Today on the Doc On The Run Podcast we’re talking about what whether or not there is any chance you can run again after breaking five bones in your foot and ankle and recovering from surgery.
Today’s episode comes from a question from a podcast listener who wrote in with a question:
Dear Doc On The Run,
My name is Alice. I’m 34 years old. I had a bike accident 4 days ago. I broke my ankle tibia bone at the medial malleolus, distal fibula bone, and metatarsal bones 2, 3, and 4. The surgery went well. I was a runner. I used to run 4 times a week. Is there any chance I can run again?
Thank you very much.
There is hope! There is a famous Henry Ford quote that says, “Whether you think you can, or you think you can’t – you’re right.”
So, Alice… the short answer to your question is YES. There is a chance you will run again.
Three things determine whether or not you will run again after broken ankle surgery:
1. How fast you heal after surgery.
2. Your outlook on your recovery.
3. The actions you take to stay strong.
How fast you heal after surgery
We already know that you had surgery, and by all reports the surgery went well. So you have already checked off the first box in the process of recovering from the accident. Now you have to recover from surgery.
How fast you heal is not based on some particular arbitrary timeline set by a research study or your doctor’s experience. The research studies we as doctors cite are based on the people who were enrolled in those studies, and not you. Your doctor’s experience and the timelines the doctor believes are most likely with other patients who have had similar injuries to you, are based on your doctor’s observations of those patients, and not you.
You get to choose how closely you follow your doctor’s postoperative instructions.
You get to choose how diligent you are about not putting your foot on the floor. If your doctor tells you to use crutches and stay off of the foot, but use your foot to change position when you’re moving around the kitchen, or use your foot to step on the floor to get out of bed, or use your foot for balance when you’re moving in and out of the bathroom, that will delay your recovery.
If you really do follow your doctor’s instructions like your life depends on your chances of running again, and running sooner go up exponentially. So the first thing I would suggest is to actually review the instructions that were given to you when you left the operating room. Do an honest and thorough review and see if you have really done everything that you have been instructed to do.
The surgeon doesn’t give you instructions to punish you or make your life difficult. The surgeon gives you instructions to optimize your healing. Over and over, I have seen my own surgical patients step on their for when you’re getting in and out of wheelchairs. Moving in and out of a treatment chair. But they don’t really recognize they’re breaking the rules.
Be honest with yourself. If you have made mistakes, if you haven’t really been staying off of the foot the way you’ve been told, make a resolution to do exactly as you were instructed. Following those instructions closely is the first step to getting back to running. You have to do everything the doctor has told you will help optimize your healing.
The second thing is to think about every additional thing you can do to heal as quickly as possible. Think about how you fuel your body when you’re running. It takes nutrients to rebuild tissue. That is true when you’re training hard for an event like a marathon. It is equally true when you’re trying to heal five fractured bones after a bicycle accident and when you’re recovering from surgery.
The third thing to think about is whether or not you’re really diligently protecting your sleep. You do not recover when you are awake or when you are working out. You recover when you sleep.
Many injured runners have a hard time sleeping. I myself know for a fact that when I run when I exercise, when I work out I sleep better. If you’re injured and recovering from surgery you may not be exercising at all.
When something changes in our routine, our routines become disrupted. Over the years I have seen many injured athletes drift into un-helpful, un-healthy patterns with their sleep after an injury. Partially because they art exercising, and partially because they’re just bummed out they tend to stay up late watching TV or movies as a distraction. And that can disrupt your sleep.
If you don’t eat like an athlete in and you don’t sleep like a recovering athlete, it will simply take much longer to heal. These are all variables that you can control.
2. Your outlook on your recovery
Four days ago Alice’s life changed in one instant. When she crashed her bike, she was instantly transformed from a healthy active athlete to an injured athlete. She had no choice in the matter.
The lack of choice in becoming injured can be hard to overcome. By definition, you are an “accident victim.” You cannot undo the accident.
But you can decide whether or not you adopt a “victim mentality.”
Today, right now, in this moment, do you view yourself as an injured athlete who may never run again, or do you view yourself as a recovering runner who is definitely going to run again?
I don’t get to decide for you.
Your surgeon does not get to decide for you.
Believe it or not, that is a decision that fully belongs to you.
You need to decide today. You need to have a positive outlook today. You need to be positive, and steer clear of any and all negativity.
Two forms of negativity you have to fight against and overcome, both from your doctor and your own mind.
“Realistic” expectations from doctors can be a dreaded Pessimistic Prognosis
All doctors wants to help you. No doctor wants to see you become disappointed.
I once her a motivational speaker named Les Brown once said something to the effective of:
“Most people don’t fail because they aim too high and miss. Most people fail because they aim too low and hit.”
We as physicians are often taught in medical school and in surgical residency training that we should not give unrealistic expectations to patients. The reason for that, as we do not want to promise patients something when we don’t actually have control over the delivery of that promise. Your doctor doesn’t want you bummed out or disappointed, if something goes wrong with the healing process.
But in the same way no doctor has a right to guarantee you’ll be stronger and faster and smarter after surgery, no doctor has the right to guarantee you will never run again.
The truth is no doctor can ever tell you what will happen after the healing process. No doctor has a crystal ball. No doctor is in charge of what you do on your own, in your own home when you’re recovering.
So the first part of that is you need to understand that the doctor really does want you to heal and really does want the best for you. But the second part of that is that you also have to understand that in a sense, the doctor is afraid that you might become disappointed if you’re given optimistic expectations.
Most doctors will promise the most pessimistic prognosis.
Your surgeon may tell you something like:
“Your life changed during that accident.”
“We want to focus on getting you back to walking.”
“We just want to make sure you can do activities of daily living like bathing, changing clothes, preparing food, and going to work.”
Of course when an athlete hear something like that it’s very easy to get bummed out, discouraged and depressed.
Depression will not help you heal faster.
There’ve been many published research studies in medical journals that demonstrate clinically depressed patients actually have depressed immune systems as well. So you need to guard against that depression.
Listen to all of the helpful advice you can get from your doctor. And simply tune out and avoid everything that you perceive as discouragement. Just leave any discouragement in the doctor’s office. Do not take it home with you.
Your own fears
When athletes get injured they have lots of time on their hands. During this time when you’re sitting around trying to figure out how you wound up in this situation, you need to be wary of your thoughts. You’re likely going to have many fears running through your head.
If you’re injured, and afraid at the same time, you have to think of your mind as a dangerous neighborhood. Don’t go in there alone. You need to be open about the fears, anxiety and negativity swirling around in your own mind when you’re sitting around thinking about your injury. Do not wallow in self-pity alone.
Who are your most positive friends? Who do you know who is always uplifting? Who can you call today who will encourage you? Who always motivates you? Talk to your positive friends and stay connected.
Listen to uplifting podcasts. Fill your mind with positivity and it will improve your outlook.
3. The actions you take to stay strong
Declare yourself a recovering runner. Write down something like: “I am healing, the surgery went well, my doctor put everything back in place, and I am making the repair and rebuilding of my body happen today, with every little action I take all day.” Put that on your mirror or your refrigerator. Read it out loud. Believe it.
The most important thing you can do right now, is understand that you do have the power to alter every one of these three variables, all dependent upon the actions you choose to take.
How to take action (when it seems like a passive process):
Trust, understand and have faith in your doctor’s expertise. Your doctor is a surgeon. Your surgeon is a highly trained technician. Your doctor is an expert at performing the surgery and guiding your recovery after the surgery.
You have no control over that part…other than recognizing, believing and allow that portion of your recovery from surgery and fracture healing happen.
But there is a way you can actually participate. Rest and recovery. Visualize. Heal.
Recognize that the doctor is focused on healing your broken metatarsal bones, your healing fibula bone, and your healing tibia. Your surgeon is going to be laser focused on orchestrating the healing your surgery and all 5 those bones, as quickly as possible.
You need to also recognize that your surgeon is very busy and will predictably, even deliberately suffer from tunnel vision. If you ask about running, the doctor may shut you down. Your doctor may, unintentionally, discourage you.
You cannot afford discouragement. You will need courage to run again. Deliberately build that courage through action.
Make a plan. Then take action!
Don’t let anyone discourage you…not even your doctor. Ignore pessimism like it is the plague. Surround yourself with support.
Listen to episodes that you may draw strength from:
A couple of Doc On the run podcast episodes that you should listen to are :
Choose a recovery mentor. Barbara Peterson fell while she was packing for a trip to defend her European Xterra Champion title. She broke both of her heel bones. Although Barbara has said that I healed her, that’s absolutely false. Barbara healed herself.
The thing that I really did for Barbara was that I actually served as recovery mentor for her. I talked to her frequently. I recognized and pointed out all of the little thing she could do on a daily basis to help her maintain her fitness as an athlete while she healed those broken heel bones.
Also Barbara was a multiple time world champion triathlete, she just couldn’t recognize what she was missing, because she was too focused on her injury. So I helped her recognize all of the little things that she could do to optimize her recovery and maintain her fitness. She hired me to help her, and I helped her in her recovery just by serving as her recovery coach or mentor.
You need to think about who can do that for you. You could work directly with me, but you certainly don’t have to. Who do you know who has the expertise to just help you maintain your running fitness while you’re recovering after surgery? Maybe it’s your primary care doctor. Maybe it is one of your running buddies who had an injury.
You just need to make sure you have someone in your corner who can help you find ways to maintain your running fitness even as you heal from the surgery. Most of you can do on your own, but it’s always better if you have someone else who has an outside perspective who can help.
Just don’t forget that there is a chance you will run again. But it’s all about choices and action.
Every day you are getting weaker or stronger. Every day you are either getting closer to your goal, or your goals is drifting further away. It all depends on what you do today.
You have to create a plan now. And that’s why I wrote the Runners Rapid Recovery Journal. It’s just a thing that actually gives you a way to really, and truly look at what you were doing in training and apply it to your healing. That’s really all there is to it. So remember you already know the path to recovery. Just figure out what you were doing in training and start doing that today.
That’s really the key!
Right now the Runner’s Rapid Recovery Journal is on sale and you can get it at discount. You can get an instant download version today. You can find a link in the show notes at the bottom of this episode at docontherun.com under the podcast tab.
Go check it out!
Get the Runner’s Rapid Recovery Journal…