Improving Ankle Mobility After Fracture: Treatment Options and Advice

Q: Improving Ankle Mobility After Fracture: Treatment Options and Advice

Hello： In response to your question, I suggest you consult the surgeon who performed your operation. <br>It's best to follow their advice regarding these matters. <br>Wishing you a speedy recovery!

What to do if an ankle fracture affects joint mobility?

In April of this year, I fractured the bones in both the inner and outer ankle of my right foot.
The doctor said that the bones were displaced, so I underwent surgery, during which a metal plate and five screws were implanted on the right side, and two screws were inserted on the left side.
Now, I can walk on the injured foot, but I can only do so with a limp.
The tendons around the ankle feel very tight, and what worries me the most is the limited mobility of the joint; the range of motion for up-and-down movement of my foot is only about 60-70% of what it used to be (based on my estimation).
As a result, when going down stairs, I can only step with both feet on the same step, and I cannot squat at all.
The physical therapist (from the government) reviewed my post-injury X-rays and the surgeon's comments on the bone healing, which were merely "acceptable" (if the healing were good, it would have been noted as "good").
The therapist explained that since both fracture sites are connected to the joint bones in the ankle, the bone may grow irregularly during healing, leading to rough connections that affect joint mobility.
She advised me to mentally prepare for the possibility that the range of motion for my foot may not improve.
The physical therapist also attempted to flex my foot manually, but the results were minimal.
Currently, my physical therapy includes exercises on a step board, stretching, using a brace, and walking on a treadmill, and I have been instructed to do more stretching at home.
I find it hard to accept this situation because the doctor told me before the surgery that the recovery rate for mobility should be around 90%.
Now, my foot cannot move up and down normally, I cannot walk quickly (anyone can walk much faster than I can), and I have issues with stairs, which is very distressing.

1.
If I continue with the current physical therapy, will my condition improve?
2.
Another physical therapist suggested acupuncture, claiming that I could see results after three sessions, which would help relax the tendons.
Would this be beneficial for my joint mobility?
3.
Should I consider seeing a chiropractor or getting massage therapy? I initially wanted to try it, but when I asked the doctor (from the government orthopedic department), he advised against it, stating that since I have metal plates and screws, if any treatment causes skin inflammation, it could lead to complications due to the hardware inside.
This made me hesitant.
Should I still consider seeing a chiropractor or getting massage therapy? Are there any other suggestions?

Ling, 30~39 year old female. Ask Date: 2010/07/29

Dr. Li Wenlin reply Orthopedics

Hello: In response to your question, I suggest you consult the surgeon who performed your operation.
It's best to follow their advice regarding these matters.
Wishing you a speedy recovery!

Reply Date: 2010/07/29

More Info

Improving ankle mobility after a fracture, especially one that involves surgical intervention with plates and screws, can be a challenging process. Your concerns about the limited range of motion and the difficulties you face while walking and navigating stairs are valid and common among individuals recovering from similar injuries. Here’s a comprehensive response to your questions, along with additional insights based on medical knowledge.

1. Continued Physical Therapy: It is crucial to continue with your physical therapy regimen. While it may feel discouraging, consistent therapy can lead to gradual improvements in mobility and strength. The exercises you are currently doing, such as using a treadmill, stretching, and resistance exercises, are essential for regaining function. The body often requires time to adapt and heal, especially after significant trauma like fractures. If your physical therapist is experienced, they can adjust your program based on your progress and pain levels. Regular follow-ups with them can help ensure that you are on the right track.

2. Acupuncture: The suggestion of acupuncture may be beneficial for you. Acupuncture can help relieve muscle tension and improve blood circulation, which may assist in reducing stiffness around the ankle joint. While scientific evidence on its effectiveness for joint mobility is mixed, many patients report subjective improvements in pain and function. If you decide to pursue acupuncture, ensure that you consult with a licensed practitioner who understands your medical history and current condition.

3. Chiropractic Care: Regarding chiropractic adjustments or massage therapy, it is essential to approach this with caution. While these therapies can be beneficial for some, they may not be appropriate for everyone, especially after surgery involving hardware like plates and screws. Your doctor’s concerns about potential inflammation and complications are valid. If you are considering these options, it would be wise to discuss them thoroughly with your orthopedic surgeon or physical therapist to ensure they won’t interfere with your recovery.

4. Alternative Therapies: In addition to traditional physical therapy and acupuncture, you might explore other modalities such as hydrotherapy, which involves exercising in water. This can reduce the impact on your joints while allowing for movement and strengthening. Additionally, modalities like ultrasound therapy or electrical stimulation may also be beneficial in promoting healing and reducing pain.

5. Psychological Preparedness: It’s understandable to feel frustrated and anxious about your recovery. Psychological support can be just as important as physical rehabilitation. Consider speaking with a counselor or joining a support group for individuals recovering from similar injuries. This can provide you with coping strategies and emotional support during your recovery journey.

6. Monitoring Progress: Keep a close eye on your progress and communicate openly with your healthcare providers. If you notice any changes in your symptoms, such as increased pain, swelling, or changes in mobility, report these to your doctor. Regular follow-ups with imaging studies, if recommended, can help assess the healing process of your bones and the effectiveness of your rehabilitation.

In conclusion, while the road to recovery may seem daunting, it is essential to remain proactive and engaged in your rehabilitation process. With time, patience, and the right therapeutic interventions, many individuals can regain significant function after ankle fractures. Always consult with your healthcare providers before making any changes to your treatment plan, and remember that recovery is often a gradual process.

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