On October 3, 2018, I was given the clearance by my doctor to take my first steps. I had already made a physio appointment for the next day to help get me moving as soon as possible. The doctor also warned me, in a slightly condescending way, that if I didn’t do what I was told, I could potentially lose mobility and flexibility in my ankle. His exact words, “We babied your ankle for six weeks. Now you have to be aggressive or you will not recover properly. You need to be out of the walking cast in one week.” Determined to show him that he misjudged me as a potential princess, I asked if I could take my first steps, then and there. He nodded and I got up, almost squealed in pain, but I wasn’t going to show any sort of emotion and then tried to walk while using my wheelchair as a crutch. I underestimated how weak I would be, how painful it was to try to walk on my now inflexible ankle and how poor my balance would be. I took my note for physio, plunked myself down in my wheelchair, and my cousin, kindly took me home. All I could think about was how was I going to take off the walking cast in a week. How was I supposed to walk more than 5 steps?
There wasn’t a lot that I could do that first day, but I committed to standing, at the very least, as often as I could, using a walker to help me maintain my balance. I only took 5 steps that day. Better than nothing but not the strides that I was hoping for either. I eagerly waited for physio the next day wondering what the difference between passive and active exercise would be. I showed up at Totem Life Science and was told to wait in my wheelchair for Katie, my physiotherapist. I wasn’t afraid of the pain that I knew would come, but I was afraid of losing my balance a little and re-injuring myself. Katie is a young, positive, skilled physiotherapist. She got me to stand, then walk around the examining table. She looked at my ankle, and showed me the passive exercises that I was supposed to do. They were the ones that I could basically do lying down. I had to rotate my ankle every hour, ten times in each direction. Point and flex the foot the same amount of times, then use an exercise band and do the same thing. I was also supposed to ice it, pretty much hourly. I walked a little more, but felt very thrown off by the cast. I started to understand why I needed to be out of it so quickly – it made me feel unbalanced and it was also hurting my hips. She told me to bring my walker, if I had one, and my running shoes the next day.
I did all of the passive exercises, every hour on the hour like I was told. I iced my ankle, and I went back to physio the next day. Katie told me when I got there, that I would be walking out the door that very day and that I was going to do physio in my running shoe. My ankle was sore, and I had my doubts, but Katie said – trust your ankle – it’s solid, remember that it will hold. So I did. I walked back and forth (with the walker) and did everything that she told me to do and being out of the cast made it so much easier. I asked what else I could do at home, aside from the passive exercises, and she said just walk as much as possible and ice my ankle as much as possible. She said try to walk without the cast when you can. I committed to doing everything that I was told to do and more. I used my mother’s walker which was way too short, when I got home and walked the corridors of the the condo. I knew that there were about 180 steps end to end, and I did the walk three times that afternoon. It hurt, more than I can tell you, but I did it. Then, I did it again, two more times that day, happy to see some progress. Over the weekend, I did it 6 laps, 4 times a day. I pushed the walker away and used I forced myself to walk to it. I did all of the passive exercises all weekend long.
When I went back to physio, Katie could see that I made a big effort and that my walking improved and I stopped using the air walker in 6 days. She was able to spend the time doing ultrasound therapy and massage versus watching me do the assigned exercises. She would add new exercises to improve my balance and my dorsiflexion (ability to move your foot upward so that it is closer to the shin which is crucial for walking). I added single leg squats, regular squats, sideways walking and balancing on my leg to my passive exercise routine. If you don’t work on dorsiflexion, you will limp, have issues walking up and down the stairs and have the potential to injure yourself. Speaking of which, within two weeks, Katie had me try the stairs. My mantra became up with the good and down with the bad. This essentially meant leading with my good foot up the stairs, and the bad foot down the stairs. Once I could figure out the stairs, I did them as often and possible and walked outside so that I could get used to different terrain. I walked as much as I possibly could.
In addition to twice weekly physio sessions, I also saw Stacy, a chiropractor, who was a great support in my recovery. She is one of the owners of Totem Life Science and referred me to Katie. She was also the person who explained to me that the intense, burning pain that I was having was nerve pain. I went to Stacy once a week for additional massage and ultrasound therapy. It really helped to speed things along. By November 5, I was able to go back to work and by December 20, Katie and Stacy both told me that I was well enough to no longer require physio. Here are some tips to remember if you are recovering from ankle surgery and starting to walk:
–Everyone is different and will respond differently to treatment and physio. Not to sound cheesy, but recovery is really a marathon and not a sprint and you can’t compare where you are to someone else. Worry about your progress and only your progress.
–Do your exercises at home religiously. Don’t shortchange yourself. If you do them at home, your physiotherapist can focus on the “hands-on” therapy that they are so skilled at rather than babysit you as you do the exercises you should be doing on your own. They are trained professionals and will know if you aren’t doing everything that you are supposed to at home. They notice your range of motion and gait. By ignoring the exercise, you hurt only yourself and you will have a longer recovery.
–It will hurt – there is no way around that, but the ability to walk is worth it. The pain gets better in time.
–You will notice huge changes the first week, and like me, you will get so excited and then….. After the first two weeks, the hard work really begins when you have to really focus on your dorsiflexion. It is the very last thing to come back, and you need to keep pushing through this part of your treatment and your progress will slow.
–Lose your pride. I walked with a walker inside and outside. I used canes, had my air cast on to help keep my distance from people. One thing that I didn’t care about was how people saw me. I wanted to walk and I wanted my mobility back as quickly as possible and if it meant that people would see me in a walker, then that was fine. I also knew that I had the good fortune of knowing that my situation was temporary. Others do not have that luxury.
–People watch and be sensitive – I always give up my seat on the subway to people who are older, pregnant and have mobility issues. When I was on public transit with a cane and cast, I was offered a seat maybe 60% of the time. People can be rude, but that doesn’t mean that you should be. Use your injury to be a more thoughtful rider.
When I went to my final orthopedic appointment on November 21. The doctor kept saying look at the nice veins! Your ankle looks really good! Look at the flexibility, it’s really coming. He told me that he was impressed with my progress. This was the very doctor who a few weeks early looked at me so skeptically. I wanted to say, you doubter! I showed you! Instead, I just said the truth – I had a great physiotherapist and chiropractor and I listened to them and did everything that they told me to do. My ankle gets a little stiff and sore here and there, but overall, I couldn’t be more grateful for the ability to get myself around pretty much like I used to. They say it takes a full year for the swelling to completely go away, so I’m trying to be patient.