Foot surgery - lots of crutch-time

[pll]

{{GLC!}} Wow. I hope healing is smooth and faster than expected.

I have no experience in this (knock on wood), but maybe checking into one of these "iwalkfree" devices might be worthwhile?

[redrhodie]

I'm so sorry about your foot! Is taking time off work possible? I don't know how tdi works, but could that be an option, at least until you don't have to keep it elevated?

[Artista]

Oh GLC...this sucks. I've recently been through a non weight bearing experience. I wasn't sure at the time that I would live to tell about it but I found out that IT DOES GET BETTER

You've already gotten a lot of good advice. Here are a few other things that I wish I had known before my experience with crutches:

I didn't realize how quickly muscles atrophy from non-use, or how many muscles would be affected. I wish that I had consulted with a physical therapist every 1-2 weeks while I was non weight bearing. A good therapist would have anticipated which problems I might experience and could have given me home exercises to maintain as much muscle, proprioception, flexibility, and motor control as possible while still protecting my injured limb. I probably could have avoided several problems that took me months to overcome had I not waited until I got out of the boot to work with a therapist.

I wish that I had had a stable walker to get to the bathroom in the middle of the night, even if I didn't use the walker for anything else. Crutches were OK for the first few weeks but I became increasingly unstable in the middle of the night as the weeks wore on. I now suspect that much of the instability was due to core muscle atrophy that I didn't realize was happening.

Most importantly, I would not have filled my down time by reading internet horror stories about people who were having trouble recovering from an injury similar to mine. Those stories scared me silly. I didn't stop to think about the majority of people who healed well and didn't have time to write about it because they had gotten back to their normal lives. I would have spent less time Googling and more time asking questions of the healthy, positive, people on TE. You're on the right track by posting here

[Sky King]

Attachment 14243 When I was using the scooter I put a rando bag on it to carry my stuff. Personally I found it somewhat hard to use but maybe it was the model. Also I would consider one of those super nice walkers that have wheels, brakes, baskets and a seat.

finally, once you can start rehab, I have been seeing results from deep water exercise. I have to be careful to not get too carried away as that hurts my foot (same break as you)

[GLC1968]

Wow, so much good information! Thank you, sincerely, everyone. Really!

I hadn't thought about gloves for the crutches, so I'll definitely start wearing those.

And Muirenn - I just thought about my hiking pants yesterday, good suggestion! I have two pair, one with zip off legs. Both are stretch/flexible (ie, comfy!) but presentable and both are designed to work over hiking boots, so they'll be perfect! I also have one pair of wide leg dress pants that will also work (also with some stretch), so that should get me by at work. I can wear the one pair of jeans that I can get over it or a pair of yoga pants on Fridays.

And I can wear skirts once I don't have to elevate it so much (and once it gets warmer).

I've ordered a knee scooter that arrives today, so we'll see how that goes. I'm hoping we can rig it a bit with all our extra bike parts, to make it more suitable for my needs (like bigger, more rugged wheels). It'll probably only be used at home. I managed at the grocery store with my husband just fine last night on the crutches. I really mostly want the knee scooter for in the kitchen. I want to be able to balance my weight over both legs/hips evenly while I'm standing there cooking/prepping. And of course, having both hands free and the ability to scoot between sink, counter, stove, fridge, etc, would be helpful. I never wished I had a tiny little galley kitchen more than I do right now!

[Artista]

I found the scooter most helpful in wide, open, areas like shopping malls and my workplace. It wasn't so good in tight spaces like my home due to the scooter's large turning radius. I felt like I spent as much time pivoting the scooter on it's back wheels at home as I did scooting around on it. Home is where I wish that I had had a walker.

[jobob]

I didn't stop to think about the majority of people who healed well and didn't have time to write about it because they had gotten back to their normal lives.

Excellent point. I think this holds true for any sort of opinion poll, consumer review, and so forth -- people are simply more inclined to post about negative opinions & experiences than positive ones.

Sending virtual hugs.

[withm]

It sounds like you already have a lot of options for clothes, but thought I'd put this out there. I did this in while in college for a totally different purpose, but it worked fine.

If you can sew... and need to wear a favorite pair of dress pants (or any other for that matter),

Carefully rip the lower inseam seam of the pants leg with a seam ripper.
Sew a strip of velcro along the seam allowances of both seam edges with a loose stitch - 6 stitches/inch or looser if you can.

This way you can get the pants on/off and then use the velcro closure to close up the pant leg. This assumes the cast is not so big that the pants leg can't be closed up and that you have 5/8" seam allowances. If the cast is bigger you could insert a gusset of some coordinating fabric.

This would be like having zippers at the ankles of your pants that you see on some winter sportswear.

Once you get the cast off, then you can just remove the velcro (remember that long stitch length you used?) and restitch the original seam. Now you slacks are back to normal. However if your seam allowances are bound together, or felled this probably won't work.

[Wahine]

I didn't realize how quickly muscles atrophy from non-use, or how many muscles would be affected. I wish that I had consulted with a physical therapist every 1-2 weeks while I was non weight bearing. A good therapist would have anticipated which problems I might experience and could have given me home exercises to maintain as much muscle, proprioception, flexibility, and motor control as possible while still protecting my injured limb. I probably could have avoided several problems that took me months to overcome had I not waited until I got out of the boot to work with a therapist.

This is very true. the more exercises you can do to maintain your muscle mass in other parts of your leg the better. Here are some video links for some non-weightbearing exercises that can help:

Side plank, you should be able to do the version with bent knees.
Bridging with the ball under your claves. Just make sure the ball is close enough to you that you're not putting weight through your foot.
Hamstring curls with the ball, you would do the bum hover version just rolling the ball in and out, keeping the ball at above the ankle in the innermost position.
Gluteus medius strengthening.
Kneeling exercises on a Bosu ball are excellent if you have access to one. This video shows someone kneeling and using a Wii. I chose it just to show the body position and how hard it is to stabilize. You can do lots of stuff from this position, pretty much any exercise you would normally do standing. Trunk rotations with your arms crossed are a great way to get excellent core work not just for your torso but also your hips.
Then there are all the fun things you can do from a plank with your shins on the Bosu, like this (just from your knees of course).

Finally, I know it sounds nutz but if you do heel raises on your non-injured side it will actually help slow the atrophy of the injured side. Part of what causes atrophy is that our body shuts down nerve impulses to the muscles around the injured area. Our nervous system behaves weirdly sometimes. But we can take advantage of that weirdness by working the other side. When you work one leg you get an overflow of neurological activity to the nerves that relate to the other side. That overflow is estimated to be as much as 20%. There is good research out there to show that you can have a clinically significant delay in atrophy by working the opposite limb.

Boy, I'm a bit verbose this morning.

[Veronica]

Boy, I'm a bit verbose this morning.

Nahhh... you're just a fount of knowledge!

Veronica

PS I have no helpful advice GLC, but I am sending you positive vibes.

[Artista]

Wahine's exercises sound excellent. I'm guessing that I could have been at least a month ahead in rehab had I done this stuff while I was non weight bearing. Some of the rehab that I had to do had nothing to do with my broken ankle. For instance, I experienced back pain for the first time in my life because I inadvertently let my core and glutes atrophy.

The idea of maintaining some calf muscle on the injured side by working the good side is intriguing. Strong calf muscles can help reduce swelling in the lower leg but I'm not sure if a strong, non working, calf muscle can still help move swelling up and out. Still, the more calf muscle that you maintain, the faster you can rehab. Take it from someone who had nothing but a mushy, jiggly, sack of skin left on the back of her leg when she got out of the boot.

The good news is that even if you don't have the energy or motivation to exercise while you're healing, you can STILL get fit again. It just takes longer.

[GLC1968]

Ah, so much more good info!

I am definitely committed to maintaining as much conditioning as I can while going through this. I'm actually kind of looking forward to the freedom to focus on UB strength and core. I've got tons of workouts and equipment at home, so I'll have no trouble keeping myself occupied!

That's interesting about working the opposing calf to reduce atrophy. It must only be to a point though, right? I mean, my brother jokes about how when his cast finally came off, he had one weakling calf and one 'Scottish Highlander' calf from all the hopping around (he hated his crutches and opted to hop most of the time...ah, to be that young again!). I definitely have plans to work my quads and hamstrings with bands and things (on both legs) as best I can. I know the calf will get weak though. And that's doubly a bummer since I spent a year conditioning my calves to minimal running...I'm not looking forward to starting that process all over again!

[Veronica]

Maybe it will be easier this time around.

I don't wear anything but barefoot style shoes now and I think that helped with my transition. Merrell has some really cute barefoot "Lifestyle" shoes or some weird name like that. They can be your reward for healing.

Veronica

[GLC1968]

I'm actually wearing a Merrell Pace glove (the kids version) on my good foot right now! I don't want to wear my regular shoes (all of which are 'barefoot style') during this period as the left one will get more worn out looking than the right one that stays in the closet. I don't LOVE this particular pair for every day use, but they are comfy and secure on my foot for when I need to hop so I don't mind letting the left one get worn out.

At least I can keep my left foot nice and 'barefoot' strong!

[Selkie]

I'm so sorry to hear about your mishap and injury! Sending you lots of good wishes for a quick recovery.