Physical Therapy, or the Easy Way to Recover from a Lisfranc Injury…
Considering that the cure used to be amputation (though perhaps for an injury that was more serious than mine) I figure physical therapy is the easy way!
I am making this a separate account for interested family members, and anyone who wants to know what is ahead…
June 22-First day: Mostly testing to see how much mobility I have in the foot (almost none) and how much strength I have lost in the leg (almost all).
Exercises:
Active Range of Motion
- Trace alphabet in air with foot
- Wiggle toes
Strength Development to do at home (3 sets if 10, 3x a day)
- Straight leg lifts keeping the lifting leg very straight (only to the height of the knee of the bent (good) leg)
- Bent leg lift sitting on a chair
- Side leg lift, being careful to keep the hips stacked and the leg slightly to the back
- Inside leg lift
- Back leg lift (lying on stomach)
- Keeping leg straight, put a towel under the knee and push down.
Strength exercises on machines:
- Straight leg side lifts
- Bent knee, lift calf forwards (9 lbs)
- Lying on stomach, straight let, bend calf back (10lbs)
Ice as needed, 5-10 minutes
She didn’t want to put any pressure on the foot herself until she got the ok from the doctor. Massaged the foot and the calf.
June 26
Range of motion:
- All previous exercises
- Flex foot up and down (3 sets of 10, 3x a day)
- Inversion-Eversion (side to side) holding knee still (3 sets of 10, 3x a day)
Strength exercises:
- Same as last week, just didn’t do the side leg lifts on the machine
June 29 Therapist got the ok from the doctor to put pressure on the foot, so she did a manual stretch forward and backward.
Range of motion:
- All previous exercises
- Calf stretch with a towel or elastic band, keeping knee straight (30 seconds, 3 x daily)
- Tennis ball manual massage of instep
- Manual stretch of foot forward and back (30 seconds, 3 x daily)
- Put a bunched out towel on the floor and try to pull it in with the toes (visualize doing it if you can’t actually do it)
Strength exercises:
- Same as last week,
July 2
- the range-of-motion exercises from before, but with a stretchy elastic strap giving resistance
- working with the foot on a board that has a ball in the middle of the underside so it rotates-forward and back, side to side, and rotating
- therapist stretching foot
- then calf strengthening on machine
These are the therabands I used. I lost the yellow one.
July 6
- We added a movement pointing the foot all the way to the right and out, then moving it all the way to the left and in, against the pressure of the therapist’s hand.
- Started working more on the toes, stretching them, then having me push back against her hand.
- Also started working the area around the scars to break up adhesions
- MEAN massage of foot and calf!
July 8
- The big addition was putting the foot (toes only, and still wearing the boot) on the ground when walking, with virtually no pressure. “Walking on eggs.” It’s actually harder and slower than not using the foot at all!
July 10
We added a leg press, using the hurt foot, with 25 lbs, and then added 6 more.
Also picking up marbles with the toes. I could only do it with the fourth toe. (The next day I could do it with all but the bit toe, which still doesn’t work.
July 14
Nothing really new. Spent a bit of time making measurements to see how my flexibility and strength have changed, to take to the surgeon on the 15th.
My calf muscle is still really tight. Massage is excruciating!
July 19
Went over the x-rays with therapist. Surgeon said there is scar tissue on the ligament going to the big toe, which is why the toe won’t work. Therapist noticed a lump on the side of the toe itself, so we have to find out if that is scar tissue.
Added exercises:
Standing facing a barre, shifting weight from uninjured (right) to injured (left) foot, keeping torso straight
Standing with barre on left side, left foot flat on ground, behind right foot. As much weight as possible on left. Slowly lift heel, rock to ball of foot, lift foot, step it forward, put down heel, ball of foot. do 10 times.
Walk, using crutches, but putting as much weight on left foot as I can take.
We did these with bare feet because when I work out it’s in bare feet, (also because I didn’t bring a shoe), but I am going to try doing them with a shoe on, since the foot feels very unstabilized.
August 12
More catch up…Since I went back to work, I haven’t had time to list a blow-by-blow description of PT. Basically, we are now concentrating on getting the toes to move forward and back, and getting some mobility in the talus. I am still doing the leg lifts, but with ankle weights (at home), and the ankle exercise with the resistance bands. We usually don’t have time at the PT session to do all the machines, but I focus on the machine that has you lie on your back and flex the foot forward and back with weights. (not a very clear description!)
I have added calf stretches done on the edge of a step, and I practice going down steps when I am going home in the evening.
August 14
We worked on going down steps. Established that there are two reasons I have trouble:
- My ankle is too tight.
- My toes aren’t strong enough. I can’t go up on the ball of one foot without the help of the other one.
More exercises to do!
I was, however, able to stand on the left foot (without shoes on). tho I cannot balance yet, because the toes don’t touch the ground.
August 25
Had a good pt session today. I have stopped writing down all the exercises and find I have forgotten some. I also don’t realize that this or that one is important until the therapist finds I haven’t been doing it!
So today we’ve added pushing a weight back with my toes, balancing on a tippy circle, marching slowly in place, and balancing on the left foot with my eyes shut (holding on to a bar).
Much improvement. I can walk without my cane, although I use it because I need it for balance if the ground gets uneven.
September 20
It’s been a bit sobering…my foot HURTS! I almost feel that it has betrayed me. This isn’t a bad thing, though. The physical therapist has abruptly upped the ante on me, and since I fear the insurance case supervisor will run out fo patience soon, it’s a good thing. We are re-training the arch muscles and the toes, and I am now tired and hurting for two days after a session.
Exercises include: throwing a ball back and forth while standing on one foot (or trying to!). To be fair, my therapist stands on one foot, too; jumping and prancing (alternating feet) on a mini trampoline; standing with the toes squished up against a step, and balancing on one foot on a squishy hemisphere. The band around my big toe really burns afterwards.
A few weeks ago, I decided I needed short-term goals. I chose a few that were measurable: balancing on one bare foot (the hurt one) for 7 seconds, walking downstairs without holding onto the bannister or using my cane, increasing the legweights to 5 lbs. for most of the strength exercises, and being able to sit in seiza for 5 seconds without support. The therapist suggested that for this one, we count the number of folds of towel I need under my ankle. Within the first week i had done the stairs (not gracefully, but who said it had to be graceful?), balanced once for 7 seconds, and am working towards the other goals. Yipee!
October 12
I am in shock! I just discovered that the hospital has been charging all my pt to the wrong insurance company and then taking a co-pay from an overpayment I had on the books, without telling me, billing me, etc. By chance I finally got to the patient advocate, who forwarded my story of woe to their finance department. The billing people, of course, had been worse than useless. I will post a detailed story later!
But I will have to continue with physical therapy, since my toes still don’t work properly! Last visit we added:
- A four-direction lunge exercise
- jumping, while lying on my back on the pilades reformer machine
Afterward, my foot and leg were both exhausted, but now I can move the heel of the injured foot off the ground without providing power with the strong foot. Just a little, but it’s a start!
Nov 4
Managed to balance on one foot for 20 seconds (with shoes on). this is a new skill. Added several exercises that involve jumping or skipping. They really exhaust my foot!
Nov 9
Had a few breakthroughs: going from cat/cow yoga pose to downward dog, plank, and slowly back to cat/cow. This involved using the toes of the hurt foot.
Did a standing back roll and a full back roll, catching myself with my toes. Yippee!
Much later...I am discontinuing this page because I am not doing formal PT any more…so I am putting the entries on the regular blog…
This is extremely helpful! I am still in my cast, but I think I can start doing a few of these exercises (at least the ones you mention before you get into pressure/weight bearing on the foot). I’ve asked the surgeon what kinds of things I can do starting now to keep the muscles active and the blood pumping through the leg and foot. He says I can do whatever I like that doesn’t involve putting pressure on the foot, but beyond that– no clear suggestions. So, anyway- thanks!
I’m glad it was helpful! I didn’t realize how much muscle I would lose, and how stiff I would get from being in the cast, so doing as much as you can safely do should really help!
hey, this blog is really helpful!! i had my injury about 6 months ago and got surgery putting two screws into my foot which luckily will not need to be removed unless they start bothering me. so now i got my cast off and im in a boot which i can remove every night.. but unfortunately i also sprained my other foot’s ankle and had a small fracture on that foot as well, so basically physical therapy is going to be CRAZY! thanks for your posts, they really gave me an idea of what its going to be like afterwards.. im now able to walk with a walker/crutches and put full weight on the sprained foot and half weight on my lisfranc foot. just scared that putting too much weight will cause permanent damage!
I’m glad it’s helpful. If you can walk with a walker, you are way ahead of where I was when I started PT. The therapist should be able to tell you how much weight is ok.
You are lucky they told you that the boot can come off at night. Both the doctor and the therapist forgot to tell me! So ask them lots of questions!
The foot may feel weird when you put full weight on it. The feeling eventually goes away. Good luck wth the PT–it does get better–really!
hey! sorry i never replied, but this blog really helped! now it’s been almost 8 months since my injury and i want to update that i have been walking on both feet, no walker no crutches no boot for atleast 5 months!! however, i have a question – how long has it been since your injury? and have you gotten back to normal feeling yet? because i still walk with a limp, and if i walk for over 15 minutes, my foot starts to ache. also, its nearly impossible for me to go on my toes without putting most of the pressure on my good foot and to crouch down or sit on the ground for extended periods of time is difficult as well. what have been your experiences with this??
I’m sorry, I don’t remember replying to this…I have been upgrading my computer and I think I missed your comment. It’s been 2 years and two weeks since I got hurt…The sole of the foot feels normal. The only strangeness is right at the base of the big toe. There is still a bit of nerve damage, so it sometimes feels a bit tight and tingly. I don’t think I am limping at all. I can jog, although I can’t sprint yet. I can go up on my toes, although my balance isn’t that good, but it isn’t that good with the uninjured foot either. Squatting down is problematic, but it’s a problem with both feet, because my tendons tightened up when I didn’t stretch them while I was off my feet. I have to loosen up before I sit in seiza..which was never a problem before. When I walk on uneven ground, especially in bare feet, I can sometimes feel that there’s something “different,” and it does hurt a bit.
I went birding in Central Park with my sister last week, and we walked all day. She commented that I couldn’t have done it a year ago. My experience is that the last year has been crucial in getting energy and strength back.
I hope this helps. The recovery from this injury really is a bitch, but I would look for more improvement, although your injury may also be worse than mine!
9:01 AM CDT
cindylmart
Posts: 1
First: 8/22/2012
Last: 8/22/2012
I am 5 months post op from a fusion from a lisfranc fracture and I cannot yet run. I am reading these posts that I must be patient. Ha Ha We all know that we runners are not the PATIENT type! I can at least do the elliptical and walk but not long distances. My question is which exercises will hastent the healing and when to lay off? For instance.going up and down on my toes seems a little severe. I am willing to do it like crazy if it helps but my PT claims that it takes so long to heal because I am on it all the time. I wonder if I should just walk normally and lay off the radical stretches and it might heal on it’s own faster?? I’m tempted to take some ibuprofen and try running!!! PT says “Patience Cindy. Let pain be your guide. If it hurts when you run you are not ready.” What do you all think?
Frustrated, Cindy
New post Reply to this post Report Abuse Edit post Delete post
Oh boy, Cindy, I know how you feel! I am going through a similar experience these days, following surgery for a meniscus tear. I know that in my case, 5 months post op from the lisfranc operation I could barely walk, much less run. I understand that this isn’t an injury one wants to push, because if it heals badly one is in a whole lot more trouble! But there’s lots you can do to build up muscle and aerobic stamina without stressing the foot. What about swimming and water exercises, bike riding, elliptical, stretching, and weight work that doesn’t require standing? Then when the foot is ready to run, the rest of your body will be, too. But remember, I’m not a physical therapist…if you have one you are working with the best thing is to listen to what they say and check with them before you start doing stuff. Really.
I know it’s pretty depressing, but now, 4 years after my injury, the foot is basically 100% functional, and I credit my PT person with a great portion of that. Good luck with the recovery!
I hope you don’t mind me putting my experinces on your blog – it’s nice to know there are others out there suffering from a similar injury (you know what I mean)
I had my injury on the 29th August and had my op on 9th September because there was too much swelling
I had dislocated and fractured (?not too sure) 4 metatarsals on my right foot having fallen 7 feet from a ladder
I have two screws and two hooks in my foot at the mo, which I am told come out in about 3-6 months time.
I have spent the last 8 weeks in a cast. First a surgeon’s cast (a half cast with all the bandages blood soaked – yuk) and then a modern lightweight cast
I have had no pain at all from the injury and am now in a boot (a Donjoy knee length) which is awkward and cumbersome. It’s like strapping on a jet pack except it slows me down.
Still I can partially weight bear now with crutches and the boot and when I take it off, once an hour I have to do ankle exercises for ten minutes very much as you did
The main problem I find with the injury is two fold
1. Everything is so damn slow – I’m told I can only go back to work after Christmas and then only on light duties
2. My big toe feels really weird – it does not hurt but feels numb inside if that makes sense
I had an injury 30 years ago where I broke my tib and fib and cut the main tendon to the big toe so maybe that’s it – I’m just a bit concerned that it maybe the c=screws causing problems
Still one step at a time – I can sleep at night without a cast and will satrt physio in 10 days time
for all of you starting out out there, hang on in, it gets better !
I love it when people write comments about their experiences! The slow recovery is really a drag. I was so excited when the surgeon told me to bring a shoe to the next appointment, and crushed when he obviously hadn’t meant it, because there was no way I could put on a shoe at that appointment. Are you able to keep the foot elevated?
My big toe felt really weird, too. First it felt as though there was a band around all the toes, then just around the big toe. Now the numb feeling is almost, but not quite gone, and after a lot of work on it, I can move the toe independently of the other toes. But it took work! So, yes, you are right, it does get better. Keep us posted as to how you are doing.
@ Chris Price: Sorry to hear about your fall, but it actually sounds like you’re healing quite well. I have the same numbness in the big toe, it’s getting better but has taken a while. There’s a nerve that runs right through the area of fusion that is often damaged in lisfranc surgery, but my surgeon told me it “wakes up” again in most cases. He also advised that I could help it along if I massaged the area and that some people even use a fine grained sand-paper like surface to gently bring the nerve around. I’m about 4 months out of surgery and it’s significantly better but still not back to normal. My blog is linked here as well, I’m overdue for an update now that I’m almost done with PT. Good luck with everything!
Hi
Thanks for the encouragement !
Especially thanks for the comments about the toe – it’s very reassuring.
You are right about asking lots of questions. The plaster room told me that I had to wear the boot ALL THE TIME. Physio told me that I had to rotate my ankle for 10 minutes once an hour. It takes 5 minutes to get the damn thing on ! When I phoned, physio told me to phone plaster room and a long conversation ensued before they agreed that “yes maybe you don’t have to wear it all the time” It seems like the right hand doesn’t know what the left hand is doing.
I think a lot of what happens is that the health service does not trust us patients so they just put the worst case scenario on everything and make us take precautions that are prohibitory
Talking about boots, how long was anyone in one ? The reason I ask is that the NHS boot they gave me is a pain in the bum and the SP cast advertised in the physio room site looks like a much more usable prospect. But if I’m only in the boot for 3/4 weeks, it’s probably not worth it
I love the Xrays by the way – my family call it Band Q surgery
Chris
High excitement ! I just went out to the car to check the oil etc (son has been using it and now lays claim to it) and thought I would try the pedals with just a trainer on.
Turns out it’s not anywhere near as bad as I thought it would be and the pedals are actually very easy to push down.
I guess I’m lucky I don’t have any pain
Point is, when did you guys start to drive again ?
Chris
I think, because this injury can be so varied, it’s hard to say when the cast or boot comes off. I was in a cast for a week between the emergency room and seeing the surgeon, who put me in one of those black boots that strap on with velcro and you keep coming out of, then in a cast after the operation, then a boot again after about a week. I kept it on for about 2 months, although I could have taken it off when I wasn’t moving around, but they forgot to tell me that.
The toe took quite a while to come back. I tapped it (and the top of my foot) too, and that helped it develope sensation.
Driving wasn’t an issue, because it was my left foot, and I don’t drive much anyway. I think I could have driven as soon as it was ok to stop elevating the foot.
I was in a velcro boot for 6 months prior to surgery, then a plaster cast for about 7 weeks, then back in the velcro cast for another 6 weeks or so. I don’t drive, so can’t weigh in there. As much as of an annoyance that the boot is, I really think staying in it for the long-end of the recommended time is for the best. I do think that waiting until x-ray confirmed the fusion is making for a more productive and quick recovery in the long run. I have an uncle who’s physician had him back on his foot/in pt too soon and just had to go through the whole surgery (and another 8 weeks of no weight bearing) all over again. You don’t want that!
Thanks for that. I intend to stay in the boot when I am mobile, but I have to do the ankle rotation exercises every hour, so I rest it elevated.
I take it from the talk of insurance companies on here that this is mainly an American blog
If you have the time and are interested, I would be happy to compare the relative merits of insurance v our national health system. Although our health system is very good (treatment when you need it, albeit crowded wards) the lack of information and advice is sometimes a little scary and the person who generally knows (the surgeon) gives you 3 minutes of their precious time
Oh well ! Back to the ankle rotations
Thank you so much for your input and advice
Chris
Sorry to take so long to respond…been a bit distracted. One of the problems with the insurance system is that even if you have decent insurance, you have to be so vigilant. In hospital, for instance, a doctor will come by, look at you, go “hmmmm” and next thing you know you have a $400 bill from a doctor who is out of network. You have to pay it and you didn’t even know you were incurring the debt. Many treatments have to be approved, and it is on you to find out.. so half way through my radiation treatments I suddenly couldn’t remember if I had checked the approval (It turned out to be OK, but who needs that in the middle of radiation?) Just finding a doctor who takes your insurance is a big job when you cannot walk and are doped up with oxycodone!. And then there’s the billing. As you may have read in the blog, I suddenly found that the hospital was billing the wrong insurance. I finally got that straightened out, then got a bill from a hospitalization four years ago. They hadn’t bothered to send an invoice for all that time!
On the other hand, I do have insurance, which is a boon. A friend who didn’t have insurance needed a hip replacement, and we all had to do a huge fundraising for her to get the money to pay the doctors’ bills.
Sorry I have not been in touch, I have been in a rehabilitation centre. Not done through our National Health Service. I am a police officer and we have three centres in the country that we pay into through our union
The surgeon said I could wear a pair of Magnum boots instead of the orthapaedic boot – hurrah for him !
I had two weeks at the centre, getting physio every morning and then exercises in the hydro pool and then the big swimming pool, together with custom exercises for my foot.
I discovered that it’s not the injury site that is the problem – it’s the fact that my ankle seized up through lack of use and my dorsiflexion is only about a 1/4 of what it should be
I have had no pain from my foot until physio started seriously – now it aches !
Now back to the real world. Saw the surgeon’s registrar and she said I could walk on it as long as I could walk “properly” otherwise I should use crutches to walk properly
I can walk for a short time properly, before the foot begins to ache so there is hope. I have been pushing every medical person that I met for better exercises and now I have them I’m begiining to regret it a bit
After the centre, the NHS is a bit of a let down. I have my first physio appointment in a week’s time. What crud !
Still, work usually offers at least 6 physo sessions to get me back to work quicker
Registrar says that I should go back to work on light duties in January and as I am not front line that should be fine, but even then I’m not looking to be back full time much before May, especially with the screws having to come out as well
It makes you realie that it takes a long time with this injury when your physio says “but Chris you are only 12 weeks into your recovery”
Hmmm
Best wishes to all of you and I hope you get to run your marathons and other sporty stuff. Me, I’ll be happy just to walk !
Chris
I had very little movement of my ankle when I finally got out of the boot. If I can find the video I took of it, I will send you the link, so you can see how much it can improve. At this point, I have pretty much full mobility. Balancing on the foot was a really problem, but that has come back, too. Do you have therabands? (Elastic bands of different resistance). They were really useful in the initial physical therapy. It sounds really wonderful to have the hydro therapy and the pool. That would have made a lot of difference for me!
I know how you feel about being happy to walk! But aim at being able to run! It feels so freeing, I can’t believe it. Good luck! By the way, at 12 weeks I wasn’t even walking without crutches, so you are ahead of where I was… lChris
April 12, 2012 was my surgery date. I have a lisfranc fracture and I broke all of the metatarsals! I am transitioning from the boot to a sneaker with orthodic. The sneaker is not big enough for my foot, which is now higher due to the plate.
Any suggestions for other kinds of shoes/boots?
Patty
Hello! This is the first time I ever replied on one of these. I have a Lisfranc fracture/dislocation as well…
I got it when I was 16 years old!!!! A golf cart flipped over onto my foot squishing it on the cement with its tire. Long story. I was in so much shock that I pulled it out from under the tire, and that’s when I heard pop pop pop! I broke 5 bones and dislocated two joints. Horrible. It was externally pinned (3 ) and that was that. I had a hard cast for two months and had to do phisyo for 4 months or so and I never played many sports after that. I just did what I thought would be fine, RUN! I was pretty poor and so I couldn’t afford orthotics until just last year (2010!).
Eight years later I am 24 now, and I have arthritis in my midfoot and I am having pelvis problems from limping. I have had two ”flare ups” once just the beginning of last year in Mexico ( I was wearing crappy shoes ) and another when I was doing hot yoga ( bending my big toe in the heat). Just recently I went to the best surgeon in the province and he said that the longer I wait for surgery the better (WTF) since it is such an invasive surgery (joint fusion where they take out one of the joints and drill it all back together). He said it is better when I am 30 or 40 years old also there will hopefully be some medical advances. Pretty horrifying. I am a bit depressed but I am trying to take this all in and learn from it. Buddhism has really helped. It has gotten me to meditate, become more spiritual and realize how fragile we all are and that the human body is an amazing gift. I am trying to be positive and the more I really try the better things seem to be. I currently am in phyiso once a week, (its free ) and I see a chiropractor for my pelvis/ foot. I somehow go to school full time and have just until now realized that I have a lifelong disability. I am currently working on the grieving process. After the second flare up, which happened right before school in September of last year, I had to drop all but one class and I was in a wheel chair for a month or so when we walked our dog (my husband pushed me! ) I am a member of the Arthritis Society—- they have helped me out so much, all for free. I take Glucosamine, MSM,Chondrotin,WildFishOil, Vit E, Vit D and a really good calcium. They seem to help. I convinced myself that running sucks for your body anyway— It helped me with coping without a good run. I have a pull up bar and work on my upper body (totally helps with my mood) and use the gym at my school to work everything else out, even my feet. I am in pain everyday though some days less. For example the pain I am in right now is a 4 out of 10. I walked a lot. I don’t smoke cigarettes but I do smoke marijuana once a week and I find that the pain gets a bit worse but I just ignore it. I heard that it does something to your circulation? I am getting used to it though! I have a rolling backpack which is great, I use Nordic Walking Sticks (They are the best! You look funny and people say a lot of comments about your liking to ski. They help with taking 20% weight off the and knees– my friends at the arthritis society taught me— plus it keeps my back straight and hip rotation to a minimum–less limp. They have removable feet- when you remove the feet there is a metal rod sticking out for when you go for a hike, for stability too.
One last thing. I have also thought of an actual amputation. If the pain keeps up like this and I get all miserable for 10+ years I will seriously think into it. I have talked to a lady with a similar problem (she is 58 years old) and she said it is the best thing she has ever done and that she shouldn’t have waited so long. OKAY. Enough typing. Anyone have anything to add to help would be greatly appreciated. I hope this helps anyone out there. Anyone that has had a Lis Franc injury for 10 + years I would love to hear from you. Thanks for reading.
Oh yeah: Here are two great books that have really helped me through all this fun stuff:
Recomended readings: Eckhart Tolle- ‘ A New Earth ‘
David S. Butler- ‘ Explain Pain ‘
Hi, Athina…I am sorry this didn’t get posted until now! I missed it completely, and just found it in the list waiting for approval. Thank you for the suggestions!
Athina, you have made me realize how lucky I am. If you can deal with your injury, I can certainly manage mine, which is so much lighter. I am going to pass on your information about the Nordic Walking Sticks to a person who has rheumatoid arthritis. They sound really useful. He also found that water exercises were useful.
I see that someone with a lot more expertise than I have has already posted a reply to you. Anyone else out there who can weigh in?
Athina,
You have endured so much more than I can imagine. My faith, too, has sustained me (Christian). I had bone fusion in Dec. and had no pain during the non weight bearing stage. I have “graduated” to being able to stand and brush my teeth. I over did it some though. So my foot really hurt. I start physical therapy next week — or maybe just an evaluation. I was told to take pain medication before going. So I’m a little concerned about the pain. My surgeon guaranteed me my foot would never be the same, I would get arthritis, and that while it will always be weak, and there were activities I would never be able to do again. I hope you do get another opinion about the fusion surgery. I’ve heard it has made a positive difference in many cases. I would like to add that after reading about others’ experiences here, I have a more hopeful outlook. I had no idea a simple fall would change my life so radically.
So my thanks to all of you who are sharing!
April 23, 2011
I have a lisfranc fracture. This site is the first I’ve seen that hasn’t scared the stuffing out of me. I have hope that after pt I’ll be walking again, and ready for a trip planned way before my fall.I tripped — nothing exciting or mystical. My doctor referred me — after putting me in a cam boot — non weight bearing, to a surgeon who would take my insurance. I had surgery Dec. 29 — two metal plates, eight screws, a bone graph, two pins hanging out of the side of my foot. But surprisingly, I didn’t have as much pain as before the surgery. (I broke my foot the day after Thanksgiving.) Temporary cast for the first two weeks, then stitches out, another cast for three weeks. Removed that cast and took out the two pins (k-wires?). Casted again for three more weeks. Moved back to the non weight bearing boot until April 21. Boot off, bare feet, and I was standing — my surgeon said walk and I took my first step of 2011. All this time I have felt guilty for not working. Just staying off my foot and keeping it elevated.After things I’ve read I’m so glad I followed doctor’s orders.
Thank you for the encouragement and hope you have given me.
Sissie
Sissie, I am glad it was helpful. Everything I read scared the stuffing out of me, too! I felt self-indulgent staying home on the couch with the foot up, but now I realize I was really lucky to be able to do it…As far as walking goes, you seem to be way ahead of where I was at that time. I was looking forward to walking when the boot came off, and then the surgeon gave two weeks PT…non-weight bearing! Good luck with your pt..it’s a lifesaver…Chris
Holy moly, Athina. I have to say, my immediate response is that there’s no way you need to have that kind of residual pain and disability this far into your recovery. I can not imagine why they are not encouraging you to do the fusion right now. I know that fusion has only recently become the standard intervention (I met a woman on the plane who was pretty much the last person University of Pittsburgh Medical Center ever chose not to fuse, and her surgery was only a year or so before mine). It’s one thing if you’re a kid and still have a lot of development ahead of you, but even at 24… I’m not sure your physiology is going to change much between now and when you’re in your 30s/40s (except surgery recovery is easier now then it will be then). I would seriously suggest getting a second opinion (or more) from a sports medicine orthopod. I eventually had mine done at Mercy Medical in Baltimore, but got the same (fusion) advice from UPMC and a few others. It sounds like they’re saying you’ll need it eventually (which is in keeping with everything I’ve heard– another reason I decided to just go with the fusion, rather than a second surgery down the road). Why not do it now? You can check out my blog that’s linked here (http://lisfranc.wordpress.com/) and please feel free to contact me there if you have questions about the surgery/recovery. It’s a pretty serious procedure, but really, really hard to imagine that it wouldn’t be worth it for you. I should add that my surgery wasn’t immediately post injury (due to extended misdiagnosis), but it was about 6 months after. It’s been about 10 months now and things are pretty dang good. Much better than your situation it seems. Sheesh, good luck. I hope you work out a solution soon.
Hi, certainly start with a free platform! It at least gets you started. Maybe start by writing your thoughts about various aspects of remodeling, and bits of advice for people who are doing it. The main thing is to start doing it!
And here I thought I was the only Lisfracer to be tracing the alphabet in the air with my toes. I’m still doing it daily four months after surgery……just to be on the safe side as I seem to not be able to let go of my non-weight bearing PT quite yet, even though I’m also doing weight bearing exercises. I’ve enjoyed keeping up with your blog and seeing that I’m actually on course with my recovery. Happy healing to us all!
Keep doing that non-weight bearing PT! It really helps with flexibility and some of the rotations just can’t be done safely while weight bearing…unless one likes straining an ankle! Four months after surgery…yup, that seems pretty good..Keep it up, Chris
Thank you for this post. I had a lisfranc fx in 2006, surgery with screws and pins to repair, and then removal, and have some bone fusion now. Shockingly, they never sent me to PT. I had almost no range of motion in my foot until fairly recently, and I actually found that horseback riding (a great way to get the fracture in the first place) has helped tons because of how you have to keep your legs with weight in your heels. I’m still working on recovery and have recently started the C25K program in VFF shoes, having never been a runner before. I’m not a heel striker when I do run, and the shoes are wonderful for me so far.
All that rambling aside, I am really glad to see the PT exercises posted here. I feel like my range of motion is still more limited than it should be and I want to continue working on it.
I’m glad you found my PT page helpful…bear in mind that I basically wrote it for myself, so I could remember what I was told to do! It sounds as though it would be helpful if you could get to a therapist to get a few exercises, even at this time! I can see that riding could really be helpful. It would build up any atrophied leg muscles, too!
One of my PT assignments, once I could walk, was to walk on uneven ground, so your running on a roughish path sounds like such a good idea. I’ll follow your progress on your blog! Good luck with it!
Hi everyone,
I fractured my foot April 4th, 2012, had surgery April 12th, two plates and 6 screws. It’s been about 10 weeks walking on crutches.
Now that most of the pain has left my foot, I am able to do a lot of the excercises you described.
I’ve had knee injuries before, so I know how quickly the quadricep muscles become atrophied. If you measure your thigh 1-2 inches above your kneecap, there’s usually a huge difference in size because of the atrophy. This is why we limp after an injury because the injured leg is shorter. And this is why we have to do all the quadripcep excercises you described – front, back, side, inside leg – in order to strengthen the muscles again.
I’ve done two weeks with no weights, now started two weeks with 2 1/2 lb. ankle weights. However, after three days my knees really hurt, so I took one day off.
I can’t work because my job requires mostly standing and walking. My surgeon has not indicated when/if he will be taking the screws out. I didn’t see a step and rolled off it and caused the fracture and broke all the metatarsols. The surgeon said he had to throw some of the pieces away because they were in such small pieces.
Thank you to every one for sharing!
Good luck on your continued recovery! Chris
hi, my name is sarah and a bit like you guys i have a lisfranc break with a compact break. my horse fell on top of me and my foot must have been crushed on top of the stirrup. My foot was in half. The A&E could not believe what they were seeing as they have not ever seen such a serious break. My Surgeon told me my foot that did not have a pulse for over three hours was in a serious state of being amptuated. Shock….. I thought i was going to be out the following day…. wrong.
I have had surgery two weeks after break, and I am nearly a week after op. I have plates screws and wires. I have no idea what is going to happen to me. I have been told, no weight bearing for 6 months. in two weeks stitches out, then cast, then 6 weeks wire out, then 6 weeks some plates out. then start the process again. after 6 months i should be able to have rehab. I have horses, 5 dogs and no home help whilst hubby at work from 7am to 7pm. Some friends have been amazing.
How am i going to cope with every day, not going about. i have two horses to cope with. I am not a person who stays in bed or chills out so this is going to be testing to say the least. if anyone has any ideas of how i can cope with my active brain and feeling like i am being physical then please write back.
I am in the first week, OMG i wished it was the last week. I event my horse and was only half way through the season. Not my year i think.
Has anyone else had their foot in cast for 6 months. I have to be in a wheel chair for 6 months and i must say the medical team have been fantastic. I could not thank them enough.
Anyone who can lift my spirits please do, I feel stuck and deflated to say the least.
Sarah
Hi, Sarah…I know (sort of) how you feel! One thing to keep a hold of is that this will pass! If your doctor tells you to keep the foot elevated as much as possible, my experience is that they mean it! Reeeeally important! This makes life a bit difficult! I didn’t have WiFi, so I got a router, set up WiFi, and my family gave me a laptop. Set the laptop up for voice recognition, so I could use it more easily lying upside down on the couch. Then set about learning something new. In my case, one of the things was blogging! However, there are lots of other possibilities. It’s surprising what you can do with your foot up in the air!
Another issue that I bet you take seriously is muscle weakness. Well, with MD approval, maybe you can set up a program for upper body, core, and at least the uninjured leg (and maybe even the injured one!). Gotta get someone who knows what they are doing.
What about training one of the dogs to be helpful? That should take some time and energy!
I bet you will work out what to do about the horses! If you are using a wheelchair, at least you will be able to go and talk to them. How is the horse that fell?
A number of the people who have blogs are really active types…If they don’t comment here, you should comment on their blogs. They should be able to give some good ideas.