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broken fibula .Oblique fracture due to incorrect yoga assist.

by basia
(victoria bc. canada)

I was doing a downward dog posture while in Ashtanga yoga class and the assistant to the instructor pulled on my calves and fibula bone and heels to bring the heels to the ground . She pulled so hard it broke the fibula . Oblique fracture. I felt no pain as I have diabetic neuropathy. 2 days later I felt sharp pain a nd found out day later that I have a diagonal fracture. I have been in hard cast for 3 weeks and in air cast for 5 weeks . I started to walk very carefully for a week now with no limping no crutches and no pain. I teach yoga even in a cast standing on one leg I exercise and eat well . The doc. got upset and told me to walk with air cast for 4 more weeks or wear the boot or a brace which I can not afford now . Is it absolutely necessary to do it I cant walk anymore in the air cast boot as it makes my back and hip go out of alignment. I have also neuropathy and carpel tunnel in the hands so so walking on crutches is brutal .My doc . is too busy to discuss my dilemma . I am single and need to work teaching yoga and massaging people as im self employed and can't take time off work. .

What exercises can I do to strengthen this leg . I started to walk normally without any pivoting or twisting of the leg .Should I go back to the boot and crutches? Seems illogical if I already started to walk normally. I am 61 and have some osteopenia.but im extremely careful. When will I be able to cycle again. What should I avoid. The doc. said the bone is healing well but he is concerned that I may not be ready. Can I damage the healing process if I continue to walk carefully and not carrying anything heavy or overdoing it?

RESPONSE
Hi Basia,
I am at a certain disadvantage here because I cannot see your x-rays. But, according to your description you have two fractures in the same area which is never good. Compounding the problem is the fact that you are diabetic and have some degree of osteopenia both of which can extend the healing process. (If you were 20 years old, these fractures would have been healed by now). So you have to deal with the situation that you have.
The biggest potential problem is re-fracture or even incomplete healing known as a non-union. As you can imagine, both of these issues would only set you back in terms of your recovery. I understand your need to work, but you also must understand that the sooner the broken bones are healed the quicker you will be able to return to work.
I would suggest you listen to the advice your doctor is giving you as he or she is more familiar with your situation than me. If the doctor has given you options as to what to wear around the ankle, wear the device that is most comfortable, because you certainly do not want to wear anything that is aggravating your back and hip because that will create other issues and unfortunately the older you are the greater the chance that hip or back issues can turn into debilitating problems as well.
There really is no exercise you can do to expedite the healing process. There is an argument out there that stressing the fracture site (via exercise) may decrease the healing time, but I do not buy into that theory. Just make sure you keep your blood sugars under control and eat a well balanced diet.
At this point you are over eight weeks since the fracture and are walking without pain, so it would be my thought that you should be back to exercising fairly soon. Once your doctor allows you to return to yoga, I would suggest you keep the ankle wrapped in an effort to reduce the strain on the joint and prevent any recurrence.

Marc Mitnick DPM
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