Tips and tricks for real life and living with an ankle fracture

As I wrote in a previous post with much more detail (see here), I fell off a mountain and broke my ankle in three places, then managed to break a bone in my 5th toe on the other foot. This meant that my right ankle was in a hard cast for 6 weeks and I was 100% non-weight bearing…but this was challenging because the foot meant to be my stable base for crutching or knee scootering was often pretty wobbly and in a lot of pain.

This post is a follow up with more detailed tips and lessons learned of things that were helpful in living with a leg cast, as well as what the return to weight bearing was really like. I couldn’t find a lot of good information about the transition to weight bearing was really like, so this is my take on information I was looking for and would have appreciated before and during the weight bearing progression process. (And if you’re looking for diabetes-specific stuff, it’s in the last section!)
Tips_weight_bearing_DanaMLewis
Dealing with lack of energy and fatigue

First, it’s worth noting something major about a fractured bone, and *especially* true if it’s a big bone fracture like some of mine were: it takes a lot of healing, which means a lot of energy going to the healing and not much energy left for every day living. I was constantly exhausted – and surprised by this fatigue – pretty much throughout this process. It made sense in the early days (say weeks 1-2 after fracture), but was frustrating to me how little I had energy to do even in the 4-6 weeks after my fracture.

But, then it got worse. Returning to weight bearing took *even more* energy. For example, on the first day of partial weight bearing, I was tasked with putting 25 lbs of weight on my foot in the walking boot. First by placing my foot on the scale and getting reliable with being able to put the right amount of weight on the boot; then by standing and repeating with the scale; then taking a few steps (with the crutches taking the rest of my weight) and re-calibrating with the scale until I was confident in that weight. With weight bearing progression, you’re supposed to spend up to an hour a day working on this.

I took to heart what my ortho said about not progressing fast if you only do 5-10 minute chunks, so after the first day, I tried to always do 10-15 minute chunks at a minimum, with a longer chunk wherever possible as permitted by pain and my energy levels.

But the first few days were really, really tough. It was hard to switch to a new weight every two days – because this meant readjusting how I was stepping/walking, and how much weight and where I placed my crutches. I started with a blister on my right palm, which turned into a squished nerve that made my right hand go numb, and ultimately damaged some tendons in my right wrist, too. This made it painful to use the crutches or even drive my knee scooter when I wasn’t focusing on weight bearing. So I had a lot of pain and suffering in the WB progression process that probably contributed to how fatigued I was overall.

So one of my biggest pieces of advice for anyone with broken bones is to expect your energy to take a(nother) dip for the first few weeks after you start returning to weight-bearing (or return to normal activity outside your cast). It’s a *lot* of work to regain strength in atrophied muscles while still also doing the internal healing on the broken bones!

Tips to deal with so much fatigue as you return to weight bearing:

Some of the tips and things I figured out for being non-weight bearing and sitting around with a hard cast came in handy for the weight-bearing progression fatigue, too.

  • I got a shower bench (this is the one I got) so that it was easy to sit down on and swing my legs over into the shower/bathtub. Once I was out of my hard cast, I still can’t weight bear without the boot, so I still need a sitting shower/bath solution while I return to weight bearing. I also removed the back after a while, so it was easier to sit in either direction depending on preference (washing hair/not) without having to ask Scott to remove the back and re-attach it on the other side.
  • Speaking of showers, I put a toothbrush and toothpaste in the shower so I can also brush my teeth there while seated.
  • I still keep most of my toiletries in the bedside table (or you could have a caddy by the bedside) so I can brush my hair, take my contacts out or put them in, wipe my face (facewipes instead of having to stand at the sink to wash my face), etc. from the bed.
  • I am taking ibuprofen 4x a day, and I get tired of opening the bottle. So I dumped a pile of ibuprofen on my bedside table to make it easy to reach and remember to take first thing in the morning or at night. (There are no kids or pets in my household; keep safety in mind if you have kids etc in your household – this solution may not work for you).
  • The one time I tended to forget to proactively take my medication was mid-day, so I added a recurring calendar event to my calendar saying “take ibuprofen if you haven’t 2x a day” around 2pm, which would be the latest I would take my second round, even if I woke up later in the day and my first dose was later in the morning. This has helped me remember multiple times, especially on weekends or times when I’m away from my desk or bed where I would have the meds visible as a reminder.
  • Pre-mix protein powder (this is what I chose) into the beverage of choice in advance, and keep it in individual containers so it’s easy to get and take (and if I’m really tired, round tupperware containers that have measurement lines make it easy to measure liquid into, put the lid on to shake it up, and drink out of without having to find another cup). I had Scott do this several days in advance when he went on a trip, and we kept doing it in advance even after he got home.
  • I kept using my portable desk for working, taking video calls propped up in the bed with pillows behind me, and also laying the surface flat to eat meals from when I was too tired to get out of the bed.

Other advice for the return to weight-bearing:

If you’re like me, you’ll switch back to weight-bearing accompanied by getting out of your hard cast and getting a walking boot of some sort. If you can, ask your ortho/doc in advance what kind of boot they’ll put you in. It’s often cheaper to get the boot yourself. Perfect example: my ortho didn’t tell me what kind of boot I would need, and I looked at various boots online and saw they ranged $50-100 on Amazon. At my appointment he asked if I brought a boot and since I didn’t, they’d provide one..and the paperwork I signed stated the price would be $427 (::choking::) if the insurance didn’t cover it. Insurance negotiated down to $152 for me to pay out of pocket for since I haven’t hit my deductible…which is still 2-3x more than retail cost. UGH. So, if you can, buy your walking boot via retail. (Same goes for purchasing a knee scooter (here’s the one I got) – it may be cheaper to buy it new through Amazon/elsewhere than getting a medical purchase that goes through insurance and/or trying to do a rental.)

  • You’ll also probably end up with a boot with lots of velcro straps. When you undo your boot, fold back the strap on itself so it doesn’t stick to the boot, another strap, your clothes, etc.
Other equipment that has come in handy:
  • Get multiple ankle braces. I had a slightly structured ankle brace with hard sides that made me feel safer the first few nights sleeping out of the cast, and it was often easier to go from the bed to the bathroom on my knee scooter or crutches with the ankle brace(s) instead of re-putting on my walking boot and taking it off again for a shower. (I transitioned to sleeping in a lighter ankle brace after a week or so, but still used the structured brace inside the waterproof cast bag for swimming laps to help protect my ankle.)
  • An ice pack with a strap to put around your ankle/broken joint. I had gotten this ice pack for my knee last fall, and strap it and another ice pack to my ankle to get full joint coverage.
  • Wide leg athletic pants…ideally ones that you can put on/off without having to take your boot off. (Women should note I found better athletic pants for this purpose in the men’s athletic section at Target..but be aware a lot of the modern men’s style have tapered legs so make sure to watch out for those and have enough width to get over your boot). Taking off the boot is exhausting with so many velcro straps, so any time I can get dressed or undressed without having to remove the boot if I am not otherwise removing the boot is a win.
  • Look online for your state’s rules for a temporary handicap parking pass, and take the paperwork to your first ortho appointment to get filled out. Also, make sure to note where the places are that you can drop off the paperwork in person (in Seattle it was not the same as the DMV offices!), or otherwise be aware of the time frame for mailing those in and receiving the pass. The handicap parking placard has been helpful for encouraging me to get out of the house more to go to the store or go to a restaurant when otherwise I’m too exhausted to do anything.
  • A new shiny notebook for writing down your daily activities and what you did. If you’re not a notebook type person, use an app or note on your phone. But despite being mostly digital, I liked having a small notebook by the bed to list my daily activities and check the box on them to emphasize the activities I was doing and the progress I was making. At the beginning, it was helpful for keeping track of all the new things I needed to do; in the middle, it was useful for emphasizing the progress I was making; and at the end it felt really good to see the light of the end of the tunnel of a few pages/days left toward being fully weight bearing.
Weightbearing_notebook_DanaMLewis

Other tips for getting used to a walking boot and transitioning to weight bearing:

  • Don’t be surprised if you have pain in new areas when you move from a hard cast to a walking boot. (Remember you’ll be moving your leg or limbs in different ways than they’ve been accustomed to).
  • My ortho told me the goal of weight bearing progression is to understand the difference between discomfort (lasts a few minutes) and pain (lasts a few hours). You’re likely going to be in discomfort when doing weight bearing progression – that’s normal. Pain (i.e. sharp pain) is not normal, and you should take a break or back down to a previous weight (follow your protocol) if you have it. I was lucky – the only few times I had pain was from trying to press down forcefully on the scale when seated, rather than standing on the scale and naturally letting my weight on my leg. I didn’t end up plateauing at any weight, and was able to follow my protocol of 25lb weight bearing added every 2 days and get to full weight bearing with no delays.
  • If you have a watch with a stopwatch feature, use it. It’s hard to keep track of actual time spent walking (especially at first when 90 seconds feels like 6 minutes) with just a normal watch/clock. You could also use your smartphone’s timer feature. But tracking the time and pausing when you pause or take a break helps make sure you’re accurately tracking toward your hour of walking.
  • The process wasn’t without discomfort – physical and emotional. Putting weight on my leg was scary, and every new weight day was hard as I dealt with the fear and processing of the discomfort, as well as learning how to step and walk and do my crutches in a new way yet again.
  • But what I learned is that the first 5 minutes of every new weight day ALWAYS sucked. Once I recognized this, I set the goal to always tough out a 15 minute session after I calibrated on the scale by walking slowly around my apartment. (I put my headphones in to listen to music while I did it). As long as there was only discomfort and not pain, I didn’t stop until after 15 minutes of slow walking with that weight and also re-calibrated on the scale during and after to make sure I was in the right ballpark.
  • I had to spend the first half hour or so working on my weight bearing by myself. I couldn’t talk on the phone or talk with Scott while I did it; it required a lot of concentration. (The only thing I could do is listen to music, because I’m used to running with music). So distractions did not help when I got started, but toward the end of the hour I could handle and appreciate distractions. Same for day 2 of a weight – having distractions or a task to do (e.g. walk from A to B, or walking while my nephew was on his scooter) helped pass the time and get me to complete my hour or more of weight-bearing work.
  • Be careful with your hands and wrists. Blisters are common, and I managed to both squish a nerve (which caused me to have a numb side of my hand and be unable to type for several days) and also pull or damage tendons on both sides of my wrists. I was torn between choosing to delay my weight bearing progression work, but also recognizing that the sooner I got to full weight bearing the sooner I could completely ditch my crutches and be done hurting my hands. So I chose to continue, but in some cases shortened my chunks of WB walking down to 15 minutes wherever possible to reduce the pain and pressure on my hands.
You’ll likely also be doing range of motion exercises. At first, it’s scary how jerky your motions may be and how little your muscles and tendons respond to your brain’s commands. One thing I did was take a video on day 1 showing me pointing and stretching my ankle, and doing my ABC’s with my foot. Then every week or so when I was feeling down and frustrated about how my ankle wasn’t fully mobile yet, I’d take another video and watch the old one to compare. I was able to see progress every few days in terms of being able to point my foot more, and wider motions for doing the ABC’s with my foot.
Also remember, once you’re weight bearing and working toward getting rid of your crutches, you can use things like strollers or grocery carts to help you balance (and also kill some of your weight bearing time!) without crutches. The practice will make it easier for re-learning your posture and gaining confidence in walking without crutches.

Don’t you usually talk about diabetes stuff on this blog? 😉

(If anyone finds this post in the future mainly for ankle fracture and weight bearing transition/progression tips, you can ignore this part!)

Diabetes-wise, I’ve had a pretty consistent experience as to what I articulated in the last post about actually breaking bones.

  • It was common for my first few days of progressive weight bearing to have a small pain/stress rise in my BGs. It wasn’t much, but 20-30 points was an obvious stress response as I did the first few 15 minutes of weight bearing practice. The following days didn’t see this, so my body was obviously getting used to the stress of weight bearing again.
  • However, on the flip side, the first week of weight bearing progression also caused several lows. The hour of walking was the equivalent of any new activity where I usually have several hours later delayed sensitivity to insulin out of nowhere, and my blood sugars “go whoosh” – dropping far more than they normally would. I had two nights in a row in the first week where I woke up 2-3 hours after I went to sleep and needed to eat some carbs. This normally happens maybe once every few months (if that) now as an OpenAPS user, so it was obviously associated with this new surge of physical activity and hard work that I was doing for the weight bearing.
  • Overall, while I was 100% non-weight bearing, I was eating slightly (but not much) lower carb and slightly less processed food than I usually do. But not always. One day I ended up having 205+ grams of carbs for me (quite a bit more than my average). However, thanks to #OpenAPS, I still managed to have a 100% in range day (80-150 mg/dL). Similarly on a travel day soon after, I ate a lot less (<50g carb) and also had a great day where OpenAPS took care of any surges and dips automatically – and more importantly, without any extra work and energy on my part. Having OpenAPS during the broken bone recovery has been a HUGE benefit, not only for keeping my BGs in range so much of the time for optimal healing, but also for significantly reducing the amount of work and cognitive burden it takes to stay alive with type 1 diabetes in general. I barely had energy to eat and do my hour of weight bearing each day, let alone anything else. Thankfully good BGs didn’t fall by the wayside, but without this tech it certainly would have.

And finally the pep talk I gave myself every day during weight bearing progression work:

This is short-term and necessary discomfort and suffering on the way to weight bearing. It sucks, but you can and will do it. You have to do it. If you need to take a break, take a break. If you need to do something else to get yourself pumped up and motivated to do your weight bearing, it’s ok to do that. But you’ll get there. Slowly, but surely. You’ve got this!

Proof that I did get there:

Best of luck and lots of support and encouragement to anyone who’s working their way to weight bearing after an injury, and many thanks to everyone who’s supported me and cheered me on virtually along the way!

65 thoughts on “Tips and tricks for real life and living with an ankle fracture

  1. Admittedly I scanned quickly because I just wanted to confirm that you were OK–glad you made it through another life challenge with such determination!

  2. Hey, I just read your post in more detail. Glad you are feeling better, Dana! Nice job taking all those notes.

    As always, YDMV … reading this brought me back to 2012, when I had a right-leg tibial plateau (Knee) fracture; 100% non-weight-bearing for something like 4 weeks and then +25% each additional week .

    Thankfully I was able to work from home – no driving when your right leg is 100% nwb. I definitely had the fatigue you describe, and I lost a lot of weight during that time. I remember my BGs being quite good – I thought that was due to a very low carb diet during that time, and almost no work stress. I ate no grains for about 2 months… my calories came from berries and cherries, and organic bone-marrow, along those lines… lots of colorful fresh food, a lot of matcha tea. Every bite of food seemed to disappear into the hard work of tearing down broken bone tissue, and building up fresh tissue.

    Recovery was easier for me than what you experienced – ouch, poor Dana! I cried for the first time the day I was at PT, when they took the brace off, and I was unable to command one of the knee muscles to contract. … My goal was to be able to get my heel to my bottom … took maybe 3 months, but I did get there eventually.

    The scariest thing once I was able to go outside (on crutches)- and for many months thereafter – were manhole covers in the rain, or anything metal on a street … the thought of slipping and potentially re-injuring the knee … the horror!

    The crutches ended up causing another “injury” for me as well – I actually had shoulder surgery to release the adhesive capsulitis (frozen shoulder) that had shown up first in one shoulder, than the other. After 2 years of PT for first the one shoulder, then the leg, and then the other shoulder, I had no patience left. Turns out, being female, over 40 and having type 1 diabetes are all risk factors for that one.

    Hope you are all better by now! take care.

  3. Thanks for the post! I have been trying to find first person perspectives on weight bearing experiences.

    I broke my ankle and had surgery (while awake) back in March. My situation has been kind of weird as I am also pregnant. And 3 weeks after surgery, a tree fell on our house during a storm causing us to have to relocate. Needless to say, it has been a crazy few months.

    I like reading about others experiences because I often find details true to my recovery that the doctors never mentioned. I have also developed numbness in the fingers of my left hand during this partial weight bearing journey.

    I go back to the doctor in a few hours. I am both hopeful and fearful about being allowed to start full weight bearing. I am 8 months pregnant so I want to walk before he gets here but each new step is scary, difficult and comes with a learning curve. Thanks so much for your post!

    1. Oh no, how stressful!! I am sorry to hear you’re dealing with all that..all at once. Glad this post helped some! Wishing you luck as you return to weight bearing!

  4. Dana, Thanks for writing your experience with your weight bearing. I broke my ankle in February and was in a cast for weeks then the walking boot for weeks. My ortho never told me anything about 25% or any percentage for that matter. All the sudden it was a checkup at the end of May he was just like OK don’t wear the boot anymore and said I was OK for FWB. I’ve been going to physical therapy since Beginning of June. Well, I am still not walking correctly and I can’t even walk a few steps without my walker. I’m totally frustrated and exhausted. I don’t know what to do anymore. I cannot use my cane which is what I was hoping to transition to. My right hand is becoming numb and tingly which isn’t helping matters. Do you have any suggestions ? I am so tired. 😣😣 I am starting to feel like a failure because I am still not walking. Oh I forgot to mention that my so called good leg just acts like it wants to hop still after using the walker to get around with while I was NWB for months.

    1. So sorry to hear that you’re struggling! I know it’s frustrating. Have you been WB in the boot? If so, what I did next was spend 1 hour in the morning in a shoe, then back to the boot..next day 2 hours…etc and work up from there until I was fully out of the boot. If you’re not WB yet (still using walker with the boot), there’s a lot of progression schedules online you can use – either X% of weight or a certain amount of pounds, depending on your preference. In any case, you’ll get there – it’ll be slow and painful (and slower than we always want it to be), but you can do it! Even if you have to go from a few steps, to 10 steps, to 20 steps, to across your house, etc., set small goals & it’ll help to conquer those as you go along. FWIW – my cane that I got ended up being not useful for anything but fending off people from crashing into my legs, I never ended up really using it for more than confidence.

      1. Thanks for a quick reply.😊 No, I did not do FWB while in the boot. My ortho never told me to do so. He basically had me wearing the boot as NWB and said to only do tip toes while at rest. So there was never any FWB. Next thing I knew after I had an x-ray he was just like OK don’t wear the boot anymore and do FWB as tolerated and started me on physical therapy. I really wish I was told to do FWB while in my boot. Maybe my progress would of been better. Now, I am not sure if I should wear it around after not wearing it since May. I mean now that I have good range of motion and its not stiff at all, like the boot does is makes it stiff and keeps it still. Thank you for listening 😀

        1. Oh wow! It’s interesting how different everyone’s experience is! Sounds like you can choose to put the boot on for your FWB progression time, if you find that helps you be more confident with going WB, or do it in the shoe. It’s great that you’ve got good ROM and aren’t stiff! Good luck!

  5. How long of a process it took you total. I fell and broke all three bones in my ankle. Slipped on the mountain on April 25.

  6. I’m in my 8/9 week of physical therapy. Trouble with weight bearing. I’m in a walker still. But just using one arm with the walker of heavy limping without the boot and shoe. Any suggestions. Thought about a quad large base cane.

    1. Hang in there! From what I can tell, it’s a longer process to return to “normal” ish than anyone ever expect. I just passed the ~6 month mark and feel like I’m mostly normal for being able to walk around and run, but I also still have intermittent soreness (especially if I don’t run for a week – oddly enough, running and impact at this stage actually seem to help keep my ankle stretched and mobile) overnight and stiffness in the mornings at least once a week still. What I found helps: set small goals (distance? time? new things you can do again, even if modified? etc) for everything you’re doing and celebrate even the tiniest bit of progress.

      1. Thanks for your post. And comment. I m actually in pool therapy, which is helping out alot. Being in a boot for 2 months brought my foot alot of problems.
        Thanks for encouraging me. And the time reading about my situation.

      2. Thanks for the tips of weight bearing, wow i am almost there. This week was the first week of 20/25 steps without the walker and cane. I probably have three more weeks till I feel comfortable and confident.

  7. Thank you so much for taking the time to write this article.. I broke my tibia 4 weeks ago…. Summertime fun ended not so fun….
    Your article has been most helpful information I’ve read.
    Staying strong and positive but sometimes I get impatient with the process!
    Thank you again

  8. Thanks for your post and replies. I too was looking for first hand experience as the surgeon did not give much detail on transitioning from NWB to full WB “as tolerated”. I have agonized over my lack of productivity until I was reminded that rest, therapy and recovery are productive as they are leading back to full strength and use. Helps me get through the slow day by day progress and discomfort.

  9. Many thanks for your post. Your comments about energy levels cheered me up after a day of getting around in a moonboot (in my country, that’s what we call the boot with velcro straps). I like your advice about progressing out of the moon boot too: I will work on it! I had sore hands on crutches too and made cushioned handle covers out of a car wash kit – slicing the foam sponge in half and using the polishing cloth as a cover. You can buy covers on Amazon but this was quicker and easy with materials I had to hand! Happy healing!

  10. Hi Dana. I have to say, after searching forever for what going back to weight bearing is supposed to feel like, I am so happy I found your blog. I have a question. How long did it take you to go back to full weight bearing after you got rid of your boot and, how long before you were able to walk w/o your crutches? I’m asking because I cannot afford PT and I am 5 weeks out of my cast and I still cannot put full weight on my foot for more than 5 min w/o the bone on the inside of may ankle feel like it’s pulling apart and then the pain lasts for quite a long time after rest. I’m just trying to get a sense if I am doing too much and put too much weight on my foot too soon. Thanks for reading!

    1. I got back to full weight bearing in the boot, the transitioned to an hour in the morning and the afternoon each outside of the boot (fully weight bearing), then gradually lengthening that time til I was fully out of the boot all the time. (Ditto for crutches – I was walking around all day in the boot without crutches before I began transitioning out of the boot). That sounds really painful! My ortho talked with me about the difference between discomfort (lasts a few minutes) and pain (lasts for hours). Worth talking to your ortho or doc if that’s still the case of having a lot of pain? Also see my tips in the post about practicing with the scale to get confident with each weight level progression. If the progression you’ve been given is too much, take smaller chunks – maybe cut each progression in half, or add X pounds at a time – whatever you can build up safely on without causing pain! And no reason not to stay longer at a stage if you need to. I got lucky and didn’t plateau at any weight on the return to weigh bearing, but from what I read, it’s super common to need to stay longer at a stage or go back a stage for a few days. Good luck!

  11. Your post helps me, too. I broke three bones in my ankle July 7. It’s been a loooong recovery, including a hospital stay after surgery due to infection. I have trouble trusting the three ortho docs that rotate in my small town.

    Should I trust myself or the Healthgrade-rated terrible ortho doc? Should I find another doctor an hour away?

    I’ve had both hips and a knee replaces–that’s was child’s play compared to this!

    1. Yikes, how scary! I’m not sure what I would do in your situation – it’s probably influenced by insurance coverage, willingness to drive, etc. But sounds like you’ve probably built the willpower for recovery and what you need to do with those replacements, so hopefully some of that knowledge will help with this. Good luck!

  12. I broke my ankle in 3 places and my shin on Aug, 11, 2019. Surgery Aug 22. Sept 30 will be my first day of physical therapy. I am frustrated with the healing process because obviously I can not do things easily – I have to plan and plan and logistically work out my movement. I have weaned myself off my heavy pain meds and am relying on Advil & Tylenol. I still have discomfort and pain. I am still 100% NWB but there were 2 instances where there were emergencies that I had to actually use my broken ankle to pick up my 50lb child. I felt pain for days after. But I know that soon I will reach the light at the end of the tunnel. I am hopeful that the physical therapy weeks will make me stronger and bring me closer to walking, running and taking the stairs.
    Your post has been very helpful!

  13. Since I broke my ankle in 4 places and had surgery on July 24,2019 I have searched the internet for information on others who have broken their ankle and their story. I am now in the boot and last week was given 100 percent with and without boot from ortho doctor, like I should just drop the crutches, remove the boot and walk out. Thank you for all the information on transition to weight bearing. From my experience it will happen but not in a week or a month already see my progresion with the boot and starting a bit without boot and one crutch. Again Thank You for explaining step by step and it seems like you were quite athletic before and are again since breaking your ankle and it was still a struggle.

    1. I also broke my ankle in 4 places. I’m on day 3 of transitioning into a boot and wb. My surgeon said that the average amount of time to walk without crutches in the boot was 3-4 days. I’ve been struggling and in pain all day and had to take a pain pill again. I was optimistic to hopefully be without crutches shortly and be able to drive again, since it’s my right foot. This article has been so helpful since I’ve been depressed about my progress.

  14. So glad I found this post. Trimeollar ankle fracture on 10/6, we took our daughter roller skating & I went down. Surgery 2 days later. Plate & screws. I’m 2 weeks post op now and 1st post op appt was 2 days ago. Healing nicely & in a boot now- still no weight bearing. Start PT soon. The boot is so heavy & still getting used to it. I have crutches & scooter. I’m getting around really good & in good spirits. My husband built a ramp for me out our front door which has steep steps. Working remote until next week but where I live we’re starting to get snow so I’m not attempting to go to work on those days. I’m 46 and first injury & surgery ever. Your tips are great! Taking off the boot to shower I felt so vulnerable with my ankle exposed & was scared, but didn’t even think of getting ankle braces!! I will now. Has been quite a challenge but I have an overall positive attitude.

    1. Thanks so much for this Dana and appreciate the comments too. I just had ORIF for a broken filbula from falling from ice skating. I’m a cast now and will see doc in 12 days. I would really like to get back to work for social and physical reasons (so not really work from home, though it’s a desk job) ASAP but also don’t want to deal with snow. Am enjoying the knee scooter as opposed to crutches! Leigh, I’m pleasantly surprised you’re in a hoot already—was expecting 6 weeks for that. Also first surgery ever, and I’m 47. Thanks for tips about ankle braces too, folks. Amazing. Happy healing to everyone!

  15. I broke my ankle in 3 places at the end of October, paragliding. I have to admit the healing process is VERY slow. Grrr
    Still haven’t got to the WB stage yet.
    However, if there is a bit of advice I can give to people in a similar situation is to get yourself an IWALK 2.0. It is the best thing since “bubble gum”. It allows you to do almost everything. It takes a little getting used to but once you get the hang of it it makes life so much more bearable. I make beds, cook, clean and have even done a little bit of garden work.
    The only negative thing about it is that family and friends see you are quite capable and will start expecting you to do more. It does make you pretty tired but makes life more bearable.
    If I can offer another tip, have a routine. Think every step of your day out
    and it will make things so much easier for you.
    Good luck to you all, and thanks for an informative post.

  16. I like your article, it sounds stupid but felt betrayed that NO ONE tells you these things before. I did a bunionectomy with osteotomy on my right foot. It was really hard, it was a shock to find me face to face with these realizations. Thank you for putting it out there, you are helping everyone. It’s gonna be 4 weeks tomorrow Non weight bearing… 😐 it’s horrible, nobody tells you that your hands will hurt so much from using crutches. Im sorry for the rant bout I think you’ll get it.

  17. Thank you Dana and all the commenters. Broke my ankle in 2 places Nov 4th. Surgery the next day with plate and screws. I am 63 with osteoporosis but never had any fracture before. Have a knee scooter which limits use of crutches to bathroom visits only.

    I especially appreciated your discussion of fatigue. I thought it was just me and my age. Have tried to keep up some Pilates work on my bed but feel strength fading.

    Looking forward to cast off on 12-18 and switch to boot. You have given me markers for what happens next.

    Thank you!!!

  18. So great to read this! Info on what this trauma is really like and knowing what to expect is hard to come by. I broke my fibula and bilateral malleoli on 11/6/19. Ortho took off the cast a couple weeks early and put me in a boot so i can remove it for showers but I’m still NWB for at least another week. Just having the cast removed has been a hard transition. And I’m starting to see that transitioning to WB will be even harder. I never expected all of this. It is exhausting and has left me in tears and frustrated so often. Ortho docs are the worst at explaining the process and setting up expectations. Like others have said, mine told me Just don’t bear weight for 6 weeks, then we’ll transition you to weight bearing in a boot for 6 weeks. Like its a piece of cake. It’s so much more complicated than that! I’m sorry there are so many going through this same thing but also comforted to know I’m not alone and what I’m going through is a normal part of this painful, slow healing process

  19. Thank you so much for this post. I fractured my fibula, displaced talus, and torn deltoid ligaments in the quest for good maternity photos of my sister. I had ORIF surgery two days after the injury and was 100% NWB for 6 weeks. The cast came off 2 days ago and now I’m struggling with a walking boot to get back to FWB. My doctor expects for me to be 100% FWB and be able to be out of the boot at my next appointment in 12 days. He didn’t give me any sort of other timeline or goals, just said to take my time, do as much as I can tolerate, and use the crutches as needed. It scares me to even think about taking a step without crutches right now. Putting more than a fraction of my full weight on that leg makes me feel like it’s going to give out. At this point, being FWB in 2 weeks seems totally unrealistic and I get frustrated because of it. I’ve been on short term disability since my injury as I work in a microbiology lab and can’t, for safety reasons, be in the lab until I can wear a shoe again. It’s been great getting to spend more time with my young niece and nephew, but I am definitely ready to get back into the world again and it’s quite frustrating to be so close and yet so far. Thanks again for your post it’s very helpful.

  20. I broke my ankle three fractures on Nov. 6th. Had surgery on Nov. 14th. Had staples removed and splinted on Nov.27th. I appreciate the information in this blog, thank you Dana. I am 63 and very active with a full time demanding job. I go back to the Dr. the 2nd week of January 2020. I am encouraged by what I have learned in the blog. No more chasing my granddaughter and slipping on paper. I will continue to read the blog for encouragement and relatable experiences.

  21. Dana… I slipped and fell on ice November 1, next morning I had (ORIF) open reduction internal fixation to repair broken Tibia fibula and ankle.
    I have been researching for the last 6-7 weeks for this type of information. I can not thank you enough. I’m typically a really active person, have found in the mornings it’s almost impossible for me to get started and just doing showering and miscellaneous things around the house have me exhausted and needing to take a nap in the afternoon. So this is been validating for me and good to know what I might be dealing with as I move forward. My next appointment is next Wednesday where I hope to get out of the cast in into a boot. I am wondering what type of crutches you used as the Walker is killing my wrists and my palms.
    Again you are an angel for taking the time to share your experience.

  22. I am so glad that I found this post! I am only two weeks into my injury, I fractured my fibula bone in my ankle after a fall. I am currently in a NWB cast and go back to the doctor tomorrow to see if the fracture has healed and then hopefully a walking boot. I still have not been back to work and as hard as it’s been, I’ve been resting and elevating as much as the doctor wants me too. The world outside of my home sounds so daunting! I feel like I have lost my drive of confidence. Your post was encouraging and I’m glad that your healing well! I have Lyme disease on top of all this, so the use of my shoulder and knee joints has been taking its toll too. But life is meant to have these bumps in the road right? Carrying on is but the only choice we have! Thank you!

  23. Ive enjoyed reading this as it feels so much more realistic than some of the clinical info available. Trimalleolar fracture October 25th surgery with external fixation for 10 days further surgery ORIF. Most metal work ever inserted by surgeon. Last week got green light to begin weigh bearing and really finding it hard and frustrating. I am in a boot, i can apply reasonable pressure whilst sitting and can use it to balance and hobble but trying to put full weight down is incredibly painful and makes me feel like i am falling over.
    Keen to get back to work and have a life! Feel like recovery is harder as i am overweight so i guess one good thing is a resolve to lose serious weight in the new year.

  24. Broke my Tibia and Fibula on 8/28 surgery for a titanium rod and four screws. NWB for 15 weeks and blood clots that hindered my PT. After 8 weeks PT I was released for FWB and had to leave my home In MI to winter in FL I’m on my own for PT now doing all the exercises my therapist set up for me. I’m so discouraged after 2 weeks of little progress. I’m getting depressed but keep toughing it out each day. My biggest problem is my knee and left side of my ankle swell pretty bad after exercising. I’m feeling like a huge burden to my husband and cry a lot. I’m encouraged by your post as I see it’s going to take a while to walk after not walking for 4 months. Just venting ugh.

  25. I slipped in shower and broke tibia, fibula & tallus bones and also badly dislocated ankle that it was round the back of my leg 3/11/19.
    I had dislocation pulled straight obviously while under anaesthetic and an external frame fitted the day after the push bones together. After 8 days I had ORIF surgery 12/11/19 and had cast removed after 6 weeks NWB on Christmas Eve. The orthopaedic doctor said I would be back walking in 2 weeks. !!!
    I was given a boot but have only managed to put it on 3/1/20 due to swelling and pain in foot. I am now managing short walks in boot with a frame around the house. Short walks have me panting like I’ve run a marathon but sticking at it.
    Physio is booked for 21/1/20 but I have been doing leg stretches etc which I found on the internet. Everybody’s posts on here have given me hope as I too have felt absolutely exhausted by the whole process of getting to weight bearing stage. I still cannot fully WB as yet. I’m 62 so she will possibly go against me too. Good luck to everyone who’s going through this exhausting process. Many thanks to Dana for her detailed log as I too found very little information about my recovery.

  26. Thank you so much for this post. I’m recovering from breaking both malleoli (?), the tibia, and the fibula from arguing with a dark stairwell and losing (Nov 12/2019, ruined the holidays). The information you’ve given in addition to some of the comments is invaluable.

  27. Thank you so much for this. I had a trimalleolar fracture on my left ankle and had been non weight bearing for about 10 weeks. At 12 weeks they want me to get rid of my crutches but I feel like it is so soon. I’m trying to stay motivated but it is a little overwhelming.

    1. You’ll know when the time is right Scarlet. I have the same tri-fracture & healing naturally; no surgery. I was NWB for 12 weeks and then told by the Ortho Consultant to get my shoes on & start walking…. not that straightforward. I hadn’t even had the use of crutches up to this point, but I spoke to Community Physio who suggested that was thd next stage. Fully got rid of the crutches at 20 weeks after weaning myself to one crutch a few weeks prior. We’re all different; just keep at it and listen to your ankle

  28. I just ran across this looking at how to use a knee scooter. I find this very helpful! I broke my ankle 3 weeks ago so I’m not at the weight bearing part yet.

  29. Thank you for this very helpful post. And thank you for all who have commented. I had flat foot reconstruction surgery on Jan 3. I was in a boot from Oct 1, 2019 until surgery. I’m NWB and in a cast, which comes off Feb 17. I was told to ‘bring my boot and crutches’. Thank you for the real scoop on returning to weight bearing. I’m ready to call and schedule PT for the day after cast removal- but it sounds like I should wait and work on it at home. We’ll see what surgeon recommends. The whole thing terrifies me- will my foot support me, will it know how to move, and I’m also worried about my ‘good’foot- all it did for the last 6 weeks was push the knee scooter. Heard the iWalk was a life saver. I did not use one because of winter weather. But two of my friends used it and loved it. Freedom to go up/down steps, walk their dogs, and do pretty much everything they used to do when weight bearing.

  30. I broke my fibula in September and had surgery September 13th. I an back to walking and cycling some. I still am very stiff and don’t have full range of motion. I am hoping it will continue to improve. However, I have numbness in my toes almost all the time. Anyone else experience this? My doctor said he will not be concerned until I’m 12 – 18 months from surgery, but he also said it could be from the nerve block, but I don’t think it is still from that.

  31. Good to read about all the other experiences out there. I broke my fibula and ankle on 16 December, surgery on 22 December, NWB with cast and crutches until 24 January. A memorable Christmas for all the wrong reasons! Was given a boot on 24 January and told I could fully weight bear as long as I had the boot on, and to use the crutches for support. That evening I decided to try and go upstairs on my feet instead of on my bottom for the first time in 6 weeks. I clearly put too much weight through my foot, the pain was excruciating. I spent the weekend with a very sore, very swollen ankle, hardly able to get the boot on. After another visit to the hospital, I was given a different boot and told to weight bear as much as I could take. Nearly two weeks on, I feel I have made no progress. The ankle is still very swollen which apparently is normal. The boot is quite high and whatever I wear on my good foot is lower so I am lopsided the whole time I am walking – this means I need my crutches for balance. I feel I am relying on my crutches to take the weight so I am not making any progress towards weight bearing on my ankle – and to be frank I am actually terrified about putting weight on my ankle again. I feel I have no strategies to help me move forward. Back at hospital in 3 weeks and I want to have moved forward by then but don’t know how. Added to all this, my mental health and well being are taking a big hit, I hate being so tired just making a cup of tea, I hate being so inactive and I hate relying on everybody else for the least little thing. I can’t even shower without help! It’s grim!!
    Any tips and strategies for any of this would be welcome. If you are going through this I wish you all the best.

  32. Thank you, Dana and all who have shared their experiences. This has been very helpful. Hearing that I am not the only one who has found this recovery process exhausting is a relief.

    I fractured my right ankle in late December after slipping on ice. It was treated non-surgically and I wore a hard cast for six weeks. Using a knee walker allowed me to remain as independent as possible during that time. I rented one but it would have cost less to buy one as Dana recommends. The knee walker made the recovery process much more tolerable.

    The cast was removed yesterday. I am using a high boot ($150) and I was instructed to use a standard walker to gradually progress to weight-bearing. I should have asked for more information about how to do that because I don’t believe I am walking as I should. It has been difficult so far. I have had mild discomfort but no pain. I told my boss that I will be returning to work next week, but now I am having second thoughts. Let’s see how the rest of this week goes.

    Anyhow, my foot and ankle are still swollen and I was wondering if that is normal and how long that is expected to last. (The doctors don’t give straight answers.) Also, I was wondering what others recommend to apply to one’s skin once the leg is out of a cast. I expected my skin to be dry after being in a cast for six weeks, but it is much worse than I anticipated. Suggestions are appreciated. Thank you.

    Best wishes to all in your recovery.

  33. This was so helpful in knowing what to expect in the recovery process. I broke my fibula (clean break, non-displaced) after a fall in my driveway on the evening of Feb. 8th. The ER put on a temp. cast and I was referred to an orthopedic Physician’s Assistant 3 days later. He said he does not do MRI’s on an ankle fracture to check for soft tissue/tendon damage. He cut off the cast and put me in a walking boot. He said he expects me to start bearing weight by this weekend. I can already tell you that this will be impossible. The swelling has not yet gone down and the ankle is still terribly bruised and discolored. I have fallen twice on the crutches and am currently in the process of trying to get insurance to authorize a second opinion to an actual foot specialist. The pain has been so hard to stay on top of and I feel there is more going on than just the broken fibula. It has been very discouraging, but reading this article has helped me realize that this PA’s expectations are quite unrealistic. Thank you for such a detailed description on your experience and I wish you well in your continued recovery!

  34. Such a great article! I had a traumatic injury on ice with dislocated ankle fracture requiring ORIF. My care was delayed by 15 days due to physician/hospital issues. Like so many people, I can’t begin to describe all the ugly moments because of everyone having their own agenda. When the dust settled I was NWB for 9 weeks. I was sent to PT but it was ABCs and picking up marbles with my toes, wobble boards and standing on each foot for increasing length of time..After 2nd 6 weeks in PT, I was on my own. After a year of pain and limping, I found a new PT. Myofascial release provided relief and increased range of motion. Water therapy brought relief. Moral of the story…We are all different. If your Doc or PT don’t fix it. Try another. There is life after breaking an ankle even if you are in your 60’s. If you know you aren’t a whiner, don’t let the medical system convince you otherwise. It is a slow recovery but it can happen. Don’t give up.

  35. Like everyone else says, it is so useful to read this post and all the responses. It sure gives a sense of ‘you are not alone in this’ and some useful hints for coping.
    I fell and broke my ankle on Feb 7th; had a bad experience as the hospital put my leg in cast and sent me home and told me to come back in 2 weeks time. Apparantly the cast was not set properly and I should have been operated on immediately. So there was no healing. However I have since been operated on week and half ago and had the pins and screws put in. Ortho doc says by this weekend I will be put in a boot which I have to wear for 3 months. I am 65, diabetic, and he found that my bones were soft so I have to be extra careful and will take longer than normal to heal.
    I am not sure what to expect once the boot is put on, so it has been good to hear others’ experiences.
    I can relate to the feelings of frustration and helplessness and low energy and crying.:)
    I wish us all great amounts of healing energy and quick recoveries.

  36. Wow thank you so much for all the information, I broke tib & fib plus protruding bones, had surgery & am I a external fixator, this is week 3, I have another 3 to ex fix removal & if no further fractures on removal will go into a walking cast, if fractures will go into a normal cast. I am nwb now & if I go into non walking cast will be nwb. So I praying for walking cast. I had no idea what to expect this has helped me so much & inspired by your strength. I thank you

  37. Thank you for your post about recovering from a broken leg! I broke my tibia in two places four weeks ago. I had a follow up appointment 8 days ago, and I am scheduled to see my ortho doc on April 1st. That will not happen because of the COVID-19. So I wanted to see what was going to be in my future. You provided great and detailed information, which I appreciate! Guess I am going to get back to well on my own. Hope you are doing well. Stay safe!

  38. Thank you Dana for the helpful post I broke my tibia and fibula in the right leg 3 weeks earlier and i am still on the bed . Next week I will start to walk with crutches and this post and others’ xp will be really helpful for me and i am hoping for good time without struggling to get on with crutches.

  39. Thank you everyone. I fell dislocated my ankle and broke it. I was in Mexico on vacation. Flew home two days later and saw doctor shortly after. Reyplaced the splint original doctor put on and relocated ankle. Painful but necessary. Surgery one week later because I followed orders and swelling went way down. It is almost two weeks later and I see the doctor in a couple of days. I usually don’t want to know what comes next but this info has certainly relieved anxiety for me. Hang in there everyone. We will get through this. In the last couple of years I lost my husband after almost 43 years, smashed my shoulder and had surgery to repair and broke my wrist. I am 70 and know I will get through this too. Have faith.

  40. This post has given me so much reassurance. I wish I had found it sooner. I had ORIF surgery in Austria 9 weeks ago after slipping on ice. Was told my injury was nothing special. Be that as it may, I’m now trying to walk again and dealing with UK hospitals in the middle of a pandemic is a non starter. My cast was cut off and I was given a boot and told that I just had to pretty much get on with it. No physio due to pandemic and the doctors have said, due to pandemic, I cannot have any further treatment. So, I borrowed a walker from my neighbour and now trying to teach myself to walk again. It’s going to be a long slog but so many accounts here have really helped spur me on. After the cast came off, 2 weeks ago, the consultant told me I would be driving after 2 weeks. I beg to differ. I will get there but when I know that I am safe. Thank you Dana and everyone else who has contributed.

  41. Thanks for this post, I have found it an interesting read. I am week 4 post surgery and in a soft cast. I will be non weight bearing until the cast is removed at my next appoint in June and then the work begins.

    Right now I am really struggling, my partner is finding it a drain having to help me, but as soon as I move around my leg swells a lot.

    With 2 weeks left I need to find ways of being more self sufficient.

    Again thank you, gave me some good tips to help.

  42. THANK YOU ALL!!! There is so LITTLE on the internet for a broken ankle! I broke mine 3 weeks ago and all the ortho said was, “Eventually you will want to start walking on it.” I was like – “ummmm……yea.” But besides that, nothing else! I did not have to have surgery but was left scratching my head. Am I doing to much? Not enough? There is no cast (outer bone broke) with extreme sprain. I am so grateful you mentioned the fatigue. I go for rides with my husband (like a dog and look out the window, with an occasional treat at the end) and after an hour, I’m tired and ready for ice and elevation. I try to go to work but only last about 3 hours in the boot because of the swelling. I am not that old so I’m bummed and surprised at how hard it is! I guess I am learning patience, learning to be served, and slowing down and getting closer to God. I pray all of you on here a speedy recovery. Many prayers to all of you. Thanks for sharing!!!

  43. Thanks for your detailed account of your progression back from injury. Also appreciate seeing the comments/anecdotes from other folks, so thought I’d add my own story….

    April 27: Stepped into my pool while skimming (lack of spatial awareness on my part), left leg went to the bottom (~3.5 feet down) while my right foot stayed on the deck. Very painful, but thought… maybe a high ankle sprain?

    April 28: Went to urgent care, x-rays indicated fractured fibula. Referred to Ortho later in the week. Due to covid, that was supposed to be a telehealth appointment. Ortho called me the day of the appointment to re-schedule in person the following week, because he didn’t have all the x-rays he needed (i.e., gravity stress) to make a definitive diagnosis.

    May 5: Ortho appt with gravity stress x-ray. Weber B fracture, borderline unstable. Discussed options (surgery vs. set and cast), and based on my age and activity/fitness level, opted for surgery.

    May 11 (two weeks after injury): ORIF surgery on the fibula (plate and screws). While in there, he did some manual manipulation and was happy with the spacing, so he didn’t need to do the longer pin through fib/tib. Sent home with a plethora of drugs and a beefy splint, NWB.

    May 26 (two weeks post-surgery): Follow-up appointment, transition from splint to a walking boot. Referred for 6 weeks of ROM PT, progressing to strengthening at 6 weeks. Told by the ortho doc to “walk around with crutches for now, gradual weight-bearing.” Unimpressed at the lack of specifics, I found your blog post. :) I like the +25# every two days approach, and utilizing the scale to gauge the weight. I missed the 1 hour per day suggestion on my first read, and am probably doing half that at best, and in much smaller time increments. So will make more of an effort going forward.

    Daily walks (1 – 1.5 hours) and 3x weekly runs (6-7 miles) were my release valve in the early days of the covid lockdown, so suffice to say I’ve been going stir crazy with this injury!

    The ortho doc said (pre-surgery) that I would be at 90% in 3 months. In my follow-up, he said 90% in 2 months, but that the last 10% would take a long time. Meanwhile, PT seems more realistic with a 4-6 month projection. Anyway, fingers crossed that everything continues to improve. So far, so good! 2x weekly PT for now, and next ortho follow-up on June 23rd.

    1. Oh goodness, I’ve been thinking of everyone who’s broken something during COVID-19 and how an already challenging time escalates to a new level! FWIW, if you can still get outside to breathe fresh air and do your WB work outside..I’d try to do that. I remember even pre-COVID-19 for my experience with a broken ankle how much better I felt getting a little bit of fresh air, whether that was during my WB work time or otherwise. Moving your body through space outside of your house makes a difference for mental health, if you can safely do so!

      Regarding the hour a day, I vividly remember my ortho saying that you can get by with less, but to help make improvement, the longer segments and the hour overall are what seem to help people progress, so it’s a good goal to aim for!

      Regarding the last 10% – the last 10% definitely takes a long time, depending on how you assess it! I was walking etc several months after my fracture, but I think it was really the 9-10 mo time frame where I moved past the stage of my ankle feeling stiff when I woke up every morning and needing to really stretch it out to get my mobility going..so there’s lots of little ups and downs still in the last 5-10%. Don’t let that discourage you – keep looking back at where you were the day you broke it or the day after surgery for context on how far you’ve already come!

  44. I am glad I found this post, it has given me some hope. I have been feeling very depressed and hopeless for the last few days, which make every day feel like a year.
    I was exercising in my bedroom on May 12 when I stepped on a shirt on the floor and heard my leg snap as I went down. To make things worse, my husband is deployed and won’t be home for 6 more months. So, I took an ambulance ride to the hospital where they told me my fibula was broken and to follow up with ortho.
    Due to insurance issues I couldn’t get into the ortho for a week. He saw my x-rays and literally said “Holy shit”. Apparently my fibula was broken in at least 3 places and my ankle was nowhere near where it is supposed to be. Due to Covid and more insurance issues I wasn’t able to get surgery for another 9 days, I went in on May 21st for surgery and ended up staying in the hospital for 5 days.
    I am now 4 weeks post surgery. I spent the first week in a splint and then a hard cast. I am looking forward to getting my cast off and into a walking boot in 2 weeks.
    I am having trouble with the loss of my mobility coupled with my husband being gone. Due to Covid restrictions, he wasn’t able to come home at all. I just needed some hope that I will start feeling better soon. I can’t wait to start weight bearing and get some of my independence back. I am so sick of sitting on the couch all day. I am losing my mind! It’s good to hear from other people and to remember that there will be an end to this!

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