Getting my knee on the wall

Up until late last year I’d never broken anything really important. I’d broken a finger, a couple of toes and I’d fractured a metatarsal in my foot. They all hurt like bejesus, but never caused any real fuss. When I fractured my talus last year, I don’t think I really knew how big a deal it was going to be. I figured I’d broken some stuff before and I’d been on crutches before, so it’s not worth making a fuss.

When I had the accident, I was pretty sure I’d just really badly sprained my ankle. I badly sprained the same ankle when I was 17 and ended up in a back slab cast and on crutches for a bit. This felt kind of the same. When I was 17 my ankle went floppy, at 29 my ankle went floppy. At 17 my ankle went funny colours and puffed up like a balloon. At 29 my ankle went funny colours and puffed up like a balloon. Immediately on landing from the fall all I thought was ‘shit. This is going to take me out of work for a bit.’ I didn’t really think any further than that.

I really didn’t think I was going to end up in hospital for 4 days. Ascot took an x-ray and were pretty sure it was a talus fracture, so they sent me to Auckland for a cat scan to double check. Auckland took an x-ray and couldn’t see a talus fracture but my ankle had puffed up bigger than a snow boot so the registrar said I’d probably need ligament surgery. I had to wait to be checked by the specialist the next morning and then they’d open me up. I really hadn’t seen that one coming.

I’ll try and paraphrase the rigmarole that was my 4 days in Auckland Hospital: Specialist said talus fracture and ligament damage, but wasn’t sure of course of action. Much waiting for CT scan and plaster (ankle still not fixed in place). Registrar forgot to do paper work for both. Much more waiting. Very angry plaster technician. Gluten free vegetarian hospital food is just pumpkin and/or kumara. Morphine made me ill. Then anti emetics made me ill. Then I got an anti emetic that didn’t make me ill so I could take morphine. Too sleepy to knit from morphine. Course of action: moonboot and crutches. No surgery. Discharged.

Because of the break and the swelling and the extreme pain (which is typical of a talus fracture) I couldn’t start physio until 8 weeks after I had the accident. I was off work for 8 weeks, and then gradually eased back into work whilst still in a moon boot. I had two ACC case managers that weren’t terrible. I had my Civil Union coming up in April. I had a great physio. I managed to walk down the aisle without anyone noticing my slight limp (I think). I managed to go on our honeymoon, and although what I could do was limited, I still did a lot, and had a great time.

Following the whirl wind of our Civil Union I realised that maybe things weren’t going normally. May was 5 months out from the accident and I was still having a lot of issues with movement. I sat on doing anything for a bit. We’d just started doing physio in the gym as well as hands on and I thought that might make some difference. It didn’t. It was extremely frustrating for me because I had made such great improvements in other areas. My balance is extremely good for someone with an ankle injury, and that ankle is very strong.

Dorsiflexion is the movement where you lift your foot up toward your leg, pushing the heel down and the toes up. I never thought about how ankles even worked before my accident. Now I know that without dorsiflexion you can’t do a lot of things. You can’t run. You can’t jump. You can’t skip. You can’t squat down to turn on computers at work, and you can’t dance particularly well. It has many real world ramifications; imagine trying to look after your kids without being able to easily pick them up off the ground? I decided to book a specialist appointment.

Meanwhile, my physio Barb had an accident of her own, unfortunately injuring her thumb quite seriously – not so good if you’re a physio. So Barb had to get some surgery herself, and is still recovering. I got a new physio. The first session with him was absolute torture. I wasn’t sure if I was going to be able to walk without crying afterward. But I could, and after a few torture sessions I started finding that the movement which has been the bane of my existence for the last 8 months was gradually getting better.

I saw a specialist a couple of weeks ago. My accident must have been pretty special because he remembered me despite having never met me. He was consulted on my initial CT because of the break, ligament damage and bone fragment mess that was my ankle almost 8 months ago. It must have been memorable. He said the amount of movement wasn’t great, but that we’d check in again in a couple of months, and if it still hadn’t improved much, we’d have another CT and go from there.

Before I started physio, I was going a little mental. I felt useless – I couldn’t even shower myself if I was home alone in case I had a fall. I felt alienated from my friends – I couldn’t easily go to parties, couldn’t catch a bus to go for coffee. I felt scared – what if my ligaments were screwed and they found out later and I needed surgery and it didn’t work and I couldn’t walk properly ever again? Despite the fantastic support from my partner, friends and whanau, it was a very sad and lonely time. I genuinely think I would have lost the plot without physiotherapy. Physio taught me to focus on the small achievements, and let go of the rest for a while.

When I started working with Barb she showed me the test for dorsiflexion. You stand with your toes on a wall, put your knee on the wall, and creep your foot back whilst keeping your heel on the ground. The average person should get their toe around 14cm away from the wall. When I started physio, I couldn’t actually bend my knee at all with a foot flat on the ground. My knee remained a full foot length from the wall. Today at physio, I got my knee on the wall.

Getting my knee on the wall is still very far away from normal movement (14cm in fact), but it is a massive improvement from where my movement was. This small achievement has solidified for me that my dorsiflexion can improve, and that I can work at it to ensure it does. I am no longer worried that there might be bone fragments restricting my movement. I am no longer concerned about being a disabled parent one day. I’m no longer worried about what the specialist is going to say to me in 6 weeks time. I got my knee on the wall, so I’m going to be fine.