I fell in Aug 2010 and broke my right ankle. The first surgery plates and pins, 2nd to remove a plate due to infection under it. My 3rd surgery was to cut the ankle bones so they could be fused and a rod and nail's up through my heel. Finally now I can put weight on it. Dr said I could start walking and come back in a month.. And I can drive when I feel comfortable about that.. I asked about PT and he said I would learn just as well at home.. Ok.. BUT I am not sure HOW to place my foot! I have a rocker boot - which is hurting the bottom of my foot now.. I am using my walker but I am having problems on exactly how to place my foot since the ankle does not bend. I have been trying different ways but they don't seem right.. Help..
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Hi shill957 - Thanks for sharing your story and bringing your questions to EmpowHER. We have several members who have had ankle fusions and I've asked one of them to respond to your post and address your questions about the boot.
I was surprised that you said your doctor said you would not need physical therapy, as that is not the standard protocol. Please see this link for more information on post-operative care for your surgery, and then decide whether or not you want to advocate to get therapy when the time is right and/or get a second opinion on this from another doctor. http://www.footeducation.com/ankle-fusion-arthrodesis
You may find the following threads helpful:
http://www.empowher.com/community/share/ankle-fusion-i-know-i%E2%80%99m-...
http://www.empowher.com/community/share/ankle-fusion-2
http://www.empowher.com/community/ask/living-ankle-fusion-and-subtalar-f...
http://www.empowher.com/community/ask/anyone-ankle-fusion-community-ever...
http://www.empowher.com/bones-amp-joints/content/ankle-joint-replacement...
February 3, 2011 - 5:59pmThis Comment
Hi Shill957,
Wow, you've been through a lot!! Sorry that you've had to deal with all of this - it's not fun as I can relate. But there is hope and you can walk, it's just going to take some time.
I had my right ankle fused back in 2006 and your right you do need to learn how to walk again. It's going to be different since your ankle doesn't move at all, but it is possible. I also had the rod and screws inserted through my heel and your right it does hurt once you start to put your weight on it, so take it easy and listen to your body it will let you know how much you can take at it time. Once my doctor gave me the go ahead to walk I stayed in my rocker boot for a couple more weeks and gradually winged myself out of it.
I did go to physical therapy for six months once I got the green light to walk on it. Not sure why your doctor didn't recommend it, but if it makes you feel more comfortable I'd request it. As you stated you don't know how to walk it's a totally different experience and I don't know about you, but I had atrophy in my right leg set in that needed to be addressed as well and the PT really made a difference. However, you do need to work with someone that knows how to deal with an ankle fusion.
The one thing that does make a BIG difference is the type of shoe you walk in. For most comfort and making it a better walking experience I wear rocker bottom shoes - like MBTs. Other brands are making them now example: Shape Ups, etc., but what you're looking for is a shoe that going to provide that heal to toe motion you no longer have.
Now how I walk when I'm bare foot is a little different. Let me try to explain..it's not that hard just weird and take some getting us to. I don't know how your foot is set after your fusion but my right foot angles a little to the left. Let's see if I can give you a visual here...if I'm sitting on my bed and my foot is dangling my left foot is normal points forward but my right foot point a little to the left and doesn't look normal. Dr. said he did it that way so it allows for some movement. This is the hard part to explain..so hang in there. When I walk on it instead of a normal heal to toe, it's almost like I walk from heal to the big toe using the side of my foot. It's not normal so you do walk with a gimp/limp but gets easier over time. You do have to be very careful that you don't mess up your hip or back. You may already be experiencing some pain and discomfort since you've been in that rocker boot (i hated that thing). Sorry if that's long winded and hard to understand but it's not easy to explain and walking might be easier for you since it all depends on what type of ankle fusion you had. Mine was a total ankle fusion, so the only thing that moves on my right foot are my toes. You make a little more mobility than that so it could be a lot easier for you.
Here's the link to my post on my ankle fusion. You'll also be able to connect with other women that have had different experiences with their ankle fusion and can also provide you with some suggestions/support.
http://www.empowher.com/community/share/ankle-fusion-i-know-i%E2%80%99m-...
Here's a link to the MBT shoes I wear, they aren't pretty but they do the job. And when I wear them nobody would ever guess that my ankle was fused.
http://us.mbt.com/Default.aspx?lang=en-US
Do you have any movement in your fused ankle?
I hope this helps you out, let me know how you're doing.
Take care,
February 3, 2011 - 6:16pmAng
Thanks for the quick reply! I have not put any weight on my right leg since I broke my ankle. And then after the surgery it was suggested to use Eucerin lotion which is great for dry skin. It also caused all the harden skin to come off the bottom of my foot. So it is very sore from me trying to walk on it. My foot is turned a little to the left - but that looks normal to me... That is another issue - when I was born my bones from my hips down were crooked and I had to wear braces on both legs to straighten them out. Which they were still a little crooked.. I have neuropathy in that leg also. I have had 2 back surgeries and the 1st left nerve damage that bothers my leg at times.. I have Restless Leg Syndrome really bad too.. So have had leg problems forever.. And being a diabetic things don't work right at times.. But I am just now being able to put weight on my leg. And starting to walk. Of course I have to wear my rocker boot to do any walking. He did tell me once I felt comfortable with my walking I could drive. I could take my boot off and wear a shoe while driving but boot back on before any walking.. I go back in a month for more xrays and see how it is doing. He had said it was completly fused and looked really good. And I could possiably go back to work after I go back to him... Which I stand for 8 hours and do walking and carrying stuff at times. Right now it seems like my foot comes straight down and I hit that hump in the middle and it hurts my foot.. I have tried to hit heel first but I look and feel really strange and it takes more time to do a step. I can go faster with foot straight down than trying to put heel down it looks like I am in slow motion.... But I need to learn how to do it.. I am also having to lean on my walker to move my right leg. The Dr had said it could be a 1 to 2 inches shorter.. I haven't had it measured yet... I need to know how to get my foot doing right while I am still struggling to learn how.. I don't like the feel of the rocker - I feel like I am going to fall when trying to go from heel to toe on it..
Thanks much!
February 3, 2011 - 8:39pmSharon
I had forgotten to say I can wiggle my toes and flex that part of my foot but nothing else. I am trying to get the rocker boot to roll from heel to to when I take a step but it doesn't seem to want to do that I just can move my foot from one spot to the other but landing on that hump in the middle of the boot.. I am trying a cane today and still same thing with foot. I seem to need a higher cane. The one I have is adjustable. If I have it to where my arm is straight on the cane I get off balanced really easy. If I have it up a little higher where I have my arm bent and then I can lean on it and that helps my balance and doesn't make my back hurt... I am probably going to look scary trying to walk.. but my main thing is to get from A to B without falling or pain...
February 4, 2011 - 9:10amSome doctor's offices provide assistance with learning how to use a cane and making sure it's the right size. You may want to check and get some assistance. The last thing you need right now is to fall and be injured while you're trying to recover from surgery. Take care.
February 4, 2011 - 4:20pmI am using my walker more now. I can use the cane a few times of a morning. But as the day goes on I am having more pain in the middle of my foot where the hump of the rocker boot is.. I was about in tears by the end of the day. It hurts so bad trying to move my foot with that hitting the middle. I keep thinking I just need to get use to it but it feels like I am trying to walk with a wedge of a plank right there. Any suggestions? I have tried to put gel insoles inside and that just made it seem worse..
February 5, 2011 - 10:50amHi Shill,
I am curious if you talked to your doctor about the pain you are experiencing? I am preparing, myself, for ankle surgery but mine is to remove an accessory bone. I will also be in a cast for several weeks with apparently no physical therapy afterwards. Which seemed odd to me as well.
Thanks for providing any updates,
February 5, 2011 - 11:09amMissie
I plan on calling this next week if it doesn't get better. I knew I would have some soreness or pain at first since it has been 5 months since I have done any walking. But have gotten over the soreness part but... I don't know if I am placing my foot wrong or stepping wrong or what. If this is normal at first I need to know. If it is not or if I am doing a wrong placement of foot I need to know.. Or if this is a problem instead.. I feel like I am floundering along alone with this issue.. I had assumed I would be going for physical therapy - he had mentioned it a few times until this last visit and guess he decided I could do just as well on my own..
February 5, 2011 - 11:43amHi Shill,
I am sorry to hear that you have been dealing with this pain for this long. Normal walking consists of the heel to toe method as described above and 5 months is way too long. I am very glad that you are now returning to the doctor.
I look forward to your update.
February 6, 2011 - 9:08amMissie
Hi Shill,
February 8, 2011 - 2:35pmIs the walking getting any better for you or is the pain just as bad? I don't recall my foot hurting in the middle when I started walking again, but I do remember it hurt at the heel. I know we all recover different but makes me wonder why you're having so much pain in the middle? Could it be the rod? Did they doctor have any suggestions? May be now that he knows you are having problems and it's so painful, he'll send you to physical therapy. They (PT) should be able to help you with the walking and pain management. If nothing else, provide you with some options (shoes, insoles, etc) as you learn to walk again.
Let me know how you're doing. Take care, Ang