Update had surgery! Chronic ankle instability -

[monsterkitty]

I had ankle surgery 10 years ago. I also had the chronic sprains from my first sprain as a kid to the one that broke the camel's back, well, my ankle!

I had an extra navicular bone and that is what caused most of the problems and weakness. During the start of a triathlon, I was pushed off the boat ramp and my foot got caught between the ramp and a rock, breaking both navicular bones and further damaged some ligaments and tendons. I did the entire race and that did more damage, as did the misdiagnosis from my doctor a few days later.

I had no choice but to do the surgery after the break and tearing of tendons and ligaments. The took out the extra bone, shaved down the real bone, and fixed the ligaments in my ankle and foot. The surgeon said my tendons and ligaments looked like string cheese. I was in a surgical cast for 2 weeks followed by a non-weight bearing cast for another 5 weeks. When I finally got my boot I was still non-weight bearing for 4 weeks. I still had the boot for another 6 weeks. I will always have the hardware in my ankle because of the type of surgery.

At the time my insurance would only allow for 4 physical therapy sessions. This was not enough! I am now having difficulties with my knee and hip because the lack of flexibility in my ankle joint. My PT is pretty cranky that I was denied the crucial PT after my surgery.

My biggest suggestions for you is insist on PT even before the surgery. The more strength you can build up now will make recovery easier. Also, the most valuable purchase I made before the surgery was a shower chair and the plastic sleeves to cover my cast. I did not use a rolling knee thing because they were hard to find and were super expensive at that point. Yes I used crutches for 11 weeks. My triceps at lats were amazing haha! Also, as soon as you are cleared, get in a pool and either swim or walk.

Good luck and let me know if you have any questions.

 

[mousefan73]

I had ankle surgery 10 years ago. I also had the chronic sprains from my first sprain as a kid to the one that broke the camel's back, well, my ankle!

I had an extra navicular bone and that is what caused most of the problems and weakness. During the start of a triathlon, I was pushed off the boat ramp and my foot got caught between the ramp and a rock, breaking both navicular bones and further damaged some ligaments and tendons. I did the entire race and that did more damage, as did the misdiagnosis from my doctor a few days later.

I had no choice but to do the surgery after the break and tearing of tendons and ligaments. The took out the extra bone, shaved down the real bone, and fixed the ligaments in my ankle and foot. The surgeon said my tendons and ligaments looked like string cheese. I was in a surgical cast for 2 weeks followed by a non-weight bearing cast for another 5 weeks. When I finally got my boot I was still non-weight bearing for 4 weeks. I still had the boot for another 6 weeks. I will always have the hardware in my ankle because of the type of surgery.

At the time my insurance would only allow for 4 physical therapy sessions. This was not enough! I am now having difficulties with my knee and hip because the lack of flexibility in my ankle joint. My PT is pretty cranky that I was denied the crucial PT after my surgery.

My biggest suggestions for you is insist on PT even before the surgery. The more strength you can build up now will make recovery easier. Also, the most valuable purchase I made before the surgery was a shower chair and the plastic sleeves to cover my cast. I did not use a rolling knee thing because they were hard to find and were super expensive at that point. Yes I used crutches for 11 weeks. My triceps at lats were amazing haha! Also, as soon as you are cleared, get in a pool and either swim or walk.

Good luck and let me know if you have any questions.

Yes I have tons of questions. Will get back to you! I’m just trying to get over realizing how long of a commitment such a surgery is. Now I know why I kept putting it off. I always had in my head 6 to 12 weeks, LOL. My main concern right now is at Covid will throw things and that maybe my surgery won’t happen. I’ll get back to you shortly on my specific questions. When I have my radiologist consultation after my MRI I learned something new. She asked me if I ever had broken my inner ankle bone. I don’t know the technical word for that. I said not that I’m aware of but it hurts sometimes when I press on it after I sprain ankle. I just assumed it was the other ligament on the inside.

 

[monsterkitty]

Yes I have tons of questions. Will get back to you! I’m just trying to get over realizing how long of a commitment such a surgery is. Now I know why I kept putting it off. I always had in my head 6 to 12 weeks, LOL. My main concern right now is at Covid will throw things and that maybe my surgery won’t happen. I’ll get back to you shortly on my specific questions. When I have my radiologist consultation after my MRI I learned something new. She asked me if I ever had broken my inner ankle bone. I don’t know the technical word for that. I said not that I’m aware of but it hurts sometimes when I press on it after I sprain ankle. I just assumed it was the other ligament on the inside.

Have them check to make sure you do not have the extra navicular bone. My surgeon called it accessory navicular syndrome.

She said that the extended time it took me to heal from ankle sprains was because of that navicular bone. She said that a person who sprains their ankle can usually heal in 6-8 weeks but with the accessory navicular it would double or triple the amount of healing time.

If this is what is causing your issues, I am really hoping for you that the surgery they do now has progressed from what it was when I had it.

 

[mousefan73]

@monsterkitty I do have some questions now.. Surgery in 11 days..
1. did you also have to do blood thinner injections the whole time with no weight bearing... I was told for the first 4-6 weeks I need to do this to prevent blood clots... ugh.. I got my first batch and oh dear God.. any tips on how to get over the mental hill of jabbing one self..
2. Do you also have lymphnode massage, drainage theraphy. The first 2 weeks I get a couple times a week this to reduce swelling... I dont believe in the States this is a known treatment.. I find it interesting...


So He fix 2 outer ligaments.. Both are ruptured.First will will check other things and might have a tight rope implant on I forogt the name.. Basically higher up on the ankle. to aid in stability.

Turns out I also had old fractures on the inside ankle... Never knew..... just shows that self-care even for chronic things is not good. I should have gotten things checked out many times before...

 

[lovemygoofy]

I had ankle reconstruction and pins put in almost 10 years ago and it was by far the best thing I've ever done!

It was miserable miserable surgery and healing. It was the first major surgery and subsequent pain I'd had and we were moving across the country on top of it. I had my tendons cut and retied, my talus (little ankle plate across) was destroyed and needed bone grafts, and had my ankle plate screwed to my fibula after the broke it to make it malleable. I was non weight baring for 12 weeks give or take and then another 3 months of PT. The first night I could dance in high heels afterwards was amazing! Now my other ankle is starting to do all the same signs and I'm thinking about doing this one soon even though it was miserable but the outcome so worth it.

I hope you get through your surgery and the afterwards as easy as possible. Have a easy accessible basket of snacks on the kitchen counter and ways to easy reheat things. I scooted a lot on a office chair around the kitchen. I had backpack for carrying my bottle waters and wallet and such as I was alone most of the time for healing and it was my driving foot.

 

[Christine]

@monsterkitty I do have some questions now.. Surgery in 11 days..
1. did you also have to do blood thinner injections the whole time with no weight bearing... I was told for the first 4-6 weeks I need to do this to prevent blood clots... ugh.. I got my first batch and oh dear God.. any tips on how to get over the mental hill of jabbing one self..
2. Do you also have lymphnode massage, drainage theraphy. The first 2 weeks I get a couple times a week this to reduce swelling... I dont believe in the States this is a known treatment.. I find it interesting...


So He fix 2 outer ligaments.. Both are ruptured.First will will check other things and might have a tight rope implant on I forogt the name.. Basically higher up on the ankle. to aid in stability.

Turns out I also had old fractures on the inside ankle... Never knew..... just shows that self-care even for chronic things is not good. I should have gotten things checked out many times before...

I'd love to know what you are having done.

I've scheduled surgery for March 4th to rectify Posterior Tibial Tendon Dysfunction which has led to a flat-foot deformity. It's not ankle surgery, per se, but the ankle is where my pain is. I will be having reconstruction of the foot which involves two different types of osteotomies (breaking the bones and adjusting them) in my food, a bunion correction, and a lengthening procedure of my gastrocnemious. This all somehow will create an arch in my foot and take the strain off the posterior tibial tendon (which is what is hurting me). I am lucky that my tendon has not yet ruptured or it would need replacing also. That's going to save me some healing time. I am going to be 6 weeks, at least, non weight bearing and in a plaster cast for at least 4 weeks.

What tendon are you having fixed?

No one ever mentioned the blood thinners to me at all so I'm guessing I won't be doing those.

I also have to get the pre-op physical done and all that stuff. The thoughts of all of this are severely depressing me.

 

[JoanneAZ]

@monsterkitty I do have some questions now.. Surgery in 11 days..
1. did you also have to do blood thinner injections the whole time with no weight bearing... I was told for the first 4-6 weeks I need to do this to prevent blood clots... ugh.. I got my first batch and oh dear God.. any tips on how to get over the mental hill of jabbing one self..
2. Do you also have lymphnode massage, drainage theraphy. The first 2 weeks I get a couple times a week this to reduce swelling... I dont believe in the States this is a known treatment.. I find it interesting...


So He fix 2 outer ligaments.. Both are ruptured.First will will check other things and might have a tight rope implant on I forogt the name.. Basically higher up on the ankle. to aid in stability.

Turns out I also had old fractures on the inside ankle... Never knew..... just shows that self-care even for chronic things is not good. I should have gotten things checked out many times before...

As a nurse, my advice for the blood thinner injections is to take an ice cube in a wash cloth and hold it on your selected site for at least a minute before you stick yourself. This helps numb the spot and it also helps to prevent bruising after the injection. The needles for this type of injection are usually very small and don’t hurt much even without numbing. You will quickly get the hang of it. If it’s really bad for you, you can ask that a friend or family member can be taught to do the injections for you.

Good luck on your surgery!

 

[mousefan73]

As a nurse, my advice for the blood thinner injections is to take an ice cube in a wash cloth and hold it on your selected site for at least a minute before you stick yourself. This helps numb the spot and it also helps to prevent bruising after the injection. The needles for this type of injection are usually very small and don’t hurt much even without numbing. You will quickly get the hang of it. If it’s really bad for you, you can ask that a friend or family member can be taught to do the injections for you.

Good luck on your surgery!

Thanks for the advice. My DH says he can do it. But want to try myself. Stupid question does skin/fat have the same feeling as putting a pin in an orange ? Lol yes I did that. I’m more stumped about how much give or force I need to do to get the needle in. I will be in hospital 2/3 days so I’m sure they’ll show me.
Is it also true not to rub the area to avoid bruising? Thx

 

[monsterkitty]

@monsterkitty I do have some questions now.. Surgery in 11 days..
1. did you also have to do blood thinner injections the whole time with no weight bearing... I was told for the first 4-6 weeks I need to do this to prevent blood clots... ugh.. I got my first batch and oh dear God.. any tips on how to get over the mental hill of jabbing one self..
2. Do you also have lymphnode massage, drainage theraphy. The first 2 weeks I get a couple times a week this to reduce swelling... I dont believe in the States this is a known treatment.. I find it interesting...


So He fix 2 outer ligaments.. Both are ruptured.First will will check other things and might have a tight rope implant on I forogt the name.. Basically higher up on the ankle. to aid in stability.

Turns out I also had old fractures on the inside ankle... Never knew..... just shows that self-care even for chronic things is not good. I should have gotten things checked out many times before...

No to both questions. While my surgical cast was a full leg cast for the 2 weeks until I got the lower leg cast, I made sure I moved a lot. While it was a pain, every hour those two weeks I would get up and walk around the lower level of our house on the crutches.

My foot swelled way more than it should have because I didn't have access to ice when I went back into my classroom two weeks after surgery. I got a stern lecture from the surgeon. After that, any teacher on their planning period would bring me ice from the teachers lounge.

I'd love to know what you are having done.

I've scheduled surgery for March 4th to rectify Posterior Tibial Tendon Dysfunction which has led to a flat-foot deformity. It's not ankle surgery, per se, but the ankle is where my pain is. I will be having reconstruction of the foot which involves two different types of osteotomies (breaking the bones and adjusting them) in my food, a bunion correction, and a lengthening procedure of my gastrocnemious. This all somehow will create an arch in my foot and take the strain off the posterior tibial tendon (which is what is hurting me). I am lucky that my tendon has not yet ruptured or it would need replacing also. That's going to save me some healing time. I am going to be 6 weeks, at least, non weight bearing and in a plaster cast for at least 4 weeks.

What tendon are you having fixed?

No one ever mentioned the blood thinners to me at all so I'm guessing I won't be doing those.

I also have to get the pre-op physical done and all that stuff. The thoughts of all of this are severely depressing me.

I will eventually have to have my Posterior Tibial Tendon replaced because it's too short now as the surgeon took too much off when she reshaped it and reattached it. It also has to travel around excess scar tissue. I am so not looking forward to this.

Good luck to both of you!!

 

[JoanneAZ]

Thanks for the advice. My DH says he can do it. But want to try myself. Stupid question does skin/fat have the same feeling as putting a pin in an orange ? Lol yes I did that. I’m more stumped about how much give or force I need to do to get the needle in. I will be in hospital 2/3 days so I’m sure they’ll show me.
Is it also true not to rub the area to avoid bruising? Thx

You’re welcome! Sticking a needle into an orange has a similar feel to sticking a person. You shouldn’t need to use a large amount of force, the needle is very sharp and should go in easily. And yes, don’t rub the area, just gently wipe the surface with an alcohol swab. They should teach you and your husband how to do this in the hospital before discharge. It’s scary to stick yourself at first but you can do this if you really want to.

 

[mousefan73]

Update! Just got home Friday evening from the hosptial. Been there since Tuesday morning when my surgery was. I had a brostrom on the two outer ligaments. They were "" catastrophic".
Tuesday: went it at 7am. ( day before was covid test and registration) went into surgery about 8:45 out by 10:15, woke up while being wheeled out to recovery. Felt totatly fit, no pain. UNTIL I swallowed. Major throat pain Got an ice and was good for a while. NO ankle pain. or nausea. Was totally alert. Then the pain meds hit and I was loopy.
Only had general ana, no pain block

First day I was not allowed out of bed, which meant using a bed pan to pee for the first time in my life. OMG but I got over it.
Worse pain and it was bad was my throat. could barely swallow, even today there is mild pain and I can feel a piece of tongue, throat hanging a bit behind my tongue in the back.. torerable thought.

The rest of my stay was good I slept alot and had physio each day.. Day two I got how to do crutches correctly, got fitted for my boot ( no cast but a boot). I also got a 30 min. lymphonic massage. Basically she rubs my stomach lymph nodes and upper leg, groan area with a light touch felt so good. Helps with drainage,, swelling.

 

[mousefan73]

I have to say I had almot ZERO pain this whole experience even until now. I was on Ibuprofen 600 4x a day and for days a drip with pain relief. I am now home and havent taken anything in 8 hrs. No pain. wierdest thing I had expected tons.. My throat hurt more.

Odd thing is my second toe and below is a bit numb. not totaly numb but like when you get a dentist shot and the numbness lingers. Surgeon said its not normal as those nerves were not impacted by surgery. He said wait it out until my follow-up next week.

Post OP looks like this.
Icing
6 weeks boot with compression tights and daily blood thinner shots . My DH will do that I am bruisiing badly.
Week 1: zero weight. roll walk with boot
week 2: 20 kg weight
week 3 40 kg weight
week 4 4 point walk.. basically two feet but using crutches.
week 5 and 6 need to see again.
after week 6 PT starts.


So far I can only say two things. 1. Almost zero pain if I dont do anything stupid (no real swellig)2. Dr. said this was totally necessary after the fact. Had I not gotten this done he could see me needing ankle replacement surgery in 10-15 years!

I see this my covid silverlining. Had life been normal I would have sucked up the last sprain a few weeks and gotten back to normal.... my mom is yelling at me for putting this off for years.

All I can think of right now. I am happy to be home and am now trying to decide the best way to wash my nasty hair.

 

[RamblingMad]

My PT guy is having me walk backwards on a treadmill at its max incline to work out muscle imbalances I have due to knee injury. I wouldn't be surprised if this fun exercise is in your future.

 

[mousefan73]

My PT guy is having me walk backwards on a treadmill at its max incline to work out muscle imbalances I have due to knee injury. I wouldn't be surprised if this fun exercise is in your future.

Interesting.. wierd how you mention that in my daily walk I have a round that is half hills. ONe part is a long incline and I often turn and go up backwards.. I totally feel how different muscle work..

 

[mousefan73]

will be months before I do that

 

[Christine]

Do you know the name of the procedures and ligaments tendon that are affected. Based on your earlier posts, it sounded like you would have things done to the joint or bone. I ask because I'm scheduled for surgery to reconstruct my foot which is what causes my ankle issues. I'm having an Evan's/Double Calc Osteotomy (which is breaking my heel bone and shifting it and breaking another bone in the outer side and repositioning), lengthening of a tendon, and a bunionectomy to straighten the foot. All this to give relief to my posterior tibial tendon (inside of ankle).

I will be in a split for the first week and then hard cast for 5 weeks. No weight bearing for 7 weeks!

 

[MICKIMINI]

Congratulations on your surgery! You are very fortunate you don't have pain. I had extreme, off the charts pain with my TKR but friends that had minimal. I will say, keep up with pain med even if you don't have pain as once it hits, it takes a very long time to get it under control. Your body does feel "weird" for a time but most of that wears off or you get used to it. I'm at 13 months and it seems like yesterday.

The worst thing for me was not being able to take a shower for a week or shave my leg for six weeks. I had to wrap my leg in a trash bag until the staples were removed when I showered. I stuck my head in the sink and washed my hair with some help from DH - better than nothing! It will get better for you just be glad it is now over and you have the rest of your life with your rehabbed ankle!

 

[mousefan73]

Congratulations on your surgery! You are very fortunate you don't have pain. I had extreme, off the charts pain with my TKR but friends that had minimal. I will say, keep up with pain med even if you don't have pain as once it hits, it takes a very long time to get it under control. Your body does feel "weird" for a time but most of that wears off or you get used to it. I'm at 13 months and it seems like yesterday.

The worst thing for me was not being able to take a shower for a week or shave my leg for six weeks. I had to wrap my leg in a trash bag until the staples were removed when I showered. I stuck my head in the sink and washed my hair with some help from DH - better than nothing! It will get better for you just be glad it is now over and you have the rest of your life with your rehabbed ankle!

Washing my hair we figured out. I have long hair. Best thing is having an office chair with good wheels. ( we don’t have carpet). I am rolling around instead of crutches. A scooter was not worth it the dr said as I Will not be out and about really for weeks since we are in a partial lockdown anyways.
The office chair has a back recline and so I basically leaned back towards the tub and held myself with my hands on the tub side. My daughter stood in the tub and did my hair. It was almost like being at the salon only my neck was a bit sore since I didn’t have support. But better than standing leaning over a sink on one leg.

 

[mousefan73]

Do you know the name of the procedures and ligaments tendon that are affected. Based on your earlier posts, it sounded like you would have things done to the joint or bone. I ask because I'm scheduled for surgery to reconstruct my foot which is what causes my ankle issues. I'm having an Evan's/Double Calc Osteotomy (which is breaking my heel bone and shifting it and breaking another bone in the outer side and repositioning), lengthening of a tendon, and a bunionectomy to straighten the foot. All this to give relief to my posterior tibial tendon (inside of ankle).

I will be in a split for the first week and then hard cast for 5 weeks. No weight bearing for 7 weeks!

I need to look through my doctors discharge letter. I have to translate from Germany but I’ll get back to you

 

[mousefan73]

Do you know the name of the procedures and ligaments tendon that are affected. Based on your earlier posts, it sounded like you would have things done to the joint or bone. I ask because I'm scheduled for surgery to reconstruct my foot which is what causes my ankle issues. I'm having an Evan's/Double Calc Osteotomy (which is breaking my heel bone and shifting it and breaking another bone in the outer side and repositioning), lengthening of a tendon, and a bunionectomy to straighten the foot. All this to give relief to my posterior tibial tendon (inside of ankle).

I will be in a split for the first week and then hard cast for 5 weeks. No weight bearing for 7 weeks!

@Christine

Hi finally getting back to you. The main part of my surgery was the Brostrom method to repair the CFL and ATFL ligaments. He first did an arthoscopy to check things out and clean up a big mess in my ankle. He removed tons of scarring, bone fragments and bad cartilage. My ankle on the outside had a permanment, looked swollen, non -painful bump, for decades.. Each sprain left its mark.

He also did something to the bassett ligament and Talus shoulder.. Originally he thought he would have to do a Tightrope fixation for ankle sydesmosis. that would have meant drilling on the fibia and tibia. but in the arthoscopy he found it was not needed.. This is probably why my recovery is faster than originally discussed.

When I attempt to translate from German and medical language, I also assume I had anterior ankle impingement sydrome.

I am lucky while I believe since I only got really ligaments fixed I avoided tons of pain had I my bones gotten involved.... good luck.