So I got my pins and stiches out and am now in a walking boot. I have some questions now since they didn't really give me any guidance, they just said you can bear weight on it as tolerated.
When do I actually begin PT rehab for this? Is it when I'm out of the boot and trying to walk again on my own?
How much is too much activity? Because uh... it's been since Mar 11 when I got injured and when I'm in the boot, I have been testing walking with varying amounts of weight on my foot and that's been going well. Today I noticed that I wasn't putting much weight on the crutches at all and decided to just try walking. I could walk without any pain! It was amazing. I am scared that I'm pushing things too far though. Suggestions on a good step-up program for anyone that's been through it?
My foot is really disgusting and still fairly swollen. When I touch the area directly above my 1st and 2nd metarsal joint on my mid-foot, near my incision point, I get a tingling sensation. Normal? Tips on reducing the swelling?
When do I actually begin PT rehab for this? Is it when I'm out of the boot and trying to walk again on my own?
How much is too much activity? Because uh... it's been since Mar 11 when I got injured and when I'm in the boot, I have been testing walking with varying amounts of weight on my foot and that's been going well. Today I noticed that I wasn't putting much weight on the crutches at all and decided to just try walking. I could walk without any pain! It was amazing. I am scared that I'm pushing things too far though. Suggestions on a good step-up program for anyone that's been through it?
My foot is really disgusting and still fairly swollen. When I touch the area directly above my 1st and 2nd metarsal joint on my mid-foot, near my incision point, I get a tingling sensation. Normal? Tips on reducing the swelling?
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bogglor - i've been walking for a week. every day gets easier and more natural. I go to pool in the morning and walk in chest deep water. ggb
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Great (relatively speaking) to read the others' new experiences, hope all are coming along. Re: arthritis, I'm not showing any (12 weeks since surgery for #1, 2, 3 fractures ORIF, 12 screws, 2 plates). Arthritis is something that an orthopedic surgeon should be able to see in an xray. It may come later but I'll deal with it then.
Meanwhile I finally got out of the boot! on Wednesday. Hurts like a son-of-a-gun to walk, feels like someone just dropped a bowling ball on my foot. And yes it does hurt in the ball of the foot, and to bend the foot from the toes, as in stepping downward onto a stair. Since it didn't hurt anymore in the boot, I'm assuming it's the foot pushing against all the hardware and such. I spent nearly an hour at a shoe store trying on every pair of New Balance walking/xtrainer shoes that were close to my size till I found one pair, New Balance 621, in a 2E (I'm regularly a D) that would accommodate my still swollen foot + the orthotic. They came in black so I can use it for work; may get a white pair for everyday
ggb, good to hear it gets better after a week because after 3 days it still hurts quite a bit and I'm limping, taking stairs one step at a time, and walking veery slow. I am back in the gym though and doing weights and riding the exercise bike feels great.
My doc said that I come back in 3 months and they'll decide when to take the two big screws, that go across and through #1, out. I think they'll take them out at about that time unless I damage the foot again. I asked how long I have to wear the orthotic and he said "a year".
So pain, yes, but getting back to a normal life, yes. The doctor's nurse said after 6 months people make leaps and strides in recovery, and that after a year they make even more leaps and strides in recovery. So in her way she told me it's not an overnight process.
Meanwhile I finally got out of the boot! on Wednesday. Hurts like a son-of-a-gun to walk, feels like someone just dropped a bowling ball on my foot. And yes it does hurt in the ball of the foot, and to bend the foot from the toes, as in stepping downward onto a stair. Since it didn't hurt anymore in the boot, I'm assuming it's the foot pushing against all the hardware and such. I spent nearly an hour at a shoe store trying on every pair of New Balance walking/xtrainer shoes that were close to my size till I found one pair, New Balance 621, in a 2E (I'm regularly a D) that would accommodate my still swollen foot + the orthotic. They came in black so I can use it for work; may get a white pair for everyday
ggb, good to hear it gets better after a week because after 3 days it still hurts quite a bit and I'm limping, taking stairs one step at a time, and walking veery slow. I am back in the gym though and doing weights and riding the exercise bike feels great.
My doc said that I come back in 3 months and they'll decide when to take the two big screws, that go across and through #1, out. I think they'll take them out at about that time unless I damage the foot again. I asked how long I have to wear the orthotic and he said "a year".
So pain, yes, but getting back to a normal life, yes. The doctor's nurse said after 6 months people make leaps and strides in recovery, and that after a year they make even more leaps and strides in recovery. So in her way she told me it's not an overnight process.
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Hello everyone, and I hope you are all healing well. As I posted previously, the CAT scan didn't show any fracture or dislocation, but I still feel there is a lis franc issue going on due to the tremendous pain. I am wearing my air cast faithfully and my foot feels good with it on, but if I bump into anything with it on, the pain is unbearable. Also, if I have my foot planted and turn my body in the wrong way, I could scream! :'( I had to forego the non-weight bearing cast and 6 weeks off work because I have only been at my job for 6 months. The Dr said I could use the air cast but really would have rather put me in the non-weight bearing one. She told me she wants to treat me as if there is a fracture since I can't have an MRI (have a spinal cord stimulator). I just wonder how much damage I may do by not having it treated more aggressively and trying to wait it out until at least the end of October/early November when I've been at my job for a year. I can't even think about the possibility of losing my job, as my husband & I have a lot of debt. Plus, good paying jobs are almost impossible to find where I live. I've only been wearing the air cast for 1-1/2 weeks, and Dr said to wear it 6 weeks. Has anyone had a lis franc injury and recovered without surgery? If you waited several months, how much more permanent damage might be done? I'm so depressed about not being able to treat this injury correctly. I thought maybe if I wear the air cast until the end of this year, at least I might not do more damage. I commute 24 miles each way to work, so having someone drive me is out of the question if I were to have a cast. I had written in an earlier post that I thought the only thing I did was to have a full jar of peanut butter fall on my bare foot from the second shelf of a kitchen cupboard. I then remembered that around the same time, I took a terrible fall in my kitchen on a wet spot on the floor and my foot hurt horribly, but there was no swelling and the pain did subside after several days. But it came back in a few weeks with a vengeance! Anyone who can help me with my questions, has your injury healed without surgery, or by waiting several months, will I do more permanent damage, I would surely appreciate it! Thanks for reading, and I wish you ALL the best in your healing and recoveries!
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Wow, this is a great thread!
My wife and I are both Letter Carriers (mailmen) on walking routes. On May 7th my wife was stepping into her vehicle when she slipped and fell ( it was raining) and severely injured her left foot. A trip to the clinic, said no breaks, but that they would send the xrays to radiology and call back. The following day I took my wife to her podiatrist, the foot was extremely swollen and she could not bear any weight and was in severe pain (she had recently been off for 8 weeks for kidney stone, said the pain from the stone was a 20 (on a scale of 1 to 10) and the foot pain was a 10).
The Podiatrist immediately diagnosed it as a lisfranc dislocation with fracture, and wanted to do immediate surgery with small incisions and wires to straiten everything. Because of workmens comp issues we went immediately to an orthopedic surgeon. Both of these drs. upon seeing the xrays exclaimed "oh my God, HOW did you do this!" and indicated that it was a very serious injury. The OS said that wires alone would no do it and
because there were no fracture blisters sent us for a cat scan and agreed to do the surgery the following morning (if it was not too swollen by then). The surgery was done with two screws inserted (looked to me like they went into the big toe and its adjacent toe, she came home from the hospital the day after the surgery, which was today.
THe Doctor has indicated that in two months she can begin slight weight bearing, we have been following RICE since the injury. This is where we are as of today.
Can anyone tell me, what does minimal weight bearing mean?
Should she be on antibiotics for infection?? She received anti-biotics through the IV but was not given any antibiotics to take on her own, is this normal?
So far the Dr. has now indicated weight bearing in two weeks and then we go from there. Can anyone tell me what to expect from here? Thanks.....
My wife and I are both Letter Carriers (mailmen) on walking routes. On May 7th my wife was stepping into her vehicle when she slipped and fell ( it was raining) and severely injured her left foot. A trip to the clinic, said no breaks, but that they would send the xrays to radiology and call back. The following day I took my wife to her podiatrist, the foot was extremely swollen and she could not bear any weight and was in severe pain (she had recently been off for 8 weeks for kidney stone, said the pain from the stone was a 20 (on a scale of 1 to 10) and the foot pain was a 10).
The Podiatrist immediately diagnosed it as a lisfranc dislocation with fracture, and wanted to do immediate surgery with small incisions and wires to straiten everything. Because of workmens comp issues we went immediately to an orthopedic surgeon. Both of these drs. upon seeing the xrays exclaimed "oh my God, HOW did you do this!" and indicated that it was a very serious injury. The OS said that wires alone would no do it and
because there were no fracture blisters sent us for a cat scan and agreed to do the surgery the following morning (if it was not too swollen by then). The surgery was done with two screws inserted (looked to me like they went into the big toe and its adjacent toe, she came home from the hospital the day after the surgery, which was today.
THe Doctor has indicated that in two months she can begin slight weight bearing, we have been following RICE since the injury. This is where we are as of today.
Can anyone tell me, what does minimal weight bearing mean?
Should she be on antibiotics for infection?? She received anti-biotics through the IV but was not given any antibiotics to take on her own, is this normal?
So far the Dr. has now indicated weight bearing in two weeks and then we go from there. Can anyone tell me what to expect from here? Thanks.....
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Wooops, should have said "Dr. has now indicated weight bearing in two MONTHS...."
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HI! Wow, tell you wife I so feel her pain...luckily I am healing and functioning as normal but still deal with some pain.
To answer your questions....
I would ask your doctor what minimal weight bearing means, get specific guidelines. I was told after the long period of being non weight bearing, to start with what my body could handle...which I must tell you, wasn't much. Its a slow process.
I wasn't on antibiotics after getting out of the hospital. However, I got an infection (very very painful, almost as painful as the actual injury) and the doctor put me on some. He said that they don't give antibiotics long term because you will become immune to them.
I am here to talk whenever you want to, for you and your wife. The injury really sucks, but there is a light at the end of the tunnel.
To answer your questions....
I would ask your doctor what minimal weight bearing means, get specific guidelines. I was told after the long period of being non weight bearing, to start with what my body could handle...which I must tell you, wasn't much. Its a slow process.
I wasn't on antibiotics after getting out of the hospital. However, I got an infection (very very painful, almost as painful as the actual injury) and the doctor put me on some. He said that they don't give antibiotics long term because you will become immune to them.
I am here to talk whenever you want to, for you and your wife. The injury really sucks, but there is a light at the end of the tunnel.
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jesrf - Sorry to hear about your wife's injury. My injury was in Jan 2008 and I was non-weightbearing for 3 months. I started weighbearing in a walking boot for 2 weeks and then transitioned to a shoe with an insert with arch support for last few weeks. I am finally getting my screw out tomorrow. Following surgery, I expect to be in walking boot again for 1-2 weeks. While non-weight bearing, I crutched and hopped for first 2 months and then finally got a knee walker during last month. I highly recommend getting the knee walker which helps do simple things around the house or work. GGB
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Just got back from surgery to have screw removed. Foot feels great not sure if it's the meds. Plan to stay home for a few days and keep it elevated. Surgeon says it may take 1 year for bones to fully recover but I can start biking again in 1 week and work up to running.
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ggb - good luck with getting the screw out. Let us know how it goes. I'll be getting the two big screws out in August, I hoped I wouldn't have to wear the boot after that. When I walk I feel those two screws more than the others.
jesrf - I did get a round of antibiotics after my surgery, but mine was more open because it was the two big screws through the lisfranc, and two plates to hold together the 2nd and 3rd metatarsals, so I had a 4" incision for that part. The screws went in small holes, it looks like arthroscopic almost. So I don't know if that's a different regimen. Can you ask your surgeon or primary care physician if antibiotics would be prudent? Also, when I went partial weight bearing at 6 weeks I was on crutches but could put 50% weight on the healing foot for 3 weeks before I could walk without crutches (but with a boot) for 3 more weeks; 12 total.
I'm walking without the boot now for almost 2 weeks. Limping really, and the foot is still swollen. It hurts quite a bit to walk which surprises me at this piont, and I hope that will go away soon! I'm tired of apologizing to people to slow down because I can't catch up. Walking on carpeted areas isn't too bad but in parking lots or on cement the foot just isn't a happy camper. Working out though, weights and riding the bike, and generally getting all back to my life, thank goodness.
jesrf - I did get a round of antibiotics after my surgery, but mine was more open because it was the two big screws through the lisfranc, and two plates to hold together the 2nd and 3rd metatarsals, so I had a 4" incision for that part. The screws went in small holes, it looks like arthroscopic almost. So I don't know if that's a different regimen. Can you ask your surgeon or primary care physician if antibiotics would be prudent? Also, when I went partial weight bearing at 6 weeks I was on crutches but could put 50% weight on the healing foot for 3 weeks before I could walk without crutches (but with a boot) for 3 more weeks; 12 total.
I'm walking without the boot now for almost 2 weeks. Limping really, and the foot is still swollen. It hurts quite a bit to walk which surprises me at this piont, and I hope that will go away soon! I'm tired of apologizing to people to slow down because I can't catch up. Walking on carpeted areas isn't too bad but in parking lots or on cement the foot just isn't a happy camper. Working out though, weights and riding the bike, and generally getting all back to my life, thank goodness.
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read most of the posts here a few weeks ago and was feeling pretty grim but, was finally seeing progress in myself and thought it was time to share my story.
i dislocated all of my metatarsals in a paragliding accident - had a big bump on the outside of my foot when i went to the emergency room. they "reduced it" - basically pulled it hard to generally bring the bones into better alignment so that the swelling would go down for surgery.
i'm 41 and super active: rock climb, surf, snowboard - all kinds of stuff + just a had a baby. my son learned to crawl the day i got home from the hospital. i went to an orthapedic surgeon and he said it would be at least 9 months before i could do much. he said that i may not ever be able to do the things i did before. i called my husband on the way home from the appointment - he kinda freaked out and started doing research. the surgeon i went to was fresh out of school and we found dr. loretta chou at stanford university hospital (from her research papers on the internet). dr chou thought she may be able to put me back together - said i might not be able to run but, it was possible to get back most of ability.
had surgery at stanford hospital (despite the travel required). two pins and 4 screws. they gave me a nerve block - very little pain until it wore off 24 hours later. the pain after was BAD for about 24 hours but, after that I was down to tylenol pretty fast. worked from home with my foot up all the time - could last 10-15 minutes with my foot down when walking with crutches. got the sutures out a two weeks after the surgery and got a new cast - 4 weeks later i still wasn't much better. at 6 weeks ater the surgery i was feeling very grin about the progress and i got the pins out. they scrounged around in a tool box, found some plyiers and just pulled. it sounds awful but, it was not a big deal at all! It stung but, almost felt good. Have been in a walking cast for a week and FINALLY feel like progress is being made. My foot still swells up but, I can walk comfortably - I can last longer and longer each day - there is light and at the end of tunnel!
A couple of sanity savers:
1) my husband pushed me around in a wheel chair at the local amusement park - went on the roller coaster - we got a season pass. it was a great way to battle the depression.
2) i got a water proof boot: http://www.waterproof-prosthesis.com/howtouse.html. I've been going in the hot tub and swimming laps in it - works great. Next weekend we are going kayaking for 3 days.
3) ask for help from friends, extended family and the larger community - not just the folks you live with.
feel like i'm getting my life back finally. HANG IN THERE everyone! Make sure to RESEARCH your doctor, KEEP YOUR FOOT UP as much as possible - it does get better. if you are feeling grim, find a low impact way to GET OUT OF THE HOUSE.
i dislocated all of my metatarsals in a paragliding accident - had a big bump on the outside of my foot when i went to the emergency room. they "reduced it" - basically pulled it hard to generally bring the bones into better alignment so that the swelling would go down for surgery.
i'm 41 and super active: rock climb, surf, snowboard - all kinds of stuff + just a had a baby. my son learned to crawl the day i got home from the hospital. i went to an orthapedic surgeon and he said it would be at least 9 months before i could do much. he said that i may not ever be able to do the things i did before. i called my husband on the way home from the appointment - he kinda freaked out and started doing research. the surgeon i went to was fresh out of school and we found dr. loretta chou at stanford university hospital (from her research papers on the internet). dr chou thought she may be able to put me back together - said i might not be able to run but, it was possible to get back most of ability.
had surgery at stanford hospital (despite the travel required). two pins and 4 screws. they gave me a nerve block - very little pain until it wore off 24 hours later. the pain after was BAD for about 24 hours but, after that I was down to tylenol pretty fast. worked from home with my foot up all the time - could last 10-15 minutes with my foot down when walking with crutches. got the sutures out a two weeks after the surgery and got a new cast - 4 weeks later i still wasn't much better. at 6 weeks ater the surgery i was feeling very grin about the progress and i got the pins out. they scrounged around in a tool box, found some plyiers and just pulled. it sounds awful but, it was not a big deal at all! It stung but, almost felt good. Have been in a walking cast for a week and FINALLY feel like progress is being made. My foot still swells up but, I can walk comfortably - I can last longer and longer each day - there is light and at the end of tunnel!
A couple of sanity savers:
1) my husband pushed me around in a wheel chair at the local amusement park - went on the roller coaster - we got a season pass. it was a great way to battle the depression.
2) i got a water proof boot: http://www.waterproof-prosthesis.com/howtouse.html. I've been going in the hot tub and swimming laps in it - works great. Next weekend we are going kayaking for 3 days.
3) ask for help from friends, extended family and the larger community - not just the folks you live with.
feel like i'm getting my life back finally. HANG IN THERE everyone! Make sure to RESEARCH your doctor, KEEP YOUR FOOT UP as much as possible - it does get better. if you are feeling grim, find a low impact way to GET OUT OF THE HOUSE.
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Hi lisfranc members
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Hi guys,
I'm new here, but not new to the lisfranc injury.
Backround: 34 year young male who fell 20' off a ladder on 3/23/08
Was diagnosed the following day with a 2.5mm displacement between the first and second Met. basically shearing the Lisfranc ligament. 2 screws inserted ( one in the bg toe going straight into the cuniform and the other going horizontally across the 1st. and 2nd. met.
Hade ORIF surgery on 4/1/08 . cast for one week the stiches removed.
Hard fiberglass cast for 5 more weeks. I am now in the Cam boot and 7.5 weeks post op.
Dr. says a total of 12 weeks non wt. bearing and then partial wt. may be added.
I would like to know from all you seasoned vets. how long it took you to walk normally and did you have any pain in the lisfranc keystone area of your foot when you started to wt. bear.
Thank you-- hope everyone heals up from this painful ordeal.
I'm new here, but not new to the lisfranc injury.
Backround: 34 year young male who fell 20' off a ladder on 3/23/08
Was diagnosed the following day with a 2.5mm displacement between the first and second Met. basically shearing the Lisfranc ligament. 2 screws inserted ( one in the bg toe going straight into the cuniform and the other going horizontally across the 1st. and 2nd. met.
Hade ORIF surgery on 4/1/08 . cast for one week the stiches removed.
Hard fiberglass cast for 5 more weeks. I am now in the Cam boot and 7.5 weeks post op.
Dr. says a total of 12 weeks non wt. bearing and then partial wt. may be added.
I would like to know from all you seasoned vets. how long it took you to walk normally and did you have any pain in the lisfranc keystone area of your foot when you started to wt. bear.
Thank you-- hope everyone heals up from this painful ordeal.
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Just an update here. I think I might be healing faster from this injury than expected. I have been walking 100% normal with no pain in my boot for about 3 weeks now.
Here's my timetable. I'm 32 years old, healthy and active.
Injury: 3/11
Surgery: 3/12
Crutches: 3/14-4/25
Partial weight bearing w/ boot and crutches: 4/25-5/1
Walking in boot full time, painless: 5/1-current
Able to walk without boot, slowly and without pain: 5/7-current
My first stand-up shower since injury: 5/19
Really when walking without the boot the thing I'm lacking most is strength in my calf and ankle. And I can not flex forward to stretch my achilles tendon on my injured foot at all. There's still a decent amount of swelling in the midfoot region and some tactile numbness near the incision area. I go for my next appointment on June 5 where I expect they will tell me that it's OK to begin physical therapy.
I think I have healed incredibly well to be walking again after only 9 weeks or so. But I realize that with the atrophy of my calf and weakness in the ankle, it's probably still a long road before I'm back 100% and playing basketball again. First there's walking, then running, then running and being able to jump, then theres the running, jumping, and hard cuts and lateral movement of basketball. Still a long way to go but I think I can get there.
Here's my timetable. I'm 32 years old, healthy and active.
Injury: 3/11
Surgery: 3/12
Crutches: 3/14-4/25
Partial weight bearing w/ boot and crutches: 4/25-5/1
Walking in boot full time, painless: 5/1-current
Able to walk without boot, slowly and without pain: 5/7-current
My first stand-up shower since injury: 5/19
Really when walking without the boot the thing I'm lacking most is strength in my calf and ankle. And I can not flex forward to stretch my achilles tendon on my injured foot at all. There's still a decent amount of swelling in the midfoot region and some tactile numbness near the incision area. I go for my next appointment on June 5 where I expect they will tell me that it's OK to begin physical therapy.
I think I have healed incredibly well to be walking again after only 9 weeks or so. But I realize that with the atrophy of my calf and weakness in the ankle, it's probably still a long road before I'm back 100% and playing basketball again. First there's walking, then running, then running and being able to jump, then theres the running, jumping, and hard cuts and lateral movement of basketball. Still a long way to go but I think I can get there.
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Hi again everyone....I've posted twice before, but I still have some unanswered questions. My podiatrist feels there may be a lis franc injury in my right foot. As I wrote before, a full jar of peanut butter fell on the top of my foot from the second shelf of a cabinet, and around the same time, I took a nasty fall from slipping on a wet spot in my kitchen. Due to the fact that I have a spinal cord stimulator implanted for severe neck pain, I have been unable to get an MRI. The xrays show a space in the lis franc portion and the cat scan only showed a small extra navicular bone. I'm now waiting for my pain management Dr to decide if I could possibly have an MRI on my foot, but in the meantime, I'm wearing an air cast boot. I can walk normally in the boot, but without it, I can't put any weight on the ball of my foot without excruciating pain. At times, I also have severe aching and throbbing pain in the foot. Due to the fact that I'm only seven months into my job, I don't qualify for FMLA, so I'd definitely lose my job if I had the foot casted in a non-weight bearing cast, as the Dr wanted to do. She was also going to pull me off work for 6 weeks since I couldn't drive the 24-miles each way with a cast on, and crutches are impossible because of my neck and arm issues. Has anyone else ever recovered from this injury without surgery? Will I be doing much more damage to the foot by putting off more aggressive treatment? I've been in the boot for about 4 out of the 6 weeks and while I'm wearing the boot, it feels fine, but when I take it off (to drive, shower, or getting ready for bed), it hasn't improved. Anything any of you may know regarding using non-aggressive treatment would be a great help. Thanks for reading, and I wish you all the best in your healing!
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