Hi Mark Kay aka Gimpy : ),
I am 32 yo female who was in a severe car accident in July 07 and underwent 2 unsuccessful surgeries on my ankle. On May 13, 2008, I finally had to have my ankle fused. I am still in a cast (6 weeks post-op), and my doc is saying he will likely keep me casted for 4 more weeks, then the walking boot.
I just had a couple of questions for you, since you had your's done so recently it must be fresh on your mind. First, when did you doctor start physical therapy? Were you still in the walking boot?
Also, do you walk with a limp when barefooted?
Where do you purchase your shoe modifications? My doc tells me my right leg is now 3/4" shorter than my left leg, so will definitely have to have shoe modifications.
Any advice would be appreciated!
Thank you,
Jennifer

Hi I am 7 weeks post ankle fusion and partially weight baring in an air cast but finding it really painful so have had to continue with crutches. Judging by the date of your posting I am guessing you are around the same stage as me? How have you found it with weight baring.

Regards Angela

Hi there,

I had my ankle fusion in April '06. I had to push for PT...my surgeon (Dr. Chou at Stanford...excellent physician) didn't want anyone pushing and pulling on my ankle, but finally got her to prescribe it after I was out of the walking cast. Also, after the fusion was complete she removed all the screws which helped with pain enormously. I highly recommend getting in a warm water therapy pool as soon as you can. I did several 6 week sessions one-on-one with a PT...it was just the ticket. Not only did it help with improving my balance, strength, etc. it just made me feel so much better!! I had been immobile for so long following a traumatic car accident in June '05 and getting in the water and taking the weight off the ankle and just being able to move was heavenly. I had several ankle surgeries, etc. finally resulting in fusion of the right ankle in April '06. I am now walking more or less normally, with a somewhat modified gait and slight limp. I ride a bike and swim...my MD says no walking (or hiking) for exercise, just what walking is needed to live my life, as more pressure is now being put on the other smaller joints of the foot as they compensate for the ankle, which in time could lead to further fusions as the cartilage in them is getting more stress than it would normally. I wear Merrell (sp?) shoes and KEEN sandals, both are great as they have rounded heels...I put a Dr. Scholl's gel heel insert under the insole of the affected foot in the Merrells and that helps alot. Going barefoot doesn't work so well as the immobility is more apparent and often there is some pain...it's always easier to walk with shoes. Sometimes my ankle almost feels normal...other times I have pain and slight swelling, not severe but there, which is easily addressed with elevation, ice and a couple of Ibuprofen. Also, I have nerve entrapment in the scar which is slowly getting better with time. I do alot of self massage on it. I went to the Stanford Pain Mngmt. Clinic for awhile to try to deal with it. After a variey of drug therapies which did nothing, they recommended Botox injection into the scar but my insurance wouldn't pay for it and so I just decided to let it be and it is slowly diminishing with time. Anyway, all in all, given that I am lucky to be alive, the fusion is something that I can live with. Good luck to all who are going through this...

Hi there,

I had my ankle fusion in April '06. I had to push for PT...my surgeon (Dr. Chou at Stanford...EXCELLENT physician) didn't want anyone pushing and pulling on my ankle, but I finally got her to prescribe it after I was out of the walking boot. Also, after the fusion and I was weight bearing she decided to remove all the hardware which helped enormously. I also had an excellent PT who was very experienced in working with ankle fusions. As for exercise and PT...I highly recommend getting in a warm water therapy pool as soon as you can. I did several 6 week sessions one-on-one with a PT...it was just the ticket. Not only did it help with improving my balance, strength, etc. it just made me feel so much better!! I had been immobile for so long following a traumatic car accident in June '05 and getting in the water and taking the weight off the ankle and just being able to move was heavenly.

I am now walking more or less normally, with a somewhat modified gait and slight limp (my friends say it's barely noticeable). I do yoga, ride a bike and swim...my doc says no walking (or hiking) for exercise, just what is needed to live my life, as more pressure is now being put on the other smaller joints of the foot as they compensate for the ankle, which in time could lead to further fusions as the cartilage in them is getting more stress than it would normally. I wear Merrell (sp?) shoes and KEEN sandals, both are great as they have rounded heels...I put a Dr. Scholl's gel heel insert under the affected side insole in the Merrells and that helps alot. Sometimes my ankle almost feels normal...other times I have pain and slight swelling, not severe but there, which is easily addressed with elevation, ice and a couple of Ibuprofen.

Also, I have nerve entrapment in the scar (probably from the initial surgeries at the trauma center) which is slowly getting better with time. I do alot of self massage on it. I went to the Stanford Pain Mngmt. Clinic for awhile to try to deal with it. After a variey of drug therapies which did nothing, they recommended Botox injection into the scar but my insurance wouldn't pay for it and so I just decided to let it be and it is slowly diminishing with time.

Anyway, all in all, given that I am lucky to be alive, the fusion is something that I can live with.

Good luck to all who are going through this...there is light at the end of the tunnel.

Hi Diana,
I had my ankle fused June 2006 and have had the same problem you are having. It's bad enough we can't wear heels ever again but our options are limited. I've been wearing MBTs since I had the surgery. And yes they are very expensive and not to attractive. You could have some custom made for you -- currently looking into this option myself. I live in Phoenix and found a company that specializes in orthotics. I can purchase a normal pair of shoes and they can add a rocker bottom to it to help me out with movement. I'm sure the cost will be just as much as a pair of MBT shoes but at least I can pick a shoe style I like. I also found an open toe sandal that has a rocker bottom from Curves (purchased through Avon for $40). Same rocker bottom concept as MBTs and they work great. Nike shocks have also worked well for me during PT and general use.
Hope this helps some! Did you have any success in Seattle? Let me know if you find anything worthwhile. If not, this may be a good opportunity to venture into a new business for us :-)

~Ang

I too, experience pain and stiffness after sitting, but once I take about 10 steps, the stiffness decreases! I have arthritis below where my ankle was fused now, which was 8 yrs ago, thus my pain. I know I did not have that problem for the first five years after my fusion though, so I guess I'd have your doctor check for arthritis above of below your fusion. Did you have your ankle done the traditional way or arthoscopically (closed). Mine was done closed and it was a very easy surgery with a very fast recovery compared to the "open" way. It is now that I'm having problems with severe pain again from the arthritis and am looking for anyone else who is five or more years out who is also having problems. I don't know if I am unique or normal. I thought my was gone for the rest of my life and now it's back again. It's very discouraging. I also have a friend who is in the same situation but his pain is not arthritis related (they don't know what's causing his).
We've both even briefly thought of amputation when the pain stops us from doing daily things!

Hi,
I had my ankle fused June 2006. I had a lot of pain once I started PT and walking on my own. I had the same thing happen to me after sitting no matter the duration of the time --it hurt to stand and apply pressure. I also encountered a sharp shotting pain going up the tibia when I walked. Doctor said the fusion looked great but after taking it one step further (x-rays, etc.) he found a small fracture on the tibia where the rod and tibia joined. (On top of the pain my foot was always stiff after sitting, I had to take it easy the first few steps before I could walk again.) Since we couldn't risk a complete fracture on the tibia the dr had to go in and remove all the hardware. I did have to wait until the year was up before the dr would go in and remove anything. He didn't want to risk further complications by removing hardware to early. So meanwhile I took it easy stopped PT right away and took pain meds to help me deal with the pain.

I feel so much better now and feel like I have my life back. I can walk and stand pain free! I know hard to believe! My foot still gets stiff after sitting to long but that's expected and nothing like before.

My suggestion would be to ask your dr for an MRI and have him take a closer look. You are having pain for a reason and if he can't help you go get a second opinion. It's bad enough dealing with the fusion and I'm sure you had it done to eliminate the pain not increase it.

What does your PT have to say about it?

Hope this helps some and know you're not alone.

Good luck and keep me posted,
Ang

Hi!
It's been 2 years since my ankle fusion and I can wear flip flops but they have to be flat and not all the time. I can't wear anything with a heel but that seems like a small price to pay now. Open-backed shoes are a little harder for me to walk in but not impossible. Just don't be surprised if you're walking and it flies off :-) I also noticed that when I wear open-backed shoes my big toe gets a workout and hurts. You'll know what I mean when you try it.

So far the best shoes I've been able to use that provide support and make it easier to walk are MBTs -- check them out
http://www.swissmasaius.com/. Not the best looking shoes but they do the job. After you get us to them you won't even walk with a limp!! I tend to walk with a limp with any other type of shoe, which makes sense since they don't support the heel to toe movement that we need.

Don't be weary just take your time, it will let you know how much weight it can handle. You'll be surprised how soon you'll be walking on it. I know I was.

Hope this helps you some! Happy 4th of July!

~Ang Mares

Hi,
I didn't start PT until after I was out of the walking boot (so that was almost 3 months after surgery). PT will be pretty easy since you foot doesn't move. I was in PT for at least 6 months it started off slow (not to much pain) and slowly progressed to more intense exercises. I did a lot of strengthening, core and balancing exercises. My swelling was pretty bad around the ankle so they did a lot of massage to keep it down. The thing that hurt the worst for me was when they massaged on the incision, I know it was for a good cause but hurt like heck.

I interviewed a couple of PTs before I started therapy. Not all of them are familiar with ankle fusions so it was important for me to know who was going to provide the best care. I actually had one of them try to move my ankle! I had to stop him and remind him that it wouldn't move no matter how hard he tried. Needless to say..he wasn't my therapist.

Are you having any lower back pain? I did after being in the cast and walking boot for so long. So we did some exercises for that as well.

When will you start therapy?

~Ang

Are there any alternatives I should be looking at prior to the ankle fusion that my surgeon is scheduling for this fall? I had cortisone shots today... such pain... I'm back on my crutches again and icing and ibuprofen, hopefully the shot takes effect after the 24 hours as my doctor advised. I know I have weight to lose and have joined Weight Watchers too... any change is a good one.
Please let me know when you knew for sure to have the surgery. I am only 45, I want to enjoy my time with my family and be active... but the pain is near intolerable even with a happy and positive attitude. Please advise. BTW, these shoes... they sound great, where can I buy them in the Vancouver area (Canada), thanks!!

Dear Tammy,

You probably will get by with three months, I did great in the beginning, make sure you get the game ready it is ice machine with compression. It helps with the pain, everyone told me elevate and ice, elevate and ice. It is great advice. I also got a scooter, you put your knee on it to get around great in the house or at school. I went shopping with my scooter and all kinds of things, I rented mine from my doctor. I believe the more you move the quicker you heal.

Now my problem, My fusion was in Jan. 08 after 4months it started really hurting it turns out I have alot of pain in my talar tendon. apparently it is swollen, I got a second opinion and my new doctor put me on a course of steroids, within 24 hours what a difference. good luck Taffy Harlan

Had ankle fusion in December- expect 8-12 weeks. You will be put into a walking boot at about 6 weeks- this gives you some mobility though they say you cannot drive - depends which foot is operated on.Once out of the boot, standing for an amount of time does become uncomfortable but you can get by with the use of crutches - first two then one. It will be a long recovery no matter what they say- you can probably expect 6-8 months for complete recovery. PT helps a great deal as do orthodics.
Best of luck!