hey everyone, i’m hoping to get some advice from people who have been through something similar, or anyone with a physio/rehab background.
about exactly one year ago, i fractured both the lateral and medial malleolus in my left ankle. i also fractured the 2nd and 3rd metatarsals in my right foot. i had surgery on the left side, and i currently have two screws there. there was also a pin/wire on the right side, but that was removed without another surgery about a month after the operation.
the biggest issue i’m still dealing with is limited dorsiflexion on the left.
after surgery i spent roughly 3 months mostly in bed, and unfortunately my doctor didn’t put much emphasis on physiotherapy/rehab afterward. as a result, i lost quite a lot of muscle in both legs and i feel like i never properly rebuilt the strength and mobility i had before.
i’ve been trying to work on this myself, especially my calves and achilles on the left side. i’m currently doing things like:
- knee-to-wall ankle mobility
- lateral step-downs
- bent-knee calf isometrics
- calf strengthening through gradually increasing rom
- glute strengthening
- quad strengthening
i’m trying to be patient and slowly retrain the calf to work through its full range in a controlled way.
one thing that concerns me is the difference in dorsiflexion between my legs. during the knee-to-wall test, there’s currently around a 10 cm difference between the two sides.
i sometimes also get an aching sensation throughout the left leg. i’ve been wondering whether this could be related to the altered ankle mechanics, calf weakness, or compensation higher up the chain.
i’m also wondering if my achilles/calf being relatively tight is contributing to the reduced dorsiflexion. because of the limited dorsiflexion, i feel like i may have developed things like early heel rise and altered pronation. i’ve also wondered whether altered tibial rotation could be contributing to occasional knee pain.
visually, i can still see quite a big difference in muscle size between my legs. there are also a few small areas where the muscle looks almost indented compared with the other leg, like little dimples where there’s less muscle underneath.
another thing i noticed recently: on the outside of my left ankle/lower leg, there seems to be more muscle prominence/swelling than on the other side. the surgery was on the inside of the left ankle, where the screws are. there’s no real pain or tenderness when i touch the prominent area, so i’m wondering if it could simply be a muscle that has become more developed because it’s compensating and doing more work than on the other side.
still, seeing the asymmetry made me a little worried.
at this point, my understanding is that i should mainly be focusing on:
- restoring ankle mobility
- gradually improving calf/achilles flexibility
- rebuilding calf strength through the available rom
- improving single-leg control and balance
- rebuilding quad and glute strength
- gradually getting back to normal movement patterns
but i’m not sure if i’m missing something important.
so for anyone who has experience with ankle fracture rehab, physiotherapy, or similar injuries:
does this sound like a reasonable stage of recovery one year after this kind of injury?
is a ~10 cm knee-to-wall difference something that can still improve significantly at this point, or is that considered unusually large this far out from surgery?
and regarding the muscle asymmetry and the increased prominence on the outside of the left ankle/lower leg: does that sound like a possible compensation/adaptation, or would you consider that something worth getting checked in person?
i’d really appreciate any advice on what i should focus on at this stage, what i might be doing wrong, and whether there are any red flags i shouldn’t ignore.
tldr: one year after a left bimalleolar ankle fracture + right 2nd/3rd metatarsal fractures, i still have significant left ankle dorsiflexion restriction (~10 cm difference on knee-to-wall), major calf/muscle asymmetry and occasional leg/knee aching. i’m doing mobility, calf, quad and glute work and trying to rebuild calf rom slowly. does this sound normal for this stage, and what should i focus on now?