Let’s face it, no-one would volunteer to have an ankle fusion unless they had pretty much exhausted all other options. It really is the last resort of operations, and once performed is irreversible The operation itself sounds horrific. The ankle bones are shaved until bleeding, then the foot is positioned into a natural walking gait whilst two screws are inserted into the ankle joint to hold the whole thing in place. Bone grows in the old joint space and the former moving part becomes an immobile, solid mass.
In consultations prior to the operation, I had been informed of the benefits and risks of the fusion and decided that it would be the best option for me and without a doubt it has transformed my mobility, however there are some realities to life with a fused ankle that took me by surprise:
- Wave goodbye to your calf muscle
It is nigh on impossible to build up calf muscles without the forward/back motion of your foot. Whilst you can activate your gastrocnemius muscle at the top of your calf with hamstring and quad exercises, the lower calf will shrivel like a party balloon tied to a gate for a week. Never more will knee length skirts or dresses be an option, your leg will now resemble a tree trunk, straight down from knee to ankle.
- Walking downhill is an uphill struggle
To achieve a normal walking gait, you need to be able to drop your knee forward over your big toe whilst keeping your foot flat on the floor. This is a physical impossibility with a fused ankle. You can approximate a natural walk by using rocker bottom shoes or shoes with a raised heel which push your knee forward but whilst this works fine on flat surfaces, it will not be a smooth ride downhill. I compensate by elongating my stride, but on steep hills, I do have to perform a little skip-hop. However much you style this out, it looks odd.
- Shoes will become an obsession
Shoes are a constant source of yearning and rage to the owner of a fused ankle. You will come to realise that over 80% of shoes on the market are no longer an option. Shoes that are too high, shoes that are too flat, shoes without arch support, platform shoes, mules, ballet flats and even wellies will have to be consigned to the back of the wardrobe or listed on Ebay. If you Google image search shoes suitable for orthopaedic problems, you will see a wall of FitFlops and Skechers Go Walk that would make faint even the strongest of hearts. I have taken to obsessively pinning on Pinterest any shoes that I come across that might work and be comfortable, because at the end of the day, the wrong pair of shoes will make your ankle throb with such pain that you would promise to only wear Go Walks for the rest of your days if it were to only go away. I have so much to say about shoes that they definitely require their own post.
- You will need to find a tall friend
If you now want to get something from the top shelf of a supermarket, you will have to use the services of the nearest tall person (or person with functioning ankles) as you will no longer be able to tiptoe. This is also a problem if you have a child under the age of three. Attempting to creep out of a child’s bedroom with an ankle fusion is neither a quiet nor a dainty operation, flat footed navigating in the dark ensures a plaintive “Mummeeeee” will be heard well before you make it to the door.
- Wafting barefoot through meadows is a thing of the past
Not that I was in a Timotei advert before the accident, but I did enjoy being barefoot. Nowadays I cannot be barefoot even in the house. Although my ankle was set to a natural walking position, barefoot walking is too jarring and stiff to be comfortable. The only place that I have found walking barefoot to feel somewhat enjoyable is on the beach but only on that Goldilocks strip of sand that is neither too hard nor too soft.
- You won’t look like a yoga goddess anymore
Pilates, yoga and barrecorre positions all require a pointed toe to finish the majority of exercises. Trying to point your foot with a fused ankle is a fierce concentration of muscles which just results in impressively splayed toes. Exercises are performed with one beautifully pointed foot and the other resolutely flexed – that does not please the perfectionist in me.
If you have an ankle fusion, what was the biggest change for you? Your constant losing streak at Grandmother’s Footsteps, that you now look in the window of Hotter with a ‘they look comfy’ face or something else?