New boot process after badly broken ankle

[el hefe]

Dislocated ankle, broken fib, and ruptured ligaments March 15th.





Recovery is going well, wake surfing, wake skating, biking and lots of heavy yard work no problem.

It does get pretty swollen by the end of the day. The plate does not seem to be bothering that badly though. Most of the issues are from sore ligaments. Pretty much full range of motion and I am getting the 2 big screws out in October that are going thru tib and fib that will give me full ROM. Plate out next year hopefully.

Just looking for anyone's experiences buying new boots after a injury like this. Right now both ankles are close to the same size, like this in the morning and then swelling with use as the day goes on. Will the ankle swell while skiing in the boot or will the liner restrict swelling (compression)? Swelling is pretty noticable by end of day.

Do I need 2 different liners? Bought some new intiutions last year, could get them re-baked? Thanks.

Have been on cochises for a long time but thinking of trying the new Fischer ranger free. http://blistergearreview.com/ski-boo...anger-free-130

[auvgeek]

My wife has a pretty awful ankle. Yes, it swells during the day but like you said, compression from the liner helps. Her approach has been to ski whatever boot/liner combo fits best when it's not swollen and ensure the plastic is warm when she pulls the boots on (or it hurts her ankle). YMMV. Best of luck!

[gregL]

Dislocated ankle, broken fib, and ruptured ligaments March 15th.

I have a similar situation on the left leg - plate and 8 screws (still in there). First season after the injury the area around the sutures was quite sensitive, I re-cooked the liners with a strip of foam over the stitches to create a pocket and it worked pretty well, but the second season it was much less sensitive. It did swell during a day of skiing but I just loosened the boot.

I never found a convenient time to get the hardware out and now it doesn't bother me at all.

I skied a couple days in the Fischer Ranger Free 130 and thought it was a great boot, sensitive ankle or no.

[mntlion]

1) wait and see in the fall how it is doing?

2) wait and see how it actually feels in a ski boot, in the cold, skiing?

3) see your local boot fitter when/if you have problems?

lots of problems can be solved, when and if they happen. This is the tail wagging the dog

[Vitamin I]

...Just looking for anyone's experiences buying new boots after a injury like this...Will the ankle swell while skiing in the boot or will the liner restrict swelling (compression)?...

I agree with mntlion---Don't try to fix anything until you experience a problem first. BUT here maybe we can help you set expectations, anticipate possible outcomes, and later you can refer back to this thread to solve those outcomes if they occur.

My case last season was torn Achilles tendon, no reconstructive surgery, no sutures, no screws/plates. I just kept using my old ski boots, no boot modifications at all.

1) If you're young, you will heal fast and likely experience fewer issues during recovery. My case: I am not young.

2) My plan was to ski 100+ days, so I justified "wasting" many not-so-precious ski days just experimenting and dialing it in during November on Colorado WRODs. Then I was stoked to be fully dialed in before the whole season of Dec-May skiing, and my ankle performed flawlessly inside ski boots after the dial-in period. But if you will ski only 15 days next season or whatever, well yeah, then of course you'd prefer to have it all dialed in BEFORE you even start your precious limited ski days. Not sure if any advice here will enable you to do that.

3) As auvgeek implied, I believe the biggest danger is reinjury during insertion of foot into boot, and pulling foot out of boot. I never needed to warm my boot plastic on my stiff 130 boots, but I ALWAYS remembered to be very slow and careful about that. But I definitely would have warmed my boots first if I had left them in the car overnight in cold-ass Montana or wherever.

4) My dial-in period took ~20 ski days before I attained flawless ankle performance all day long in ski boots for unlimited consecutive days. After the pain appeared each day, it would always increase as the ski day progressed. My theory was that the primary cause for pain was when inflamation/swelling both made everything tighter inside the boot, as well as making the tissue sensitive---so to prevent the pain, I focused on preventing the swelling. After ~20 ski day trials, I dialed in my favorite dosage and schedule of NSAIDs, with intent to prevent swelling. During the drug dial-in period, my ankle performance improved noticeably each passing day, and the first sign of daily ankle pain would not begin until later and later into the ski day. Clearly my daily progress was not 100% attributable to drugs---it was improving with more time skiing inside the boot, plus nightly rehab in swimming pool, including hot/cold cycles with hope to increase nightly blood flow/nutrient exchange to the injury. My favorite dosage was 500mg naproxen right before skiing. And then right after foot came out of the ski boot at end of the ski day, I would take another 500mg naproxen ONLY if I planned to ski again next day. After dial-in period, I stopped all rehab/pools/etc., but I continued the drug schedule ALL SEASON for ~138 ski days, and loved it. I'm planning to try drug-free in October, we'll see how it goes.

5) The good news is it's possible to have a TON of fun skiing HARD even while your ankle cannot handle summer sports (because ski boots are rigid support). The bad news is your recovering ankle is not progressing/rehabbing if all you do is ski for 6 months. So my ankle is now "behind schedule" for summer sports, and I still can't do ANY explosive cutting/jumping yet, but my summer progress is looking like I will be able to start half-intensity soccer after 2 months of dedicated summer rehab work---and I expect to progress very fast from there to high-intensity summer sports. YMMV.

.

[el hefe]

Thank you, agree with all points and with mntlion that its a bit early but I was planning on getting new boots this fall prior to the accident. My current ones are toast but planning on wearing them around outside for a bit in August and see if the plate gives me issues.

Don't count days but a couple of days a week normally with one being touring. Our season normally starts mid to late November as well.

[steved]

This isn't a voice of surgery experience, but to me...if you don't let it heal, somewhat, ...before ski season, it ain't gonna heal during....y/n?

[auvgeek]

My theory was that the primary cause for pain was when inflamation/swelling both made everything tighter inside the boot, as well as making the tissue sensitive---so to prevent the pain, I focused on preventing the swelling. After ~20 ski day trials, I dialed in my favorite dosage and schedule of NSAIDs, with intent to prevent swelling. During the drug dial-in period, my ankle performance improved noticeably each passing day, and the first sign of daily ankle pain would not begin until later and later into the ski day. Clearly my daily progress was not 100% attributable to drugs---it was improving with more time skiing inside the boot, plus nightly rehab in swimming pool, including hot/cold cycles with hope to increase nightly blood flow/nutrient exchange to the injury. My favorite dosage was 500mg naproxen right before skiing. And then right after foot came out of the ski boot at end of the ski day, I would take another 500mg naproxen ONLY if I planned to ski again next day. After dial-in period, I stopped all rehab/pools/etc., but I continued the drug schedule ALL SEASON for ~138 ski days, and loved it. I'm planning to try drug-free in October, we'll see how it goes.

NSAIDs also mess with a lot of things, including your gut bacteria/microbiome. My wife swears fish oil is as good of a pain reliever as any OTC NSAID, and eating an anti-inflammatory diet kept her swelling down. Diet (and sleep) is such a big part of how her ankle feels these days. YMMV, but it's something to consider for next season. /soapbox

[Gobstopper]

I had the same injury in April of 2015 on my left side. I was out of a boot and rehabbing by July. Key here is do PT like it's your job, don't skimp. I spent the money for a great PT, went 2-3 times a week, was dedicated about doing the workouts, stretches, etc. The following ski season I jumped right back in to existing boots with no issue. The first few days of the season it was a bit uncomfortable with the weight of the ski hanging on chairlifts (I might have lowered the bar, don't tell anyone) and you might have some days where pins, etc. rub the wrong way but it didn't slow me down. Believe I got 40-50 days in the following year at full speed after a few days of getting comfortable again and past the initial fear of re-occurrence.

The swelling you have now likely isn't the swelling you'll have come December. Keep working through it, icing and taking care of it and play it by ear when you get there on day 1. If you can do the PT right, you're likely to have forgotten about it until something brushes the plate / pins. Can't stress ROM enough though, I've talked to people who didn't work through it and were never the same.

[Schemeboat]

I am in the same position Hefe. Need some new boots for work and fun next year, and as you know, very similar surgery. I'm subbing this thread and I will jump in if I find anything useful.

[el hefe]

I had the same injury in April of 2015 on my left side. I was out of a boot and rehabbing by July. Key here is do PT like it's your job, don't skimp. I spent the money for a great PT, went 2-3 times a week, was dedicated about doing the workouts, stretches, etc. The following ski season I jumped right back in to existing boots with no issue. The first few days of the season it was a bit uncomfortable with the weight of the ski hanging on chairlifts (I might have lowered the bar, don't tell anyone) and you might have some days where pins, etc. rub the wrong way but it didn't slow me down. Believe I got 40-50 days in the following year at full speed after a few days of getting comfortable again and past the initial fear of re-occurrence.

The swelling you have now likely isn't the swelling you'll have come December. Keep working through it, icing and taking care of it and play it by ear when you get there on day 1. If you can do the PT right, you're likely to have forgotten about it until something brushes the plate / pins. Can't stress ROM enough though, I've talked to people who didn't work through it and were never the same.

Good to hear. I have been PT and was on a trainer bike asap. Bike helped a ton I feel. Now working to get strength back, can run up stairs now which feels great.

I ice like crazy, work in a office so pretty easy to get it done.

[hutash]

No personal experience but I have heard a few people with funky ankles after breaks get fitted in the Fisher heat moldible shells.

[mntlion]

a process like this (heating shell, heating liner, adding padding) is a good start for anyone with unique feet

https://www.tetongravity.com/forums/...V-boot-molding

[Vitamin I]

NSAIDs also mess with a lot of things, including your gut bacteria/microbiome. My wife swears fish oil is as good of a pain reliever as any OTC NSAID, and eating an anti-inflammatory diet kept her swelling down. Diet (and sleep) is such a big part of how her ankle feels these days. YMMV, but it's something to consider for next season. /soapbox

Yep, if you can use diet/food to get effective results to manage your case's inflammation, pain, progressing healing/strength/performance---then definitely skip the drugs.

I want a drug-free life in general, but am willing to resort to drugs during my temporary 1-year recovery from injury. I likely won't even need any anti-inflammatory diet/supplements after that 1st year.

That said...

el hefe,
I'm no expert in supplements, etc. but I was willing to do ANY inexpensive injury improvement methods for my dream ski season, just in case. So, at the end of ski days, if I planned to ski again next day, then for joints injury healing & performance, I was taking naproxen, fish oil/omegas, zinc, Vitamin C, glucosamine/chondroitin, collagen, turmeric, ...and I would have taken bone broth if it were cheaper/easier to make. To me, those supplements were cheap enough that I didn't care if they turn out to be just myths, or placebos, or whatever. If I weren't so lazy, I probably could have calculated how to eat the right real foods to get the equivalent of all those same supplements.

Also, I met mr_pretzel (super-cool maggot and human being) on a ski lift, skied 3-4 days with him, and he told me he trusts a study that concluded something vaguely like this: Injured ankle ligaments/tendons heal faster and return to sport sooner if you simply stimulate healing for 5 minutes every 8 hours (5 minutes of even low-intensity, slow-motion tension moves (even isometric) on the injured ankle ligaments/tendons, or just jumprope) and ingest >=15g of collagen (even the cheapest cooking gelatin) at each session, then rest the ankle between sessions. Sounds believable to me, so I've been doing 2-3 sessions per day this summer for my Achilles tendon, and will stop after I reach the final result of high-intensity soccer performance for consecutive days. YMMV.

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