Lisfranc dislocation, good news on recovery

Hi Lisfranchope,

 

That was a good report and update.  I am interested in knowing how you progress bootless.  When I was NWB, I worried a lot about going anywhere, unless it was in a wheel chair.  It must be stranger still to think about going around without your protective boot!

We are doing similar exercises but you are farther along.  I am also doing the leg lifts to strengthen the upper thigh of the injured foot - 15 leg lifts . I am also on all fours and lifting each leg to work on the glut. max.  After sitting for so long everything must be strengthened to walk.  

I don't have any pain. What about the heel pain that you mentioned earlier?  In terms of the screws.  There is no reason for removal but they can break.  Do you plan on doing anything that is high impact?   I think about whether removal is also traumatic to the cartilage, thus increasing the possibility of arthritis.  But let me know what you find out about screw removal.  

I continue icing for swelling.  The first time that I put 50% weight on the foot, it swelled a lot at the side of my ankle in one place.  Now its just swelling dependent on how long I remain upright.  

 Yesterday, I walked around the hospital.  From PT to my OS office.  No wheel chair, just crutches.  It was such a good feeling to be independent.  And your arms get stronger from using the crutches, too.  

 The mental part of this injury is just as bad as the physical.  You really lose your independence.  I live in a the City so I think about who I will encounter, will I take public transportation,  and whether there are people who would steal an Iphone , etc.  With the lack of balance, you can easily feel like a potential victim.  Although people are nice and want to give you a seat.  I signed up for temporary assistance from The Ride. which is a public transportation service that provides door to door car service for $4.  

 I'd like to know when your swelling subsides.  Being upright, one would think swelling would be considerably reduced?  

I have been passing up fund raising things or weddings because I just don't feel like wearing my boot and crutches.  Have you been hiding out at home too?  After yesterday, I am thinking about going out again.

Waiting for Light,

WaitingforLight, Up until 2 weeks ago, I also was dependent upon a wheelchair. I would use crutches to get to car, but would have husband load the chair. The crutches were just too hard on my hands and like you I was not well balanced, had several near fainting episodes and fell twice using them. I believe now that it was from de-conditioning as a result of the injury, low blood pressure and the extra challenge of Chronic Fatigue Syndrome. Now that I can be full weight bearing, I can walk to car and even driven a few times (left foot was broken). But when I arrive, so far I've only walked into doctors offices and that is with an awkward gait partially from the airboot restriction, but also because I am still building confidence and strenghth. The heel pain zinger only happened a couple times. My heel does feels tingly with the first step and aches after I've been walking awhile, but I understand that pain is from the foot getting used to weight again and doesn't concern me. It feels like healing pain, so to speak, and is not terrible. I do have other pains-knee, ankle and other parts of foot, like my big toe. But these are not awful either. Occassionally I will get a short lightening bolt through the injury site that sucks in my breath, but again that is rare and tolerable. The strongest medication I take is Tylenol and that infrequently. The swelling did lesson as I started weight bearing. I continued to ice though until I was given the okay to sleep without the boot. I too have that outside of ankle swelling. It is going down but it still present. I have had to return to some icing the more I walk. PT says sometimes walking will increase inflamation and it is good to ice. I completely relate to your comments about this being as much the mental challenge as physical. The loss of independence has been humbling. I've felt more impatience, fear and vulnerability than ever in my life. I live in the country and have a husband to take me to doc appts, but they have been on his schedule. He is a bit lacking as a nurturer and I was reluctant to ask him to do things. For example, when the kleenex is out of arm's reach, (might as well be in the next country), it hardly seemed worth bothering him. I learned to jot down things I needed and ask him to do them when he came to check on me. As time went on and I admitted to myself there were things I just could not do for myself and was not above calling his cell if he was too deep into football to hear my shout. Glad you were able to get door to door service. I can truly imagine a sense of vulnerability in public places. I have felt that inside my home. We are surrounded by trees in an area of high unemployment and home burglaries have increased. I have struggled with images of being unable to run from a burglar, even gone so far as to hope I would at least have my boot on during this imaginary breakin, so I don't reinjure my foot! With my door locking vigilance, I've accidently locked my husband out more than once. I have yet to set foot in a store since July! I do have a Disabilities parking pass now and could make my way from lot into a store, it's just all the walking from that point I can't face. The first time I attempt shopping will have to be in a supermarket that offers those little electric carts. Yup, will just have to suck in my pride. It seems like too much trouble at this point. Will let you know as soon as I conquer WalMart. Saw my surgeon yesterday. He showed me before and after images and one can hardly see evidence of the break, except for the neon screw, of course. He mentioned removing the screw, claims it involves little pain, but unfortunately I didn't read your message before seeing him and didn't ask questions about potential trauma to cartilage. Will see him again in 3 weeks. He DID say that in 3 weeks, which well be almost 4 months from surgery that I will be 80% healed. I will not be doing anything high impact down the road. This Chronic Fatigue brought that level of fitness to an abrupt stop quite a few years back. But my surgeon told me about a teenage patient with a lisfranc facture who who was able to return to cheerleading. At that stage in recovery (sorry, don't remember how many months), she was only restricted from high jumps. I know of another man in his 50s who had a severe lisfranc injury in a water skiing accident. His fellow water skier said his foot literally flopped sideways. It did take him 1 1/2 years, but he has returned to ALL his sports activities. I also heard of a man in his forties who had a railroad tie fall on his foot in 2008 and is due for his 4th surgery. BUT his daughter said he absolutely did not comply with doctor's orders. Personally, I feel compliance is key. Trying to tough one's way through just doesn't work. Sorry you have been 'hiding out.' It is tough knowing that a mean spirited 3 year old could kick a crutch and land you on the ground. Full weight bearing has its' challenges, but a returning sense of independence and personal power are the bonuses. Keep the faith. It does get better. Take care of your good self, Em

Waiting for Light,
Sorry about the run-on paragraph in my previous post! I tried to edit and that was the result.
Em

I have been reading your posts and wanted to give you my opinion from my experience. I had my three screws removed on April 30th 2012 and My recovery was not as bad as the first. They make only small incision and back out the screws and my foot swelling and pain was not as great. I am walking around fine still cautious and wear very stable shoes and I am so glad I had the screws removed for me. I can curl my toes like my other foot with screws in it would swell at the base of my toes and get real tight. My swelling today is so minimal and only when I have been up walking all day. I live were there is snow and I have noticed at night a aching feeling which is probably arthritis but I think with any injury that is inevitable. But it isn't that bad to keep me up at night. I am very active and with all of this I have become very week keep up the exercises it really helps with the circulation and you will be come stronger and feel so much better. Best wishes to you!

Hi Lisa,
Thank you so much for chiming in! It is encouraging to hear news from a fellow lisfranc survivor! I went back and reread your story and cringed at the part where you climbed AFTER you broke your foot! My July 2012 injury was not the least dramatic or impressive. I fell off my shoe...a low heeled one at that! I hit the deck and didn't put weight on it until a couple weeks ago. My podiatrist broke his foot falling over his dog, so all stories aren't nearly as exciting as yours.

Am I calculating correctly that you had the screws removed 5 months after your surgery? Were you anesthetized? If not, how much did it hurt? Did your doctor give you any warnings of possible negative side effects after screw removal? Mine hasn't mentioned any, but I'm concerned about bone stability in the long run.

My doctor did say arthritis was a strong possibility, but after reading so many distressing stories about lisfrancs, I am just excited to be walking again!

You mentioned you are active, but very weak. Do you mean you are currently weak, or were during your recovery?

Interesting that before removal of the screws the base of your toes swelled. I experience that as well. My big toe will have the odd zinger, too. Maybe that will resolve when I have mine removed. I am encouraged by your update and nice to know that for you removing the screws has been a positive thing.

Thank you again for posting! So nice to have input from someone farther down the recovery trail.

Hope to hear from you again soon,
Em

Hello Lisfranchope,   

I have been busy walking 50% WB with my boot and crutches.  My Lisfranc foot is getting stronger.  I walked 3 blocks outdoors this week.  The foot still has some pin pricks of electricity when I first set the boot down.  After the initial surprise of the pin pricks, I can walk on the foot with 50 WB.   I am still hiding out though.  In fact, I do most of my walking around the hospital before or after PT.  On Friday, I will be 10 weeks post-op and expect to be able to begin walking with the boot and no crutches.  

I am now doing calf stretches similar to a jogger - standing up with injured foot behind to stretch out calf muscles.  Your calf muscles are tight and work hard when you begin to walk again, so they need a good stretch. Here's what I do: 

1. Place both hands on a wall with arms extended. 2. Lean against wall with uninjured leg bent forward and the injured leg extended back with knee straight and foot facing straight forward.3. Keep the heel of your rear foot on the floor. 4. Feel the stretch in the calf of the injured leg, and hold 30 seconds. Rest then repeat. 

Also, I am spelling the alphabet with the injured foot.  Some spelling with just the 1st metatarsal fractured toe, leg lifts lying on my back to strengthen thigh muscles and on all fours with legs bent to strengthen my gluts.  I also have smaller motions to do with the PT bands.  

I have a lot less swelling.  But still have swelling after walking on the foot a lot.  

I even drove a car last weekend!  Not quite sure about driving yet.  I drove when there was no traffic around.   If you had to jam on the brakes, would you hesitate and want to protect your midfoot more than wanting to slam on the brakes?  That wouldn't be good, would it?  

Anyway, I hope all is well with your lisfranc Em.   I hope you are getting out of the house as well.  If you use crutches, the biceps will get so strong from using crutches, they don't want to give up doing the work of walking.  

I already went out to vote today!  There was a line full of crabby, city folks who weren't interested in letting me cut in.  I just stood there and after a few minutes, a young man told me to cut in the line in front of him.  Can you believe it?  Aren't the crutches enough?  Do I have to wear a handicapped sign on my jacket?  I can stand but not so long as it takes to stand in line.  

Can't wait to see my OS!  Its great as long as you continue to get better.  I hope I can return to jogging, at least on an elliptical.  

Let me know how you are doing,

Waiting for light

Hello,

My Surgery was Jan 6 2012 screws removed April 30th 2012. It was about 4 months and I was very glad to have the screws out and I haven't had any side affects. I just wear good supportive shoes while it is still healing. My doctor said that after the screw removal it can take another 6 months till the swelling goes away because it was another surgery to the foot and it takes time to heal but it was not anything like the first surgery.

My doctor asked if I would like just a local but I wanted to be put out. I didn't want to hear them drilling out the screws. Don't be afraid it isn't that bad. This injury occurred on my good leg. My other leg I have had multiple surgeries. Due to a birth defect I was born without a hip socket and have had several reconstructive joint surgeries, a hip replacement and revision. My first hip replacement This has made my circulation poor and when I 'm not walking or swimming keeping active this leg tends to get very weak. So when I was down the atrophy for me was bad and so I have had to work hard to strengthen my legs. My calves became skinny and the tendons tight. I really think that this is the cause of my heel pain with the plantar fasciitis my achillies tendon is so tight that it is causing this issue. I continue to stretch them like you mentioned all the exercises and they are feeling better.

I really have enjoyed having the screws removed and feel so much better. When you get to walk without the boot. My Doc had me walk about 1 or 2 weeks with with a supportive tennis shoe before they removed the screws and  then they x-rayed to check out the arch.  When I would walk and bend my toes it would feel so tight and when the screws were removed it hurt to bend but not that tight feeling like you could tell there was something in there and it bothered me. With the physical therapy they had me practicing walking with more emphasis on bending the toes it got better. After walking so long with the boot when you can  finally walk in a shoe. You tend to not want to bend the toes and keep your foot straight because it does hurt and you get the zingers but if you continue to exercise and practice your walk it gets better and your gait to your walk gets better also.

After all, this experience  has been a long journey with lots of ups and downs but it does get better. Sure it is not pain free but as time goes on its not as bad. It is hard to believe November 30th 2011 was the day of my injury and that date is approaching and all I can say is wow! It's been a very interesting year and I am so thankful for my family and friends and all of their help along this road of recovery. All I can hope for is that this coming year my life will be back to normal and I will be pain free.

Take care, Lisa

Hi Waiting for light,

Very glad to hear you are in the 50% weight bearing stage. I had a hard time estimating what constituted 50%-very subjective. I tried using the scales to get the 'feel' of 10, 20, 30 lbs, etc, but it didn't translate into walking for me. I'm glad crutches are working for you and that you get that biceps strenghthening bonus-a lisfranc silver lining!

I applaud you for getting out to vote. I can relate to the weird, vulnerable sense of the recently vertical-not knowing when to ask for help. When I came out of PT last week, my car was blocked. Went back into the office to find out who was blocking me. No one there, so ended up hobbling to 3 other offices, including up one flight of stairs. Turns out it was someone in the 1st clinic! My foot was honking on the way home- it wasn't happy that night or the next day.

I'm in that limping stage. Once released to full weight bearing, it's been quite the process of trial and error, fear of overdoing, of not doing enough. I've gone from arriving at PT in a wheelchair, to that strange walker (with arm platforms), to a cane only. At home I alternate between walking without assistance to using the wheelchair to give my foot a break . The first few times I stepped with a normal gait-heel to toe, my foot seemed fine at the time, but had quite a lightening storm later. So, I went back to limping, walking flat-footed. My PT says if I limp, though, I need to at least use a cane. Apparently, limping without an aid throws other bits of the body out of whack. It's so nice to be implement-free that it's hard to go back to lugging a cane around, but I get her point, it does provide balance.

So that's where I am now...walking most of the time (using the cane some of that time) or using the wheelchair to give my foot a break. My swelling has gone down, but still have quite a bit around my ankle, especially after a lot of walking, so am back to some icing and elevation.

Thanks for the reminder of the calf stretch. (That used to be part of my warmup in my running days.) I am amazed how taut my calf is! My PT said I could add that to my stretch routine. Still doing exercises twice daily and have added 30 semi-situps and lifting small hand weights. Feels good to exercise no matter how limited it is! I think it is vital part of recovery, prevents deconditioning, or restores back to condition.

I have yet to go to a supermarket. My foot just wouldn't tolerate that much of a workout and I'm too embarrassed to use an electric cart. Will have to swallow my pride eventually.

I will see my surgeon next week and have more discussion about removing the screw. Not sure if I'm ready, but we'll see. All in all, I feel so much better, so happy to be walking again.

Take care and thanks for posting. Always happy to hear from you,
Em

Lisa,
So sorry it has taken this long to reply. Have had a lengthy bout with the flu.
Thank you so much for detailing the removal of the screws. Since I've been sick, I haven't been able to see my surgeon about removing mine. I'm struggling with walking. I've tried walking in a normal way including bending my toes, but it would really zing later, so I've gone back to walking flatfooted and with a limp. I'm blaming that zinger pain on the hardware and I cringe at the thought that I might be bending or moving it. Did you stop having zingers after you had the screws were removed? Do you think there are other reasons for 'zinger' pain?

Did you have to be non weight bearing at all after your hardware surgery? Can you walk barefoot at all now? I would love to walk across a floor just once without having to put shoes on! I used to always walk around the house barefoot, or in slippers, so it's quite a change.

Thank you for writing about your experience with PT and working your foot to become more flexible. I have fear about putting my foot through it's normal range of motion, but as I said, it's because I'm so aware of the presence of that neon screw! Did you feel freer to work on walking normally AFTER your second surgery?

Please write again. I cannot begin to express how much it helps to hear from you! Thank you.
Em

Hello Lisfranc friends and Happy Thanksgiving,

I am now 12 weeks post op and walking. No crutches and no boot - just walking. Beginning to walk was trial and error and exercises from PT. It did swell sometimes, and also hurt. At one point, after wearing the wrong shoe, I had to ice and rest my foot. The shoe was a flat New Balance shoe that just didn't fit my foot. It felt like a metal bar running across the shoe and pressing against the midfoot. I am now wearing a Privo shoe that feels comfortable. I am going to continue looking around for shoes though. The Privo doesn't have any arch support. My foot zingers disappeared with using the foot. The more I used my foot, the more it began to improve. The stiffness in the morning has also improved. I returned to using a gym and found that the elliptical is a great machine. There is no impact and yet your foot moves in all the ways that are important to walking and running. I have also been using the circuit series equipment to strengthen my legs both the leg curl machine for the thighs and the leg extension for the back of the thighs and glutes. My walk is changing all of the time. When I was wearing the wrong shoe and every step was painful, it was easy to believe that I would end up like a lot of the posts I've read on the internet - unable to walk and in pain. Beginning each day new and never giving in is the only way to make progress. Just yesterday I tried to walk the stairs normally with some success. Going up is easier that going down. On Monday, I couldn't walk the stairs at all! I discussed removing the screws with my OS. He keeps saying that it isn't necessary. He says that 2/3 of his patients leave them in. I asked about swelling around the screws because of Lisa. He scheduled me for another appointment in Dec to monitor my progress and possibly schedule screw removal. Hang in there and keep working on your exercises. I can give great thanks this year for returning to walking.

Waiting for Light

Waiting for Light,

It is great to be walking again, isn't it? I will never take it for granted again! I know what you mean about going from boot to shoe feeling strange to the instep. I started out using an old pair of running shoes and was amazed when I was able to get my foot into the shoe. (I did have to loosen the strings.) So far, the only alternate shoe I use is a cheap pair of Wal-Mart velcro shoes I had been using for jumping on my Rebounder before my accident. I found a pair of "Powerstep" inserts I bought somewhere along the line for previous foot pain and because it iprovides great arch support I slip them into whatever shoe I am currently wearing. The velcro closing shoes are not glamorous, but I really don't care. So far, I haven't gotten the okay to walk barefoot, so it is much quicker to put on the shoes that I can secure quickly, (in the middle of the night, for instance), rather than tying a running shoe.

New development-I have a screw loose, literally. When I tried to walk using a normal gait, (rolling from heel to toe), I had sharp pain. It wasn't necessarily while walking, but later it would shoot those lightening bolts-maybe 3 in a row. My surgeon took a closer look at my last xray and said based on my pain description and a faint shadowing shown on the xray, he believes the screw has loosened. We had previously discussed taking it out, (the bone appears to be healing nicely), so he set me up for the procedure December 14. I know some people do well with their hardware, (my niece has screws and a plate and is still a professional dance teacher-don't think it was lisfranc though.)

He said in some cases the screw can be removed after several deadening shots to the foot, but in my case, he will use general anesthesia of some type. He said it is more complicated, which I think may mean 'more painful.' Like Lisa, I prefer to be 'out of it.' I can handle dental pain, but there's something about the carpentry of it all that bothers me. The surgeon said the hardest part is seating the drill to the head of the screw-then it's just a matter of seconds to back it out. I'll go in for a pre-op appointment Dec 6. My impression is that this procedure is not a big deal, that there is little recovery time, but I'll know more next week. I am not anxious about having this done, kind of excited. I currently have a decided limp and am hoping I will be able to walk with a more normal gait after it's taken out.

My physical therapy had to stop because of the loose screw and I'm finding it a challenge motivating myself to do exercises that aren't foot related that I had added to my home physical therapy routine. I had been doing them twice daily and haven't done them once today. (I will after I finish typing, though.) Thanks for your reminder to continue working out. I am impressed that you are back in the gym!

I agree that having a positive attitude is more than half the battle! It DOES get better. We are walking again! I am so grateful. There is life after lisfranc! Thank you for continuing to communicate. It's very encouraging to share our progress.

Take care, Em

Hi Em and Lisa,

How was your surgery Em? Even though I have yet to send out any Christmas cards, I wanted to check on Lisfranchope and find out if surgery has improved your mobility and erased your limp?

I am driving and walking and working out. My favorite machine is the Cybex cross trainer. Like Lisa and others, I still have a sensitivity around the area of the screws. I can even run on the foot but because of the sensitivity, I am thinking about having the screws removed too.

Everything else is going well. I finished PT and just do my own work out in the gym. I love the cross trainer Cybex. One day after using the strengthening routine on the Cybex, my foot, which had tight ligaments and tendons, relaxed on its own. The work on the machine relaxed and lengthened the ligaments so I could walk more comfortably instead of the uncomfortable feeling of toes that won't relax and touch the floor, which virtually ensures that you will keep striking any surface that you are walking on with your heel, instead of rolling onto the front of the foot and large toe.

I did have one low moment. On a day that my foot felt good, I went to my shoe closet and tried on two different pairs of boots. A black boot with a 2 1/2 inch heel wouldn't go over my foot at all. A brown bootie with a high heel went on, but I couldn't walk on it. And when I took it off, my foot hurt like hell for 3 days along the top of the foot and the side. Both places where the surgical incisions were made. I felt bad for all three days accepting that none of my shoes will fit again. I have been wearing the same Privo by Clarks shoes since I returned to walking.

I also have a new pair of Uggs, over the knee boots that fit. Happy Holidays to both of you.

Take Care and let me know how you are doing.

Waitingforlight - and found it in 2012 (even without a pair of killer black boots) :-)

Waitingforlight,

So nice to get an update from you. Again, I'm impressed by your workout regimen! I empathize about shoes...I miss mine, too. I really need to get in there and wipe the dust off, but I'm just going to consider it patina and imagine my shoes increasing in value..Ha!

I had the screw removed 10 days ago. The surgery went well, I was put back into my walking boot, sent home with pain meds and told to ice and elevate. I only took pain meds once, followed instructions faithfully...used the ice machine and wore the boot to bed the first 4 nights. It really hasn't hurt much and there has been very little swelling. Also, even though I was prepared to be bedfast and nonweight bearing for awhile, I only used a wheelchair the first few days. Went back to the doc on day 4 for xrays and a bandage change. Will see doc again in couple days for stitches removal. I'm still wearing the boot during the day and when I get up in the night. The doc said we will talk about an orthotic of some sort in a few weeks (a shoe insert, I believe), and he'll refer me for PT in about a month. I'll let you know how my next appt goes. Am looking forward to shedding this boot again.

I hope you have a Happy Holiday and Merry Christmas (if you 'do' Christmas).
Take care of yourself and please stay in touch. Don't give up on glamour. (I'm going to google 'over the knee' Uggs.)

Em

Don't feel bad when you have your screws removed your swelling will go down even more and I can wear my boots my foot is real snug on the surgical foot but not bad. Your right though I wore some boots with a two inch heel to the mall and my foot swelled on the top and hurt bad for a couple days also. I wasn't t bright and wore them all day and went to the mall. I tried them out again for only couple hours of walking and I was ok. My doctor later told me to wear my super feet orthodic's for arch support for a couple more months in good supportive shoes so I am minding. I did climb up on a ladder to decorate my two trees one is 9 feet tall. Standing on just my toes for a couple hours that is not to smart wouldn't recommend that one either again it swelled and hurt for a couple days I hope both of you had a Merry Christmas!

Hi. Not very tech-savvy, hence don't know how to create a blog. New here. I injured myself in auto accident on the 5th. All my midbones have shifted/dislocated. Last Friday had fusion and 2 pins(ORIF). It is a challenging time. Everything stopped. I am a school teacher, so no more work. Laid up as you all know is the hardest part..the long hours, the uncertainty. Hoping to make friends here,and  listen to stories of hope. I don't even know how to really reach out to other LIsfranc sufferers, but at least I know that I am not alone now. The days are really long. :)