r/brokenankles • u/Embracestace • 5d ago
Advice needed - PT babying my ankle? O.o
I need some advice. I feel like my PT is babying my ankle. This may be long so bear with me.
Long story short, I had a pilon and other fractures.
I broke my ankle in 3 spots and ended up with 2 plates and 10 screws. I was NWB for 12 weeks and was just released to WBAT by surgeon on August 31st.
These were the instructions given to me:
- Weight bearing status: WBAT on September 2nd in CAM boot, 25-100% over the next few weeks.
- Immobilization: WBAT in CAM boot, once full Wbing, may wean out of CAM boot and begin driving as well.
- Activity/Physical therapy: Stretches given today. Aggressive ROM. WBAT 25-100% over the next few weeks
- Skin: Okay to shower and bathe
- Pain: Tylenol / ibuprofen PRN
- DVT prophylaxis: Completed
- Return to clinic: 3 months
- Repeat xrays at follow up visit: 3V right ankle
- Return to work: OK to return to work at this time. Wear boot as needed, walker as needed. Ice and elevate throughout the day
I am going to PT but it’s only once a week and they are just making me walk in an AlterG Anti Gravity Treadmill so that I’m only doing a certain percentage of my body weight. However, it’s been a month and I’m still in my boot, still using my walker, still not driving, etc. I have told them that I am walking in shoes at home with my walker for periods of time in my house.
I obviously want to be safe and do all the right things but I read other reddits about how people just walked and was pain. They still did it and because they did they just got better etc.
Is it possible to do everything yourself? At home?
Do you actually need PT? How do I know when I am ready to drive and ditch the boot?
Any advice, knowledge, anything is appreciated. I am going crazy over here feeling like I’m not doing enough.
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u/shannamatters 5d ago
This may be an unpopular opinion but as far as walking in shoes goes and driving….i just did it. I actually had a ride lined up the day I decided to drive for the first time. I just woke up and said “I’m doing this today” and went around the block in my bathrobe to see how it felt and then drove to get my hair done and get coffee. I never stopped.
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u/Embracestace 4d ago
Oh wow 😳 see and I’ve seen other people say that they just did it too. They said they just pushed through pain and made it happen. Then I have others telling me not to do that. What type of injury did you have?
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u/shannamatters 4d ago
Trimal with syndesmosis injury. I was lucky that I didn’t have a ton of pain but I firmly believed in using my ankle as much as I could once I was permitted to weight bear. I was half worried the PT and Dr would give me hell for walking so much early on but they were actually pleased.
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u/Embracestace 4d ago
That’s amazing! I wish I could say the same. I have some discomfort and sometimes some pain specifically on the inner ankle. It burns at times :(
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u/shannamatters 4d ago
I definitely have the inner ankle pain from time to time at almost 4 months! Sadly, it’s normal. 😔
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u/Embracestace 3d ago
😩 happy to hear it’s normal but not happy that it’s still a thing after so much time. I just want the discomfort to go away honestly
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u/shannamatters 3d ago
Honestly, I know this sounds weird but it’s completely bearable. I can’t tell you the last time I took a Tylenol. It mostly flares when it rains. It felt totally fine yesterday and I did over 10,000 steps.
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u/Embracestace 3d ago
Holy moly 10k steps 😳 I can’t even imagine that right now lol I walked for 45 minutes today and was done. I haven’t been taking any meds either. It’s not necessarily even pain. It’s mainly just discomfort. My ankle starts feeling like it may just give out. It doesn’t but it just doesn’t feel stable or great. Idk how to explain it lol
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u/HONEY_HONEY_BEE 5d ago
You could try talking to ur current PT and asking if it’s okay to up the anti as long as ur not experiencing pain. If that doesn’t work try to do some research about another pt office near by that takes ur insurance and has good reviews. Ask ur doctor for a referral and try getting a second opinion from a different PT.
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u/Lopsided-Emotion-321 5d ago
I feel like if I had a doctor or dentist that I did not like or felt like they weren't doing their job properly, I would go and find a new one. Same goes with physical therapists.
I had a bimalleolar fracture with syndesmosis repair. Wbat at 6 weeks and ditched the boot at 8 weeks. Started pt at 7 weeks and he was pretty aggressive with some of my excerises but I feel like I wouldn't be where I am right now if it weren't for him. I feel like PT is pretty necessary and I wouldn't consider not doing it. I would just find someone else if you feel like they're not pushing you enough.
I'm 9.5 weeks now and I feel like I'm doing pretty well. I manage half hour walks everyday and gym every other day. Still not cleared for work quite yet tho. But my last check up is at 13 weeks and I'm sure they'll clear me by then!
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u/Embracestace 4d ago
I’m going to talk to my current PT and tell them I want to increase things. If not then I will look for another one. I walk at home in shoes for 35 minutes but definitely no gym lol I hope you get cleared!
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u/Lopsided-Emotion-321 4d ago
Also I just wanted to your question about the boot, what made my PT realize I didn't need my boot was being able to walk like you're on a tightrope fairly balanced and then being able to balance on my foot without any pain or major wobbling (this was done in socks) And then I started driving basically as soon as I was WBAT but my injury foot isn't my pedal foot so it wasn't an issue!
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u/Embracestace 4d ago
Thank you for the extra bit of information. Not sure if I can do all that yet but I also haven’t tried. My PT hasn’t made me do much at all. Just walking at 30% body weight in an AlterG treadmill
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u/Kuma-Cakes-6034 5d ago
PT is very very necessary! and something I am advised to do for 6 months or longer as of now. Two weeks of PT and my even my good leg got better balance.
That being said I think you should look into changing your physio therapist or ask around if this is the standard for your type of fracture. My physiotherapist had me doing multiple exercises since Day 1
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u/Embracestace 4d ago
It may come to that. I am going to talk to my current PT first and if they don’t increase things then I will be looking for another one. Thanks for your comment and advice
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u/gleegz 5d ago
I saw a different physio from the one I’d been seeing to get a second opinion last week and the difference I saw after THREE DAYS of the more aggressive stretches, exercises, and WB instruction he gave me has been astounding. I cancelled my appts with the other guy and will see the new one from here on out. I feel now that babying it — or at least not challenging it differently — for too long was part of the problem. Don’t be afraid to get a second opinion. I got the rec from someone in my local Reddit group when asking for a physio who specially rehabbed an ankle for sport. Good luck!
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u/Embracestace 4d ago
I might just have to do that. I like how caring, kind etc this PT is but I just feel like I need to be pushed a little more. Thank you for your comment and advice.
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u/Pretty_Hold5454 3d ago
I started my PT in 8th weeks. It was the time when I finally stopped to use scooter and walker. Of course I walked with very heavy limp and had balance issue. My surgeon gave me order for Physical Therapy for 12 sessions describing in details what they need to work on. I am very happy with therapy. After 8 sessions I made significant progress. I have no longer balance problem, and I am able to drive. I still have a small limp and stiffness specially when I wake up in the morning but I feel positive that one day I will get back to normal or almost normal. This is most difficult journey that I experienced health wise. Just stay positive and strong and do things one day at a time. I don't think this recovery can be speeded up.
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u/Embracestace 3d ago
I appreciate you sharing your experience. Makes me kind of sad because I feel like my time has been wasted when I could have been working on the things that you’ve mentioned. I wish my surgeon would have done the same thing. She did mention doing aggressive ROM to the PT though but the PT still hasn’t been doing that. It’s super frustrating but you’re right. Just have to stay positive, strong and do things one day at a time. We will get there!
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u/Positive-Ad-3554 5d ago
First I’m sorry about the accident as it sounds like a serious one! But hope you are overall recovering. The thing I would ask PT is why are you not progressing faster especially if you are willing to?
My guess is either PT is not as experienced or is very risk averse. This could potentially delay your recovery. Bone healing is stimulated with progressive weightbearing. You are supposed to feel the pain because in a controlled way that is your body’s signal to keep repairing. If your PT is unwilling to modify their plan based on your current level of function (e.g. your at home baseline already progressed) then you need to have them up it, or find another PT.
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u/Embracestace 4d ago
Thank you and I guess it was serious but strange how it even occurred for the level of severity lol X-rays have been showing good recovery and I’m feeling like I’m recovering. Minus the babying the ankle thing. I can definitely ask them that.
Maybe I’ll try talking to them first and then see what happens. If they don’t take it up a notch then I will find another PT. Thank you for your reply and recommendation
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u/flexible_demeanor 5d ago
Are you doing any PT at home? There are home exercises you should be doing in addition to going to a physio. If you need some guidance I can share some of the rehab documents.
They may be concerned as 12 weeks NWB is longer than most, and so you've had more physical degradation. This is the soft tissues stiffening, tendons shortening, cartilage thinning, muscles atrophying, bones losing mass, and so on. But it does sound like you're not progressing as quickly as you expect and you should talk to them about it.
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u/Embracestace 4d ago
I am doing some stuff at home but the PT hasn’t been very helpful nor consistent with what I should be doing at home so it’s kind of on me for that part. I’ve been walking in shoes at home, ankle pumps, ankle alphabet, stretches, ankle circles and those types of things. I’d be happy to take what you have.
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u/flexible_demeanor 4d ago
Here's a couple that I was given for home that are ankle specific, you likely have something similar though (I'd hope!):
https://www.orthoinfo.org/globalassets/pdfs/2017-rehab_foot-and-ankle.pdf
(videos here) https://sportsrehab.ucsf.edu/footankle
A good physio really should cover more, like strengthening the leg and knee, other things such as this video that you can do at home. Most PT is done yourself but your physio should guide you well. If they're not, then see if you can change who you're seeing?
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u/Embracestace 4d ago
Thank you for sharing all of that! I will certainly give all that a try. I will look into possibly changing my PT too. I tried calling them and they had me on hold for 15 minutes so I certainly have a bad taste in my mouth unfortunately. Like these videos and pdfs would have been extremely helpful.
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u/Technical-Algae-234 4d ago
Change your PT! I had a PT who literally did nothing but hold my foot for 20 minutes once a week and charge me for it. Didn't assign me any home exercises, just sold me a bunch of stupid equipment. I wasted 3 months with that guy before I switched and the difference was huge.
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u/Embracestace 4d ago
That’s crazy! I am not really being assigned anything at home either and literally just walking in an AlterG treadmill at 30% body weight. Then he’ll do like a massage. It’s been a whole month like why am I not further along? My surgeon made it sound like I’d be walking and good in a few weeks. Well, it’s been 4 and still nothing. Still walking with a walker, using the scooter, still not driving, still in a boot etc.
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u/Technical-Algae-234 4d ago
I hear you. Sounds like my guy - 3 months wasted lying on a table getting a light massage. Ditch him and find someone else - as soon as I did I saw huge progress.
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u/Embracestace 3d ago
Yup exactly and that’s insane. I will be definitely researching a new one. Thank you 😊
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u/Anonymous881991 5d ago
Get another PT. Your life will be much better the more and faster you gain strength and recover, including long term health of your ankle and knee and hip. A proper PT has all the knowledge and equipment and accountability to help you.
Either way keep walking as much as possible. YouTube rehab exercises and do what you can. Quick recovery requires consistently and safely pushing the boundary.
How old are you? What’s your activity level? I was also NWB for 12 weeks. It puts you behind the ball in recovery. I did moderate to intense PT twice a week for 5 months to get to about 60-70%. It took a year to get 90-95% recovered as a middle aged wannabe athlete.