broken fibula seeking advice

psrrobbins

USA
1 Posts
 
Posted - 10/07/2006 :  04:02:56  Show Profile  Reply with Quote
I am a 65 year old male, slightly out of condition and recovering from a recently (April) broken fibula that required surgery. The surgical pins were removed in July. (Right ankle area). Currently I still have some swelling in the area of my leg, ankle and foot and have not fully regained the strength and range of motion that I had in my injured ankle and foot. I am also experiencing a problem with balance. (From recent readings I have formed the opinion that some of my problems may be associated with diminished proprioception, although I do not have a professional opinion confirming this.)I now walk with a noticable limp.

After 10 weeks I was released from physical therapy. Prior to releasing me the PT advised me that he thought that I had reached a plateau in my recovery. He gave me a series of home exercises which I am doing on a regular basis.

I have access to a local fitness center and have a balance ball, stretch bands and a mini trampoline in my home.
I am seeking a recommendation as to exercises that you would recommend and if there are any products on the market that you believe may aid or hasten my rehabilitation. I am not, nor will I ever be, engaged in competitive athletics, and I do not believe that I will advance beyond the beginner – intermediate level of an exerciser. Prior to the break I regularly enjoyed bicycling and hiking. I stand at 67 inches and weighing about 175 pounds.
Thank you in advance for any suggestions that you can make.

psr

Psr

Ask a PT

156 Posts
 
Posted - 10/08/2006 :  23:21:01  Show Profile  Reply with Quote
The best option would be to contact your physical therapist again and obtain further ideas for your home exercise program. He or she knows you the best and knows what deficits you continue to have. Most therapists don't have a problem speaking with their patients and helping them upgrade their home exercise program after their patient has been discharged.

For someone with your condition, it is not abnormal to continue to experience edema in the region of the lower leg, ankle and foot. With time this does decrease for most individuals. You mention you continue to experience range of motion and strength deficits and you mention your therapist has given you exercises to perform on a regular basis. I would recommend you continue with what your physical therapist has given you for your home exercise program. I am sure after 10 weeks of therapy you are not only performing exercises in nonweightbearing (ie. thera band, AAAROM/PROM, joint mobs, etc.) but functional weightbearing exercises as well (ie. heel/toe raises, partial lunges, step up/down, stationary bike, etc.) to help promote your range of motion and strength. You mention your ankle/foot may have a decrease in proprioception (proprioception meaning- having a sense of what position your ankle joint or joints in your foot are). This could be the case as this would be a common occurence secondary to immobility. After 10 weeks in physical therapy I am sure your PT worked on helping you improve on this aspect as well with activities such as the BAPS board (biomechanical ankle platforms system), single or double leg stance exercises on an airex, balance boards, etc.. You can easily simulate this at home as well for proprioception by using a couch cushion or using your trampoline to simulate an airex pad or use of a ball with board on top to simulate a BAPS board (for sitting exercises), or even the purchase and use of a half foam roller to simulate these exercises. Without knowing the severity of range of motion deficits you are experiencing, it is hard to recommend a product. For indiviudals who have difficulty with obtaining range of motion, particulary dorsiflexion, a dynamic splint for your ankle may be beneficial. For more information on the dynamic splint visit http://www.jimmedical.com/pages/dynamic.html . If your gym has a pool, it would be beneficial for you to perform exercises in the pool because this can assist with decreasing your edema and increasing your ROM/strength. At the gym, the stationary bike and perhaps the leg press (using it for a calf raise/calf stretch with light weight) could be beneficial as well.

Again I would strongly suggest you consult with your therapist first before taking on any of my recommendations which you are not already performing. I hope this has helped and thank you for using CyberPT.