Broken ankle

[Lemongirl]

Hello, I haven't posted here for a while but was hoping for some advice.

 

My 16 year old dd has recently broken her ankle.  She's been in a boot and walking with crutches for the past 4 weeks, they've said around 6 weeks for it to mend.

 

She doesn't dance as much as her sisters but was hoping to start a modern class just before the injury.

 

At her check up today, the doctor said it could take up to 3 months to heal completely and sometimes even longer.  She's going to start physio in a few weeks to help with the movement.

 

She's keen to get back to dance as soon as possible but I imagine it's risky going back too soon?

 

Has anyone experienced this type of injury and is there anything she can do to help the healing process?  Thank you.

[taximom]

Sorry to hear this, the after effects of an ankle brake can be quite long lasting and it would be worth asking if your GP can refer you to one of the NIDMs dance injury clinics at Bath, Birmingham or London, if you can get there.  The physio is for dancers and they know what they are doing - https://www.nidms.co.uk/. 

 

Best wishes

Heather

aka Taximom

[Lusodancer]

I have. I have also broken two wrists separately. All doing sports. But as an adult.I am also an amatuer violinist so my ability to play at the same level was affected by the two wrist  breaks. I have lost some extreme rotation required for playing high on the finger board on the lowest string and fine bowing.

 

I am a dentist so I have some knowledge of how bones heal. All I can say is allow a full 6 months for full calcification before loading heavily. My healing process made me adjust my working practices as a dental surgeon with a view to placing implants and loading them with crowns or bridges. My colleagues may chose to place crowns at 4 months, but I will load only after 6 months.

 

After a break we have connective tissue organisation and then immature bone forms after approximately 4 weeks. Bone cells turn over about every 6 weeks, so plaster or boots are removed about this time but the patient feels much more fragile in those first few weeks after losing support.At about 4 months bone is reasonably dense, but my personal experience is that I was still feeling that strange internal itching sensation of changes occuring up to 6 months, hence my approach to implants in my patients.I did not 'feel' fully recovered till 6 months at least. 

 

Physiotherapy is essential when advised and indeed recuperation is helped by flexing and relaxing muscles inside the boot to maintain muscle mass and flexibility before it is even off. Young people may recover sooner and with growth hormone bone cell turn over will be a little faster. However unless your orthopod has also suffered such breaks, he may know the medical theory and physiology, but cannot speak from personal experience as to what it 'feels' like .

 

Please advise patience to your dd. She can support her school in other ways if she wishes, backstage, costume prep, music cuttting, social media publicity, poster design.....lots more to learn and also welcome help for the teachers. Silver linings and all that.

[Pups_mum]

I am currently recovering from a car crash in which I broke multiple bones and although they have healed I am still not "better" 8 months on unfortunately. Admittedly I am a lot older than your DD, and my fractures were complex, both of which will have impacted on my recovery time, but even allowing for that I would urge caution. Patience is definitely a virtue here. Even when the bones are healed, the soft tissue damage can take some time to recover, and the loss of muscle that results from immobilisation is often quite dramatic. Proprioception - the sense of knowing where your body is and how it is moving - is also often altered after an injury and has to be relearned. These factors mean that the risk of further injury is increased during the recovery phase so it is really important to follow physio advice and build gradually back up to full activity. It is very frustrating,  especially for someone who is usually very active, but I would encourage your DD to be patient. Returning too soon after injury runs the risk of actually prolonging the recovery.

I hope she has an uneventful recovery and feels better soon.

[LinMM]

I'm currently recovering from a trimalleolar fracture of the ankle sustained the first week of August in a ballet class!!

 

Ive broken both ankles before ( twenty years ago and fifteen years ago) but they were very simple fractures.

The first one took about six months before I wasn't even thinking about it anymore. This one I slipped on some wet grass and sort of sat on it. 

The second one ( same as leg now) took 9 months to get to this stage but was more of a wrench when I did it as I was running trying to catch up with someone and it sort of twisted and I went over sideways. 

 

I remember the first one ......after about five weeks was charging around on the plaster and when it came off was shocked just  how weak the foot was and how much muscle tone had been lost in the leg  😢   It was reasonably strong though about four months later but I was nervous on uneven ground and walking on the pebbly beach here ....even though that was probably good for it!! 

 

If if you pay attention to the ankle and the signals it's giving you it will sort of let you know when it's ready to do what .....when can you stand on one leg without any pain for instance ....a basic for ballet ....or being able to rise onto Demi likewise ....do a full Demi plié ....walk without limping too much ....There will be a natural point to return to ballet class and times may vary depending on the complexity of break and age etc. When it's ready some ballet exercises can be beneficial of course for the ankle and your DD can always start by just doing the barre initially. 

 

With a more complex break needing surgery (as is my current one ....now got bits of metal holding bones together) things will take a bit longer. Personally Im hoping to be back at the barre by next February/ March/ April depending on how it goes. 

Im nine weeks in and walking ....or rather hobbling around the house without the crutches but need them outside and the foot gets tired so limits too much walking at mo but at least the big boot has been ditched....first time I've recovered with a boot rather than plaster and it's much better. I've started writing the alphabet with my ankle but letters are a bit small as yet!! 

 

I will add that I'm also a lot older than your DD!! Definitely granny age to her age 😉 She definitely has age on her side if it's a simple break too. 

 

Sorry to hear about your accident Pups mum that sounds really traumatic and am sure completely zaps your energy and confidence. 

Hope you get back to full health in the very near future. 

 

 

 

 

 

 

 

 

Edited October 22, 2019 by LinMM

[alison]

Again, once she does get back to somewhere near class-taking level, I'd guess floor barre might be a good idea first, as non-weight-bearing, but obviously take professional advice.

[Lemongirl]

Thank you all for great advice and for sharing your stories.

 

Since I last posted, we have been back to A&E!  The top of dd's foot was red, hot and swollen this morning.  After a 3 hour wait in A&E, she has been given antibiotics and told to rest.  Some sort of infection/inflammation or cellulitis.  No idea what caused that....

[LinMM]

Has she been walking a lot in the boot? I had the boot but was non weight bearing for six weeks.....though even this can vary from consultant to consultant!! Some like you to try walking sooner in the boot. It was only four weeks ago for your DD  so perhaps not too much weight bearing? Just a bit. Unless she has been advised to. Has she been keeping her foot raised.....I was really rigorous about this and as I had to wear the boot to bed had it up on pillows in bed too. It could just  be unlucky one of those things but may be best to rest it at mo.

 

However when I had my accident I was in London so all first treatment and operation etc were at University College Hospital ( my old hospital when I used to live in London) but then transferred down to the Royal Sussex in Brighton.

The surgeon who had performed my operation had indicated that after stitches were out a further four weeks in plaster so non weight bearing for six weeks altogether. 

However the Consultant here in Brighton who I saw on the day the stitches came out ( just under three weeks since the op) said he would manage it in a boot and to start some weight bearing 😳 already. I said isn't it too soon to weight bear and he said not in my opinion!! 

He could see my somewhat aghast look and said you'll be fine the metal will keep the bones together as long as doesn't move out of place 😳😩😳😩 What!! Another aghast look....But what about my age I said ....So what was virtually his reply!! 

In the end he said well it's up to you ....you can be non weight bearing for six weeks ( as suggested by the other hospital and Consultant) or you can try to weight bear it's up to you  🤔🤔🤔🤔 .........

He then explained that the Royal Sussex is classed as a major trauma hospital but UCH isn't .....implying that the trauma hospitals are more up to date in treatment. Well I didn't believe him but when I got home I found it was true .....the huge impressive looking UCH isn't classed as a major trauma hospital but Brighton is...but it just  looks such a mess at the moment .....lots of rebuilding going on ......you could take one look at the moment and think glad that's not my hospital!! 

In the end though I couldn't get the idea out of my head that I might move all the metal work out of place and require another op .....just my luck sort of thing....so went the no weight bearing route as felt safer to me ......and as advised by the Consultant who actually did the op.....and who probably thought God what horrible feet better keep her off them for a while 🙄   even though I know these days they get hip replacement people up and about in the first week. 

Having read quite a bit about it now it seems to me that you may get people walking a bit more quickly initially but 12 weeks down the line the recovery rates for general movement of the ankle are pretty similar. 

 

Anyway hope your DD 's foot calms down soon ....have you got one of those gel things usually a blue colour you can put in the freezer and then wrap around ...with a cover on....to cool things down. You can get them from Boots.

 

 

 

 

[Lemongirl]

Gosh LinMM that sounds so confusing!

 

So the consultant we saw just after she did it said she could weight bear as soon as it was comfortable.  He said as the fracture was horizontal, bearing weight would help the bone to fuse.  For the first few weeks it was too painful to bear weight but after that dd started to put a bit of weight on it when she could.

 

So I'm still not sure if weight bearing makes things better or worse!

[LinMM]

Me neither!! 

If I had been a lot younger I would have probably gone for the earlier weight bearing but decided to play  safe!

[Vonrothbart]

I had horrible ankle problems when I played rugby, caused mainly by playing before it had healed properly. The bone can be straight forward, although bad enough, but the ligaments can be far worse if they have stretched at all. When you think / told it has healed, give it another couple of weeks.

[Lusodancer]

Dear Lemongirl, 

How is you DD now? Have the antibiotics kicked in? I do hope so. Keep paying attention and ask the medics lots of questions. Don't take one opinion for granted. There are lots of examples above of different circumstances , healing times and results that should let you realise that case is perculiar to its self. In Portuguese 'cada caso é um caso'. Each case is a case. Thinking of you and your DD

[Dance*is*life]

I broke my ankle twenty years ago and it took me 6 months to get back to dancing again properly. I was in plaster for 6 weeks but did gentle exercises all the time and when they took the plaster off they were really surprised at how well I'd kept the muscle tone.  Physio and patience is the order of the day. I do remember going to the physiotherapist for the first time and telling her that I'd lost a great deal of flexibility and couldn't point properly.  She asked me to point and seemed to think it was fine - until I showed her my other foot!!!!  The moral is try and find a physiotherapist who works regularly with dancers!

Edited October 26, 2019 by Dance*is*life

[LinMM]

Yes you don’t get many shots at the hospital physio if they think it’s progressing normally ..my next one is now in another four weeks...has been fortnightly ... so I think that will be the last on the NHS and will then switch to my physio who is more dance orientated (but not cheap) to start preparation for returning to ballet ....look beginning to middle of Feb at mo ...starting with one barre/ class ( minus jumps) a week if all carries on going well ... so will be roughly six months since accident then. I will be 72 by then so am lucky I think!! 

[glowlight]

1 hour ago, LinMM said:

Yes you don’t get many shots at the hospital physio if they think it’s progressing normally ..my next one is now in another four weeks...has been fortnightly ... so I think that will be the last on the NHS and will then switch to my physio who is more dance orientated (but not cheap) to start preparation for returning to ballet ....look beginning to middle of Feb at mo ...starting with one barre/ class ( minus jumps) a week if all carries on going well ... so will be roughly six months since accident then. I will be 72 by then so am lucky I think!! 

 

Oh LinMM - what an inspiration you are.  Most 70-somethings would be happy just to be walking properly 6 months after their accident, let alone dancing.  Good luck with your recovery.

[LinMM]

Thank you glow light .....it’s hard for me not to have at least ONE ballet class a week though🙄

Theres no guarantee that I will be ballet ready by February but I’m guessing that as it’s nearly 11 weeks now another 11 weeks or so should do it!! The foot is feeling quite strong now but flexibility will take longer 😬 
 

[Lemongirl]

Thank you all so much.  Antibiotics are kicking in although they make her feel a bit sick 😞 Better with food.  We should hopefully be covered privately for physio so will ask the consultant about that.

[LinMM]

Glad your DD on the mend

The hospital physios are usually okay very initially just to get you walking again and giving some simple exercises for flexibility etc....mine was brill last week as I just mentioned I needed more confidence with stairs and she had me walking up and down the hospital stairs with a crutch and then without..  really useful for me .......but you don’t get seen that often in the end unless your case is particularly complicated ...so for anyone hoping to get back to any Sport or Dance ...especially young people ...once beginning to walk without crutches it may be best to organise own physio especially if it’s someone you know and trust although of course you have to then pay unless covered by insurance etc But worth it!