Trimalleolar Fracture Recovery

Yesterday was the two-month anniversary of my injury, on 1/10 I slipped on the ice in my front yard and fractured my malleolus, what they call a trimalleolar fracture. On 1/15 I had surgery to stabilize the bones so they could start to heal. It has been an arduous two months, but I have progress to report, the trimalleolar fracture recovery game is on.

NWB – Non-Weight Bearing Stage

After my surgery, I was non-weight bearing, commonly abbreviated as NWB, for about 6 weeks. This period of a trimalleolar fracture recovery is the most challenging for people with lower extremity injuries. Depending on the severity of the injury, the NWB period might be longer, or shorter. Non-weight bearing means you cannot put any weight on the injured leg at all. Some doctors will say that even includes resting your toes on the ground in a seated position, while others will say that when you are sitting your butt is bearing your weight so it’s okay to rest your foot on the ground.

While this stage is essential to healing, it can be the most frustrating and challenging. This was certainly true for me. I mean, everything is more challenging when you can’t put one foot down. Add pain from the surgery and the injury itself, the first four weeks of NWB were the most difficult weeks of my life, probably.

2-Weeks Post-Op

My anticipation was high for my 2-week follow-up appointment. I wasn’t sure if I would get a hard cast for four weeks or if I would be lucky enough to get a boot. By that point the splint was uncomfortable. It was super bulky and it was rubbing against my foot and I couldn’t tell what it was hurting, just that it hurt. Turns out it was my incisions that it was rubbing against, ouch. I wasn’t feeling like I’d done much healing at all, but in the grand cheme of things, my trimalleolar fracture recovery journey was on track.

Luckily, after they removed the splint removed I got a walking boot. But I had to remain NWB for four more weeks. Also during that appointment, the nurse removed my staples. And I got to see the incisions and my foot for the first time since the surgery.

The scar on the fibula (the small bone in your lower leg) side of my leg is about 5 inches long. The incision on the other side is smaller, only about 2 1/2 or 3 inches. The incision sites were gnarly, and my foot was very swollen overall. My foot, I noticed immediately, leaned sharply to the left. And when the doctor asked me to straighten it out, I couldn’t. Like I sent all the signals from my brain that would normally cause my foot to move but literally nothing happened.

Uhh That’s Going to Work Again, Right?

It was terrifying. The doctor said it was fairly normal for it to not be super mobile and to just start doing some light stretching exercises at home to help mediate some of the damage being sedentary causes. As a note, your body quickly starts to forget how to do things if you are sedentary and not using them. Nerves go to sleep and redirect energy to other parts of the body that are actually being used. I started to research more at this point, because I like to be informed, especially about my own health.

PWB – Partial Weight Bearing

My next follow-up appointment was on 2/19, 6 weeks post-op. At this appointment, the doctor cleared me for partial weight bearing on my foot. This was great news, except for the fact that my foot still didn’t remember how to function like a foot. For at least two weeks leading up to this appointment, I started preparing my foot for the next stage of my trimalleolar fracture recovery.

The doctor sent me on my way with several exercises to do at home. So, I was doing those exercises daily, along with some others that it just seemed like my body needed to do. My Achilles tendon had tightened so much that I could not set my heel down if my foot was flat on the ground. I knew this would be something that we would have to immediately start to rehabilitate, so I started stretching it in hopes of facilitating PWB and eventual PT. Some doctors have patients starting PT way earlier than I did. It ended up being 7 weeks post-surgery before I started physical therapy.

Physical Therapy

I started physical therapy this week, on Monday. Last Thursday I had a preliminary evaluation but this week started my actual sessions. On normal weeks, I will go to physical therapy twice a week for six weeks but because scheduling was difficult I had one session this week. It was tough! Since the doctor cleared me for PWB I regularly walk with crutches around the house. But I don’t get as much practice as I probably need.

Physical Therapy Exercises

The exercises I have been doing at physical therapy would be simple for an uninjured ankle/foot. But for my poor janky foot, they’re hard. Some of the things I’ve been doing are:

1. Trace the alphabet with my foot. This one is fun and gets my foot moving around in interesting ways.
2. With a towel wrapped around my foot, pull it back towards me to stretch it out.
3. Using a balance board, flex my foot forward and backward.
4. Using the same balanceboard, flex my foot from side to side.
5. Using the same balance board again, move my foot around in a circle, both clockwise and counter-clockwise.
6. Pick up a bunch of marbles with my toes.
7. Curl my toes under and try to move a lever on a device.
8. Slowly walk with the parallel bars. Make an exaggerated step to get my foot moving in a stepping motion.
9. Shifting my weight onto my bad leg, with the balance provided by the parallel bars or by the wall if I am at home.
10. With a band tied together, doing abductor presses.
11. Doing adductor presses with a ball held between my knees.
12. With my foot out in front of me, flexing it forward (plantar) and back (dorsi), side to side, and working to straighten out my foot (as it’s still crooked)

I can’t think of any more, but you can see that this is a pretty extensive list of exercises. None of them are super hard but my foot doesn’t want to cooperate for most of these. I can do them, sort of, but I feel super uncoordinated for the most part. But I do them. I try hard. I know improvements are just around the corner.

A Part of the Healing Journey

I know this part of the journey is super necessary though because I have goals. It doesn’t make it easier. But I want to walk normally. I want to be able to take Sunny on walks. I need to get better. Two months into this healing journey and I can walk. With crutches, partial weight bearing. But my mobility is still severely limited. I started back to work this week after two months of FMLA and I am using a wheelchair at work, simply because I couldn’t keep up with the pace of middle school with the crutches. I wish I were further along the timeline. But sadly this isn’t something that I can speed up. I need to be vigilant about all these exercises because everything is supposed to help.

Anyway

I’m fae. And if you’ve found your way to this post I want to tell you that I normally post about other things like MM book reviews, my dog Sunny, education, and crochet and knitting. Check out some other things and you might find something else to enjoy!