MtnBug

Hello, All,

Several weeks ago I broke my ankle (and dislocated my foot) while mountain biking and ended up with a titanium plate and 10 screws in my ankle (bimalleolar fracture). It was pretty brutal.
Nine weeks in I've been cleared to walk in a support boot and have been slowly upping my walking activity for about a week now. However, having severely sprained just about everything connecting my ankle together the soft tissue is still healing.
My question is:
Is it okay to start riding on an indoor trainer since I've been cleared to walk in the boot? I tried some easy riding while wearing my boot and I can definitely feel it but, obviously, don't want to slow my recovery by fighting off unnecessary pain. After riding for just 5 minutes I ice my foot in a cold pool and elevate it afterward and that seems to work pretty good.
Any tips/pointers about recovery would be appreciated.
Thanks,
Steve

knitguy

TL: DR - get a PT who has a lot of experience in sports medicine and work with them.

This is something you really need to be working on with a physical therapist, preferably one who works in sports medicine. Even if your question wasn't about anything sports related I would say that you need to be working with a physical therapist.

For reference, I have had four tibial tubercle osteotomies (two revisions - a lot research came out shortly after the first two surgeries on how best to do them) and an MPFL reconstruction on both knees. Essentially both tibias have been broken and screwed back together twice. I'm about 11 weeks out from my fourth surgery and go to PT once a week. I was going twice a week for the first six weeks.

Honestly the best way to not slow your recovery is going to be to work with a good PT. Yes we have essentially rolled in biking on my indoor trainer into my PT, but that is only a very small part of it and I suspect I wouldn't be given as much freedom with biking indoors had I not have had the experience of having the same surgery last winter (with the same surgeon and one of the same PTs after the fact). They know that I know how not to hurt myself and how to hold myself back even if I really don't want to hold myself back. Part of that is about patience but a lot of it is about knowing how my body works in the context of this surgery. I am coming back surprisingly strong and I also know that had I not been seeing my PTs that wouldn't be the case.

FBinNY 

The trainer can be helpful in improving range of motion and SLOWLY rebuilding strength in the affected muscles and tendons.

Use toe clips and uncleated shoes to allow unfettered lateral float (or clipless systems with plenty of float). Stick to lower gears and spin rather than pushing. Lastly, consider moving the foot forward on the pedal to reduce load on the ankle and Achilles tendon.

Then, use some common sense, and listening to your body to stay within limits, which will expand fast enough if you don't go crazy.

MtnBug

Thanks for the info. I've been limiting my time on the trainer to less than 10 minutes of light spinning, so far, and haven't had any pain that I don't already associate with walking in the boot. Not putting near as much pressure into the pedals as into walking, in fact, as this is mostly a flexibility exercise.
Since I go back to the DR in about 10 days, and expect to lose the boot at that time, I'll continue down this road until I get cleared for more extensive strength training. I don't expect to be able to clip in for several weeks, possibly months.
Thanks again for the input.

Cyclist0108

As with my bike, I got steel rather than titanium.



I broke mine on Jan 1st and had surgery that evening. I was still on crutches in April, but by mid-March I had bought a trainer and was climbing onto the bike on that.

I still had significant trouble walking in July. It was a long recovery. Get a very aggressive physical therapist and stick with the program. Not moving it is what will prolong the injury. My main mistake was not being aggressive enough. Another thing you will want to work on is regaining range of motion. Buy a wobble board, and use it until you scream in agony. No pain, no gain.

Cyclist0108

Also, lots of good advice here: Broken Ankle Advice.....- Mtbr.com

PM City

Here is mine. I went in for a few PT sessions but didn't feel like they were pushing me hard enough. So I just got active again. Walking, running, riding. That was the best PT I could ask for. Range of motion is a big one though. Ligaments get stiff and you need to really work to stretch them back out.

Cyclist0108