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Rehabilitation exercises for ankle athrodesis

Discussion in 'General Issues and Discussion Forum' started by c.pod, Sep 3, 2013.

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  1. c.pod

    c.pod Welcome New Poster


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    Hi I was wondering if someone could help me, I have a client in her mid twenties that had an ankle athrodesis 4 years ago. She currently wants to get back walking and also some light jogging. Both calves needs strenghtening.
     
  2. Admin2

    Admin2 Administrator Staff Member

  3. Dr. Steven King

    Dr. Steven King Well-Known Member

    Aloha,

    I have in the past suffered from an Osteochondral lesion or osteochondritis dessicans in my right ankle and have required two scopes and an arthroplasty.

    My range of motion is very limited to 0 degrees dorsiflexion,,i cannot get past 90 degrees of ankle dorsiflexion much like a fusion.

    Rocker based footwear can be helpful but are difficult to run in.

    Perhaps you could click on the Kingetics banner posted and avertised on this website and inspect the new advanced composite internal rocker orthotic system we are proposing.

    I have found it very helpful for my ankle pathology and it has allow me more freedom for excersing and fitness activities than foam and plastic based footwear.

    I know you are looking for Physical Therapy solutions but footwear is important as well.
    Just a thought.

    Mahalo,
    Steve
     
  4. efuller

    efuller MVP

    Was the fusion on one side? Was the fusion a tripple or just a talo tibial fusion? I don't have any patients who have wanted to run after an ankle fusion. It might be done, but I'm having visions of trying to run in ski boots.

    Eric
     
  5. Dr. Steven King

    Dr. Steven King Well-Known Member

    Aloha,
    An important lesson we learned in podiatry school was that if a patient loses range of motion in one plane the body will compensate by trying to regain that plane of motion in the next closest joint with a similar motion.

    Why not add an extra joint externally to the body that allows for that motion?

    You can run in ski boots if they are attached to an orthotic that has a motion similar to the ankle and to a lesser extent the sub talar joint. ie a simple spring machine tricorrectional joint.

    This also will allow mechanical robotic systems to walk with a more fluid human type gait.

    Just a thought.

    Mahalo,
    Steve
     
  6. bruk

    bruk Member


    Send her to a physical therapist experienced in ankle arthrodesis/fusion. There are undoubtedly areas that need to be addressed besides simple calf strengthening.


    I work almost exclusively with runners and endurance athletes, and I rarely tell anyone that their running career is over, but it should be for your patient. I don't say "you can't run anymore," but I would say " you will ruin joints above and/or below the ankle if you jog with any regularity. Given your age and existing altered biomechanics, adding jogging stress will undoubtedly create a host of other problems that you will have to deal with for the rest of your adult life, which has only just begun."
     
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