Total Ankle Replacement: Advice on beginning weight bearing?

It's a joint under the ankle - I didn't know about it until after ankle surgery it still hurt at the bottom of my ankle. The orthopedist didn't notice that the cartilage was gone there too. Cortisone injections are helping in the meantime.

The ankle surgery repaired all the torn ligaments, and he installed an internal splint so I don't roll my foot anymore. The surgery was a Brostrom Procedure.

@flachon3, I wanted to check in and see how you were doing now that your hard cast has been removed?

Recovering from an ankle fusion was one of the most difficult things I have endured. I have had my right knee replaced and needed two manipulations done to break the scar tissue loose, but that seemed like a cakewalk compared to getting the ankle fused. The pain was much worse, and the recovery is a tough road. What no one can really prepare you for is the softening of your foot bones. You are off your foot for so long, that beginning to walk on it again feels like walking on broken glass for many weeks.

I did a few different things. What I found most helpful was walking in a pool to start (when you get the OK from your surgeon that being in a pool is OK). It was a great way to get some pressure on my foot while also taking much of the weight off and reducing the pain. At the time of my surgery, I was also really into weightlifting. I would take lighter dumbbells, sit on the bench and place the dumbbell on my leg to apply some "pressure" to the bottom of my feet. I started out really light and slowly worked my way up. I found heel lifts in my shoes helpful for awhile after my surgery as well, but ultimately put them aside once I became more comfortable.

Everything was done at a snails pace and with guidance from my Mayo Clinic care team. I followed the rehab pretty closely. I unfortunately have to do my other ankle some point in the future but I am in no hurry to experience the rehab again just yet. The recovery is long and grueling, but I will say, when you come out the other end it is worth it. I am far more active now that I was with my end-stage arthritis that severely limited my ability to go anywhere or do just about anything.

Thanks Jennifer. U r right about it being a rough road prior to my fusion. This is my 10th surgeon that I’ve been to. 10 is my lucky #! This surgeon is amazing. Everything he’s said is true and I’m so impressed with MAYO! Got the cast off Thursday and started PT on Friday. Was in lots of pain Friday night, but I actually walked with the walker!! Yay! I’ve had my knee replaced as well as both hips prior to this ankle fusion. So at least those joints can’t bite me! This has been the most painful surgery of all! 7.5 weeks in bed with my toes above my nose, having every bad reaction imaginable to every pain med & having to go to the ER due to all that was no fun. Then the ER doc said it was super infected and I could loose my foot…NOT! Went back to MAYO on following Monday and they said it’s not infected, it’s just an ‘angry foot’ whaaaat?!! From all the trauma from the surgery, the foot turns bright red and hot. No infection at all. They reassured me that it would be ok…they were right. BUT that’s all behind me. The pain has eased up and I’m now rocking it in PT today will be my 3rd PT visit & it feels darn good . It’s stronger than I thought it would be. Walking is odd, just doesn’t feel the same, if that makes any sense. They worked on my scars, 6 of them to break down the scar tissue. Now that was very painful, but after it did feel a lot of relief on the incisions. U sounds like u have been thru the mill. Back surgery on top if all of that!! Wowza!! Doc says that I may not need an orthotic for the left (surgical) foot. I have very flat feet (thanks Dad) & that contributes to all this. I’m moving the ankle now and walking with a walker. Feels weird but I’m plugging thru. This has been the toughest surgery that I’ve ever endured. I was an equestrian back in the day and I hope to get back in the saddle again one day. That’s my dream. Doc says it can happen! Can’t quit dreaming! Thanks for ur advise and info on the shoes. Ur an Angel. Hang in there!
Later, Flā

Thanks Justin. I totally get why u aren’t in a big hurry to have ur other ankle done! Me too. When he removed the cast, I asked what about the other ankle cuz it’s right behind the left one. He says it would be exactly the same. Ugh! Will wait till I can’t handle it anymore! Who would want to go through that again?!!! Just walking with the walker at PT did feel stronger than it did before. But it’s like walking on glass, like u said. I hope to ride a horse again. Doc says I will but that day seems mighty far away right now. Dream big! Today will be day 3 of PT. It feels super good to be out of bed and that lazy-boy! I feel that the work is just starting in PT. Thanks for ur valuable input!
Later, Flā

OUCH!! I had my Achilles stretched during my surgery , along with 4 other major repairs. Ur injury sounds like it’s really painful! I had to be fused due to a deformity I had, flat feet which caused my foot to pronate, that caused everything else in my ankle to splay out, or sorta flatten out after a botched plantar Fasciaectomy
(sp?) in ‘88. Life grabbed me, work, mom had Alzheimer’s & Daddy had cancer. So I could not go down for surgery. I had braces, AFO’s & orthotics. It got to the point of not being able to walk barefoot at all. Then I had difficulty walking in shoes. Had been to 9 docs, that I did not feel could do the surgery correctly, was in an air cast for almost an entire year then I found MAYO! I found my Angels! When the surgeon at MAYO said “I can fix that, it’s routine for me” I almost fainted. I felt safe, revived & knew I was in the right place! Cast is off & I’m in PT. Life is good and I can actually see the light at the end of this extremely long tunnel! Maybe I’ll ride a horse again one day. That was my world since I was 3. I’ll get back in the saddle again one day. How are you doing now with your healing? Hang tough!
Later, Flā

@flachon3 I sounds like you're a rock star in your quest to get your fused ankle and foot rehabbed. You will get back to riding again. Did you notice the picture on my avatar? That is my old horse, a Tennessee walker who helped me rehab my spine after my cervical fusion by trail riding just at a walk. He taught me a lot about riding with balance, because he had arthritis issues and tripped fairly often. He had to retire because he was unsound and passed a few years later. I was offered a spare horse to take on a trail riding trip with friends, and that is how I broke my ankle falling off a spooked horse 4 years ago. After I recovered, I decided to get a new younger horse that I can bond with, and I did. He's also a Tennessee Walker and my ankle does fine riding and it does not cause me pain. I was not sure if I would be able to hike in hilly terrain, so I got a horse that can do that for me.

I also decided not to ride horses that I don't know well. It takes a long time to develop that bond and trust with your horse which is essential to safe horsemanship. I was talking with another Connect member about trail riding and I posted these pictures of trail riding with my horse. This is the horse I have now. He's also smaller and easier to get on and off.
https://connect.mayoclinic.org/comment/1057894/
When I think about that for you, it will be different getting on and off with your ankle.

My ankle surgery was the most painful for me too, and for a much longer period of time. Spine surgery was a lot easier for me, but it was cervical, and it makes a difference if you are bearing most of your weight where you had the surgery. My surgeon promised me an ankle fusion in my future, and I'm doing everything I can to try to prevent that. I recently learned that equalizing tension on my lower leg helps and I keep loosening the surgical scar tissue when it gets tight. That takes away the ache and fatigue.

Take it easy.
Jennifer