3 ankle surgurys, still can’t walk might be central cenzitiation

@addy15
What does your orthopedic surgeon say about why you aren’t making progress with weight bearing? Have you been referred to a pain management specialist to help manage pain (like with steroid injections)? Is your ankle or foot swollen? Have you tried heat/ice/elevation/rest and pain creams (lidocaine/capsaicin)? Do you have muscle, joint or nerve pain? Are you using NSAIDs like Motrin/ibuprofen for inflammation?

You may want to see a neurologist for EMG/nerve conduction studies to check nerves controlling ankle and foot and central sensitivities and possibly a podiatrist that specializes in foot/ankle care.

I think sharing my story may help though the body parts are different , the still load bearing is not. I’m older in need of a hip replacement. Both hips are bad but right one the worst. Supposedly same day surgery. In and out is what insurance wants. Got home with walker healimg nicely. 8 days later I slipped one ice. Fractured my right femur and totally messed up my brand new right hip. Spiral fracture of femur and a totally messed up my brand new hip. It took months of PT to get the strength and endurance to put weight on the right leg. There was pain and lots of support to get me through the worst of it. Once I weaned on the walker to get me around I knew I passed a milestone. That I could do this. Now I can run jog do almost anything. I had a great surgeon which was my calling card. I think if you do to much at once it won’t allow your body to heal. Don’t overdo it. Take baby steps. Listen to your body. Your young. You have a long ways to go.

@addy15 Ankle injuries take a very long time to heal. 3 months is just the beginning. Some say it may take 6 years to get maximum recovery after a bad fracture. It is too soon to give up hope. I had a bad ankle fracture called a bimaleolar frature in 2020. In simple terms, it fractured off both the "knobs" on each side of my ankle. It was a fracture of the tibia (larger weight bearing bone) and the fibula was snapped completely (which forms the knob on the outside) The front of the tibia looked like puzzle pieces. I didn't have tendon or ligament tears that needed surgical fixing.

I remember how painful it was to start weight bearing after the cast came off. I started with 25% weight bearing the first week and was to increase it by 25% each week so when I came back for follow up, I should be full weight nearing. It did hurt a lot.

As I healed over a few years, it was like living with a sprain all the time, and I had a limit of how long I could walk until my ankle became very painful. I went through physical therapy, but still lived with this cranky ankle. Finally 4 years after my injury, I figured out that I needed to equalize the tension on my muscles in my lower leg and between the strong and the weak side. I had several scars, and some on the front of the tibia from an external cage that had been attached right after the injury. That created scar tissue adhered to the bone, and as I stepped off my foot, my ankle would collapse as it pulled tight. I figured out that this was putting extra pressure and tension on the tendons and ligaments on the outer and weaker side. My tendons all took turns hurting depending on if a muscle opposing them was tight or spasming. My physical therapist had shown me how to do myofascial release which can loosen scar tissue, and I stated working on my leg myself. After 4 years of pain with walking, for the first time, I could walk pain free. It was enough that I could even go hiking in the mountains on vacation last summer which I had given up on because I thought the injury was too bad. An injury makes you compensate, and some muscles get tighter because of it. I have to keep working on them as tightness arises to keep my pain free ability to walk.

Here is our discussion on myofascial release where you can learn more.

Neuropathy - "Myofascial Release Therapy (MFR) for treating compression and pain"
https://connect.mayoclinic.org/discussion/myofascial-release-therapy-mfr-for-treating-compression-and-pain/
There is a provider search at http://mfrtherapists.com/

Have you heard of myofascial release before? I'm guessing you may be in physical therapy now, but it would be worth asking your surgeon about doing some MFR to work on the scar tissue in the muscles and the surgical scar tissue. I think you may be able to improve things and decrease pain if you start working on all the extra muscle tension. Being young is an advantage, and I think you'll be able to do this. I'm routing for you too!

Hi there, I am also almost 3 months post op from my ankle surgery and are experiencing similar issues. I am also still using my crutches, and it is driving me crazy. I am only able to put full body weight on my ankle for very short walks on the treadmill, and it’s still uncomfortable. Although I am not 17, I too have been very active, and this inability to recover more quickly is starting to get very frustrating. These are my thoughts… I know that my ankle is repaired and stable to hold my body weight….however all of my muscles, tendons, fascia etc, were out of use for 7 weeks, with absolutely no use, and now, for the last 4 weeks I have been slowly starting to use them, but initially, you couldn’t even call it walking….. I think that my recovery from here is more about lengthening and strengthening all of these muscles, so it is not uncomfortable for me to walk. I have been getting red light therapy with massage on my foot 2x per week, doing my pt and trying to add more walking without crutches, or with just one crutch to get stronger. I am also having a swelling issue, where my foot swells when it is put on the floor…this has improved over the last month, but is still an issue with restricting my mobility, so anti inflammatorys and icing are also in my daily routine. I am also going to try some chiropractic work to jump start my parasympathetic system to help with the swelling. I believe at this point it is about consisitency and patience, you will have good days and you think you are on your way, and then you will have a setback, i think this will last for a while. You are young and you will heal, just try to be consistent with your rehab program, and use this time to practice self care so you will be back stronger than ever ! I am right there with you, keep working 🙂

@mlemon64 Welcome to Connect. Yes, it is hard at 3 months when you have not been able to weight bear on your foot, and your muscles and scar tissue are very tight. I think the swelling is going to go on for awhile, perhaps a few years. It is a normal response after a bad injury as the body tries to protect itself. I am no spring chicken myself, and I had swelling for a few years after an ankle fracture. Now that I am 4 years past it, my ankle isn't swollen with normal use, but if I exert myself hiking, it will swell just slightly the next day. It's only perceptible because if I tap on my ankle, I can make it tingle. It doesn't really look different or affect wearing a shoe.

You might be interested in my responses in this discussion on swelling where I described my recovery and a current update. There is hope for you, but it takes time, and lots more time than you expect. Myofascial release with a good physical therapist helps a lot, but only after you are cleared for tissue stretching by your surgeon. I will include that discussion as well.

Bones, Joints & Muscles - "How can I reduce swelling after surgery?"
https://connect.mayoclinic.org/discussion/after-surgery-swelling/
Neuropathy - "Myofascial Release Therapy (MFR) for treating compression and pain"
https://connect.mayoclinic.org/discussion/myofascial-release-therapy-mfr-for-treating-compression-and-pain/
Ankle injuries are difficult recoveries and very painful. It takes patience, and recovery comes in baby steps. Make sure to celebrate those small victories and keep believing you'll get there. As tension and pain crops up periodically, I do physical therapy stretching that my physical therapist taught me to relieve the uneven tension which stops the pain, and I walk without pain again. My surgeon promised me a future that likely includes an ankle replacement because arthritis sets in right after a serious injury. I took that to be a personal challenge to see if I can prevent it and keep my ankle functional. I also got custom orthotics made by my podiatrist.

Have you heard of myofascial release before?

Yes I have, and i went for sessions when I was rehabbing a knee injury, along with some Graston Techniques…..it was very painful, but definitely helped. I have been getting some of that stretching in my PT sessions, but very imited in these early stages…… I appreciate your feedback, thanks