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Loose Ankles?

My experience with Brostrom Surgery – Ankle Ligament Repair

In January 2018, I had ankle surgery to repair torn ligaments. There is plenty of medical information online, but I couldn't find many first-hand experiences of the problem. I put this together in the hope others in a similar situation will find it useful.

Back when I was in boy scouts, our scout troop leader had a limp. He lamented to us often about the importance of good boots. But I was young then and I figured I had nothing to worry about. In college I took up jogging, and every now and then would trip and twist my ankle. No big deal. But over the years the trips and sprains added up. The big ones stick in my mind; sprains while hiking down from overnight camping trips, trips while trail running, trips while out for a morning run.

My mother cautioned me to look after my ankle. She said I would get arthritis. But I figured arthritis was for old people, so I didn’t pay much attention.

The years passed by, the sprains kept coming. Then there were a few good sprains that put me out of running for months. Compression socks from different countries started to pile up in my drawers. I started wearing an Active Ankle brace occasionally, then all the time. Along the way, I saw a few doctors who diagnosed ‘chronic ankle instability’ and recommended ankle strengthening exercises. I did my best to improve my balance with my eyes shut while washing my teeth, but there didn’t seem to be much more that I could do; except be careful.

I wish I’d known….

Whenever I sprained my ankle, I would wrap it up with one of those ACE bandages that you get at the drugstore. They didn’t really add much support.

What would have worked better for hiking and running would have been an ASO Lace-up Ankle Brace

Eventually, I stopped running; it wasn’t worth the risk. I stopped hiking; it also wasn’t worth the risk. But by then I would sprain my ankle crossing the street or even doing laundry. The ankle started to ache… not badly, but noticeable. So, with insurance in hand, I went to get some long overdue physical therapy.

By this point the physio laughed at me, and said there was nothing she could really do. Time to talk to a surgeon.

Ankle Ligaments.

Inversion sprains are the most common types of sprain where the foot bends outwards. There are three ligaments that are designed to keep things in place, but repeated injuries will weaken and eventually tear these completely. The doctor knew right away from pulling my ankle out at a funny angle, and the MRI confirmed: Two of my ligaments, the ATFL and CFL were completely torn. Only the strength of my muscles kept me upright.

Fortunately, modern medicine has a few tricks up it’s sleeve and the Brostrom Repair is one of them. The ligaments can be sewn back together, and they’ll reattach, stronger than new apparently.

The MRI also showed other damage. With each sprain, the corners of the bone starts to grind into the cartilage. Eventually that cartilage started to rub away and the result was friction where the bone starts to grind on bone. The associated inflammation and pain is known as arthritis and it’s bad news. The arthritis damage is less easy to fix, but a technique called ‘micro-fracturing’ of the bone makes it possible for the body red blood cells to escape and regrow some insulating material where the cartilage had formerly been.

With trepidation, I signed myself up.

Brostrom Repair – The Surgery

I had my surgery done with Daniel Thuillier at UCSF. This surgery has a high degree of success, and even though my ankle started to feel better in the months before surgery, both my PT and the doctor felt this was the right decision long-term.

The morning of the surgery, I was nervous. I took a long walk down by the canal in the morning drizzle before I went in, and then I resigned myself to the professionals.

Leg shaved, colored pens to mark which ankle they were going to operate on, IV drip hooked up, sedatives infused, ultrasound to find the leg nerves and a nerve block applied, and then I was wheeled into the OR, strapped in and a couple short breaths later…

…. I woke up. It didn’t feel bad. In fact I felt fine like I’d just taken a morning nap. My foot was all nicely packaged up. The nerve block was clearly doing it’s thing as there was no pain at all. They kicked me out of the hospital soon after, and I rode home to enjoy two weeks under house arrest.

Elevation is key to reducing swelling, so I lay back on my bed, with my foot propped up on a multitude of pillows. The nerve block lasts about 12-18 hours

After the nerve block wears off, the pain kicks in. They sent me home with prescriptions for lots of ibuprofen and opioids (oxycodone). Apparently it’s important to ‘get ahead’ of the pain. It’s much harder to use the drugs to overcome the pain once it arrives. So I signed myself up for the basic dose before I went to sleep and braced myself for the pain to come.

Surprisingly, severe pain didn’t come. The drugs did their job and I felt fine and only slightly loopy. By morning I could move my toes, and the pain level was probably at no more than a 2. If there’s one thing that I could pass on to others going through this, it’s that it wasn’t that bad… at all.

The next couple days, it’s best to remain in bed, and believe me, I had no desire to be up and about. I drank lots, and repurposed a laundry detergent container into a bedpan. The drugs stop up the rest of your system, so you don’t have to worry about #2 for a couple days. Then you have to start worrying about #2.

After a couple days in bed, I was ready to get up and move around.

Life on crutches.

Ok. So there’s a shopping list of things you need to prepare for.

1. You’ll want to shower. You can buy a waterproof covering that will go over your cast and keep everything dry. Buy it.

2. Don’t use the underarm crutches. They’re awkward, uncomfortable and can cause nerve damage even when you have them adjusted properly. Instead go buy some forearm crutches – also known as Canadian crutches, or Euro crutches, or quite frankly Rest-of-the-World crutches. It seems only America is stuck in the mid-1800’s with it’s preference for underarm crutches. Believe me, forearm crutches are the single best piece of advice I can give. You can buy a pair for $40.

After two weeks of hobbling around the house and keeping my foot elevated, the doctor took my stitches out, put me in a boot and allowed me to go out.

Note on the boot. UCSF charged my insurance over $1000 for the boot. If I’d bought the boot without insurance it might have only been $700. But go look on Amazon, you’ll find the same boot for $65!!! – A damning indictment on the state of over-charging in American healthcare.

Be careful of those knee scooters. One friend clipped a cubicle while zipping around the office and put herself back in hospital.

The first couple weeks on crutches is hard. Hard on your hands, hard on your self-confidence. This is offset by the ample kindness and generosity exhibited by almost everyone. Buses would wait for me, people would hold open doors, carry my food, strike up random conversations. I would go so far as to describe this period of convalescence as both character-building and life affirming.

Driving with your left foot

Since I’d had surgery on my right foot, I was told I couldn’t drive for six weeks.

Right. You can’t walk, and now you can’t drive?

I refitted the car with a left-foot accelerator made out of soldered copper pipe. Now you might think this a crazy idea, and everyone warned me against it, but in reality it wasn’t much different than driving on the left side of the road. There’s a mental shift, but it happens fairly quickly. You do need to be very cautious as you get started, and you do want to keep that right foot out of the way. I swung mine over to the passenger seat, so that muscle memory would know it had no role in hitting the brake should a surprise arise. It was left foot or nothing, and the left foot rose to the challenge.

Home made left-foot accelerator modification
This modification enabled me to drive with my left foot. I found it fairly easy to learn and get used to. Note that the police, and your insurance company, may not be as impressed by this. You should do your own research, and give consideration to the liability of getting into an accident while left-foot driving.

Rehab

The weeks passed quickly. My arms grew strong. My disabled parking placard came. I learned how to carry a cup of coffee while walking slowly on crutches. The scar healed; it healed well. The boot became comfortable, and then it was time to move on.

Six Weeks

Up until six weeks, I’d successfully managed to stay off my foot (with only a couple minor mishaps). My pain level had never been above 3. I figured I was through the worst, and would soon be able to throw away the crutches and start dancing. Wrong. The fun was only getting started.

Six weeks of non-weight bearing had left my leg a shrunken noodle. As I started to move my foot, all sorts of stuff started to feel wrong. My leg muscles started cramping up at night. The foot was bruised, tingly and uncomfortable. Pain would shoot out as I started to put partial weight on the foot while walking in crutches

But the boot came off, and it was soon time for physical therapy!

Nine Weeks

Physical therapy started with range of motion and simple exercises to bring the muscles back to life. I was soon on an exercise bike every other day, and 30mins on the bike seemed to leave me a little more mobile than before. Walking with the crutches became more natural. One day, I found I was able to stand. The next I was able to stand up. Then I could walk across the kitchen unaided. Soon I found myself able to walk up stairs, then down stairs. I’d take the crutches for longer walks. I was able to get around.

Friends came to visit, and I took them to Yosemite. I managed to walk the Vernal Falls circuit partially weight bearing with the underarm crutches, up slippy rocks, and through snow. My physical therapist was not amused. But I think I will use forearm crutches for all hiking in the future. It’s fast and easy, and everyone seems delighted to see a cripple with determination.

Twelve Weeks

After three months, the crutches are in the basement, but my ankle is still sore and stiff. Every day is better though and I’m back on my bicycle, and back to swimming. I’m able to walk to the store, and every week the limp seems to be less. Doctor says this is completely to be expected at this stage.

Six Months

Recovery is definitely plateau-ing. My ankle is much more stable, and I am comfortably getting around on it, but it still aches and it doesn’t feel good to run on it. I can make it maybe a half mile, but after that it lets me know that it definitely isn’t happy. I saw the doc, and he recommended I go easy on it and see where we’re at after a year. That feels right. I’m still hopeful for a full recovery, although a little fearful that my running days are over.

Twelve Months

I’m back to running again. Not a lot, but I can comfortably trot out four or five miles now, which is all I’m after really. After a longer run, my ankle will ache for the next 24 hours, which I assume is from scar tissue and inflammation around the damaged cartilage. Nothing that a little ibuprofen and a bit of ice doesn’t take care of. I only run once a week or so as part of a a varied exercise routine, so perhaps I should push it more and see if it sorts itself out. The biggest improvement is that my ankle now feels much, much, more stable. I’m more confident on my feet, and that cloud of worry on uneven ground seems a lot less heavy.

Eighteen Months

Running a couple times a week now, without any noticeable problems from the surgery. My foot feels strong and stable. So, at this point, I’m really happy. It took a while to get to 100%, but it was well worth doing!

Two Years

So it felt great being able to put my running shoes on and go explore new places. I started regularly running again and loved it. And then, on a gorgeous morning in the Marin headlands, my foot landed funky on a rock.

It was such a bad twist that I couldn’t even hobble out. I just lay there on the trail for hours until some friends and the park ranger hiked in with my old crutches. I was devastated.

Long story short… that put me out of action for most of this year. I started re-twisting my ankle again on stupid things, so I went back to the doctor fearing all had been undone.

All hadn’t been undone. The Brostrom repair is a strong one, but I am learning the hard way that ankle laxity and proprioception are issues that I need to continue working on with physical therapy and exercises. Just getting the surgery doesn’t fix it. I’m hoping surgery, plus vigilance, plus exercises and strengthening will.

I’m back to running short distances down the beach!

Good Links

350 Comments

  1. KC Simon on January 2, 2023 at 4:11 am

    Hello Everyone,
    I had the Bolstrom surgery done after being on crutches for 3 months. I rolled my left ankle and broke it walking to the car. I had surgery Nov. 12, 2021 so I am 14 months post surgery. I am still having significant bouts of pain and swelling around my ankle. I was on the table for an MRI but my referral was incorrectly written. No clue how you mix up foot and ankle. I go in about 2 weeks for the MRI. Reading most people’s healing time and trajectory I seem to be falling outside of the norm. Is anyone experiencing tightness or pain arcing from outside ankle bone to interior ankle bone? I get a pain then a snap my foot goes kinda loose then I get swelling and more pain?

    • Jane on February 1, 2023 at 10:13 am

      Yes this is exactly what happens to me as well but nobody really understands my explanation of the pain I get. almost 2 months post op I rolled it and it never truly recovered. Its almost exactly one year post op but nobody can really figure out what’s wrong with it so Ive been doing pt.

      • Nicole on May 22, 2023 at 8:07 am

        Hi . I had lateral ligament reconstruction on 4/28/23. I have to say it has been a mental battle everyday . Is the ligament ok ? Why is the area sore ? Dumb questions but I feel so scared to damage this . I walk in a boot and use a scooter when I want . I ditched the crutches and now only use the boot . It’s been 3 weeks post op and started physical therapy already as per the Dr. Foot is swollen still and I’m sure that’s normal as everyone says it but here is my battle . Tingling , tightness in the skin and my last 3 toes feel as though they are glued togther . I have feeling . I pinch my toes and that hurts . I itch them I run my fingers over my foot all sensation is felt : I even asked my Dr if he cut my nerve lol.
        Inam told this is normal. It’s swelling compressing the nerves and it takes time . I have no patience and I am so scared this will now be my life . Anyone experience this ?
        Thanks



    • Cathy on July 13, 2023 at 12:53 am

      Hi folks. I am going on 11 months post modified Brostrom surgery and synovectomy of left ankle. I have been having tough time still as probably am. It exercising it enough and need more therapy. Firstly, I continue to have some numbness esp. in the toes. Secondly, I still have some tightness in the top of the foot, from poor circulation I am guessing, so I am going back to wearing pressure sock. Thirdly, plantar fasciitis returned in the foot. Sometimes there is a pulling sensation underfoot from big toe though the arch too. I do not know if that is similar to your “snap” sensation. So, lots of exercises, manipulation and loosening needed. Am heading back for more physio and am buying some accessories to help. Am trying to be patient. Ankle definitely stronger though.
      Good luck to all of you.

  2. Patricia on January 18, 2023 at 6:35 am

    Thank you James! Having a modified Broström done soon and this was helpful. My CFL is attached to a bone fragment of my fibula which is no longer attached to my fibula :/

  3. Ilya on January 21, 2023 at 3:45 am

    Damn I’m happy to find this. 33 yeard old, football injury that never headled. Had the surgery yesterday. Been told pre-op that the cast will stay for 2 weeks, but post-op they told me 3 weeks, cast removal and boot phase set for February 12.
    So far, severe pain. Nerve block stopped influencing during the day, I got some weak opioids and Ibuprofen. So far nothing I take actually helps the pain and I can’t sleep. Will try to inform about my progress here.. the general timeframe the docs gave me are;
    3 weeks cast
    4 weeks boot
    4-6 months full activity.

    I’m praying that it goes this way, since I’m an active person and am having an actual depression as I write this.

    • Ilya on January 26, 2023 at 1:12 am

      5 days post-surgery, things are looking better. Pain stopped being severe, I’m off opioids and can sleep. Got used to my new best friends (Crutches) though I’m waiting to ditch them. The pain is now very mild and I stopped taking any meds for now. The one thing that remains is a strong stinging electrical type pain in the surgery area, whenever the foot goes down. 2.5 weeks left until cast removal (3.5 weeks total).

      • Nigel on August 4, 2023 at 5:22 am

        How is life now, how are you healing? I’m having the surgery next month and am afraid



  4. Dsimerly on January 26, 2023 at 1:31 am

    Hi all. I am very glad to find this site and I want to thank James for his recounting of his journey. I am older, 71, but an active outdoor enthusiast who does a lot of hiking, biking, paddling. I have suffered from a lifetime of ankle sprains due to ligament laxity and have seen many ortho docs and been in boots, on crutches many times, the whole deal. After another hiking ankle injury I ended up with the right doctor who said he could fix this. I just had surgery on 1/09/23. I had a modified Brostrom, superficial deltoid reconstruction, repair of talas dome lesion and destroyed cartilage, and extensive debridement. I have been searching the web for what to expect as to length of time and how to proceed with recovery. I am a person that overdoes quite easily and do not want to do it this time and mess up the surgery. So I will be following everyone’s comments and will contribute if I think I have anything to add that might help. Thanks again James. Dot 🙂

    • Crystal on February 21, 2023 at 4:24 am

      Hi Dot, how are you doing after your surgery? What pain medication did you receive?
      I’m due the Brostrom procedure in 3 weeks time and feel like I’m going into it a bit neive as I am also one that overdose it and I also don’t like asking for help(.. I was adamant I’d be able to walk my dog very carefully after 🤣)

      Wondering how long it’ll be until I’m back weight bearing again

      • jayde on April 1, 2023 at 5:13 pm

        Have just had right ankle ligament reconstruction and it’s more than I expected it’s no walk in the park unfortunately prepare yourself for the fact that you are going to need alot of assistance and probly lose your dignity while your at it .no harm done tho if your foot needs to be fixed then get it done I say 🙂



  5. Crystal on February 20, 2023 at 5:31 am

    Hi all! And thanks for this post and all the comments!
    Fair to say I’m stressing as I have Brostrom procedure coming up in 3 weeks time- after 7 years of not being able to walk on my ankle properly!!
    I broke my foot and severed the tendons in my ankle by tripping over a wheelchair, and ever since then I’ve had repeated sprains to the ankle and ended up having to wear a metal plated splint everyday to prevent further sprains!
    Finally saw a surgeon who advised that Brostrom is the best way to go ahead!
    After reading all the comments- people seem very 50/50 about their pain and ability to weight bear again… However I’ve been told I’ll be 1 week in a cast?? And 6 weeks in an air cast boot (I’m from the UK)… What are peoples opinions on this as I don’t want to go into this very nieve?
    Also why type of pain medication were people given (my pain tolerance is very high)
    I’d be very grateful for all your advice!

    • Luke on February 24, 2023 at 3:10 am

      Very odd Mine was two weeks in a cast, then two weeks in boot (none weight bearing, at four weeks 50% weight bearing for two weeks then full weight bearing at 6 weeks in the boot.

      • jayde on April 1, 2023 at 5:15 pm

        Yes I’ve just had this done 3 days ago 2 weeks in an open cast then 4 weeks in boot .



    • Emily on April 30, 2023 at 5:24 am

      Hey! So I had a right ankle brostrom procedure done July last year in Chester, UK. I had the expected 2 weeks in a cast and then due to the laxity of my ligaments and being hypermobile, the surgeon opted for another 2 weeks in a cast, followed by 6 weeks in an aircast boot and, then 6 weeks in a brace. I was given paracetamol and codeine and told to take ibuprofen if I needed from 48hrs after the surgery. The surgery has definitely helped with my ankle giving way following a dislocation a year before the surgery. There are a few problems as a result of the surgery but nothing horrendous. Mainly hypersensitivity around the scar. If anything knocks my ankle where it was operated on the pain is horrible. There is some numbness on the skin and still get a bit of pain in my ankle too.

  6. Steph on February 28, 2023 at 7:44 pm

    I’m 6 days loose surgery and feel like i’m making a fuss with the pain. Today’s pain feels worse than yesterday. It sounds like i have a long way to go!

    • Kara on October 13, 2023 at 1:14 am

      I feel you here I’m 6 days past surgery and went to my surgeon crying today to reduce the pressure in the cast!!

  7. Brooke Anderson on March 4, 2023 at 4:54 am

    Hi, I know this blog was written a while ago, but I noticed a lot of Brostrom surgery patients have commented here, so I thought I would put this out there to ask about anyone else’s experiences. I’ve just passed the nine-week mark of my post-op. I am now being asked to leave my boot for the brace. Honestly, I’m finding the transition really difficult. It’s causing stiffness and soreness in my ankle, even worse than the boot (no matter how tight or loose I wear it). Does this get any better? How have you coped with this transition?

    • Jams on March 15, 2023 at 10:15 am

      ATFL and CFL fully torn and Had a minimally invasive surgery 15 days ago (27/2/23) and was able to be in walking boots on day 2.

      Pain was at it peak on day 2 prolly cause i spaced the time of medication a tat bit too long apart.

      1 week post op the pain has subsidy and it was more of an occasional short sharp pain when you land “wrongly” while being in the boot. Also started doing leg hold to get the quads firing up again.

      2 week post op (day 14) I’ve removed my stitching and is out of the walking boot and is on stirrup brace. Was adviced by the doctor to be on boots when outdoor and brace indoor (but i just went full brace instead)

      I was doing quite a far bit of weightlifting prior to the surgery, so that makes the muscles atrophy very significantly when i compare my left and right leg.

      Writing this post on day 16, calves has been real sore since I’ve been pushing it hard with alot of walking and other leg strengthening exercises.

      • Sierra on March 18, 2023 at 8:18 am

        I had the Brostrom Gould repair done 11/28/22 and have been doing really well post op. Recovered very quickly. I was participating in indoor cycling classes and walking and running without pain or issues. Sadly today 3/17/23 I just rolled the ankle and I’m terrified I ruined the repair! Any others with experience like this?!



    • Cathy on July 7, 2023 at 11:27 am

      Hello Brooke. Had modified Brostrom procedure on left ankle with synovectomy 10 months ago. About 1 month or so after surgery, I transitioned to an air cast boot. I did obtain two ankle braces, and was encouraged at about 3 months to use them, but I only use them when doing heavy duty exercising like getting out of my kayak, hiking, or alot of walking. More often I used sports/ace bandaging and tape. It will differ from person to person, but I recommend buying some very solid trainers like Hokas or Oofos and in a larger size, and try bandaging instead of the brace, at least for ordinary daily movement? Also, keep a cane handy. Make sure you bandage/tape your ankle properly. There are videos on how to do this.

  8. Narelle on March 25, 2023 at 7:14 am

    My 16yo son, an elite soccer player, rolled his ankle running for the train to get to training. Turns out he has completely torn his ATL and Deltoid ligament and ruptured the CFL. He also has a small talus fracture. Going to see the surgeon next week but we know he will definitely need surgery. We are so concerned that his soccer aspirations may be over (well they are for the season but concerned for long term). Are there any other elite athletes who’ve had this experience and did you get back to what you love and how long did it take? I’ve been told that elite athletes are rehab’d different to the general population.

    • Catherine ebeling on April 1, 2023 at 9:53 am

      I live in Boulder Co, a town full of athletes, professional and amateur. I had a similarly damaged ankle and found an orthopedic dr who works on lots of athletes. He is also the official US rugby team Dr and works with elite level soccer and rugby players. I got a Brostrom, clean out of my ankle area and bones spurs and a micro fracture to regrow cartilage. I’m only two weeks in, just got an air boot, still not allowed to walk for two more weeks then I will start PT. So far very little pain. I’m gross it will be painful when I start Pt. He said he’s putting me on his athletes protocol. I’ll keep you posted. Good luck to you and your son. Find a dr who is good with athletes!

      • Catherine ebeling on April 1, 2023 at 9:54 am

        His name is Dr Ocel. I really like him, he’s very good and has a good reputation.



      • Catherine ebeling on April 1, 2023 at 9:56 am

        PS im a former elite level competitive bike race and psycho cross racer.



      • Brooke on August 26, 2023 at 8:56 am

        How’s your recovery coming along? I’m having the very same two procedures I’m a few months. I’m a mountain sport athlete (44 years old) and am hoping you are getting back to some activity now! Let me know if you have a chance. Thanks!



  9. Shauna Shepherd on May 19, 2023 at 11:30 am

    This post and comments gave me some hope! Thank you! I’m just over 5 months out and walking alright, but still have pain and aching. I made a goal to run 50 races in my 50s and got 9 races in before surgery (I’m talking 5K, not crazy races.) Hoping to improve to get one or two in this fall, but nervous to push it too fast. I have my six month post op appt in 3 weeks, and crossing fingers that they say it’s healing as it should. I thought I’d be back on the road by now, and reading about your timeline makes me feel a little better about the reality.

  10. Sherin Joy on May 31, 2023 at 1:11 am

    Hello, Thank you for sharing your experience.

    I tripped from stairs and rolled my ankle in January 22 2023. These was full disruption of ATFL and surgery was recommended. After so much back and forth thoughts I did the surgery on 12 th of may 2023. Now it’s 17 days after surgery. The upper side of my foot feels so numb including the 3 small toes. Even though it’s num, still over sensitive and gives me burning tickling or various different kinds of pain and irritation. My doctor asked me not to put any weight for 6 weeks. Today I accidentally put some weight on the ankle when lost balance and now I am very worried thinking it might affect the healing process. Anybody have experience or any advice?

    • Sherin Joy on July 4, 2023 at 1:46 pm

      My cast is removed after 50 days and now I am walking with a walker giving 50% weight to the operated leg. It gets too swollen by evening and it’s painful to walk also it’s painful to do dorsiflexion and plantar flexion. Is this pain normal? Any thoughts!

      • snigdha on July 29, 2023 at 2:27 pm

        what is your age? 50 days cast is really scaring me.



  11. trish on June 27, 2023 at 12:06 pm

    I just had brostrom, microfracture, cartilage clean up and biocartilage with bone marrow stem cells. I get the electric shock thing too in my small and fourth toes and top of the webspace with certain movements, not sure what they are but on night sleeping on my left side (left ankle) I awoke with the pain. Hurt like hell. Otherwise two and half weeks out still pretty swollen but not much pain.

    • Cathy on July 7, 2023 at 11:40 am

      Hi Trish. Hang in there. You seem to have had more than what others of us here have had procedure-wise. Hope your surgeon prescribed painkillers. I took acetamin (codeine with Tylenol) rather than oxycodone as was easier on my stomach. I am 10 months out, and yes, still have tingling in my toes, though not electric shooting pain. Still experiencing tightness too. Exercises, ice, elevation of the foot at night time, pressure socks all help with swelling. Swimming for me is the best therapy of all. Foot always feels better after…

  12. Charlotte on July 25, 2023 at 2:59 pm

    I have this surgery booked in for later in the year, after 7 years of sprains, 2 particularly bad ones, my doctor decided because of my job (firefighter) it was best to get this fixed. I am due to run a marathon next year (will defer) in everyone’s experiences is it totally doable to run that distance 18 months after surgery?

  13. Snigdha on July 29, 2023 at 2:25 pm

    Hello everyone from India.
    I have got ATFL and CFL surgery done on 10th July this year after my ankle became unstable. I don’t know but looks like the author wrote my story only as the pain was of several years of ignorance. Finally, after conducting the MRI surgeon suggested me that the surgery was the only option when you have chronic ligament tear. Today I completed 3 weeks, and I had doctor’s appointment day after tomorrow.
    My concern is that is he will again put the cast on me as he said that the cast will be there for 6 weeks. Although no pain but wearing cast and living life with it is really uneasy for me. I am having sleepless nights and high urge to move my ankle. I there any option called openable cast so that at least I can sleep at night.
    Any other suggestion or precaution you would like to tell for speedy recovery is most welcome.
    TYIA

    • Nigel on September 15, 2023 at 12:19 am

      I have Aircast AirSelect Standard, a fantastic boot that I can open up any time. I can basically take my entire foot out, no issues. I have it since day 0 (today I’m on day 1). Hope you are better every day.

      • snigdha bhargava on September 20, 2023 at 11:58 am

        Hey Nigel, Its been a while i wanted to thank you! I too got aircast boot on your suggestion and wearing it since then. I will soon be completing 12 weeks in the boot. Hope things went well too after this



    • Sneha on November 26, 2023 at 4:35 am

      Hi Singdha,
      May I know in India from which doctor or city you have done the surgery? How far you have recovered and how about the pain now?

  14. Anna on August 12, 2023 at 2:18 am

    Thank you so much for this blog and all the comments! I had Broström (atfl off bone) one month ago and today I ditched crutches to walk around home! I have little pain and am more confident walker every day!
    One thing that wasn’t explained to me before the surgery is how difficult the first 3-5 days will be.
    So let me share my experience the first week: I was taking codeine, ibuprofen and paracetamol. I’ve slept about 16 hours every day, codeine was knocking me out and I only had maybe 2-3 awake hours between doses. During this awake time I was dizzy and weak, getting out of bed was too much of an effort, walking (on crutches) even one meter was a lot.
    So what I’m trying to say here: get a toilet sorted out next to your bed (for #1, meds will make you not need #2), have someone stay at home with you for min 4 days, bring you water (you need to hydrate and won’t feel like drinking, someone motivating you is helpful) and food, and help you with anything you need.
    I was able to get out of my bedroom only day 6.
    Also I’ve discovered a number of hacks that saved me afterwards (all available on amazon):
    – have a stool in the shower; I would also go out with a light foldable telescopic stool, so that I can rest my leg up when seating
    – get gel pads for the crutches (hands will be sore) I also wore cycling gloves for the first few days
    – if you go out: waist bag instead of hand bag, backpack instead of a bag
    – some activities at home were easier done kneeling or sitting than standing: gel knee pads and office chair with wheels helped
    – and just be creative when needs come: i used crutches as an extention of my arm, so I’d turn on the lights etc with my crutch to avoid few extra steps
    Hope it helps! Good luck!

  15. Adrian on September 1, 2023 at 12:50 am

    Thought I would share my experience to date – it’s been a nightmare so far but hopefully my lessons learned can help others. Prior to surgery I was very active – running 3 to 5 miles 2x per week, backpacking, hiking and mountain biking. However, I tore my ligament 15 years ago (I’m 51) and knew someday I would need this surgery to increase stability and reduce the anxiety and discomfort (from various braces) I would experience while hiking and backpacking. So I bit the bullet and had three procedures done on my left ankle in Oct ’22 (brostrom, bone spur shaving and removal of a cyst). Prior to surgery I was told I’d be ‘fully active’ in 4 months (hah!). If any surgeon tells you this, ask them specifically what they mean by ‘fully active’ and what the distribution of recovery looks like by age and procedures performed. I also asked if there were, ‘any bad outcomes.’ The answer, ‘there are no bad outcomes.’ That’s BS so run to someone else if you hear that.

    I proceeded and even purchased a ski pass to get back at it in the Spring of 2023. The good news is I was up and doing PT on time (Nov-Dec). The bad news is that’s when my struggles began. Looking back on it, my frame of reference was I would be ‘fully active’ in four months so I threw myself with full gusto into PT. I believe I over cooked it and I started having set backs throughout Jan and Feb. What I mean by setbacks is doing the PT work but then being in pane for a week or longer (not 24-48 hours). I tried to adjust but it took me at least two months to get on some kind of progressive path forward. I checked in with the doc and was like, hey, four months doesn’t seem likely, what’s up? ‘Well, we did a lot of work on your ankle so I guess it’s just gonna take longer – whatever you do, stay active.’ One of the things I experienced during these setbacks was pain in my peroneal tendon (back of the calf and under the left ankle.’ This was the worst pain and took the longest to get back to zero. It turns out, I do have a short segment split in this tendon and issues with the peroneal are not uncommon for people who have chronic ankle instability (they take up the slack from your torn ligament). So another lesson – ask your surgeon about the health of your PERONEAL TENDON prior to surgery and what they are going to do to inspect them. Also, go SLOW. I would almost recommend thinking of it as a ‘TENDON LOADING’ program where you very slowly add tension to the tendons and ligaments. This was not spelled out in my PT recovery program – the guidelines for which are quite vague. This vagueness means finding an experienced PT person is critical. Identify someone prior to surgery who has experience working with people who have had this procedure and is an expert in foot and ankle rehabilitation. I did not have this level of support and it might have made a difference to the trajectory of my recovery.

    After six months I was able to hike about 5 miles (1000ft of gain/loss) fully braced (Ossur laceup). I could not run – significant pain going down hill. Mountain biking was uncomfortable whenever I shifted weight to my left side (felt like a bone bruise – probably from the bone spur procedure not being fully heeled). I opted to head out on an outdoor vacation of hiking and biking and using the brace for all activities and adjusting as needed. Looking back on it – this was a mistake. I wasn’t close to being ready for that level of activity. While I made it through a three-week trip, I took days off, modified distances, etc. and was always in some level of discomfort despite using the brace. Toward the end of this trip, we got caught in a lightening storm and had to walk run back to the car for a mile. This was another mistake that led to a similar setback I experienced in Jan-Feb – radiating soreness, peroneal tendon damage symptoms, etc. I ended up back in my surgeon’s office begging for an MRI which revealed irritation where the brostrom sutures are located. I pushed hard on the peroneal issues but he said they were ‘clean.’ In reality, the MRI showed a short segment tear which I subsequently discovered while getting a second opinion. He offered up a cortosone shot (June) which I took as I had been in constant pain for a month. His advice again was to ‘stay active’ after a week of rest.

    I felt great after the shot and got back into rehab with a goal of getting back to the level of activity I was at prior to the trip. Looking back on it – that was the wrong goal. I believe I should: (a) have not gotten the shot; (b) rested and healed naturally; (c) commenced a tendon loading program; and (d) sort second opinions. Instead, I threw myself into PT and getting active again. I did great for three weeks (was up to 4 miles walking and 12 miles road riding, but then over did it again (classic overload). The month of August has been continual resets and restarts. I now have two second opinions lined up, am going to see a PT ankle expert, and have self prescribed onto a very conservative tendon loading program built around issues with peroneal tendons. I have no idea if this will work or whether I will need a second procedure, but as of month 10, I can walk for about 20 minutes and that’s it. My key lessons learned so far are:

    1) Go SLOW in rehab and set your recovery expectations at 6 months to a year or longer.
    2) Get a PT person who has deep expertise in this recovery process and foot and ankle therapies
    3) Read your MRI reports and educate yourself as best you can on any post-surgical issues you may be experiencing. Make sure to discuss the health of your peroneal tendons with your surgeon prior to the procedure.
    4) Be your own advocate. If you run into challenges and don’t get answers from your current provider that make sense, get a second or even a third opinion about what might be going on.

  16. Ngl on September 13, 2023 at 3:30 pm

    I’m 34 yo. My ankle was sprained 3 times but I manage, walk normally but do sports always in a brace. I don’t have a severe case, but I decided for the operation because I want to properly and safely walk and do sports when I’m older. I will have an arthroscopy to remove some little fragments all around and the Brostrom procedure to tighten a stretched ATFL ligament. The ligament is also ingrained into the old scars so its rather loose.

    Hopefully in a couple of weeks I will be able to respond here that it’s going a little better. I found this comment section very useful to prep mentally, there is so little info on the web and so little stories told. Google barely shows any results other than clinics that make these procedures.

    • Nigel on September 14, 2023 at 8:13 pm

      I’m after the surgery, already home. Day 0 and 1. Its painful but painkillers can manage, it seems like it went pretty good, I can do most things around me myself, I can walk on crutches, go to the toilet etc. I have an aircast boot and my post op checkup is in 15 days.

      • Ngl on September 18, 2023 at 5:52 pm

        Day 1,2,3 – 3 painkillers a day, little movement. Not much swelling, I’m changing my patches every 2 days.
        Day 4,5 – Pain levels down, only 1 painkiller a day. I am able to put my leg sideways while sleeping (I took the backrest of my sofa and am elevating my leg with it) which is a huge upgrade in quality of sleep. The leg, quads are very sore from having the leg straight and lifted all day, but its ok. I am confident on crutches and one leg.



  17. Lois on September 14, 2023 at 1:18 am

    I had this surgery March 2023. I’m having very sharp pain when I walk. It hurts to stand, sit, lay in bed, drive the car….basically every bit of my life is affected by this surgery. I told my original surgeon it was the worst mistake of my life to do this surgery. The only worse mistake was choosing him to do it. I have since gone to a second Dr. I had a second MRI and second set of xrays done two days ago. My follow up is Friday.

  18. Nigel on September 14, 2023 at 8:10 pm

    Please let us know how your situation advanced, hard to read that its still so painful when this procedure is so well known and often made.

  19. Seppe on September 21, 2023 at 7:38 am

    (Running for getting rid of ankle pain) Painful in beginning

    Hi everyone. I had my first surgery and it was successful in Dec 2022. 8 months later I have done my other foot. I know usually durable athletes shouldn’t have all these injuries but I was told they would heal on their own and then once one got injured the other one eventually got worn down over all the years, so I am glad to get them both fixed now.

    That being said, for me who is a pretty athletic where I can run a lot without having muscle fatigue and work out. IF you are experiencing pain especially in the nerves and in the ankle for me, increasing the running everyday and pushing through the pain in the beginning week 12-16 , made my ankle much stronger and made the pain go away, the pain actually came back if I didn’t run 3-4 times a week, so that is my advice.

  20. Kara on October 13, 2023 at 1:26 am

    I’m so happy to find this page as there are honestly no other that I can find to hear real life experiences (even though some sound a little scary!!).
    I’m now 6 days post surgery and the pain has honestly been excruciating!! I know I have a low pain threshold but I was not expecting this. The oral morphine, codeine and paracetamol/ibuprofen combo have helped but I’ve still been waking up in the night crying in agony when they wear off so I went to see my surgeon today and he reluctantly opened the cast to check everything was ok and removed some of the surgical padding which was such an instant relief from the constant pressure I’ve been feeling on the wound as it literally felt like a medieval torture device even just not moving with it elevated constantly. I’ve not left my bed except for trips to the loo (pee only so far haha so be prepared for that blockage people) and a few sink washes to try and feel more human.
    Really hoping this is the turning point now and I’m due to see him again in a week to remove it properly and review if I’m ready for the boot!
    It’s tough I’m not going to lie but prior to this after not being able to run or do high impact exercise for a year I’m still hopeful it was the right decision and that things will improve slowly but surely..
    Wishing everyone the best on their road to recovery 💕
    P.s. totally up for a Facebook support group page or something!!!

  21. Charlotte on October 20, 2023 at 10:19 pm

    Had my surgery on the 2nd of this month, had my cast removed and stitches taken out 3 days ago, feels good to be able to air out the leg. Still not allowed to weight bare until next week so spending quite a lot of time out of the boot. Did you sleep in the boot? Because I tried for 2 nights and was so uncomfortable, way more than the cast was, so last night I just slept very carefully without it on, had my foot supported with my other one away from my partner

  22. Ngl on October 24, 2023 at 3:10 am

    Will post this to give people some faith. I’m almost 6 weeks post-op.
    – Started PT (1/week) at the end of week 3. At week 4 I could weight bare a few times a day, a bit, with pain.
    – Currently I’m almost walking, of course limping, slowly, but can already weight bare a lot. Doctor told that I technically should still walk in a boot but judging by USG everything looks ok inside the ankle. My PT does a good job of encouraging and getting deep into my tissues and tries to unlock me.
    – I’m not driving or anything, just walking around the house but crutches become less useful than walking without them. In the evening I’m a bit swollen but each time I sit down (eating, by the PC, on the couch) I always elevate my leg. I’m still taking Clexane shots into my belly (last few shots).
    – I’m not there yet but overall, at the 6-week mark I’m long without boot, starting to walk a little, making sure I get good practice at PT. Considering going 2/week since now for a few weeks.

    My PT usually starts with a deep tissue massage 20 minutes and 30-40 minutes of training (stability, balance, calf, leg, depends on your situation).

    • Sneha on November 28, 2023 at 11:41 pm

      Hi Ngl,

      How re you doing now? I will be operated next week. So just wanted to know how you have been doing?

      Are you full weight bearing as of now? Is the pain still persists?

  23. Jolene on November 20, 2023 at 4:42 am

    Thank you so much for this writeup! I’ve been searching everywhere on the internet for something like this. I just had my surgery a week ago and I’m cleared to start PT already at two weeks. I had a ligament repair as well as Brostrom. I wonder why you had to wait so long to begin PT?

  24. Erin on December 20, 2023 at 12:35 pm

    Hi I’m 25F, and I’m 12 days post-op of Brostrom procedure with internal brace.

    I tore every ligament in my right ankle around 10 years ago from a basketball injury. I have sprained my ankle numerous times since then. Dr was unable to salvage my own ligament for repair, so he opted for a brace during surgery.

    The first few days of this procedure are no joke. I got a nerve block about one hour pre surgery. It lasted for about 24 hours. I took Norco (hydrocodone and Tylenol) before I went to sleep after surgery (about 12 hours post surgery) to get ahead of the pain. The splint was incredibly tight feeling, and there was a general throbbing throughout my ankle and foot for about a week, as well as sharp pain around the incision. Listen to the doctor when they say to keep it elevated. It greatly relieved the pain of the first 5 days. I was off the Norco 5 days post surgery. I had one slight complication which was a pressure sore under my big toe from the splint. I went and got fitted for a new splint at day 8. It’s absolutely incredible how much better I felt at the one week mark. The pain has subsided each day since then. I don’t have to keep my foot elevated all day anymore either. At the time of writing (12 days post op, I have little pain, and the biggest issue is itching from the incision)

    I go back to doctor in 2 days. The plan is to have 2 weeks on crutches, 2 weeks in aircast, 4 weeks in walking boot, and then ankle brace (time dependent on PT progress). I will start PT at the 4 week post op mark. I hope this helps anyone facing the procedure!

    PS. I got a glimpse of my ankle when I got refitted for the new splint, and it looked better at 8 days post op than it has in years. I feel very hopeful about the surgery and recovery!

    • Jolene on December 26, 2023 at 8:08 am

      Hi Erin! So happy your surgery went well! Will you post how you’re feeling about two weeks into PT? I’m 6.5 weeks po today and have been in pt twice a week for just two weeks and the pain came back with a vengeance ;( Hoping you have a better experience than me.

      • Erin on January 5, 2024 at 11:10 am

        Hey Jolene! I’m sorry to hear you are having pain with PT. I’m starting PT in 3 days, and I will come back here in a few weeks to keep you updated. I hope you are feeling a bit better now!



    • jolene on January 7, 2024 at 1:29 am

      Thanks Erin! I appreciate it! For some reason I couldn’t comment on your most recent reply.

      • Erin on January 30, 2024 at 3:41 pm

        I’m sorry I’m just now getting to respond. PT has been somewhat painful. It comes and goes, and I still can’t figure out what will cause the pain and swelling one day while I’m fine the next. The most painful part to me has been rebuilding my calf muscle. Even at 7 weeks post op, I can’t weight bear in the boot for more than a couple of minutes without shooting pain down my calf and into the ankle. I know you’re a bit ahead of me, so I hope you’re feeling better by now!



  25. Ryan on December 30, 2023 at 2:55 pm

    Thanks James for putting this together and everyone for the comments – it’s hard to find detailed personal stories online!

    I’m considering surgery after 3 major sprains on my right ankle from running – age 25, 3 months on crutches; age 29 – 4.5 months; age 32- 3 months – after which I gave up running and switched to cycling and swimming, but in the 5 years since have experienced numerous less serious twists and rolls from any sort of basic everyday activity which usually leave me needing crutches for 2-3 weeks each time and a couple of months strapping/compression/constant elevation when possible. About a year ago I began wearing an ankle brace full time to avoid rolling it but I’m worried this may not be a long term solution.

    Does anyone have experience with long-term bracing as an alternative to surgery? For reference I am using a Donjoy Velocity ankle brace.

    • jolene on December 31, 2023 at 8:49 am

      Hi Ryan! I’ve tried long term bracing, PT, and everything in between, it seems and nothing worked for me. I just had a partial tendon repair and Brostrum procedure for ankle stability on November 10th. Still on PT and off work (flight attendant) and in a bit of pain, but Tylenol is helping with that. I can let ya know in a few months how it’s going, but as of right now I think I’m doing pretty good 👍🏼

  26. Luke on January 6, 2024 at 8:48 pm

    Hi all, quick update from me. I had the surgery in February 2023. It was the brostrom with syndesmosis abridgement.

    The timing the surgeon provided was sport on, 2 weeks in a cast, 2 weeks air cast non weight bearing, 2 weeks 50% and then boot on with pressure as could be tolerated.

    I was diligent in keeping the leg elevated and then commenced Physio. After about 8 weeks I took the boot off l, even travelled with it to Australia from London. I played some golf (with a cart) and started the gym whilst following the rehab program.

    I gradually incorporated some running then after about 3 months played touch football for the first time. I’m now back to pre-injury levels – im running 30-35k a week cycling and have played over 60 games of rugby.

    Don’t underestimate the value of the gym, strength training post injury has changed my life – I’ve dropped ten kilos and feel better than ever.

    I do wear the aircast a60 ankle brace whenever I play sport now but I feel great!!

  27. Bryce Johnson on January 23, 2024 at 8:45 am

    Hi all,

    I got the brostrom procedure about 5 years ago. Nowadays, I can pretty much do any activity I want (basketball, running, etc..) but it is always accompanied by at least a little bit of stiffness. But I’ve chalked this up to the fact that my ankle is just never going to be 100% again. I don’t experience much pain in the ankle itself but I’ve never regained full dorsiflexion and I get a painful pinching situation when I force it. Although, it often gets better the more warmed up my ankle is. Another change i’ve noticed since my surgery is that my foot points a little more out than my other. My surgeon told me it was because we locked my ankle in that position in the cast to allow the ligaments to heal in tightly and that over time my foot positioning would go back, but it never did. Has anyone else had this experience?

    Thanks!

  28. Ray Stonecipher on March 24, 2024 at 9:55 pm

    I’m coming up to 11 weeks post op and have my last consult at 12 weeks. My procedure was like everyone else. Cast for 2 weeks, boot NWB for 4 weeks. I used the scooter to get around, I’m useless with crutches. At 6 weeks went to WBAT with the boot then a visit at 8 weeks they moved me into an air cast brace. Going to PT 2 times a week and expect to get rid of the brace at my 12 week visit.
    I had absolutely no pain only some soreness and now fatigue if I push too much. The mental part was worse 6 weeks NWB was a grind.
    Do plan to get back to the gym and cycling, grateful that I had such an uneventful recovery.
    I would suggest that going into the Surgery you make sure you have the right surgeon. Someone who specializes in ankles, does sports injuries and has a lot of experience doing this surgery. My original orthopedist said he could do it but he does more shoulders and gave me a list of 3 ankle specialists to see

  29. Arricka on April 9, 2024 at 12:56 am

    Hello,
    I am a 42 year old woman who just had a modified Brostrom procedure on my left ankle three weeks ago. (March 21, 2024) This was to repair chronic lateral instability of the ATFL with an anchor attached to my fibia and talus. With an arthroscopic debridement of the ankle joint, where mild synovitis was found.
    I elected to have surgery after I had a nasty fall with my ankle giving out from underneath me while stepping down from a step off my back door. I went to urgent care, had X-rays done and my ankle examined, the doctor said it was a grade 1 sprain. I was sent home with ice and advised to use a supportive ankle brace. The whole RICE method.

    The next day I received a phone call from Urgent care radiology and was informed they found an avulsion fracture on my left ankle and they were going to refer me to a podiatrist for a consultation the next day. At the podiatrist I recounted my troubled history of sustaining ankle sprains since middle school all the way through my latest ankle injury from a night hike last summer. He examined my left ankle and compared it to my right. There was too much laxity on the left and the joint was very loose. He suggested I get the surgery to fix the instability. As the problem would only get worse. Already I was dealing with 25+ years of this but my biggest concern was recovery time because I am moving across country in 6 weeks.

    Also my friend had the procedure done on her right ankle last summer and she was in a cast for 4 weeks then a boot for another 4 weeks plus PT. She had an Orthopedic surgeon and her PT was more difficult due to atrophy of her calf and lack of ankle strength. I was worried I would be one of those patients. However, he informed me that he could get me walking and back in an athletic shoes in 4 weeks! His philosophy is that NWB and a cast for 4 weeks is counter productive for healing and gaining back mobility for this type of soft tissue surgery. The recovery time table would be 1 week NWB in a splint , 3 weeks in a Boot. Also he specializes in these ankle surgeries and could get me in the OR by the next week. I was sold and agreed to get this done.
    The Surgery went great. It was an out patient procedure and my ankle was in a splint. I spend the first three days doing nothing, except sleep and bathroom. The hardest was the first 3 days because of pain and swelling and my first shower. Get a shower seat. I Opted not to take the prescribed Opioids because they make me feel loopy and the constipation is a horrible side effect. I just took Advil instead and I was good. Elevation is a must , plus ice behind the knee. I purchased a special leg pillow from Amazon to keep my ankle above my heart. These two things helped tremendously. Eat healthy and take vitamins, like vitamin C and D which promote bone healing and building of collagen.

    My first post op was a week later. My podiatrist was so impressed with my healing, lack of pain, and minimal swelling that I was ready for the boot full weight bearing as tolerated. I still, medicated, iced and elevated through the second week. I walked around the house but not too much. I did ROM exercises with my ankle when out of the boot. I slept without the boot but sleeping was still uncomfortable, the stitches were really digging into my skin even with the leg pillow.
    Last week on April 2, I had my stitches removed and I was cleared to drive. Swelling is barely noticeable and I am adding more PT exercises which helps with the stiffness. (Thanks YouTube). I use the boot but also walk around without the boot to get my ankle strength back. It is crazy how fast my calf muscle shrunk by not using it fully in two weeks. I went for a mile walk the other day in my boot and I was a little sore in the ankle joint by the end but some stretches and elevation helped.
    I am glad my surgeon is progressive and wants me to get my ankle back to fully functioning through actually walking on it and FWB right out the gate. But it really depends on the individual person and how fast they heal and pain tolerance. Pain really isn’t an issue for me, I have a high tolerance. I get some twinges of pain at the incision site and the fibia where the anchor is. So I take it slow and don’t rush things with rehabilitation, basically just listen to my body. And what my ankle is saying. I can tell my ankle is getting stronger and better every day. I just keep plugging at it.

    April 8 , Three weeks out and I drove my kid to school without a boot on this morning . I have an ankle brace and athletic shoes. I still walk with a limp and walk slowly but three weeks it still early in the game of healing. I just want my ankle to be healed up enough to keep up with the rigors moving a house.

    And though I am not an athlete, I don’t run 5Ks , I am an avid hiker and walker. I really miss my morning walks up and down steep hills. I know I will get back to it in the next 4 months.
    I am glad there is a blog about this type of ankle surgery (Brostrom procedure). It nice to see how everyone is healing and handling getting back to pre injury life with their ankles. Your personal experiences have been super helpful with gaging my own recovery. I hope my experience helps the next person. Best of luck!

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