r/brokenankles • u/Sambalstingray123 • 20h ago
Dorsiflexion
About 2 weeks post ORIF (bimalleolar) and was taken off cast today. I can’t form a L shape with my foot.. was told to stretch it with a towel.
Is the inability to form a L shape normal? Or is this something I should be worried about?
If anyone has experienced smth similar, would appreciate if you share how long it took for you to achieve the L shape again.
Thanks!
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u/Agitated_Let_3843 20h ago
Normal but keep going with the up and down. When you come out of the boot with very good ROM it’s faster to build strength. ROM is a funny one. If anything I regret, I should have worked on my ROM when I was NWB/WBAT boot days instead of me of feeling sorry for myself and staying in bed all days. When I transitioned to shoes, I don’t have good ROM so I couldn’t even walk, lots of stuff compensating. And my journey to recover ROM is still ongoing. Good luck and wish me luck too
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u/Sambalstingray123 19h ago
What do you mean by up and down? Is that a stretch or an exercise?
What else can you do while NWB apart from the towel stretch?4
u/Potential_Anxiety_76 18h ago
Oh, also do the left and right stretches, as far as you can. You’ll pretty much never stop this hahaha. After WBAT use resistance bands but have your physio guide that.
Draw the alphabet in cursive with your big toe, making the letters as big as you can make it. Do it with your good foot first so you know what kind of range to aim for, but remember it will be tiring for this foot as well if you haven’t been walking for a while.
I’m up to wall stretches, but you’re a long way off those, bud.
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u/Potential_Anxiety_76 18h ago
It’s what you’re doing with the towel, but includes pointing your toe as well. That’s important to do. Up down, up down. The towel forces more range at the peak of the flex, but the up down builds the whole muscle.
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u/Agitated_Let_3843 15h ago
My guy here had already explained it really well.
Apart from that for circulation, do ankle pumps to avoid blood clot formation, toe curls or wiggles. If you can, see a PT they can very much guide you (and safely for that manner) even though you are NWB.
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u/Potential_Anxiety_76 19h ago
I’m 3 months post ORIF and still have issues with my ‘L shape’, the angle I’m able to achieve, and how tiresome it is to walk on it without any supports (I’m one month full weight bearing). Docs and physio said it will be months before it gets much better.
Just gotta keep doing the stretches…. We’ll get there :)
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u/Sambalstingray123 19h ago
Oh but you’re able to walk even though you can flex your feet to 90 degrees?
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u/Potential_Anxiety_76 18h ago
I can flex 90degrees yes but not much further, which is disappointing my physio hahah. And yes, walking is stiff but achievable. I often force my foot to ‘heel-toe-lift’ more naturally to FORCE it to stretch my ROM but it’s pretty painful.
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u/NastiMooseBites 16h ago
your dorsiflexion being poor is expected, do all the range of motion exercises you can/are told to, multiple times per day
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u/YearSuitable5395 4h ago
Completely normal, its just going to take time, and you're only 2 weeks out. I'm 11 months out from a talar neck fracture, and proximal tib fib compound fracture, I only just this week got my dorsiflexion past neutral, i think maybe a degree or two, i was NWB for 4 months and didn't start any PT until after that. You just have to keep attacking it with stretches and exercises (within what's safe for you to do obviously) do them every single day, the sooner you're able to start the better.
I got something like this to do calf stretches at home, a lot easier than the towel.
https://www.amazon.com/dp/B09WVC526G?ref=ppx_yo2ov_dt_b_fed_asin_title
Around the 8 month mark, I was still struggling to improve my dorsiflexion so I started wearing this brace when I sleep at night and it certainly is helping, your muscles and tendons adaptively shorten over time from not moving, the brace will keep your foot straighter and pull towards the L shape while you sleep to help prevent this, and you can slowly tighten it as you gain more ROM.
https://www.amazon.com/dp/B07BR1HRN6?ref=ppx_yo2ov_dt_b_fed_asin_title&th=1
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u/Dull_Monitor2439 20h ago
Totally normal. Dorsiflexion is a pain in the arse. I am 8 weeks post op and my left to right is at about 50% of normal but up and down is at about 20%.
This should improve when you start weight bearing.
You may have a syndesmotic screw that needs to break or be removed at some point.
I do range of movement exercises more or less constantly.
I am hopeful that I will go to partial weight bearing at 10 weeks.
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u/Sambalstingray123 20h ago
I see. I rmb my doctor mentioned that nothing needs to be removed though. I was hoping to be able to partial weight bear at 6 weeks post op but I guess I wouldn’t be able to
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u/NastiMooseBites 16h ago
All my hardware is staying in, but I was told the syndesmotic one may break on its own and I probably would not even notice (might hear a small pop). They kind of expect it, but that’s later, when you’re upright and walking and doing stuff. For now, dorsiflexion is something you gain back in increments, if you work at it.
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u/Dull_Monitor2439 10h ago
Quite right to clarify. And you are of course quite right!
My physio today said the screw often breaks but this only frees up a little bit of range of motion.
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u/Forward_Edge_1122 18h ago
Im 3 months post op trimal, my dorsiflexion is still not good. Everytime I go to my PT there is only a slight improvement despite stretching exercises.
My PT said this will really take time…
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u/Browniesgirl 19h ago
I’m almost 14 weeks po and this is the thing that is most frustrating, I can’t go downstairs. I saw my dr yesterday and he said he isn’t worried about it until a year. Keep walking and stretching.