Talus Avulsion

Consultant Advice

HOW TO FIT YOUR WALKER BOOT

The walker boot is worn for minimum of 4 weeks.

Your Recovery

These links will guide you through a number of rehabilitation exercises to help you recover from your injury. You will need to follow them in the correct order.

Phase 1: 0 - 2 weeks

Below you will find important information to follow 0 to 2 weeks post injury.

Pain relief: Paracetamol can be used by following the instructions on the packaging. For stronger pain relief or if you have any allergies please contact your General Practitioner or a pharmacy.

Walker boot: Do not sleep in the boot. It is important to place as much weight as possible through the boot when walking to help the healing process. The boot should be worn when walking but can be taken off when you are:

  • resting
  • applying ice
  • elevating the ankle
  • doing simple exercises

Ice: A cold pack or frozen peas wrapped in a towel can be applied to the ankle for 15 minutes, 3 to 4 times a day. The ice must not come into direct contact with the skin. Ice is most effective within 72 hours of injury.

Elevation: The ankle should be rested and elevated above the level of your hip regularly throughout the day for 20 to 30 minutes. Phase 1 exercises can be undertaken whilst the ankle is elevated to help reduce swelling.

Exercises: 

Undertake exercises little and often as pain allows.

Phase 1 exercises

1. Sit down straight and trace circles with your foot by turning your ankle in one direction without moving the knee. Return to the middle and repeat in the other direction.

2. Lie on your back. Point your toes up and down as far as you can. Relax your feet.

3. Sit on a chair with the affected foot resting on a flat towel. Slowly bunch up the towel by curling the toes. Replace the towel and repeat.

Sick Note: You will not require a sick note for the first 7 days that you're absent from work. Please contact the fracture clinic if you require a further period of time off work.

You may progress to phase 2 once you are 2 weeks post injury.

Phase 2: 2 to 4 weeks

Below you will find important information to follow 2 - 4 weeks post injury.  

Pain relief: Continue to use appropriate painkillers as necessary.

Walker boot: Continue to use the walker boot for walking. You may increase your walking distance as you feel comfortable.

Ice: You can use ice to help with pain and swelling.

Elevation: Continue to elevate the ankle if it looks swollen in comparison to your opposite side. It is normal to have ankle swelling for 3 to 4 months post injury, particularly in response to increasing activity levels.

Exercises: 

Undertake exercises little and often as pain allows.

 Phase 2 - Ankle exercises

1. Bring your foot as far as you can toward the inside and outside with your hand.

2. Sit and loop a towel or belt around the base of your foot, ensuring the towel or belt is on the front half of your foot. For inversion (supination), pull on the inside portion of the towel until a stretch is felt on the outside of your foot. For eversion (pronation), pull on the outside portion of the towel until a stretch is felt on the inside of your foot. Maintain the stretch and relax.

3. Sit straight on a chair with your feet flat on the floor. Flex the ankle to go on the tip of your toes, raising the heel off the ground. Lower and repeat.

You may progress to phase 3 once you are 4 weeks post injury.

Phase 3: 4 to 6 weeks

Below you will find important information to follow 4 weeks post injury.

IMPORTANT

  • Phase 3 exercises should only be done if you were able to do them prior to injury.
  • If you were unable to do these exercises before you were injured, only perform phase 2 exercises .

Walker boot advise

  • Please start to walk without the  walker boot on.
  • Try spending time walking without the boot on at home. Then progress to walking outdoors in comfortable footwear.
  • You can stop using the walker when you feel comfortable.
  • Do not wear the boot beyond 6 weeks post injury.

Exercises: 

Undertake exercises little and often as pain allows.

Phase 3 - Ankle exercises

1. Stand in front of a table and place your hands on it. Shift your body weight onto the affected leg supported by your hands. Return to the midline and repeat. When you shift your weight, keep looking straight ahead of you and maintain your shoulders leveled.

2. Stand in front of a counter and hold onto the countertop. While maintaining your back straight and your hips above the level of your knees, slowly lower your body into a semi-squat position without leaning forward and keeping your heels in contact with the ground at all times.

3. Stand on both feet with your hands on a chair or table for balance. Raise on your tiptoes without bending the knees. Lower under control to come back to the starting position and repeat.

4. Stand and lift one leg. Hold that position for the recommended time.

5. Stand and place one foot against the wall. Place the other leg behind with your heel on the ground, foot parallel to the front one and knee straight. Keep the torso upright and push the hips forward to feel a stretch in the calf.

You may progress to phase 4 once you are 6 weeks post injury.

Phase 4: 6 week onwards

Below you will find further information to support your recovery.

 

  • By the sixth week post-injury you should have moved into phase three of your rehabilitation package the exercises. 
  • You should have improved your movement and overall function.  
  • The injury you have sustained takes six weeks to heal but it is not uncommon to experience pain and or swelling for three months post injury. 
  • Continue to use pain relief as appropriate. 
  • If you are happy with your recovery and outcome, you can discontinue your exercises.  
  • You may return to sport after six weeks post-injury if you feel able to do so. 
  • We do not routinely follow up this type of injury.  
  • If you continue to experience pain after three months post injury, please contact us for further consultation. If we do not hear from you within three months, you will be discharged back to the care of your general practitioner. 

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