Do it

Pre-surgery

You’re anxious, you’re googling, you’re in pain and you feel hopeless. I know. Still, don’t spiral. This is a journey, and you’re only at the beginning.

• Second opinion: The ER doctor told me I wouldn’t need surgery, the surgeon he referred me to was kind of a dick and said I did need surgery but he’d “do his best” to avoid the huge nerve in my foot. He gave me the creeps, but I felt completely at his mercy. Until my parents stepped in and found me a second opinion with a surgeon who was thorough, kind, and broad-thinking. If you have any doubts or anything feels off — and if you can afford it, take the time for a second opinion.

  Note: I think it’s important to share here that your bar should be high for an orthopedic surgeon, but for their skill, not necessarily their warmth. They should make you feel confident that they can perform the surgery well and set you on a solid (literally) healing path, but don’t expect warm fuzzies. These types of doctors are known for being serious, straightforward and down-to-business. They fix bones. That said, there are all kinds of orthopedic surgeons, but have realistic expectations and let them focus on doing their job #1, putting you back together again.

• Meditate: The best thing to try and control right now is your mind, because it’s going to try and rule you. If you don’t already meditate, there are tons of apps to learn. I love Headspace (and they actually have a meditation course just on pain).

• Pain management: Speaking of getting your mind right and managing your pain, it’s time to start finding some peace with your relationship to pain. You’re about to have aches and pains you’ve never had before (and if you’re pre-op, that means you already do), but that doesn’t mean you should immediately reach for the hardcore drugs and take the maximum dose — now or throughout this journey. Things will ache and things will hurt, and how you deal with that is on you — it’s not one size fits all. Listen to your doc, and also listen to yourself. Now’s a good time to start that practice. Dr. Gellman talks more about pain management here.

Immediately post-surgery

I spent the night in the hospital and was out the next day, but from talking to my ankle surgeon, it also sounds like it’s common to leave same day (which TBH I cannot imagine!).

• Snacks: Bring your own food, especially if you have any restrictions. Hospital food is gross and depressing. Things like crackers, fruit, nuts and dried fruit are great to have on hand. I also brought my own gluten-free bread for them to toast and put butter on. I didn’t know this for my first surgery, but I came prepared for my hardware removal.

• Bring ear plugs: Coming out of surgery the sounds were so loud and annoying, I really wish I’d thought to bring ear plugs — not only for sleeping but also for drowning out the noise while I was awake.

• Pain management: I’m going to keep beating this drum. Unless explicitly told by your doctor, you don’t have to take the full drug dose. Ice and elevate constantly, use Ibuprofen and/or Tylenol as approved by your doc, keep using meditation to quiet your mind. You don’t wanna get addicted to that crap — and your body quickly can, even if it doesn’t feel like it in your mind. That said, if you’re in a bunch of pain, stay connected with your doc on how to manage it.

First few weeks post-op

If you’re anything like me, all you want to do is lie around. My energy was low because I wasn’t eating much, and I was still feeling so sorry for myself. Still, there are little things you can (and should) do.

• Get outside: Whether you go for a scoot/crutch around the block, a hang on the porch, or you just open your window, get fresh air and give your body as much normalcy as possible. A nurse told me that for every day you stay in bed and do nothing, it takes your body two days to regain the strength you lost. I don’t know if that’s true, but it’s motivation enough.

• WORK THAT ROM!: Guys, as soon as your doc says it’s ok, start working your range of motion!! Up-down-up-down-side-side-side-side. Write the alphabet with your toes. Do it until you can’t anymore then ice and elevate. That’s your new job, and it pays (off) well. Check out tips from Ellen from Broadway Physical Therapy here.

• Non-weight-bearing yoga: This was a huge unlock for me. I was feeling so stiff in bed. I could feel everything getting stagnant — my blood, muscles, bones — I needed something that resembled exercise. The first time I got on the yoga mat post-surgery felt pointless. I rolled around on my back a little like a dying bug. I tried to sit up and extend my legs out in front of me, but my right leg was misbehaving and wouldn't straighten along the floor. The muscles in my ankle, calf and thigh were too rigid and my heel was too tender. I couldn't turn around and get on hands and knees, because the top of my foot wasn't flexible enough to rest flat on the ground. So I nixed the idea — considering myself doomed to spend a full 8 weeks on my back in bed, day...after day...after day. But I didn’t know about the big pillow approach (which I feel like I invented — may or may not be true). Check out this video to see how I used a big pillow for help.

• Get a temporary handicap permit for your car: Do this proactively even though you’re not driving yet — your surgeon should be able to help you out — even before you start driving again. It will be such a godsend to you once you start working/grocery shopping/etc. again.

2-3 months post-op

Ok, you’re picking up speed. You’ve put in your time just lying around doing basically nothing, with the exception of getting outside, working your range of motion, doing a little yoga, meditating and eating well. Now it’s time to take it to the next level!

• Go to physical therapy: I can’t tell you how many messages I’ve gotten from ankle-breakers who said their surgeons told them they didn’t need physical therapy, so they were looking to me for tips. Listen, if you can afford it and can make it happen, physical therapy is a MUST in my opinion. My physical therapist helped me feel my ankle and foot again — to reconnect with my toes and what they can do, my arch, my heel, my calf…she gave me a safe place to explore my range of motion even further and also start strengthening. So key. Have you seen my physical therapist interview??

• Keep icing and elevating: Once you start bearing weight, that doesn’t mean it’s a straight line from injured to healed. You’ll still have milestones along the way, like taking your first long walk, doing a workout for the first time, going to work, and so on. Always come back to icing and elevating, it doesn’t mean you’re moving backward — it’s part of moving forward. It was around 3/4 months post-op that I also got really into doing ankle ice baths.

• Know when to leave physical therapy: When you break your ankle it feels like the only thing that matters in your world is your ankle — but guess what? The rest of your body gets super impacted too, and that needs to be addressed. Physical therapy is awesome at the beginning stages when you feel fragile, scared, and need to bring your ankle and foot back to life. But for me, there came a time when I began to feel bored with PT and under-challenged. Still, I knew I had a long way to go in my healing — and then my surgeon recommended I go to a former ballet dancer turned pilates instructor. She worked with me on the articulation of my feet, balance, leg muscles and general alignment. It was just the next steps I needed. I discovered that my core had weakened tremendously (or maybe it was never strong?), my non-injured foot was SO TIGHT from compensating for the other side, I had some weird shoulder stuff going on from my crutches, etc. The movements and exercises we did were slight, but so powerful.

4-6 months post-op

You’re moving and grooving now, baby! I know there are still hard days, but there continue to be new and fun things you can do to drive and promote healing.

• Massage: You will have gotten some light massage in physical therapy, but if you’re anything like me, you’re tight all over. I had an awesome massage therapist who really got in there. I had a different complaint every week — tight toes, tight achilles, tight arch, tight calf — and we’d usually spend the majority of the time on my foot/ankle issues, and then the last few minutes on my neck and shoulders which are chronically messed up, but made worse by crutching and compensating. Another key spot to get massaged, and listen to me very carefully — SCAR MASSAGE. It’s terrible. It’s sharp and tight and makes your whole lower leg hurt, but if you don’t do it, that scar tissue will get tighter and tighter. Also, when you do do it, you feel immediate relief after. Scar tissue is no joke, don’t mess around, get it worked on. Go watch my video with Ashley to learn more about scar massage and the importance of massage more broadly.

• DIY Massage: Don’t have access to massage? There are some great DIY tools. I love gua sha (I bought this one and love it) and use it on my actual scar, as well as the surrounding muscles (and also on my face and other parts of my body that have nothing to do with my ankle). YouTube offers tons of tutorials. I also LOVE these silicone cups to loosen all the muscles in my leg, and I also use the teeniest one on my scar. For the bottom of your foot, I love this weird spiky ball to massage out the kinks — and bonus use if you’re feeling up for it, try to pick the ball up with your toes as a strengthening exercise.

• Try yoga: Real, weight-bearing yoga. You don’t have to be good at it or super bendy, but it’s a gentle way to continue coming into your body. When it comes to online platforms, I’m a huge fan of Glo and Strala, but if you need to ease in slowly, check out the video below.

• Build up that calf: Calf-atrophy SUCKS. And the only way I found to build it back at this stage was specific, targeted exercises. Below I show how I did it.