Pain, stiffness, swelling, dry skin and weakness are frequent symptoms experienced after your plaster is removed.
Pain can be eased by simple analgesics prescribed by your GP or Consultant. The pain that you experience once the plaster is removed may last for at least 6 weeks initially, but improvements can be made for up to two years after your fracture.
Ice or heat may also help reduce your pain. Heat can be applied simply in a bath of hot water or by a hot water bottle/wheat pack wrapped in a towel. Ice may be applied by placing a bag of frozen peas in a damp towel. Either can be applied for 20-30 minutes up to four times a day.
You may notice that you have swelling once the plaster is removed. Elevating the ankle, higher than the level of your heart, can help reduce the swelling. This is normal and may remain for up to a year after your fracture.
It is normal for you to experience stiffness after your plaster is removed, again this can persist for several weeks/months. You may notice that you feel weak after your plaster is removed. Again with appropriate exercises and general use of your leg this will improve with time.
Often people find that their skin is dry and scaly once the plaster is removed. By massaging a simple moisturiser or baby oil frequently to the skin after washing your skin will improve.
You may notice a lump or bump at your ankle. This is part of the healing process as extra bone is laid down to heal the fracture. With time this is often re-absorbed over 18 months, although it may always be evident.
You may also feel vulnerable without your plaster. Sometimes tubi-grip or simple ankle support can help your ankle feel supported and also remind people that you have had an injury. These can be purchased yourself from most pharmacies; you can discuss this with your physiotherapist.
You may be still using elbow crutches. If you have no restrictions to your weight bearing status, you should slowly increase the amount of weight you put through your foot as pain allows. You can wean yourself to one crutch (using the crutch in the opposite hand to your injury) as pain and ankle movements allows. Some people then progress to a stick or discard their crutches completely.
Driving can started when you have sufficient movement and strength to safely control the pedals. You must be able to perform an emergency stop safely and pain free. This is usually 6-8 weeks after the removal of your plaster cast or moon boot, but will vary in individuals. You should seek guidance from your insurance company and advise them of your injury.
It is important to remember that all these things are normal after your plaster has been removed.
It is also important to remember that you have had a fracture and that your ankle may not return to completely normal after the plaster is removed. Provided that you exercise and use your leg as much as possible it will improve with time and patience.
Ankle Exercises
The following exercises should be repeated 10 times per exercise, 3-4 times daily.
1) Gently move your ankles up and down to bend the ankle joint and point your toes.
2) Gently move your ankle round in circles, both clockwise and anticlockwise or write the alphabet.
3) Gently move your ankle from side to side, ensuring you keep the knee still.
4) Use a towel around the bottom of your foot. Gently pull on the towel to bend your ankle. Hold the stretch for 10 seconds.
5) Sitting with your affected ankle crossed over the opposite knee. Point your toes and add pressure with your hand to stretch the top of your ankle, hold for 10 seconds.
6) Sitting with your feet on the floor. Push up onto your toes and then roll back through your feet and onto your heels.
Exercise progressions: Strength and Balance
1) Place the theraband around the top of your foot and to a stable surface. Pull your toes up towards you against the band.
2) Place the theraband under your foot. Point your toes against the band. Relax.
3) Place the theraband on the inside of your foot and hold in the opposite hand. Do not allow your knee to move and pull your foot inwards. Relax.
4) Place the theraband on the outside of your foot and hold in the opposite hand. Do not allow your knee to move and pull your foot outwards. Relax.
5) Try to balance on your affected foot. Start with some support and gently wean this as able.
6) Stand holding a stable surface. Roll through your feet and push up onto your toes. Slowly lower.
