Cycling after ankle fusion

[TALUS]

Would be interesting to determine to what extent muscle atrophy has taken place due to limited functional capacity, if any.

Many studies on rotator cuff of the shoulder. Actually one gets fatty infiltration /degeneration and that can be measured. It doesn't matter in a typical arthrodesis because the muscles don't have to move the joint again. The calf is a little different because it actually act on the knee as well.

[BarHugger]

Many studies on rotator cuff of the shoulder. Actually one gets fatty infiltration /degeneration and that can be measured. It doesn't matter in a typical arthrodesis because the muscles don't have to move the joint again. The calf is a little different because it actually act on the knee as well.

 

Agree, but also thinking towards m.Ant.Tib and Peroneus group ito mid-foot support.

Not forgetting all those other pesky extensor and flexor muscles of the wiggly foot attachments

[TALUS]

Fair enough. They should not degenerate too much because their primary function is not to move the ankle thus they always remain stimulated. The intrinsics tend to become less functional with age anyway. Tib Ant definitely takes a knock.

[TYGA]

Thanks for starting this thread SuperChick, I am staring down the barrel of a fusion as well and it is not a decision to be taken lightly.

 

After a Talus fracture in January 2012 I have also been dealing with pain levels in my ankle ranging from between being able to walk relatively comfortably to not being able to put any weight on it at all. I've been lucky enough to still be able to ride quite a bit and subesquent to the original surgerybut the pain got progressively worse to the point where I could barely put any weight on the joint after being out for a ride. It turns out I had ostheophytes growing over the spots where the screws were inserted to stabilise the talus fracture and it severely hampered mobility of the joint.

 

I spent the last year on prescription anti-inflammatories which helped but I wasn't happy having to take pills just to get by and eventually it wasn't helping all that much at all as spent a lot of time doing research and spoke to a lot of ortho's, (thanks Kobus!!) and was so fed up with discomfort I had made up my mind to go for a fusion.

 

Anyway as an alternative to Fusion, the Ortho decided to first have a bash at removing the screws from the initial surgery and cleaning out the ankle joint two months ago. It has helped a bit and freed up a lot of mobility but only with quite a bit of pain. I am still suffering with hectic arthritis in the joint and am back on prescription meds which has helped a LOT. I think two months post surgery is a bit early to make the call but I am a bit disappointed with the outcome of surgery and have already made up my mind and made peace with the fact that a fusion is on the cards for me.

 

As TALUS says whether you are happy with the outcome of a fusion will probably depend a lot on how much you were suffering beforehand. Given how long I've been battling with the discomfort and the effect on my family, sport, work and general mindset I would happily trade in a sore joint with limited mobility for a fused joint without pain.

 

Sorry I have nothing more than my own experience to offer here, sometimes just talking about a problem is already a start in the right direction.

 

Good luck with your decision, keep posting here.

[SuperChick]

Definitely not an easy decision.... Thanks for sharing Tyga, shared troubles are lighter...

 

I understood a bit what Talus and Barhugger is on about, but if they could elaborate I would appreciate. I have had trouble with my Tiberus Anterious(?spelling), Achilles tendon and Plantar faciitis since the original injury, will an ankle fusion aggravate or alleviate this? Presently most nights my whole leg is painful from my toes to my bum (periformes)/lower back (sternum) to an extent that I have difficulty sleeping, I am convinced its due to walking with a bad limp, will this improve post surgery?

 

I have to confess that although it has been prescribed I never continually took the anti-inflammatory for more than a week at a time due to tummy issues. Will the continued daily use of anti-inflammatory assist in the long run? I would take the anti-inflams for a week then stop for about five days and then repeat.

 

As I understood from my Ortho, that post-surgery I will have very limited mobility in the ankle up/down and invert. I didn't even think of the upward angle of your foot walking in a cycling shoe, will it even be possible? No high heels for me ever again either.

 

My other passion is swimming, but the challenge I see here is that your foot cant flex thus kicking is a bit futile.

 

I have read that with therapy, shortening stride and walk training one would be able to walk without a limp. But the article was silent on any exercise activity.

[Jay_B]

I shattered my navicular a year and a half ago and after all the screws were removed recent x-rays show that the navicular has naturally fused itself to the bones around it. I dont have much sideways motion and about 80% up and down motion in my ankle. I personally have found cycling makes my foot feel alot better and reduces the swelling and bruising.

 

Have you been to see another Ortho for a second opnion?

I think ultimately it comes down to pros and cons of having the fusion as well as personal prefference.

[Mousea]

I shattered my navicular a year and a half ago and after all the screws were removed recent x-rays show that the navicular has naturally fused itself to the bones around it. I dont have much sideways motion and about 80% up and down motion in my ankle. I personally have found cycling makes my foot feel alot better and reduces the swelling and bruising.

 

Have you been to see another Ortho for a second opnion?

I think ultimately it comes down to pros and cons of having the fusion as well as personal prefference.

VERY valid point.

Go to another Ortho for a second opnion, and prefably at a different practice. If they both say the same thing you know you are on the rite track. Ask all the questions that need to be asked ?

Edited September 11, 2014 by Mousea

[Rocket-Boy]

A good friend of mine had a fusion of sorts, Im not sure what exactly though.

He has done two half and one full ironman since then and is doing pretty well with running.

I always joke that he has a mechanical advantage with all the metal in his one foot.

[TALUS]

Some good points here. Work and Oscar takes priority. I will try to answer some of the points later. I forgot the name of a competitive masters cyclist that had a fusion.

[SuperChick]

A good friend of mine had a fusion of sorts, Im not sure what exactly though.

He has done two half and one full ironman since then and is doing pretty well with running.

I always joke that he has a mechanical advantage with all the metal in his one foot.

Could you please get more info from your friend, please?

[Rocket-Boy]

Could you please get more info from your friend, please?

I will definitely ask him and post back here when I know.

[TALUS]

Some points to clarify : there are more than 30 joints in the foot (yes it does differ), there is only one ankle joint and only one result to the successful fusion of said joint.

 

There are many causes of arthritis.

 

Many other joints in the foot can be fused. Some of them are very close to the ankle. These operations all have different effects.

 

Ankle replacement is a well described procedure with more than 10 surgeons performing the procedure regularly in South Africa. It is not done in the majority of cases due to the strict patient selection that should be applied by a responsible surgeon.

 

Many people have continued to be employed as manual labourers after ankle arthrodesis.

 

It is VERY good as a pain relieving procedure IF THE PAIN IS GENERATED IN THE ANKLE JOINT.

 

The simplified flowchart is: Do you have pain that cannot be relieved by other means? Is the ankle joint the only or primary source? Should a replacement be considered? Are there contra-indications? Consider socio-economic factors such as social support and sick leave. Arthrodesis indicated.

 

Right, now fire away...

[BSG]

Could you please get more info from your friend, please?

I haven't got any metal in my foot accept some wire or something that the drs use to bind the bones together, all my pins were removed but two or three of the bones on top of my foot got fused.

[TYGA]

Talus I'll take a shot: how long after debridement surgery can you expect to be "at your best"? Am I too quick off the mark expecting great things fresh off crutches two months after surgery and do patients generally continue to improve up to a point as scar tissue, bone healing etc settles down?

[TALUS]

As a general rule I would think 12 weeks is a reasonable time for 80% improvement (the old 80/20 rule). Sometimes a follow-up up shot with corticosteroids can put out the fire of inflammation.

[TYGA]

Thanks. Funny thing is when I initially put weight on my cankle first thing in the morning or after sitting down for an hour or two I t hurts like hell. If I stand up and gradually increase weight I eventually walk around pain-free. If I sit down for more than a relatively short time the process starts again. Not sure if that is arthritis or post surgery inflammation, will give it a bit more time and reassess. Thanks for all the chats and advice.