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  1. #1
    Join Date
    Dec. 16, 2010
    Posts
    218

    Default PT & Walking for a broken ankle & a sprained Ankle

    Had surgery on my left ankle almost 2 months ago (two screws put in), so I am finally in PT to help heal that ankle and the 2 Grade 3 torn ligaments in my right ankle.. go me, I know!

    I started PT last week, but I am trying to decide if I should stay or find somewhere else. My dad was in the military, so I have been going to the military hospital for PT (they usually only take on active duty members, but my surgeon said since he operated on me, I'm allowed to stay there).

    So, first question:
    I've never been to PT before I don't know what to expect. What should I be looking for to decide if its a good PT clinic or if I should look for another? Honestly, I would like to go to a clinic that understands my needs as an equestrian, but my insurance is covering everything so I am not paying a cent for anything.

    Second Question:
    How long until others were able to walk after surgery? I am finally down to walking with just one crutch after getting the walking boot about 2.5 weeks ago. But of course Christmas and my birthday are coming up, so I have company parties and my birthday surprise that I really want to be walking without crutches for.
    Any tips to help with the healing process?

    I just want to ride!!! I finally bought the horse I was leasing and this is KILLING me hahaha



  2. #2
    Join Date
    Feb. 23, 2005
    Location
    Spotsylvania, VA
    Posts
    14,870

    Default

    It really varries. I was NWB for 11 weeks, told not to let my foot touch the ground. It was that or more for my son but I really think his surgeon messsed up. t was another 2 months until was allowed to ride, so 5 months total.

    PT's often underestimate the range of motion we need. I was able to show my PT what my good ankle did. I sat on a chair with my good foot flat on the floor and slid forward until my knee was well in front of my toe.

    Her eyes bulged.

    I did PT for 5 or 6 months and have almost full use of my ankle though mornings can be ugly. I don't jump any more though
    I wasn't always a Smurf
    Penmerryl's Sophie RIDSH
    "I ain't as good as I once was but I'm as good once as I ever was"
    The ignore list is my friend. It takes 2 to argue.



  3. #3
    Join Date
    Oct. 14, 2010
    Posts
    3,642

    Default

    Since I only had chipped bones and sprains, and my OS is a huge fan of PT, I did PT from day one. About 4 months of it. I was beginning to think I was going to be at the office Christmas Party in a few weeks.

    It started with a lot of partial WB stuff. I did all the wobble board stuff from a chair for about 3-4 weeks. Anything that I had to stand for, I did while carrying most of my weight in my arms, leaning on something. As I could carry more weight on my ankles, I did. Expect some strength training with a rubber band type thing.

    As I progressed, I did a lot of stability work, standing on one foot on progressively squishier (??) foam pads. My personal most hated event is standing on one foot (later on the squishy pad) and picking up pennies. It just SUCKS. The first time I did it, I had the brace on, and it about scared me to death - my ankle was rolling all over the place, I think the only thing holding me up was plastic & velcro.

    My PT isn't a rider; however one of the other guys in the practice is. I found out by accident; I asked my PT, got the deer in the headlights look, didn't trust him and asked one of the older guys. The practice I use is pretty deep; 2 of the 3 guys are DPTs and the 3rd has 30 yrs experience. If no one rode, I would have still stuck with them. I ride saddleseat, so I don't think there isn't quite the same angle needed through the ankle. They have let me ride for the last 2 months. I was more worried about it than they were.



  4. #4
    Join Date
    Dec. 16, 2010
    Posts
    218

    Default

    Thanks so much!! I am finally walking without the crutches but spend some time with one crutch so I am not over doing it too quickly

    Did you get a more one-on-one experience with a PT from day one? It seems my clinic has several patients (2-3) per session, so I am typically told what to do and then left alone to do. I have only been doing basic exercises at the moment.. strength training with a rubber band, some weird sand machine with my ankles in it while doing the ABCs with my foot, and then leg press and calf press on my right ankle. I have an appointment with, I guess, the therapist on Dec 2. I'm going to bring her a photo of a rider's position to hopefully get her to understand my needs, since I believe she creates the workout schedule and then gives it to the assistant who I see when I go to PT.

    I actually think I want to switch clinics the more that I think about it, but it is going to have to wait until after Dec. 7 when I can get a referral from my OS :/



  5. #5
    Join Date
    Jan. 12, 2007
    Posts
    587

    Default Get thee to a sports medicine program

    Do whatever you have to do to get to sports medicine. I will fight like ^^$$%& if they ever try to send me to PT again when I am hurt, well, until I'm 90 or so. PT appears to be for 90 years olds or really heavy people who never intend to move much. This is of course my experience.

    I was attacked by a dog while riding my bike and broke three bones in my leg/ankle area. Had plates and I think 13 screws. Non weight bearing for 4 month s(extra month because I fell while on crutches..which are not my friend). Went to PT. Nice, but.....I just didn't feel like it was "Right" for me and the others at PT didn't seem to have active lifestyles...I would say low expectations. 4+ years later I came off a horse, and in my infinite wisdom thought "I'll land on my feet" - not the best...sprained the **&^ out of that ankle. DEMANDED sports medicine. Felt "at home" and thought I progressed very well. Of course, I know what to do and not do...most against Dr's orders, but I knew that sitting around was bad...but, sports medicine seem to know that I was going to be active and so they best make a plan for that

    Watch for swelling - if you have it, suspect lymphodema. There is great therapy for that. I went from a 10EEE shoe (my normal is 8M) in three treatments over a week...I had to wrap, use a compression stocking (still use that when I ride) for a long time after, but it was miraculous. Getting the swelling down really helped with recovery. The massage for it is a bit odd (and I not modest and am somewhat into holistic treatment, but it was a bit odd), but it works.

    Good luck. BTW, I was about 40 when the initial break happened. I am sure age makes a difference.
    "Fool! Don't you see now that I could have poisoned you a hundred times had I been able to live without you." Cleopatra VII



  6. #6
    Join Date
    Jan. 12, 2007
    Posts
    587

    Default

    One amusing ancedote...when the surgeon visited when I was being prepped, he was explaining (as the drugs kicked in) to me that I would lose range of motion, but he would try to give me as much movement in what I call "ballet" position as possible, pointing your foot forward...I went nuts and basically begged him to set it the other way - "heel down" Glad I did....I do think that helped me after...
    "Fool! Don't you see now that I could have poisoned you a hundred times had I been able to live without you." Cleopatra VII



  7. #7
    Join Date
    Feb. 23, 2005
    Location
    Spotsylvania, VA
    Posts
    14,870

    Default

    Quote Originally Posted by Kdash1228 View Post
    Thanks so much!! I am finally walking without the crutches but spend some time with one crutch so I am not over doing it too quickly

    Did you get a more one-on-one experience with a PT from day one? It seems my clinic has several patients (2-3) per session, so I am typically told what to do and then left alone to do. I have only been doing basic exercises at the moment.. strength training with a rubber band, some weird sand machine with my ankles in it while doing the ABCs with my foot, and then leg press and calf press on my right ankle. I have an appointment with, I guess, the therapist on Dec 2. I'm going to bring her a photo of a rider's position to hopefully get her to understand my needs, since I believe she creates the workout schedule and then gives it to the assistant who I see when I go to PT.

    I actually think I want to switch clinics the more that I think about it, but it is going to have to wait until after Dec. 7 when I can get a referral from my OS :/
    I've had PT for my back at a sports oriented practice and hand, shoulder and ankle at the PT's affiliated with my ortho. Both had similar routines, some"go off by yourself and do these exercises" and some one on one time with the PT.

    My favorite (not) part of the ankle routine was with the PT who would try to break down the scar tissue in my ankle, producing some really spectacular cracking noises.

    ETA: I think one of the best things I did on my own was spending hours in my pool just walking around in circles and side passing
    Last edited by carolprudm; Nov. 29, 2011 at 08:23 AM. Reason: add
    I wasn't always a Smurf
    Penmerryl's Sophie RIDSH
    "I ain't as good as I once was but I'm as good once as I ever was"
    The ignore list is my friend. It takes 2 to argue.



  8. #8

    Default

    Now ankle surgeons have to remember to ask: are you more into ballet or riding?!

    On your specific two questions, I can't help, but I can offer the tip from many badly sprained ankles as you're PTing, throughout your day: don't limp. Letting yourself limp creates more problems. If you have to move more slowly in order to not limp, that's fine, but the limp hoses up your strong side, your knees, your pelvis, your back. Limping is just bad for us.



  9. #9
    Join Date
    Dec. 16, 2010
    Posts
    218

    Default

    Lisa - good thing you told me that! I actually do start to limp at times but I guess I never realized it would be a bad thing.

    Carol - when did you start the pool exercises? I have access to my school's pool, the military pool, and I can pay to go to another pool by my house. I actually want to start swimming to get back in shape during the winter instead of running. But I just wasn't sure when others started. My surgeon and PT know that I ride and have certain physical needs, so they are trying to get me back to where I need to be.

    What is the difference between a "normal" PT vs. a sports medicine PT? What do they do differently from each other?



  10. #10
    Join Date
    Oct. 14, 2010
    Posts
    3,642

    Default

    Ditto on the limping screwing up the good side. I just got a second brace to prove it. Now I have a pair.

    Ask you PT about swimming. I got reprimanded by mine because apparently when he said I could swim, he didn't mean 20 or 30 laps with a few sprints thrown in. OOPS. I'd been doing it for months before they found out the ankle was hosed. Ask specifically what they will let you do. I keep having to remind them that if my judgement was so great, I wouldn't be in the mess I'm in.



  11. #11
    Join Date
    Feb. 23, 2005
    Location
    Spotsylvania, VA
    Posts
    14,870

    Default

    Quote Originally Posted by Kdash1228 View Post
    Lisa - good thing you told me that! I actually do start to limp at times but I guess I never realized it would be a bad thing.

    Carol - when did you start the pool exercises? I have access to my school's pool, the military pool, and I can pay to go to another pool by my house. I actually want to start swimming to get back in shape during the winter instead of running. But I just wasn't sure when others started. My surgeon and PT know that I ride and have certain physical needs, so they are trying to get me back to where I need to be.

    What is the difference between a "normal" PT vs. a sports medicine PT? What do they do differently from each other?
    I started water exerecises as soon as I was weight bearing....but I wasn't swimming. I was walking circles and side passes and doing calf raises and toe circles in the water.

    Kicking ...20 or 30 laps!!!!!! might not be a good idea
    I wasn't always a Smurf
    Penmerryl's Sophie RIDSH
    "I ain't as good as I once was but I'm as good once as I ever was"
    The ignore list is my friend. It takes 2 to argue.



  12. #12
    Join Date
    Oct. 14, 2010
    Posts
    3,642

    Default

    Quote Originally Posted by carolprudm View Post
    Kicking ...20 or 30 laps!!!!!! might not be a good idea
    Have to remember, I'm the freak in this show that didn't have surgery. It's not like I was knocked out or completely immobile. I walked into the office, got handed a brace, here - have a nice day & walked out. Other than the brace, nothing changed; I swam that far a couple days before I got it, and had been doing it for months.

    You can swim - medical folks -> person will do a few laps, float around some
    You can swim - me -> hey great, I can keep doing what I'm doing

    Just make sure you're both on the same page, or at least reading the same book.



  13. #13
    Join Date
    Jan. 27, 2002
    Location
    Arlington, VA US
    Posts
    1,359

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    Find a place with a pool that includes water therapy as part of the course of treatment
    Appy Trails,
    Kathy, Cadet & CCS Silinde
    member VADANoVA www.vadanova.org



  14. #14
    Join Date
    Jan. 12, 2007
    Posts
    587

    Default

    Late in checking this thread..

    RE sports vs. PT, not sure what the difference is in training, etc. In my area, they are separate areas, the PT room has things like stairs, beds, what looks like paralle bars, doors, normal stuff...thes sports medicine area looks like a gym, with a bit added equipment and "raised" beds. The people working in SM SEEM to be more educated about what sports use what muscles, etc. I felt more challenged in SM. The attitude is more, this person is going to be active so we best help them get back active. I felt like PT was more following x protocol no matter what my end goal was. PT focused on part that was hurt, the SM gave me a workout routine for a wider range of muscles, so say my arms didn't waste away while I recovered...
    "Fool! Don't you see now that I could have poisoned you a hundred times had I been able to live without you." Cleopatra VII



  15. #15
    Join Date
    Oct. 25, 2011
    Posts
    376

    Default

    I went to PT in 2009 for an ankle syndesmosis and broken fibula that required surgery and 90 days of complete non-weight bearing. I was able to go to a PT clinic recommended by riding buddies. My experience was good except they kicked me out just when I was getting really fit!

    Ask your riding buddies who they use--they'll likely have had experiences to share--ouch! Do talk to the therapist, explain your needs as a rider.

    Good news: my injured ankle, for some reason, is now my good ankle, perhaps because I never had therapy before for any of my sprains over the years. In lessons, my instructor is baffled because I can flex the "bad" one more and really get that heel down. Best wishes on your recovery.



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