as you can before lowering and repeating with the other leg. 
• Repeat 10 times

Physiotherapy for Ankle Rehabilitation

11 weeks post operation,

5 weeks since cast removed

3 weeks since referral by GP

Hooray physio appointment !!

I found it really difficult to get information on appropriate rehabilitation methods on the internet so hopefully this will help anyone who happens by my blog:

Task 1 - Walking with one crutch

The trick to walking it seems is that walking slowly with one crutch is better than walking quicker without any but doing it badly.

1. Hold the crutch on the opposite side of the bad leg.


2. Put the crutch slightly in front of you


3. Step forward with your bad leg, putting your heel down first (as confidence grows you will start doing step one to three together so the crutch and your foot should hit the floor at the same time).


4. Follow through with your good leg


5. Repeat ensuring you use the full heel to toe motion (push of with your toes as you make the next step)

By holding the crutch on the opposite side you can take weight off of the injured side and better support yourself as you walk.

Task 2 - Walking up and down stairs with crutches

1. If you are going to walk or hop up the stairs, hold on to the rail with one hand and the crutch with the other.


2. Push on the rail and your crutch and step up on to the step with your good leg.


3. Bring your bad leg up on the step and then your crutch.


4. Coming down the stairs, swap your crutch in to the other hand.


5. Lower the crutch down on to the step, push on the rail and your crutch and then step down first with the bad leg and then with your good leg.


6. The crutch should always stay with the bad leg to support it.

Once you have completed your exercises you will need to carry out contrast bath therapy.

You will need one bowl of hot water (not too hot as to burn yourself), and one bowl of cold water (with ice cubes).

Place the injured foot in the hot water for one minute, then place it in the cold water for one minute.

repeat for a total of ten minutes.

It is not very nice by the way - but I am assured it works.