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tamtanz
Oct 28, 2004, 2:32 PM
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i was leading a slabby route down at the Red in Kentucky. around noon-ish on oct. 3rd, i had to veer right off the route and as i was heading back, my right foot gave and i took a spill; i have nothing against falling, but a ledge broke my fall on the way down (as well as my right talus bone). upon immediate impact, i figured the pain would die off and leave nothing more than a big bruise. as it turns out, the pain continued to shoot up like nobody's business. from there, i tried to apply pressure to it, but only felt mush. i said, "it's broken! augh!," and proceeded to be lowered down. looked like there was a tennis ball growing out of my ankle. my friends rushed to get our stuff together and seek medical attention.
local climbers helped us locate the nearest hospital. was admitted to the ER and one x-ray after another showed that things were not just bad, but pending an operation. apparently, i had fractured one of the few bones in the body that doesn't heal well. they attempted to reduce and realign the broken talus, but that wasn't going to cut it. went into surgery monday morning and was pretty much out of it for the remainder of the day.
prognosis as i know it goes something like 5 more weeks on this cast, no weight-bearing for another 4 weeks or so and then PT/rehab. i was more angry than anything else that this happened, considering this is peak climbing season. i'd appreciate any advice as to a sound recovery and training so i can get back on the wall asap. thanks a ton.
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mtnjunkie
Oct 28, 2004, 2:54 PM
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My girlfriend fell bouldering a year ago (she was less that 3 feet off the ground) and got a compression fracture of her talus. The bone didn't actual crack, so it took an MRI to actual diagnose what happened. The doctor told her that this was going to be harder mentally than anything else. He was spot on. She was non weight bearing for 6 weeks. In that time it was amazing how quickly her leg atrophied. The uphill battle began once she could start putting weight on the foot. It took a long time to get back to normal (probably 6 months). She still has problems with pure crack climbs (although some of it also might be mental).
Sorry to hear about the accident. It was tough on my girlfriend. I hope you do better.
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maldaly
Oct 28, 2004, 3:49 PM
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Sorry to hear about your talus. I powdered mine in a 200' foot fall and it never recovered, even though we tired for two years to save it. During my epic I was stranded for a couple of days and ended up with frostbite so it doesn't sound like yours is as bad. Climbing with a prosthetic foot now. Here's some of the stuff I learned while trying to heal my bones:
Your doc is correct--the talus has the worst blood circulation of any bone in your body so it's as waaaay slow heal. If they say weight off, that means weight off. One stupid jaunt to the bathroom at night coud set you back months or force a fusion.
Stay away from the caffiene. It intereferes with calcium absorbtion and will slow bone healing. Loose the lattes, coffee, Pepsi, Coke and whatever else your vices are. Additionally it's a vaso-constrictor and will reduce blood flow to those areas. I think tobacco is a vaso-constrictor as well so loose the cigarettes.
On the bright side, alcohol is a vaso-dialator so unless you're on some kind of drug that contra-indicates alcohol, a drink or two a day is probably a good thing. I got to drink beer while I was in the hospital in Alaska recovering from frostbite.
Good luck.
Mal
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miklaw
Oct 28, 2004, 3:54 PM
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It varies between people, I've broken both in seperate injuries (soloing, racing M/cycles) when I was in my 30's, both healed to allow walking within 2 months.
I cut the casts off as soon as possible and worked on range of movement for about 3 weeeks before I was able to bear weight. No problems at all now, but sometimes pain on cold mornings (but hell, I'm 46).
I beleive most treatment is very conservative and assumes people won't do ant stretching or physio. If you are keen to recover, the treatment should be altered, casts are good at reminding you not to walk, and stopping you hurting it, but almost guarnetee a stiff ankle afterwards. Besides, I couldn't get a racing boot on over it.
BTW, I get scared soloing now.
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numbnut
Oct 28, 2004, 4:44 PM
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Wow, I was just about to make a similar post! I fractured my talus in a bouldering fall. Had to have four screws put in. The accident happened over three months ago and I am walking and just got back from physical therapy. The hardest thing about this injury is that it is a "wait and see" proposition. Some people have great circulation and some don't. After you get out of the cast I recommend a stationary bike to start physical therapy. I'm assuming your doctor will suggest the same. This really gets the blood pumping through there. Cigarette smoking is really bad for circulation, it constricts the red blood cells or something. As far as coffee goes, I just finished a cup while reading the above post, it bummed me out. I've asked both my doctor and my physical therapist about it and they have said that it just dehydrates you so drink water too. I would be prone now to take the above advice. No coffee. Wow, that'll add to the psychological difficulty of being injured!
On a separate note this injury has been psychologically tough. I'm assuming you will find it that way too. Not knowing what will happen sucks! I can see the Flatirons from my yard and knowing that I can't go climbing or running drives me nuts. All you can do is take it day to day and hope for the best and do everything your doctor tells you. Wow! Trying not to drink coffee is going to be a mother%$#er . Maybe we should take calcium supplements too.
Hope my little rant helps you out. I'm in the same boat. Stay glued. :D
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acacongua
Oct 28, 2004, 5:02 PM
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Sorry to hear that. I actually fractured my medial malleolus last spring on a route at the Red. And I bruised the talus.
I was climbing again within four weeks, but I wasn't supposed to. I was hiking a lot by then as well, but that wasn't a good idea. Thankfully I healed okay, but I have heard stories where others didn't heal quite as well.
I drank a lot of wine, which actually helps (and I rarely took any Aleve for the pain because I didn't need it). Wine helps with blood flow, which seems odd because alcohol in general inhibits blood flow.
The time off to rest up did a lot of good. I'm now climbing harder than I ever was before and I'm running faster. It took a couple of months before I could get to that point so once you start climbing again, don't be in a hurry.
Stay away from the slab. Which route was it?
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acacongua
Oct 28, 2004, 5:05 PM
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Definitely take calcium if you don't already and continue taking them after you heal.
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johnson6102002
Oct 28, 2004, 5:09 PM
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right now i am in a similar perdicament as you are. 2 weeks ago i was messing around on my slackline and did a front flip dismount landed real bad and i spiral fractured my fibula in 2 places along with fracturing my tibia in 2 places, the worst being the bottom peice of the tibia breaking off entirely. this required surgery with screws and pins to put the peice back on. the doctor told me i had to lay flat on my back with my leg up for 2 full months bc of swelling reasons and that after that i will have to come back for surgery after the 2 months to get the screws and pins back out because they are too close to my ankle to stay in. after all of this i will have to be off my feet again for a couple of weeks before i start physical thereapy. So i know exactly what your going through and know that you just have to take it day by day. the worst part about it is the fact that you truely have to rely on your freinds and family for everything. hope everything goes well for you with a speedy recovery and get back into climbing as soon as possible i know that this will be difficult for me.
best of luck
- scott
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sandstone
Oct 28, 2004, 6:00 PM
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My advice is listen to your MD and physical therapist, and don't short circuit your recovery by second guessing them. I cracked mine in NH, jumping into a little snow gully after walking down off an ice climb at Frankenstein Cliff (front point of my crampon caught on something that was hidden under the snow). I was really bummed, but a few weeks after my cast came off I did Liberty Ridge on Rainier.
Make sure you've got a good physical therapist, one who is used to working with athletes, and follow their recommendations.
Tell your Dr and therapist what your goals are, and don't hold back on asking dumb questions. I told them I wanted to do a mountain route in the spring, and they were quite supportive. I asked how soon it would be before I could get on a stationary bike, and figured they'd laugh and tell me I'd have to wait until a month after my cast came off. Well they had me on the bike (with the cast on) as soon as they thought it was safe. My injury healed completely, and has never given me any more problems.
Good Luck!
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tamtanz
Oct 28, 2004, 6:07 PM
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Thanks to everyone for the beta thus far. Just enjoyed a cup of coffee this morning, but am switching over to wine for the remainder of the healing process... :wink:
And yes, the mental aspect of being dependent on people, not to mention being unable to hike, climb, or run has been a bear. I'm planning my next backpack for the spring to keep me going. Thanks for all your encouragement. Btw, I forget the name of the route, but it was a 5.8 or .9 at Torrent Falls.
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reno
Oct 28, 2004, 6:47 PM
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In reply to: I got to drink beer while I was in the hospital in Alaska recovering from frostbite.
You must have had a really cool nurse! Most of the ones I know make Nurse Ratchett look like a healing angel and wouldn't let booze within 100 yards of the ER doors! :)
Mal's post is right on target... The Talus is a slow healer, and that's the bad news. All the things mentioned (no caffine, no nicotine, lots of rest, etc.) is the path to healing. A drink or two is OK, but don't use this as an excuse to drink. Or, if you don't drink now, don't start just to heal the talus.
Calcium supplements won't hurt. Nor will a little extra in the vitamins... C, B-complexes, E, and the like.
Pay very close attention to your foot. If it's getting cold for no reason, or is colder than the other foot, call your doctor. If your foot is pale, painful, numb, or you notice a weaker pulse in that foot (feel for the pulse in two places: on the inside of the ankle, just behind the tibia, and on top of the foot, inline with the big toe) call your doctor.
Best of luck, gimpy. ;)
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boulder_boy
Oct 29, 2004, 6:55 AM
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just recovered from mine. I got lucky no AVN(avascular necrosis=bone dead) no pins. I did it in may and I'm climbing 10's right now but I guess everyones fracture is different
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maculated
Oct 29, 2004, 8:20 AM
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You know what fractured talus is, right?
Scree. :P
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colkurtz
Oct 29, 2004, 8:35 AM
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i just broke mine and my acupuncturist took a blow torch to my foot. i'm not sure that it helped
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benpullin
Oct 29, 2004, 8:46 AM
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Any calcium supplementation should be coupled with magnesium in a 1:2 ratio. Magnesium is crucial for absorption, so I've been told.
Stay away from soda as well as caffeine and nicotine. The carbonation competes for calcium in your body.
Take it slow and follow the direction of your PT, to the letter. Don't try to come back too fast.
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pt
Oct 29, 2004, 2:01 PM
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I've seen a few of these in the clinic over the past couple of years (I'm a PT). They all did pretty well. It takes time and patience, but you should get back to doing everything you want. I started climbing with a guy I was treating after calcaneous and talus fractures. He is doing well and slowly building up to where he was. Good luck and listen to the advice allready mentioned in this thread, alot of these people know what their talking about!
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numbnut
Oct 29, 2004, 7:40 PM
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I've heard from two doctors so far that caffeine isn't nearly as bad as smoking for the constriction of blood cells or the absorption of calcium into the bone. Quote "Your probably not going to see a difference in healing between those who frequent a latte or two and thos who don't." From one of the doctors at http://www.myfootshop.com under the discussion section. This is an excellent website from which to glean free advice from a very competent doctor.
Of course it is probably always better not to indulge in caffeine, if your a junky like me quitting is easier said than done.
Also, Vitamin C is key for the production of collagen which is an "ingredient" in our bones and key for bone healing.
From all of the doctors I've asked, it seems like blood flow to the bone is the key to healing. After you can weight bear on the ankle, go to physical therapy, stretch the ankle out and ride the stationary bike. Get the blood pumpin through there. :!:
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fredo
Oct 29, 2004, 11:18 PM
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Ya know, everyone is different. Fractured mine in a similar situation. Lead fall manky pro pulled (DOH!) and took the king swing and about a 15 footer. Tree and the opposite wall I was climbing stopped my momentum. I was lucky, not fully broken, no surgery or cast. TONS of PT. Lots of bike and stuff to keep the joints strong. Was weight bearing after 10-12 weeks and climbing comfortably 4 months post injury. No problems since then although I notice a certain soreness when the weather turns cooler. Don't rush the healing and cause more injury. It won't be worth it. Good Luck. BTW just to flame the helmet fire. My head scrapped and banged down the wall during my fall (red on the rock to prove it) Could have broken my jaw or effed up my ear had I not been wearing one. Something to think about.
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climberstephen
Nov 3, 2004, 4:23 AM
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Don't you hate it when people say, "How did you break your leg?" and before you can answer they say "Well, I broke mine (x) years ago and ... blah blah blah" as they continue to tell you their life store... ugh!
I feel your pain. I broke... no SHATTERED mine in 5 months ago on Memorial day weekend bouldering. Basically the tibia (big leg bone and shin bone) is what breaks the talus in most falls. Your foot lands flat and as your knee travels down to the ground (towards your toes) beyond normal range of motion, the tibia is then forced into the talus breaking it. If you are really unlucky the foot then begins to roll inward towards the opposite leg possibly tearing tendons and ligaments and risking a protrusion (compound fracture) in the outer ankle bone location.
Mine was severe enough the orthopedic surgeon had to cut off the end of my tibia to perform the surgery on my talus, screwing the four of the five pieces of it back together (leaving a floater), then screwing the end of my tibia back on. Many talus fractures do not need this drastic of an approach as they are just fractured and not broken completely apart or the pieces are close enough together they will re-attach on their own.
As earlier posts have noted, it is slow healing due to it being covered in cartilage which helps absorb the shock of walking, similar to the function of cartridge in your knee. This means there are only micro-vessels of blood to flow to the bone itself, which are usually disrupted or destroyed during a break, especially a severe break. This leads to AVN (bone death, as noted before) which is an impossible-to-prevent condition of talus fractures.
The swelling will be there for months and months, if not a year or more. I have been prescribed Bextra for it. Keep the swelling down using ice, elevation, compression stocking, and/or whatever your doc says. Swelling is not excess blood in the joint as many think. It is the retention of water by surrounding cells due to a certain chemical created by damaged cells. This swelling squeezes the blood vessels and restricts blood flow, which is critical to healing, so keep it under control. Anti-inflamitories neutralize this chemical which in turn lets the cells release that water. Some anti-inflamitories, such as Motrin in particular, are bone growth inhibitors and should NOT be taken during a fracture due to the fact it neutralizes another chemical that your body generates to generate new bone.
This was my case. I have since spent 3 months (12+ weeks) of non-weight bearing (due to the severity of my particular fracture) and will spend another 6-8 months in PT. Talus fractures heal slowly and, due to it's importance to foot to leg motion, usually require great amounts of slow progressing PT. Five months after the fact, I've been in PT for 2 months now and am still walking with a cane and limp. Take it slow, as the healing process is slow. If you re-injure it, you will be f**ked in the long run as it is super hard to repair again. This includes just simply twisting the ankle.
I've taken, calcium pills, multi vitamins, and some other soy pill thing. I watched my diet and for the first 2 months cut out all caffeine, alcohol, and a lot of sugar. I don't know if any of it helped, but I but I'm sure it didn't hurt. I researched which foods were bone healers and which were bone growth inhibitors (salt, sugar, caffeine, you know, all the good stuff). Taking extra calcium now, though is a good idea, is too late to help bone growth. Unfortunately, nothing will speed up by any measurable amount of time this slow healing process. A reasonably healthy diet will do you good, especially since you will be sitting around a lot more than normal. Keep exercising what you can. I still did some exercises that I could such as sit ups and pull ups (be careful!). Of course, exercise promotes body healing chemical production.
As for climbing... when asked about when I could try climbing again, my PT guy said flatly "I suggest finding a new sport." Yea, "whatever," is what I said, too. Within the last couple of weeks, I've tried some easy TR problems at the gym, being sure NOT to take any falls on the bad ankle. DO NOT boulder where you may come off and land on your bad foot! A tight belay is what you need. Other than pain due to decreased range of motion (tight tendons) and strength, I have had no adverse effects. If anything, it has helped the strength and ROM. About all I can do with it is stand on it. Things like toe hooks are still all but impossible. I climb in a tennis shoe on that foot because of the extra ankle support it offers over a climbing shoe and the fact that the swelling doesn't allow a climbing shoe to fit. Plus it hurts like hell trying to force that foot into it. A hiking boot is a good idea, too. In the end, the bad foot does little to help me climb other than stabilize my balance. I compensate with my upper body and good leg and have climbed gym 5.8s already. Also, I have started yoga again, which is even less impact and is working on strengthening the rest of the leg as well as the ankle itself. PT and these exercises hurt, sometimes a lot, but it's what we have to go through to get back to normal.
Good luck! If you have questions, let me know. I've researched this issue a great deal in the last 5 months, so have much knowledge on the subject now. If you want to see some cool pics and the story of how I actually fell, go to:
http://www.onlineclimbing.com/stephen/brokenankle.asp
http://www.rockclimbing.com/photos.php?Action=ListPhoto&PhotoID=42979
Stephen
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antigravity
Nov 14, 2004, 4:13 AM
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Sorry to hear you broke the most dreaded bone in your body to break (or atleast in my opinion). Seems like everyone had a ton of things to do (such as listen to your Dr. and go to PT) and tons one things not to do (like DON"T walk on it). But here are some alternatives from becomming a complete couch potato from now and when you can actually go to PT. To stay in shape, go swimming. It is non-weight bearing, but don't kick. I know it sounds silly, but it is suprising how much the water pushes your foot around when you kick. Instead use one of those floater things between your legs. You can also still go climbing if you are super diligent not to put wieght on your bum foot. But on TR, you still have both arms, one foot and one knee. You can still climb, just don't expect to be doing anything technical. But hey, you are on the wall. You have to take what you can get. I also think it would be a good idea to get a hang board put in real low to the ground so that when you hang with your knees bent they are bearly off the pad. That way when you do start climbing again, you will have some grip strength left.
I broke my talus a year and a half ago. I wish you a complete recovery. It is also a good idea to research the type of talar fracture you had so that you can understand the complecations that are possible with a talar fracture and double check how your Dr is treating you. (Most nurses think your talus is in your heal!)
Good Luck.
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treez
Mar 22, 2006, 10:03 PM
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Does anyone have any talus fracture recovery stories?
I am freaking out that my active life may be over due to one fall.
It looks like I may avoid the operation because it's not displaced, but I've found some horror stories on the web today. Any miracles out there for me to focus on?
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scrapper
Mar 22, 2006, 10:37 PM
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I fractured my left talus in late 2003, crushed the top of the interior side on my fibula in a 3rd degree ankle sprain (right ankle 3rd degree also, no fractures, at the same time). I was fucking around on the easy wall at the local rock gym, climbing backwards in loosely laced running shoes. I hopped down, about 6 feet, landed in an old pad and they turned like ball bearings. It sucked.
I had the cast and boots for about 6 months, was very careful and kept it elevated. My recovery went well as far as the bone healing and the swelling going down. I had very atrophied muscles when I took off the cast. It took about a year to really get that leg back to full size.
The real struggle for me has been to regain the range of movement in that ankle. It has continued to improve for the past 2 years, and I am hopeful that I will eventually restore my entire range of movement. I rarely notice it when climbing, and never really during tennis or basketball, tho I don't get as much lift off of the left side anymore.
Easy traversing, such as ARC training, has been really good therapy. Doing exaggerated footwork, anything with strength and articulation of the ankle, has helped. It will swell afterwards, but ice it, and when the swelling goes down, you'll notice improvement. It's a long cycle of stretching all the ligaments, tendons and muscles that shrunk up during healing. You will probably have more than one painful stretching experience, but over time it loosens back up. Writing the alphabet with your toes is a good exercise if you can't do something more involved.
Also, if you have the cash, find a good physical therapist. Don't settle. Many of them suck. Shop around until you find one that really makes your ankle feel alive again after your sessions. Do this early, I made the mistake of staying with a guy who was not very interested in my therapy. He would often start by working the wrong ankle.
Keep at it, make articulating your ankle a habit. It's a shitty bone to break, but it heals, albeit very slowly.
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noshoesnoshirt
Mar 22, 2006, 10:42 PM
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In reply to: Does anyone have any talus fracture recovery stories? I am freaking out that my active life may be over due to one fall. It looks like I may avoid the operation because it's not displaced, but I've found some horror stories on the web today. Any miracles out there for me to focus on?
Fractured mine years ago. 6 weeks in a cast, then a couple of months of limping. I was back on the sharp end quickly (err, actually while the cast was still on; I glued stealth rubber to it).
Wiggle your toes all day everyday to keep the blood flowing. As soon as the cast is off give your foot a lot of love - massages and passive stretching do wonders. Ice frequently. As soon as it can bear it start walking. Try standing on the bad leg asap as well; balance takes a long time to regain. I used to work on putting my other sock and shoe on while standing on one leg.
Buck up. I was back climbing, hiking, running, etc. before long. My foot hurts when the temperature drops, but that's life.
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treez
Mar 22, 2006, 10:57 PM
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Thanks Scrapper.
I got off pretty easy for a 30 foot ice whipper.
I don't have any cash as of the incident, so I'll probably be on my own for PT. If you have time - what kind of excercises did they have you do?
noshoesnoshirt -
Thanks for the encouragement. I think if anyone can come back fast, it will be me. The X-rays showed that I had broken other bones in my foot before and not even known it.
I just hope I can be me again soon. The debt doesn't scare me as much as the possibility of not being able to work/play like I used to.
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