Coping with Limited Mobility
The idea of having strict mobility limitations after surgery can be intimidating. Many patients have anxiety about how they will manage their daily routine without being able to walk or drive for a period of time. Though it is important to remain non weight bearing to allow you ankle replacement to heal it does not mean you are bed bound or house bound. Most people are able to go about their normal lives with some modifications and equipment to help you get around.
You may notice initially that performing simple tasks might require more energy than usual. This is normal for the post-operative time period. Do not get discouraged. By making arrangements prior to surgery you can make you post-operative experience more manageable. Having the proper equipment is key in maximizing your mobility. Before surgery you will be given a prescription for a roll-about walker. This device is a three or four wheeled scooter with handlebars that allows you to rest your operative extremity on a stand while you use your non operative extremity to propel yourself. Using a roll-about walker will allow you to keep weight off your operative leg while still being able to perform daily tasks. Other devices such as an iwalk (hands free crutch), standard crutches, or wheelchair may be an option as well. Other considerations to address during your time of limited mobility are arranging your home in a manner so items you use regularly are within easy reach, preparing meals in advance to make cooking more manageable, and making sleeping arrangements if unable to safely move up stairs to a second floor bedroom. Remember keeping weight off your operative extremity is only temporary and will allow for maximal healing. For more information on coping with your limited mobility visit the following websites:
How to Be Non-weightbearing After Surgery
So you’re considering foot or ankle surgery, and your orthopaedic foot and ankle specialist has said you’ll need to be non-weightbearing for a period of weeks after your procedure. What does non-weightbearing mean, and what options do you have for getting around?
The term non-weightbearing, sometimes prescribed simply as N.W.B., refers to restrictions placed on you immediately after surgery. You will be advised to not put the surgically repaired foot on the floor. This typically means no weight whatsoever, not even for a second or two whether standing or seated.
Why is touching the ground so bad after foot or ankle surgery?
Most people cannot accurately gauge how much weight they’re putting on a foot even if they’re just grazing the floor with it. Putting any weight on an operated foot or ankle can do damage to the repair that’s been done. Bones need time to heal. Plates or screws that may have been added during surgery need the bones to heal around them. Adding weight too soon can interrupt this important internal healing process.
Equally important, surgical wounds heal better when they are not stressed by weight. Incisions such as those for an Achilles tendon repair or a fracture repair can particularly benefit from being non-weightbearing, but all procedures that involve surgical cutting need a period of no weight so incisions can heal.
In addition, a period of non-weightbearing also helps reduce swelling, which is common after foot or ankle surgery. Keeping swelling down will help tissues heal more quickly, and sometimes elevation helps control pain.
What are my options for getting around?
If your orthopaedic foot and ankle specialist has said that avoiding any weight on your foot is essential to healing, there are several options to consider for maintaining mobility.
Crutches. Many patients use crutches after surgery to keep their affected foot off the ground. The most common type, axillary crutches, are made of wood or aluminum and fit under the arms. Adjustment is important. You should be able to fit two fingers under your arm when standing with crutches. With your arms hanging down, the crutch handle should be at the crease of your wrist. Review the How to Use Crutches page for details on safe handling. For some patients, a standard walker may also be useful.
Knee scooter. Also known as a knee walker, the knee scooter is designed with a knee pad and wheels. You place your knee on the pad and roll yourself forward using handle bars to balance and steer. Brakes help keep the scooter stationary when you get off of it. Accessories can include a basket for stowing your cell phone or medication, a cup holder and non-skid wheels. Knee scooters can be rented or purchased and may be covered by insurance.
Seated scooter. Narrower and lighter than a wheel chair, the seated scooter allows you to roll about from a seated position. And like the knee scooter, you get around using your own power, though some models come in powered versions. Similarly, accessories such as a basket and cup holder add to convenience. Brakes typically are standard, and seated scooters can be rented or purchased.
Following your surgeon’s orders, especially when it comes to staying off of your operated foot or ankle, can make the difference between a normal healing period or a longer healing period with potential complications. Before your surgery, make sure you understand your surgeon’s non-weightbearing instructions, particularly the length of time you’ll need to avoid weight on your foot. And then plan ways to stay mobile during this time.
Preparing your home
It is best to prepare your home before you actually have surgery, so that it is compatible with your recovery needs. Here are some recommendations:
- Prepare some meals ahead of time for yourself.
- Stock up the refrigerator, freezer, and pantry so that you will not have to go grocery shopping for at least two weeks.
- Stock the freezer with ice packs. An alternative to ice packs that works very well is a large bag of frozen corn or frozen peas – they can be refrozen and reused for the duration of your recovery.
- Place frequently used kitchen equipment and utensils in an easy to reach location.
- Remove throw rugs so that you will not slip or trip.
- Arrange for help preparing meals or explore setting up a meal delivery service for yourself.
- If you live in a two-story home, it would be helpful to prepare a sleeping area for yourself on the ground floor.
- Ensure sufficient lighting between your bed and the bathroom.
- Keep a flashlight at your bedside.
- Place the phone within easy reach at your bedside.
- You can cut out one side of a box and put it under your bed linens and blankets if you wish to avoid their pressure on your foot.
- Remove throw rugs.
- Consider a shower chair or plastic garden chair in your shower.
- Purchase a short leg shower protector (a device that keeps your leg dry while you shower) ahead of time.
- Remove throw rugs or other objects (cords) on the floor the can cause you to trip or slip.
- Set-up your couch or a chair so that you will be able to make yourself comfortable and elevate your foot – make sure that you have foot rests to elevate your foot.
- Rearrange furniture to allow for clearance of crutches or walker (and wheelchair, if needed).
- Place a list of emergency phone numbers and our department phone number next to each phone.
- Bring your medications wherever you go.
- Plan sedentary projects for while you are recovering – reading, organizing photo albums, etc.
- Keep the TV remote control handy.
- Allow ease in dressing by wearing loose-fitting pants, shorts, or skirts.