Week 11: Harder, Better, Faster, Stronger…I Think

So, in some ways, this week felt like week 9 when I didn’t really achieve much. I can’t say that there were any milestones reached. On the other hand, what makes me feel like I am actually making progress is that my PT exercises are definitely getting easier, and I am moving onto more challenging things. And again, I think that my limp is getting better.

This week was characterized by a ton of walking. I think that on Saturday, I walked probably three miles in total, 2.1 of which was in one stretch without sitting. I think that could have been too much, and after I backed off the walking on Sunday, my leg definitely felt better on Monday. I also did the elliptical again, and while it didn’t hurt while I was on it, I think that I could feel it the next day. My PT told me that I shouldn’t do it until I had no pain, and I do still have pain while walking, so maybe I will listen to his advice. (Did it because there was a class in the spin studio.)

But I’ve doubled the weight that I began with on the leg press machine (using only by bad leg). Now I only have an 80 lb differential between my two legs, ha. I also have moved onto more advanced balance exercises which I simply could not do two weeks ago. Did I mention that I really hate balance exercises? Strength = bring it on, balance is something I really have to push myself to do. Because it’s hard!!!

Something both terrifying and exciting: on my way to my new office, there is a shortcut that saves a lot of time but that has a drainage canal that you have to step over that is rather treacherous with my leg. The first day I looked at it and was like, “no way,” and walked an extra five minutes to go around it. But then on Monday I decided to try it — and I did it. Going back across it at the end of the day was worse, because there is a fairly steep hill, and it was hard to hold myself back from going down it quickly. But, I’m doing it. Today was even easier, naturally.

In other news, I went to a regional bouldering competition here — to watch! Watching it made me feel like that is soooo far away for me. Not only landing, but leg strength too. It made me wonder if it will take until May, when I can return to my regular climbing gym. But then I realize that that is nearly four months away (May 15) — that’s way more time than the thing has even been broken. Surely I will get to return at least with my shoes broken in, no?

Oh, and I’ve been dreaming about running. Or rather, I’ve had a number of dreams in which I’ve been able to run. Hopefully starting to get back to that — very slowly — soon.

 

Week 9: The Two Month Blahs

For a long time, this felt like a week when nothing was changing. I didn’t feel like I was getting stronger, I didn’t feel like the pain was diminishing, and on top of that, I tripped three times and used my bad leg to catch my fall which…hurt. Not sure why I tripped so much this week.

Notable things:

• I walked 1.5 miles for the first time on Friday evening, and it was a slog, for sure. Took about 30 minutes.
• I have been going to the gym like a mad woman. Rode the spin by 4x in a row, followed by a day off, and then back on. Doing lots and lots of PT exercises as well.
• Did 20 squats holding a 20kg (44 lbs) kettle ball. Seems like this means I could move onto the bar soon? Going way below parallel.
• Walking almost normal pace when I hustle.
• Happened to find myself goofing around on a bouldering wall (don’t ask), campused up to a hold that put my feet about 4″ above the pad. Forgot that I couldn’t fall, and fell down onto the pad. It’s not like I couldn’t feel it, but I was totally fine, surprisingly.
• Part of my PT is one leg presses on the leg press machine. The differential between my two legs in terms of how much I can press is, uh, 100 lbs. Yikes!

Not sure what other notable things there were, but then, on Monday afternoon, suddenly I started walking with a lot less pain. I walked 1.5 miles again and felt fine. This morning I was back to ache-y, but then this afternoon it got better again. So that felt like some progress.

Also, this Sunday was my two month breakiversary. This made me 1. kind of check my expectations about recovery and 2. go back to my entry from my one month breakiversary and compare where I was.

First, I realized that initially I thought I was going to be in a cast for 6-8 weeks (initially, i.e. when I was laying on the mat with a floppy foot waiting for the paramedics to come). Sometimes I get frustrated that I’m not further along in recovery — particularly these days because the early recovery went so quickly and everyone was saying, “I can’t believe it’s been three weeks and you are off crutches,” etc. So the fact that going down stairs is still kind of hard, that balancing on my bad leg to put my pants/socks on in the morning is still hard, and the fact that I have very little lateral stability all make me feel like things aren’t progressing fast enough anymore. Like, as though I should be starting to run by now. Even though it’s been two months since my break.

But second, I did look back at my week 5 post, and realized how different things were that week from now. I remember how ridiculously slow that one mile walk to the grocery store was. Though it does still feel like progress is slowing down.

So: this week was kind of blah I guess. We shall see what next week brings, aside from flying half-way around the world.

Week 7: Eh, but No Hands

Short post this week because I really don’t have much to say. Here are some things:

• I’ve ditched stair handrails entirely, including going down. Pretty sure this was one of my goals last week. Got way faster and better at going down stairs.
• My fracture site is warm to the touch. I was a bit worried about this, but I asked my PT and he said warm = healing. So, good!
• Continued to ride the spin bike, and did the elliptical once. Oops. I did it for 40 minutes and it turned out to be too much. I paid for it the next day, and my PT surmised that I probably did a bit of muscle damage that slowed the healing down a bit. No more of that for a while!
• Tried to go bowling with my family for Christmas. Guess what activity is terrible with a broken leg? I did the regular technique for a while and then wound up bowling standing holding the ball between my legs. I did really well with the latter technique I must say. I didn’t think bowling would be a problem, but now I totally see why it is hard: there is a lot of weight transfer, deceleration, balance, etc.
• Got a replacement pair of Solutions (climbing shoes) for Christmas! Downsized a half size, and switched to the women’s model, hopefully they will be really solid for heel hooks now.
• Asked my PT when I’ll know that I’m ready to climb and to ride a bike. Answer: when I have no pain walking/can walk without a limp, and for climbing, when I can jump and land no problem. Which seems like it will coincide with feeling 100%. My guess is the beginning of March? Kind of don’t think I’ll be able to top rope before I leave on January 16.
• Cleared to use the leg press with very little weight — up to 75% bodyweight with two legs, up to 30% bodyweight with just the bad leg.
• Wow my calf muscles on my bad leg are small.
• Kind of tired of this thing.
• Goal for next week: not sure if this is within reason, but be able to stand up on one toe? It’s kind of the only thing I have left. Maybe try the elliptical again?

I think that is about it.

Week 6: Balance and Mobility

I’m learning to measure progress in new ways. As I said at some point, since I’m not sending (finishing) anything in the climbing gym, I have to find other ways to get my dopamine going. Without further ado:

Things that happened this week:

I’ve started going down stairs alternating feet, holding onto a handrail. This has actually gotten significantly better over the course of the week — shallow stairs actually don’t feel that bad, and I’m pretty fast. The limiting factor on this — and it seems like on everything else — is ankle mobility.

As of Sunday: I can put my pants on! That is, I can get my good leg into my pants leg while standing/balancing on my bad foot. It still feels scary, but I’m doing it consistently. I’m doing a lot of balance work in general — still doing 2 minutes 3x/day — but also trying to figure out what kind of dynamic balance stuff — i.e. balancing with the rest of me moving — I can add in. Did this (picture on the right)!

Riding the spin bike for 40 minutes. Actually sweated a lot for the first time since November 9. Considering trying the elliptical too.

Slightly overdid it trying to work on my calf strength so that I could go up on one toe. This caused extra swelling around my fracture site. Backed off, swelling went down to lowest levels yet.

Getting very close to being able to fully lock my knee.

I wore heels! Not for very long, but I did it. (special occasion)

As of today, my bodyweight squats feel totally normal/even on both sides. I can easily go below parallel.

Other things:

Now that the swelling around my fracture site has gone way down, I can feel the callus formation around my bone, which is cool, because callus = bone healing. Here’s a handy diagram of the stages of bone healing. I am somewhere between phase two and three, the latter of which occurs around weeks 6-8, or 8-10, depending on what website you get your information from. Once the bony callus is fully formed, your bone is technically back together, but complete bone remodeling is finished after a year.

Upcoming goals:

I crossed off two of my goals from last week, and I’m carrying one over. So, updated goals are:

• Be able to stand up on just my left toe.
• Going down stairs without a handrail.
• Ride a bike outside

Believe it or not I feel like riding a bike outside might not be that far off!

Pictures:

This week (left) versus last week (right). Not too much difference.

This week (left) versus last week (right). Pretty significant difference. Really pleased with this.

 

Week 5: Lots of Steps

Things I’m learning: you never know what kind of progress will come next, or when it will come.

The biggest development this week was that on Saturday, the pain that I had always had while walking finally went away! It had been getting better, and then just…poof! This is not to say that I’m walking normally. I’m still slow and I still have a limp, just that it now doesn’t feel like I’m only going to be able to go X far before it hurts too much to continue. I am really happy about this! Lesson learned: if you complain about something the week before, it will probably get resolved the next week.

Other things that happened this week:

Walked just over a mile (in total) to go grocery shopping on Thursday. Wasn’t sure if I was going to make it, but I just decided that I would. And then did. This was the furthest I’ve walked without crutches — and without a break, no pun intended — yet.

Starting to pass very very slow people in the very long hallway at my school. By the end of this week, I think I’ve moved up to walking at about 75% of a normal person’s pace.

Able to sit crosslegged.

I itched my fracture site a lot! Apparently this is normal.

Wore my compression sock all during the day when I wasn’t icing. Really makes things feel better.

Physical therapy:

Moved on to longer sets of more advanced exercises. The following are currently in my daily routine: standing lunges, one leg balancing, body weight squats, heel walking, heel raises (up onto toes), and 6 minutes of calf stretching 3x/day. It’s kind of a pain/annoying, and I can totally see how a lot of people would slack on everything that is prescribed. But you know what is more annoying? Not recovering.

My PT was impressed that I walked a mile four weeks out, and that I could balance only on my bad leg for a full two minutes. I was impressed with the latter myself — reaping the benefits of all my core work?

He did ask me to try to stand up on my toes only on my bad side, and I couldn’t even get my heel off the floor. It’s really bizarre to just not be able to do something like this.

Goals:

Three things that are currently in my head as milestones:

1. being able to walk down stairs alternating feet

2. being able to put my good leg into my pants/shorts/underwear while balancing on my bad foot

3. being able to rise up on my toes on just my left foot

This morning I decided that I am going to do the alternating feet thing going down stairs, with a lot of help from a handrail. Clearly it is a matter of ankle mobility/stability, but I think that trying will help. Hopeful about the toe/heel raise, and i keep trying everyday. With that, it’s a matter of muscle strength — underneath my knee toward the inside and the area above my ankle on the outside of my leg seem to be the problem spots.

Psychological, etc.

Getting more used to going to the gym to do weights. Had to stop doing dips however because of my shoulder injury. Doing a fair amount of work on my good leg (assisted one legged squats, leg press), which I think is back to normal size. Atrophy on the bad side seems to have abated as well. Tried to ride the spin bike, but I decided it was a waste of time. I wasn’t going to get an aerobic workout nor burn very many calories given the speed and resistance I was able to tolerate. Someone asked me about riding a bike on the street and I was like, are you kidding me? I’m so far off from that.

Re-asked my PT again about 12-16 weeks for getting back to real exercise (running, climbing), and he confirmed that that is what he said. 12 weeks is the end of January. Climbing will come first apparently, which is great.

Annoyed by people who think that I wasn’t being safe while climbing and that is why I broke my leg, or who claim that the padding at my gym is inadequate, or who quasi-lecture me about how people shouldn’t boulder because it is too dangerous. Still feeling like breaking my leg doesn’t outweigh how much I enjoy it. At no time have I even thought, if only I had decided to only top rope since there is so little risk in that. Or: if only my recreational activity was sitting on the couch watching Netflix. Life is risky, and yes, climbing is riskier than not-climbing, but, I’m happy to pay the price. Saw a friend with a finger injury this weekend, and it’s funny how my broken leg might heal faster than his finger. Basically, I’m starting to understand this thing as just another sports injury, and really not that big of a deal. Then I think about the fact that someone hammered a rod into the middle of my bone, ha.

Missing climbing a bit but I’m still fairly occupied with both leg stuff and work stuff that I’m not feeling like there is a huge void in my life, plus my rings and abs workouts now are still social. If 16 weeks is correct, I’m more than 1/4 of the way there. My PT thought that I would still have trouble walking when I leave in January (around 9.5 weeks out). I am determined to prove him wrong! 🙂

Pictures:
Weekly pics of my legs. My ankle is in full view (swelling is down), and the muscle on my left side is building back up. In the picture on the right, you can see the lump at my fracture site. I am not sure if this is the “callus” formation or swelling or both.

 

Below you can see the swelling on my bad knee (right picture), compared to my good knee (left picture).

 

 

Week 4: And Then There Were None

In the same way that it’s easy to blast through low grades in climbing and then start to take more time to advance, my progress this week was not as dramatic as in past weeks, but I’m still working hard to recover, and each day is better than the day before.

Milestones:

Day 22

It seems like exciting things happen on Tuesdays. First I broke my leg on a Tuesday (exciting is maybe not the right word), then I got rid of my boot after the first week, then I went down to one crutch after the second week, and this week, Tuesday was my first day going entirely crutch free. I haven’t used one since. Exciting! What will come next?

I also wore jeans this day, instead of tights or leggings, and stood up in the shower, both for the first time.

Other notes:

Went to my first PT appointment. Some good news is that my range of motion in my knee and ankle is basically the same as on my good side. The other good news is that the PT guy estimated 12-16 weeks until I could run and boulder again. What?!?! That is so contrary to other people’s experiences I’ve seen on the internet, as well as that of my doctor who said 9-12 months for running, that I’m not even sure I understood correctly, but I’m pretty sure that’s what he said. The bad news is that after years of running, my soleus muscle (deep in the calf) is super tight, even on the good side. Yes, that is the bad news. I’ll take it!

Apparently much of the pain I feel while walking is due to swelling at both the knee and the ankle. As a result, I now own an over the knee compression sock (black, not tan/flesh color, thank god) and a 12″ x 18.5″ ice pack so that I can ice my ankle and knee and the fracture site all at the same time. I am really hoping these things help, because I’m not going to lie — walking hurts and kind of sucks. Got some exercises to due daily — heel raises, wall squats, and calf stretches. Heel raises and wall squats are kind of fun (1×15 daily), but the stretches (6 minutes worth 3x daily) are kind of annoying…but I am doing them!

Also:

• Tried to stop taking Tylenol for pain, since I only have pain while walking, but decided to go back on to deal with the pain while walking.
• Can balance a fair amount on just my bad leg. At the beginning of the week I stood in the shower,  at the end I stood on my bad leg with my other foot up on the top of the tub to shave my leg! And didn’t even notice that I was doing it.
• Going up stairs feels great — better than even walking on a flat surface — but I still can’t go down stairs without matching feet. I think going down stairs is going to take a long time.
• At the beginning of the week, I also tried to go up on my tiptoe just on my bad leg while holding onto a railing, and it was SO HARD. By which I mean, I wasn’t even close. Just before typing this, I was actually able to do it a little bit.
• Also, I have successfully taken a few tiny jumps, getting both feet off the ground! If I land on my toes, it’s no problem.
• My legs are definitely smaller than they used to be — particularly my bad one — which I know from getting back in jeans. Climbing friends encouraged me to keep it that way since I have the opposite of skinny climbing legs.
• Even though it hurts, walking has certainly improved over the beginning of the week — I’m probably 75% faster by the end of it? And if need be, I can go at normal pace, I just have a huge limp.

Psychological:

Getting off crutches was an amazing psychological boost! Since then, it has felt like progress has been slow, mostly because there won’t be any milestones as big as getting off crutches for a while. But in writing this out, I realize how much progress I actually have made over the course of the week. Which is also a nice boost.

Everywhere on the internet, the advice that I’ve seen is to maintain a positive mental attitude, do physical therapy like it is your job, and push yourself to keep trying new things. I’m doing pretty well at this, though the pain while walking is getting to me a bit. Ready for that to go away, and to be able to walk further.

I am still a bit incredulous about my PT’s suggestion that I could be back to bouldering 16 weeks post-fall. I mean, I’ll take it if it happens, but really, I decided that I *must* be back to it by May 16, 2016, when I get back to the States, which is 27 weeks. Definitely going to pack my shoes and a chalk bag when I go away, just in case.

A more short term goal is to be able to bowl in my family’s annual Christmas bowling excursion. And I really want to go top rope one time in January before I leave the country. Also, I’m interested to see how strong I’ve stayed/gotten through all of this lifting, abs, and pullups I’ve been doing — and whether my shoulder injury will actually get better before my leg — or not!

 

Week 3: And Then There Was One (Crutch)

Everytime I think I have reached a short plateau in my recovery, something new happens. It is really amazing.

Highlights of the week:

Day 15

I went to see my doctor for the first time, exactly two weeks after my fall. They took some new Xrays, which showed that my tibia is aligning perfectly. My fibula, which was a segmented break (two places), is not quite so perfect, but my doctor was unconcerned about that for the time being. Also took my stitches and staples out.

Most importantly, I got to ask questions about what I would be able to do with the rod in. The answer was everything, and that only in rare occasions do they take them out, despite everyone on the internet wanting them out. I think I was a little too afraid to ask about bouldering specifically, because I didn’t want to hear that it would be a year before I was able to fall on my leg again. (Somehow I think everyone thinks that I fell accidentally onto a hard surface while roped in, and doesn’t even know what bouldering is.) But it is clear that bouldering is in the cards at some point. I asked about taking another similar fall and he was like, “well, your leg will just be that much stronger with the rod in.” Lesson learned: don’t believe the internet.

I asked about running directly, and he said that most people take 9-12 months. That’s obviously a long time to wait for someone who had run consistently for 15 years, I am hoping that I will be on the short side of this, since I am in such good shape? I honestly think that I will be able to top rope in January — basically once I feel like I can put my full body weight on my leg. (Unfortunately I will be out of the country from Jan 15 – May 15, and my only option where I am going is bouldering.)

My doctor also asked me if I had walked at all without crutches, to which I replied yes — a little. He asked me to show him, and then muttered that I was still doing something or other, but suggested that I go down to one crutch. I was hesitant, because sometimes I need to go all the way across campus, and I’d be so slow on just one crutch. I also wasn’t so sure about stairs.

Finally, I got a prescription for physical therapy, which I will start this coming week.

Day 16

Well, so much for my initial one crutch fear. In the middle of the day, I needed to run an errand that was about 0.3 miles away, and I decided…let’s do this on one crutch. And I did. Having a free hand to carry things was amazing, and I never went back to two. I also decided to start using no crutches in controlled situations, like inside my apartment for example. This was also the day when the feeling that something was stabbing me at the top of my ankle as a walked went away.

Day 18

Decided to walk 0.3 miles (each way) to get coffee, without any crutches. Coffee place was closed (!), but I did it! (very, very slowly) I tried stairs too which weren’t bad at all. Also, I was able to go up a stair or two without matching feet — holding onto a handrail. Very slowly rode a stationary bike at the gym — just to see if I could.https://instagram.com/p/-m8WEfvM0x13u82p4laTy6Rgz-Sy4ljZNSr-M0/

 

Day 19

Took a shower standing up for the first time. Discovered that I can do bodyweight squats — though probably unevenly weighted. Did a very long flight of stairs without matching feet and without crutches — going up only.

Day 20

Did 30 minutes of water running and 15 minutes of kickboarding in the pool. (Am also doing upper body/ab workouts). This was the first time that my leg muscles were really engaged in anyway. Left leg is really starting to atrophy, and I still can’t really fully lock my knee, which I believe is due to the fact that they cut into your patellar tendon in order to insert the rod. I hate the pool but I can tell that this is a great way to strengthen my ankle muscles, and I seem to hate water running and kickboarding less than actual swimming.

Other notes: 

1. A friend of mine got in touch about her own tib/fib break, which was much worse than mine, and the progress of her recovery. Here is what she wrote:

I broke my tib and fib VERY BADLY on Nov 1st, 2010. I had ORIF with 11 screws, 2 plates, 2 hooks, and wire in. It just looked bad. I almost threw up when they removed the cast after 2 weeks and put me in the boot. I cried. Then I got really strong arms from crutches. The winter sucked, but I made new friends who gave me rides and helped me shovel a path to the bus stop.

I went to the pool as soon as the wound healed, one month after surgery. I swam a lot. I put my foot down on Jan 1st. I was bike riding by late January. I could not walk until I completed therapy in March. But I was doing a lot of pilates. I was walking in April. Walking with no pain at all in June. Hiking in July in the mountains and jumping.  Little running in August and a lot of walking. Completely running in September. Removing all the screws and plates and metal stuff in late September.

2. I don’t really understand why so many people have had the same IM nail surgery but were told to keep all weight off of it for an initial period. I mean, I surmise that there have been recent studies that have showed that WBAT is useful in healing, but I feel terribly for people who had to go through that.

3. I feel very lucky to be able to keep my foot relatively elevated — and most significantly, to be able to ice it throughout that day. I think that icing is REALLY helping.

4. I’ve really been trying to do as much crutch free walking as possible, but the transition away from one crutch is not going to happen this week. I can tell that the muscles in my legs are just not strong enough yet for me to properly pronate. Additionally, and probably relatedly, my balance is terrible. All of this makes it hurt at the fracture site when I walk entirely crutchless. On the other hand, I am using the one crutch very lightly, as much supporting me in the horizontal dimension as vertical.

Here are some pictures of my healing yet weakening leg(s). I know that the atrophy isn’t that pronounced, but if you let your eyes go a bit blurry, you can definitely see it. Random question that I’m interested in is will my toe bumps from my climbing shoes, which you can kind of see in the second picture, go away with my break from climbing, or are they permanent?

Also, here is a pic of my knee range of motion. This is actually very similar to that of my right (good) leg, but it is definitely stiffer.

Psychological:

My doctor’s appointment and going down to one crutch were pretty exciting and motivating, and at the beginning of the week, I felt like I was crushing everything. Now that it’s the end of the week, I’m feeling like my life is more or less back to normal — though a new, slower normal. This is good in some ways, but also makes me less super motivated to go to the gym, watch what I eat since I’m not burning nearly as many calories, etc. I am doing those things, I just don’t get the same dopamine rush out of them that I did when I was like, I can’t believe this is happening! I’m also able to focus more on my work, particularly after my doctor’s visit, which is good.

I took some friends who had never climbed indoor bouldering at my gym on Saturday, since it was free for first-timers, and they loved it. The whole experience — hanging out and helping, and just seeing them get into it — really made me happy, and thinking about it does motivate me to try to return to bouldering by the time I get back to the States on May 15.

Looking ahead, I am excited to start physical therapy, and I am really hoping to be able to go crutch free within the next week. Of course there is nothing more that I can really do to achieve this goal, but I’m hoping anyway.

Week 2, Pt 1: Physical Recovery

So, something that is important to know about my progress is that my whole procedure/recovery is IWBAT — immediate weight bearing as tolerated. This means that I am actually encouraged to put as much weight on my leg as possible, as the rod is fully load-bearing. The idea behind this is that it actually helps bone union (for the two side of my broken bone to grow back together), and that — it seems like it at least — I get my life back way earlier. Interestingly, I’ve found very few other accounts of IWBAT IM nailings, though there are a number of papers about it if you google.

Highlights of the week

Day 7 (Tuesday):

I got a follow-up call from my doctor, who asked if I had been walking at all without my boot. I told him I had a little around the house. He suggested that I try to do it a bit more, so that morning, I put on a running shoe and walked around the house like that, and then decided that I was going to try for the whole day. It was awesome! Goodbye boot and good riddance!

I also walked at least 2 miles that day, which — I am encouraged to be as active as possible, but was really active, and I wound up taking an Oxycodone pill in the middle of the night. Not that I was in a ton of pain, but I already find it uncomfortable sleeping with my leg up.

Finally, I decided it was time to go to my school’s gym, since I suspended my climbing gym membership. It was a depressing atmosphere — no one talks to each other, and everyone was so beefy, ha. But did about 20 minutes of arms on machines, and used the grippers. Unfortunately I couldn’t do pull-ups because I didn’t know how to get up and down from the bar safely, but I had done some on a bar in someone random person’s office already that day. Also thinking about going to my school’s bouldering wall (where I learned to climb) to do pullups (and hangboard) as an alternative.

Day 9 (Thursday):

I was really thinking that getting out of the boot was going to be the milestone for the week, and then something amazing happened. I walked. Without crutches. Very slowly, in a kind of shuffle/with a huge limp, but I walked from my desk about 9′ to pick up a document from our office printer. I was kind of dumbfounded.

https://instagram.com/p/-RSGjBvM6s34pCwqh_YUj1eSktitSe6h9_2_00/

 

Other notes:

My pain has subsided a lot this week. It’s also not all that annoying to sleep with my leg up anymore. I do have some pain when getting out of bed in the morning — once I get up and start crutching around, it feels like there is this rush of…blood? fluid? draining down into my leg/foot and creating pressure. It goes away, and has gotten less pronounced over the course of the week, but had been noticeable.

Walking with crutches had been okay, but painful, with it feeling like something was pushing down at the front/top of my ankle with flexion. I finally discovered that because it’s hard for me to lock my knee/have my leg perfectly straight, I had been rolling over my knee too much — I think — while walking, which probably exacerbates that digging in feeling. Trying to take smaller steps with a straighter leg now, mimicking the motion of my good leg. Hopefully I will go to PT soon and get this all sorted out.

I think that my ankle mobility — along the point/flex axis — is pretty good. It’s almost the same as my good foot, though it feels like I’m pulling all sorts of muscles and skin really taught when I do it. I do point and flex exercises basically all day long as I sit at my desk.

My guess is that I’m not elevating my foot enough because…I have things to do. I try to keep it up on pillows on top of my desk at work and then lower my chair such that my heart is technically below the leg, but the leg is also bent at an angle, which I feel is probably not the best in terms of getting blood to the area for healing. I also hadn’t been icing because no one told me to do that at the hospital, but I ran into a fellow climber who is also a PT who suggested it at the end of the week. My swelling and bruising have definitely gone down though. I am noticing some muscle atrophy in both my upper and lower leg. I think a major issue is my inability to lock my knee, so I can’t fully engage my quad.

Here are some pictures of my leg:

Day 6 (shown for bruising)

Day 7 (shown for swelling)

Day 12 (shown for atrophy)

Tips and Tricks:

#1: I hate auto-closing doors. You will hate auto-closing doors. They are way way way worse than stairs. But I finally figured out how to deal with them. Jam the bottom of one of your crutches into the bottom of the door as it swings in, using it like a doorstop, then go through.

#2: You will get better on your crutches. I promise. Also, your balance in your good leg is going to get awesome. Crutching is also good for your triceps, but if your arms are already in great shape, this sadly isn’t going to be that much of a workout for you, particularly if you are trying to weight your foot as much as possible.

#3: The best way I’ve found to get as much weight as possible on my bed foot is to do “silent crutches.” I.e. you try to make as little sounds as possible with the crutches. (I borrowed this from “silent feet” in climbing) You will slow down considerably doing this, but I’m figuring that it will help me speed up in the long run.

Weirdest comment I’ve received from a stranger: “That looks painful. Was it elective surgery?”

Best comment I’ve received from a stranger: “I hope you feel better soon and get to take many more falls in the future!”

Me too!

Week 1, Pt 3: At Home

I have to admit that I was petrified to go home, because I just hadn’t felt very stable on crutches at the hospital. But, my first few days at home have been so much better than I expected, with each day getting easier and easier, just like they said it would. I was only even temporarily sad unpacking my climbing stuff.

My pain is basically gone, with the exception of the incision sites, where my skin just feels tight, understandably. I am getting better and better at crutching, and more significantly, I am able to put more and more weight on my bad leg. If I stand up straight with my feet parallel, I can almost get 50% of my weight on it. This morning (6.5 days after my fall) I tried to walk with only one crutch, and I could, albeit not particularly well.

Here is a picture of my leg from the first day I got home. I have eleven staples and seven stitches. These couldn’t get wet for a bit, but this morning I was allowed to take a shower. Yay. I am using gauze pads as cushions on my wounds, a giant tube sock they gave me in the hospital, and my Aircast boot to walk. Last night and this morning I started to crutch around my apartment with my bare foot , though putting very little weight on it. Basically I just didn’t feel like putting on the boot to go to the bathroom. This was okayed by the doctors in the hospital.

My mood is great, in part because I am so thankful to everyone who has been so supportive of and helpful to me in this ordeal, and in part because I’m so pleased with how this is becoming just a kind of pain the butt (or…leg), more than the life changing catastrophe it first felt like it could be when I was lying on the mat.

Now I have some tips for you! Here is what I learned in week 1:

Tip #1: Particularly if you are an athlete who loves being active and challenging yourself, do everything you can to get back to your normal routine. Get out of bed. Make your bed. Make yourself breakfast. Put on regular clothes rather than sitting in your pajamas. Leave the house. Run local errands if you can. Set yourself a goal of walking around the block. Be social! These things have been critical for me in maintaining a positive attitude and the motivation to get through this.

Tip #2: Get a tote bag to hang from the handle of your crutches. You will quickly learn that you can’t carry anything around any more. Use the tote bag for this. Use water bottles and coffee thermoses for liquids. Use tupperware to move food.

Tip #3: When being social, remember that drinking alcohol and crutching might not be a great combination at first. 🙂

Tip #4: Ladies, if it’s not summer, consider investing in some leggings. I found that my regular tights are too constricting right now for my swollen leg. Dudes…I don’t know, maybe sweatpants? You’ll definitely need something that works with your boot if you’re getting one.

Tip #5: Make yourself a new exercise routine, and look for opportunities to turn something in your daily routine into exercise. I’ve been continuing a lot of my old ab routine, doing dips in the morning between the kitchen counter and island, leg lifts in my boot, working on my single leg balance as I brush my teeth. If you miss climbing, have fun with trying to reach far for things while balancing. (Be safe of course.) Crimp on door moulding to pull the door shut.

Tip #6: Don’t be afraid to ask for help when you need it. People are awesome, and actually happy to help you.

Tip #7: Duh, but don’t obsess over other people’s stories on the internet, including mine. Everyone’s breaks are different, as are everyone’s recoveries. Not that I know this from experience, but I’ve kind of scoured the web at this point and have found people who are back to outdoor bouldering or playing college basketball in months and people who still aren’t fully healed after two years and are not interested in climbing again. So, no real point in thinking that what happens to one person will happen to you too.

Week 1, Pt 2: The Hospital and Surgery

I got to see a very calm third-year orthopedic resident in the ER about an hour after I got to the hospital. At that point they had started an IV for me with antibiotics since I had an open wound, and I believe they put some morphine in there pretty early, since the risk of interaction with my other medication is not a problem in a monitored setting.

The doctor elevated my leg on a “hammock” he made by stringing gauze from one bed rail to the other — apparently his colleague invented the technique and published a paper on it — which allowed him to make a plaster splint for my leg. He also straightened my floppy foot out, which hurt, but not as badly as I thought it would.

It turned out that since I had an open wound, even though it was small, I would get to go to surgery as soon as possible, which turned out to be the next morning. I didn’t sleep much, and had a moment when I just kind of broke down psychologically after getting a super sweet email from a climbing friend. A nurse came in to talk me out of it, which I totally appreciated. They came to get me at 7 am, took me to a prep area where I met my surgery and anesthesia team. The anesthesiologist was very enthusiastic about giving climbing a try, and I gave him some tips about where to go, and tried to convince him of how awesome it is.

The doctor the night before had explained to me that there were two options for surgery: either a rod that went down the center of my bone, or a plate and screws. He seemed to think that the rod was slightly advantageous, but told me I would discuss the options with the surgery team in the morning. It turned out that there was nothing to discuss, and that I was getting the rod. Which I learned later is definitely the better option. The best thing about the rod, technically known as an IM nail, is that it is completely load bearing from the moment they put it in. In other words, the only thing between you and walking again is pain and soft tissue damage.

One of the doctors also asked me about my healing fractured rib that showed up on my chest xray, which I actually never knew about. I mean, I knew that I had a painful overuse injury in my rib area from about five weeks before, but assumed it was a pulled intercostal muscle. Oh, climbing.

I got carted into the operating room. I was a little scared but was just telling myself how routine this was. The next thing I knew I was in the recovery room, and oh my god, I was in pain. I rated the pain of the bone break a 6 when I came in, and a 9 after surgery. I cried from pain for the first and only time of the whole ordeal, and told them they had to give me more morphine, which I guess they did, and then I fell back asleep.

That evening I got into my own room, and stayed there until two days after the surgery. My leg was simply wrapped up in an ace bandage, and elevated on pillows. The pain was better than in the recovery room, and I had been taken off morphine and put on oxycodone. For some reason I was only being given 5 mg of oxycodone every four hours, instead of the 10 that I was also allowed to have. During my first night, the pain was pretty bad, and I finally got some Demerol intravenously, which was great. The next day my pain had reduced a good amount — I was down to a three on the pain scale — still taking either 5 or 10 mg (as necessary) of oxycodone. I saw a physical therapist who, given the strength that I had in all of my muscles in his initial diagnostics, thought I would be able to go home that day. I got an aircast boot, and we did some crutches training, but I didn’t do particularly well and got dizzy. So no release for me yet.

At 10 that night I took the last oxycodone pill I would take in the hospital. The next morning I had very minimal pain — maybe a one on the pain scale — and tried again with the crutches/pt guy. He was pretty sure I was going to be released by noon. I tried walking to the end of the hall, and got very dizzy this time. Because my blood pressure was 80/40. So: back to bed, and they pumped me up with some saline intravenously. My blood pressure went up, I did some crutching and some crutching up and down stairs, still felt a little dizzy, but was cleared to go home. I have to say that I was pretty scared about how I going to be able to manage everything once I got home, since I felt unconfident on the crutches, and in the hospital someone could attend to my every need.

Psychological take away: the pain, and your desire to get out of the hospital, will probably facilitate this for you, but don’t think about when you will be climbing — or whatever exercise you are missing — again. It’s going to be a while. Let it go, and move onto when you are going to be able to go home, when you are going to be able to shower, when you will get your staples out, etc.