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TrevorJ
Trad climber
Aberdeen Scotland
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Topic Author's Original Post - May 9, 2009 - 06:50am PT
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Last week I took a 5 foot leader fall, hit the deck and busted my anle. Ive been in hospital for a week now waiting for the swelling to go down so I can get surgery to put some screws in it. I have a 3 week California climbing trip booked in mid sept. Im not sure how fit my ankle will be by then.
Anybody else done something similar and how long before they got on rock again. The doc says no way but the physio says yes.
cheers
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Porkchop_express
Trad climber
the base of the Shawangunk Ridge
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What was the specific bone that was fractured? Also, how long are they projecting you to be in a cast? My wife fractured her Talus and was in a cast for 3 months and was barely able to climb in 6. It was doable, but not without a lot of pain and weakness.
I would imagine that if you are going to have surgery then it would likely extend the time till you can really climb comfortably. It took about a year for her to get back on track and climbing where she was at the time of the injury.
Not knowing the specifics of your injury I can't say much, but I wish you all the best and a quick recovery. All told patience will be the key for you whether or not you are able to climb in September since it definitely is slow going getting back into it.
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TrevorJ
Trad climber
Aberdeen Scotland
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Topic Author's Reply - May 9, 2009 - 09:50am PT
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Thanks guys. I broke the bone between my heal and tib/fib. It is cracked in half and will need a coulpe screws and there are 3 fragments they have to remove too. They are talking 6 weeks in a cast.
Im bumming as the sun is out i am stuck in hospital. I have been planning this trip for a year and it will be my second shot at doing an El Cap, plus classic 5 star routes. Its a long trip from Scotland.
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rick d
climber
tucson, az
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the Talus has a very poor blood supply so take it easy and follow orders. The single worst recovery detail for me was stretching out my Achilles tendon - but I was off mine for months.
best o luck
rick- no ankle
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neebee
Social climber
calif/texas
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hey there trevorj, say, .... take care and get well and god bless you, as you do so...
it is very hard for folks when their life is put on hold for a while... just keep finding things to keep your mind busy, in the mean time, and be thankful that your life is not completely changed, causing you to have to life in a whole new unexpected way, that could have meant things far-far worse...
also--think of this down as a door to do something that you may not have known you needed to do, or, use the time for something that can turn into a different dream-come-true, concerning something else that is going on in your life, or with your folks, or family, or something... then, in the end, after this break is healed, you will haved walked away with TWO treasures:
your health and some other goal, that was conquered, as well....
best wishes....
(you'd be surprised at the special projects that can appear--ones that'd you most likely rather not have done, as the call to the rocks-and-climbing was too strong to detour from...)
*who knows: paintings to exibit or donate, a book to write, a photo album for family members, .... plan and think, and you'll find something...
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Willoughby
Social climber
Truckee, CA
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Man that sucks. I pulverized the neck of my talus last July. I'm a little surprised to hear that they've been waiting a week for the swelling. Mine swelled up to where my foot looked like a bloated eggplant but they went in immediately anyway. The risk of going in while it's swollen is that things won't settle back in place, but the risk of waiting is increased odds of avascular necrosis (AVN) of the talus, due to what Rick D was talking about. What you really want is immediate surgery, before it swells, but the knuckleheads at the ER misdiagnosed my injury and sent me home with instructions to call an orthopedist the following Monday! Here's a mid-rappel, self-portrait of my own ankle (does this look dislocated to you?):
Anyway, I got a couple of permanent lag screws holding the head and the dome together, and then a whole lot of demineralized dead-guy bone matter to graft around it to hopefully form a new talar neck. No hard cast for me, but non-weight bearing and on crutches for almost 10 weeks. What Rick D says is absolutely right; don't mess around with compliance on your PT or you'll wind up with AVN and then they'll have to fuse the sucker. That may happen anyway; I'll be getting an x-ray this July to see if what's left of my talus is showing any signs of viability or necrosis or what. Anyway, I was hobbled up pretty good all winter, but once the bone heals you can get more aggressive with range of motion and building everything back up. Even though I was skiing a bit this winter, it still hurt like hell, and running was out of the question until about two months ago. Those first laps around the block were absurdly rickety, but since then I've knocked loose and flushed out a lot of the rust or scar tissue or whatever was in there, and it's finally starting to feel pretty good. I'm still way out of balance in terms of strength and such, but I think I could have been working on that more aggressively in recent months. I climbed some slabby stuff back in January, but it felt really weak and hard to trust (plus it hurt - but you just ignore that), but wasn't until about 8-9 months that it started to feel any sort of normalcy. The hardest part, by far, has been psychological, so hang in there!!!!! I think a trip in five months might be possible, but it almost certainly will NOT feel very good in terms of pain, strength, stability, etc. My first skiing was almost exactly 5 months after my surgery - doable, but rough. My advice would be to get really aggressive with PT for the 3-4 weeks leading up to your trip and I'll bet you can speed things up, but listen to your therapist and don't try to push things too early. Good luck and heal well!!
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Ksolem
Trad climber
Monrovia, California
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The issue of blood supply to the injured part has been mentioned and is an important factor.
Find out from your Doctor how soon after surgery you can begin a program of serious aerobic exercise. This will serve you well in several ways: increased blood flow to the injury, overall better fitness during and after recovery (faster comeback to sport,) and it will help you keep a positive attitude.
Obviously having one leg in a cast will require you to be somewhat creative to find sustained aerobic exercises which are fun. A few things come to mind including a good daily bout with a heavy punching bag, the speed bag, etc. (good for working out frustration too.) Juggling progressively heavier balls is another one. Also, some gyms and P/T places have a machine like a stationary bike but you can “pedal” it with your arms. These are great. And do lots of push ups. Your shoulders will thank you when you get back to climbing.
I’m sure taco members can come up with lot’s of ideas for ways to run up your heart rate while being safe on your leg.
I would also look into the subject of meditation for healing.
Disclaimer: I am not a Doctor. I have healed a fair number of difficult broken bones though.
good luck!
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mongrel
Trad climber
Truckee, CA
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I had a bad broken ankle once, but returned to rigorous field work (much hiking on uneven ground) in 4 or 5 months. Mixed prospects for your Sept trip. It would set you way back to injure it again with screws still in, even if they're just holding a chunk of bone back on. So just do NOT fall; why did you do that in the first place???? Yosemite cracks will not be good on it, nor slabs, but steep face and aid might be OK except you likely will want to belay on a portaledge so you can elevate a bit (even after all that time). My recollection is, the hardest thing was walking down, not up. So getting down the E. Ledges descent with a bag will be difficult but doable, probably very slow.
More significantly, 6 weeks in a cast sounds like WAY too long. Med folks can weigh in, but I thought the modern way was to start some minimal movement and PT within a week to 10 days of surgery at the latest; this would seem to be especially true for parts with poor blood flow. I'd seriously look into this. Even if the med ghouls who've got you in their clutches won't start working the limb itself, Ksolem is right, start on your own to exercise on a bike or whatever. The more you get your whole body circulation going, the better the healing. All that said, some of the most regular posters on ST have recovered from the most grievous imaginable leg injuries to go on to decades of Yosemite walls, obscurities, huge first ascents, so take care now and you will have forever to pull off your climbing plans.
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oldcragger
Trad climber
Truckee,CA
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Not the same injury but I'm in the same situation as you.
I took a lead fall two weeks ago and swung into the arete, small fracture in the talus and ruptured the achilles. Reattachment surgery this Monday. Two months in a cast before PT. I too am concerned about loss of range of motion and regaining strength off my toes. Any and all advice is welcome.
Michael
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Fishy
climber
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Please dont confuse a "regular" broken ankle with a Talus fracture.
As neatly outlined above - AVN is a major concern, and the worst case outcome is really bad (a fused ankle, no more movement for life).
I have been through a Talus fracture, and it is not pretty. 4 months with external fixator, then anouther 2 months before any weight bearing, and 12 months before starting any real activity again.
Even now the ankle is partly fused, easily aggravated, and not at all happy with humping heavy loads.
Good luck - I hope you get going faster than I did.
Cheers
Pete.
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seankirsch73
Trad climber
Mountain View, CA
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Trevor,
Aah bummer dude. I broke my talus bone climbing myself. I was in a cast for 10 months. Cracked it right in half. The whole bottom part was in splinters.. too small to pin. Now its a little misaligned, but manageable. It really sucks b/c it doesn't get as much blood flow as the larger bones so takes longer to heal. Good luck to ya.
The only advice I could give ya, is don't blow off the therapy. I was in really good shape when I broke my ankle and figured I didn't need therapy and that I would recover on my own, but the range of motion exercises, albeit as painful as they are, are invaluable. Your muscles and balance will start to compensate in other ways if you don't start it and keep up on it right away.
You will get good driving one legged and pushing a grocery cart with your cast on the bottom shelf though. I would crutch through the grocery store steering with my casted foot. Its miserable, but its better than being totally dependent on someone else.
S
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Willoughby
Social climber
Truckee, CA
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Oldcragger - is Dodd doing the surgery? He and Halat did mine, and they really did a great job on what was an absolute mess. I know because I sat up and watched the whole thing. Pretty surreal. Tom Deurloo was my main PT guy, but there's loads of competent folks around. He and Sabine Endriss were very knowledgeable and helpful in getting me back on my feet. FYI, in that same PT office, I was not impressed by Laura Mohun (I don't think ankles are her thing). Good luck!!!
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TradIsGood
Chalkless climber
the Gunks end of the country
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It is very likely El Cap will still be there next year.
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TrevorJ
Trad climber
Aberdeen Scotland
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Topic Author's Reply - May 10, 2009 - 06:51am PT
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Wow thanks for the advice and support. I was only 5 feet off the deck was, just putting in my 1st piece of gear when my foot slipped, I came off and I landed badly. I broke the big rule, the leader doesnt fall. I went to the ER and they told me it was sprained. 2 days later they called me back as they thought they missed a fracture. By then it was very swollen. Its coming down and hope to get it sorted this week.
I wanted to be strong for the trip, the idea of going all the way to CA and not climbing at my best is not good. I grew up in Tahoe and was looking forward to going back to climb at Donner summit and the Leap. Last time I was there to climb was 1980.
I going to stay positive, take 1 day at a time and see how the ankle gets on get alot of PT and take it slow. Thanks again every body.
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pip the dog
Mountain climber
planet dogboy
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May 10, 2009 - 09:11am PT
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Trevor,
I’d urge you to talk to the very best PT you can find (someone focused on injuries in active athletes) -- even before you have the surgery.
Ask them about which MDs do the best work for those who intend to return to ankle intensive sports, like climbing. That and ask about the best protocols for maintaining ankle strength and flexibility. There are some simple things, like replacing the cast often to change ankle angle during early recovery, that can make a big difference in the speed and quality of the outcome. The kinda things that aren't standard routine - but they always do with professional athletes.
I dated this excellent woman who was training as a PT about a year after I broke my right tib/fib combo just above the ankle on a way too high “highball” while in college. While not an ankle, I ended up with ankle ramifications. She and (more to the point, then) her then faculty were appalled at some of the decisions the MDs had made about me. With that they offered all manner of very high quality "should have" insights.
Perhaps details later; right now my climbing buddy/chauffer Lupe is standing behind me howling “TIME TO GO, IDIOT!” (and i mean _really_ howling; most defininately not a morning person).
That and I’ve already told you the one piece of useful advice I wish I had heard earlier -- find a really good PT and talk to them BEFORE the surgery. Other than that I have no special expertise in this arena.
Finally (sheesh Lupe! - just 30 more seconds…) the fact that Lupe and I are planning on some routes as hard as anything I was doing before I demolished my tib/fib is evidence that these things can work out well. They eventually did for me, just took longer than it needed to.
All the best,
^,,^ (michael)
and with that we be outta here… wooosh…
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ron gomez
Trad climber
fallbrook,ca
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May 10, 2009 - 10:08am PT
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I'd go see a good Certified Athletic Trainer for the most aggressive and fastest recovery, that's what they specialize in. That being said...healing has to take place first and foremost, but there are things you can do in the mean time to prevent any further atrophy of surrounding muscles and to keep the rest of your body in condition. Shoot an email if you'd like to talk about specifics. Certified Athletic Trainers work with athletes in getting them back to competition as soon as possible under the given conditions, P.T.s work on getting people back to function. I'm not saying that you won't get good results with a PT, but I'd go to someone who's background is working with athletes at a competitive level and getting them back to a competitive level ASAP.
Peace
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scooter
climber
fist clamp
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May 10, 2009 - 11:24am PT
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TJ-
You can recover in time. Eat really well. Don't smoke chronic amounts of anything. That way your blood oxygen saturation is always high. Drink a lot of water. Think positively. Also current studies have shown that music, especially reggae (no Bullshiz) helps speed recovery. Something about the levels of seratonin released while listening. Those are little and simple things that will help.
hope you get all healed up and a trip out to California.
Pat
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Zander
Trad climber
Berkeley
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May 10, 2009 - 03:37pm PT
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Good luck TrevorJ!
Zander
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kimgraves
Mountain climber
2 exits North of the Gunks
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May 11, 2009 - 08:32am PT
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I missed a dyno in the gym and fell from 3 feet breaking my ankle - no longer remember which bone. 6 weeks on crutches followed by 6 weeks of rehab. I was back easy climbing after about 4 months. But it didn't really feel normal (so I didn't notice it) for a year. You loose a lot of muscle tone when you're on crutches. Do try to swing your broken foot as you use the crutches rather than keeping it still. Even that little movement is supposed to help.
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mooser
Trad climber
seattle
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May 11, 2009 - 09:20am PT
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Heal well, TrevorJ! Sorry about the mishap.
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