Me and My Trimalleolar: Walk a Mile in My Screws

Today is November 20, 2011 nearly one month after my last post.  So much to share and so little time!

On October 26, 2011, I had a post-surgery follow-up appointment with my OS.  It was exactly two weeks from the day of my second surgery and two weeks of nonweightbearing on that left foot.  This 2-week mention is important, because the surgeon previously told me it could take up to six weeks for the hole (which once housed my syndesmosis screw between two bones) to fill in.  I was delighted to see the surgeon’s enthusiasm when the x-ray revealed no trace of a hole.  My body, with a lot of help from my (high-calcium, high Vit K, high vit C) plant-based diet and the Frequency Specific Microcurrent machine (I think this played the most major role) expedited my recovery.  No hole.

I knew something was very good when the surgeon remarked (with enthusiasm) about how great my recovery was on more than one occasion.  She looked at me and said, “Your bones are healed.”  I was told to bear weight as tolerated, stay in the hiking boots for support, be off of my crutches in a week, and to call her if I had any questions.  She gave me a permission slip for freedom, and I began to tear up.  Life was so good.  So very good.

My dream-like state was quickly ripped back to reality (envision that sliding record player needle-on-a-record sound you hear on TV or in the movies) when I shared a concern about my left knee that was buckling/sticking popping. I really didn’t think much of it and simply wanted an opinion.  I mean, the pain was tolerable, and the only real issue was that my knee got stuck and in order to unstick it, I had to move it in a certain way to make it crack.  I didn’t think much of it, that is, until they whisked me back to x-rays and gave me a script for an MRI.  An MMT, turns out, is something (Medial?) Meniscal tear.  That was the presumed diagnosis (presumably brought on by the initial injury and unnoticed due to my only recently bearing full weight), and would require another surgery for repair.  I could not believe what I was hearing, and actually, did not.  I called up my denial mechanism, and it came immediately to my rescue.  I could not and would not believe there was another surgery in my near future.  Sure, next year (July or so), I was okay about getting the rest of my hardware removed, but that’s considered noninvasive and another move toward normalcy.

I left the office with nary a care in the world, because I was healed and blissfully relishing in the joys of denial – my all-time favorite defense mechanism.  And THAT is exactly where I planned to place my focus, on healing.  Walking did not initially come to me as easily as I envisioned.  It actually hurt like hell.  I thought I’d be dumping Starsky and Crutch in a day or two, but alas, I held onto Starsky for nearly two weeks (after 1 week only in the morning and at night when I really needed him).

On Friday, October 28, I was back in PT and given the goal of walking 1 mile on an uneven surface without assists (crutches, etc).  Two days later I took my first walk on the beach since July 2!  I was so elated!  While I brought Starsky for company, I didn’t use him.  I did, however, hold tightly onto Scott’s arm for about 85% of that walk. It was intimidating, even with my hiking boots.  My foot bobbing all around in the sand.  Still, I was so thrilled to be back on the beach.

On Thursday, November 3, exactly 4 months from the date of injury, I walked 1 mile on the beach (an uneven surface) without assists.  I went back to PT the next day and told her I reached my 4-6 week goal in less than a week, and she upped the ante.  Walk 1 mile on the beach without shoes in 3-5 weeks.  I told her that I could walk that shoeless mile in 3 weeks or less!  Walk that mile!

On or about November 6, Scott took me and Stella out for a walk.  We went to the park where I used to walk Stella every morning.  I’ve been holding off on going there, because it’s very bumpy, rocky, muddy and has steep parts.  I managed to walk another mile or so without help except on the steepest parts.  My feet simply don’t bend that well still.  I was so happy to be back out there.  Happy!  I’m aware that I can tolerate the pain because it’s so exciting to walk again.  I hope the pain wears off before the excitement does!

On November 17, my MRI (Did you ever have one of those?  WEIRD!  I felt like I was on stage with some heavy metal band – peculiar, obnoxiously blaring, distorted, sounds)  revealed a “fold” in my meniscus, but the OS does not think it’s a tear.  She thinks that the months of nonweightbearing lead to weak knee muscles and that my knee cap is moving off of its ridge (the locking/sticking), and when I walk and kick out my knee is gets back into place.  She prescribed even more PT for my knee to strengthen that muscle.  If the problem does not correct itself, she will go in with a scope (didn’t ask, didn’t want to know).  As I was walking away from her after our meeting, she enthusiastically noted how well I was walking.  I smiled.  Funny thing.  Walking does not come without pain, which usually leads to a limp.  Here’s what I do to overcome the limp:  I pretend I’m an actor who is acting like someone who doesn’t have an injury.  With that, I focus on my even steps and limpless walk.  It’s quite validating to have the surgeon (and also the PT later that same day) comment on my limpless gait.  Turns out, this whole acting thing works.

Today is November 20.  I am up to 2 miles walking on uneven surfaces in sneakers.  I would try walking shoeless, but it’s too darn cold.  I can now balance on my left leg for up to 2 minutes before I start to feel the burn of those underused muscles.   I: can take steps with more ease, can stand and turn in the shower without the fear of falling, can walk to the bathroom in the middle of the night without excruciating pain, can carry things in two hands without the worry of toppling over, can sometimes look up while walking, can sleep without elevating on three stacks of pillows, can be on the floor and get to a standing position in two movements (and without holding onto the table, the sofa or any other solid piece of furniture) instead of about seven.  I am beginning to feel like my old self.

Here’s the stuff I need to work on:
1.  Building up/strengthening the muscles in my left leg/foot
2.  Breaking down scar tissue (myofascial crap) which is preventing me from gaining range of motion, causing (or perhaps is the cause of) inflammation, and leading to some of the pain.   My muscles are all caught up in the scar tissue.  This lends itself to some of the pain.  I need to continue building strength.  The other day, I was walking and pretended like I was going to run.  I took the first running step and clearly my foot was not ready for it.  The muscle screamed at me and threatened to crumble under pressure.  I backed off.
3.  General range of motion stuff (in all ways, left, right, up, and down)
4.  Focusing on my gait as not to throw the rest of my body out of whack.
5.  My confidence, which has been badly shaken by this whole experience.

Last I checked at PT, I was at 10 degrees dorsiflexion and 34 plantar-flexion.  My right foot goes 25 degrees dorsi and 64 plantar.  I have a way to go even though I was told that 15 degrees dorsi is where most people are.  I want my left to be exactly where my right is.  I want them to be equal. And equal they shall be!

And you, too, can walk a mile in my screws.  Check out all my Trimalleolar Posts here.  Things DO get better!

screws and plate trimalleolar fracture
Me and my screws – minus the syndesmosis which was horizontally located just about at the bottom threads of the vertical screws.

Trimalleolar fracture xray

Trimalleolar fracture x-ray
One down, seven to go!
Trimalleolar fracture remove syndesmosis screw
Nasty.
syndesmosis screw removal trimalleolar fracture
October 26 – post-op (#2) follow-up
removing stitches syndesmosis screw surgery
Tanya, the expert assistant removing my stitches

To see all the  posts in the trimalleolar series, click away!  Things DO get better!

Post #1 Me and My Trimalleolar:  A Life-Changing Tripulation
Post #2 Me and My Trimalleolar:  Transcending the Funk
Post #3 Me and My Trimalleolar:  Tiny Bubbles of Progress
Post #4 Me and My Trimalleolar:  A Healing Ankle
Post #5 Me and My Trimalleolar:  Talus All About It
Post #6 Me and My Trimalleolar:  A Week of Firsts
Post #7 Me and My Trimalleolar:  Cast of Characters
Post #8 Me and My Trimalleolar:  9 1/2 weeks…
Post #9 Me and My Trimalleolar:  The Screw, Some Scars, and a Busted Uvula
This is Post #10  Me and M Trimalleolar:  Walk a Mile in My Screws
Post #11 Me and My Trimalleolar:  11 Months and Moving Right Along
Post #12:  Me and My Trimalleolar Go to Mexico…with my husband and our pooch

13 Comments

  1. Nicole

    Hey there! I’m so glad I found your blog. August 28th i was in a car accident and sustained a trimalleolar fracture. I read your first blog and really related with what you said about the universe telling you to slow down. Before, I was always working. I work in a lab drawing blood. Always busy, always moving. Sometimes doing extra work to help my supervisors. I was on my way to work that morning. I guess I needed a break. Being always up and about to not being able to, really puts a damper on your life. I cried that whole first month. I had a doctors appointment this past Wednesday and the bones are healed but I still can’t walk till the ligament heals. When that heals they want to remove those screws (can’t think of the name). The time definitely goes fast. Just not fast enough. It sucks not walking. It sucks not being able to do stuff for yourself. Showering sucks,each move has to be thought out. And now I’ve noticed my kneecap is kinda off. Did yours fix itself?

    1. Ciao Nicole!

      I’m so glad you found my blog too. Thanks for writing in. I’m just sorry for the reason that brought you here. I can see that you are an active, on-the-go woman. I imagine working in a lab is even busier work now than ever before given the pandemic. I also know how difficult it is to be very active and then suddenly being forced to a screeching halt. Like you, I shed a lot of tears those first weeks. Bouts of mild depression are totally normal in a situation like this.

      Now you’re 2 months out and your bones are healed – that’s great news! My guess is that you have a syndesmosis screw (s) like I did. Not many on this blog have had the torn ligament too. Did you by chance dislocate your talus? Those syndesmosis screws are removed at 12 weeks. Is that the timing they told you, too?

      I hear ya…it all sucks: not walking, not being able to do stuff for yourself, navigating a shower. Do you have help at home? This is difficult timing with the pandemic. I hope you’re getting support. My heart really goes out to you and to all the others on our Tri-mal team who are dealing with this injury in the age of COVID. That’s an additional burden to bear.

      Yes, the kneecap worked itself out but I did get some help from the PT to build back strength and I used a lot of arnica and I gave it a lot of attention like heat and little massages while watching a movie at night. Are you in PT? I hope so. Let your OS and your PT know about the knee situation.

      Please keep us updated if you get a chance? This shall pass even if on some days it doesn’t seem like it will pass quickly enough.

      Cheers to you and your healing,

      Kenda

  2. Hazel

    Hi Monika – I suffered a Trimalleloar Fracture almost 1 year ago. 3 plates 19 Screws. I found it really difficult and searched the net hoping to find answers as it was both a physically and mentally challenging time.

    PT will really help and you have to dedicate the time each day / Night to improve. You will be in pain but I had to tell myself it was good pain and that the pain was aiding my recovery.

    Purchase walking boots and wear them for at least 3 months – they were an invaluable purchase for me.

    Swimming and Hydrotherapy was another fantastic method in helping my recovery.

    I was in pain and suffered swelling for almost 6 months ( although it reduced over the months)

    I adopted a positive attitude and set myself waking goals extending the distance each week. And still 1 year down the line continue with my PT exercises and now yoga.

    3 weeks ago I was walking 10 miles per day ( lockdown) I still suffered some swelling but my strength has improved dramatically.

    Things will get better – my ankle including all the metal work is only a fraction bigger than the other one.

    The scarring from the op is still pretty noticeable however has faded .

    I had to keep pushing myself even though at times I did not have the physical or mental strength.

    You will get there and each time you move forward you will feel good and also grateful.

    It’s not easy you will have ups and downs just keep a positive mindset where possible and you will do it.

    I never though I would get to where I am – last week was the first time I have been able to wear boots with heels – that was another obstacle I wanted to overcome personally .

    I wish you a speedy recovery at the beginning the mental challenge will be more that the physical

    1. Hello Hazel,

      Thank you for sharing your journey of hard work and positivity with us! It looks like you’ve emerged from the difficulties and life is getting back to normal for you. That’s great!

      Feel free to stop back any time with updates.

      Cheers to you and your healing,

      Kenda

  3. Jamie

    I am so glad I found this blog. I joined this unfortunate club February 16 when I was knocked down wearing roller skates from behind. It has been such a roller coaster. I had ORIF and tightrope syndemosis in February 22, 2019. Even though I am 5 months post operation, I still have a lot of stiffness and swelling. I have tried compression sleeves and socks and taking Aleve. I walked a block to the beach yesterday and walking in the deep sand was pretty painful. Every time I try to do more the swelling and pain gets worse. I know I need to build up my strength and look forward to being able to do every day things like walking down steps without so much effort. Any advice you can share is helpful! What kind of shoes or sandals would you recommend?

    1. Hello Jamie,

      I’m glad you found this blog, too. I’m just sorry you had to. But you got the injury doing something fun! Did the person who knock you down help you up or did s/he just skate away?!

      It is a rollercoaster, for sure. I don’t know what tightrope syndesmosis is, but I assume that’s a procedure that replaces the syndesmosis screw. I think that’s probably better than the syndesmosis screw, because you won’t likely need the second surgery. Having had a syndesmosis screw, I had to have it removed at 12 weeks.

      You’re right, you have to keep working on building up strength. Swelling and stiffness is a normal (and unfortuante) part of healing through this injury, but if you think something doesn’t seem right, go back to your OS or check with your PT. I moved from the walking boot to hiking boots for a couple of months, but that could be difficult (hot and cumbersome) in the summer. A couple folks on the blog have worn Birkenstocks if you’re feeling groovy!

      Please keep us updated if you feel like it!

      Cheers to your healing!

  4. i had trimallular r. ankle fx. severe dislocation /surgery 9 screws, 1 plate , no syndesmosis screw however, when i prob needed one, asked nurse when my recent MRI showed WEAKENED ATFL ligament, SHE said, thats a given, so if it was agiven and torn, why the heck didnt he fix it at the time of surgery, PT tell me i wont ever have full range of motion with hardware in there. so i had 2 tibia screws removed, due to pain, surgery was a yr and 6 mos ago. still have instability, left knee buckled ,fell ,broke l. wrist, 3 mos. ago. still dont have rom like other foot, still have pain, still have swelling 2 spots, i know it wont ever be like GOD made it, but i think i dont want reconstructive surgery to repair ligament(s?) that shudda been done at time of injury. i go see an ankle specialist next. take him everything, see what he says, i wish i had agood lawyer, for medical negligence, haha

  5. Kenda

    Amanda I have to share something with you. Last night I had a dream that I was looking at my email and I saw a new blog comment. Here’s where it gets nutty: When I looked at the name, it was “Amanda.” True story! I actually dreamed about your comment. How wild is that?!

    On a more pertinent note, I very glad to know this blog has answered many questions for you. Thank you for taking the time out to let me know. It really means a lot to me.

    I hope you’re well on your way now and doing okay.

    Cheers to your healing,

    Kenda

    1. Monica Hook

      Thank you so much for documenting your experience. I suffered a trimalleolar-fracture and dislicatio on 5/27/2020. I had ORIF the next day. 2 plates, 18 screws. The surgeon told me before surgery that I would be NWB for 6 weeks. Today was my 5 week checkup and he told me that I will not be putting any weight on it for at least two more weeks. I was so disappointed. I start PTnext week. I’m determined to start putting weight on it after week 7.Fingers crossed. Thank you again!

      1. Hi Monica,

        Thanks for writing in and welcome to the T-Team! You’re the fourth person that’s written in who has dealt with a tri-mal during this pandemic. You have my deepest compassion to have the added burden of dealing with hospitals/doc appts/surgeries/PT at this time. How is that going?

        I hear your disappointment about the extra week of NWB. I hope that time passes swiftly and easily so you can continue your healing and start to bear weight at 7 weeks.

        If you get a chance, can you send a quick update? I loved PT because I felt like I was progressing (even if only a little at times) with each session. I hope you have a good experience with it too.

        Cheers to your healing,

        Kenda

  6. I am so pleased I found your blog. I experienced a very similar injury in October 2018 and am currently four months into my recovery, with no clue whether I was doing ok. Your blog has answered so many questions about how I am doing now and what I can expect in future.

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