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@archanagupta

My son is now 28 years old. He had a really bad ankle, tibia and fibula fracture end of January. Surgeon put a plate and screws in ankle, tibia, fibula. PT was interrupted a bit due to covid. The added stress wasn't/isn't great either. Insurance capped at 20 PT visits, he has got some more now through a local hospital, he does not walk as before, pain starts after standing for a while or walking approximately 2-3 blocks. I am not sure what follow up has the surgeon suggested or any follow up images he has taken.
Does anyone know the optimum modalities, therapies, approaches, dos and don't so the bones heal well for continued good health, mobility, strength, movement etc?
Would greatly appreciate if anyone knows of effective, quality PEMF devices, read about those on another mayoclinic link. Thank you. Await your reply.

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Replies to "My son is now 28 years old. He had a really bad ankle, tibia and fibula..."

@archanagupta I am rehabbing from a bad tibia fibula open fracture that happened in May. I've spent the last month working on strength and range of motion in PT. After 3 months of a cast and no weight bearing, I have a lot of work to do to rebuild muscle that was lost and my entire leg is smaller, but it is regaining muscle. Some of what I'm working on now has to do with muscles for balance and I do lunges on a half therapy ball. My foot is unstable, but that is what starts to strengthen the muscles I need. It is slow progress, but I make gains every time I go to PT. I also have a lace up ankle splint that helps a lot, and it prevents me from rolling my ankle which would re-injure my ankle. My injury was basically a twisted ankle and dislocation that broke the tibia in pieces and snapped the fibula. I have 2 plates on the tibia and a screw inside the fibula. This type of injury takes a very long time to recover from. The brace supports my ankle enough so I can do more walking before it gets tired and I have custom orthotics from a podiatrist that help a lot. I got an ASO brace from medspec.com. It laces, then a strap crosses over the top of the ankle and velcros up the sides, and then an elastic band closes around the front. I got the one with plastic stays for extra support. That supports the ligaments and tendons that were stretched during the injury. I found this for about $30 online when I searched, but it was listed around $50 at a lot of websites. My therapists also manually work on the muscles that get tight in my lower leg and make sure my pelvis is balanced. I also stretch the hip flexors in front because that is so tight for sitting so much. For your son, I would think after 8 months, the bones likely are set and the pain may be due to weakness and limits on range of motion, but that's a question for the PT. Things can be slightly misaligned in the ankle because of muscle weakness not holding it properly so it doesn't glide, and my PT has gotten my ankle "unstuck" which helped immediately. I have to keep stretching the plantar fascia, the hamstrings, the front of my thighs (quads) to keep moving with less pain. I still have limits on how much I can do and I just rest when I need it. My therapist also does myofascial release to release tight tissue. Some of that you can do yourself by laying on a ball on the tender spots. I do have some sensitivity around the plates and incisions, and my PT has used a Dolphin neurostimulator to lessen that pain. That is a very expensive device that sends a current between 2 handheld wands. A TENS unit can also send current between adhesive electrodes that stick on the skin and that can help with pain temporarily. Those can be a lot less expensive. Here is a link to our myofascial release discussion. Topical Arnica gel may help too. It blocks pain temporarily and lessens inflammation.
https://connect.mayoclinic.org/discussion/myofascial-release-therapy-mfr-for-treating-compression-and-pain/