Who needs an ankle bend?

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:

  1. 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.
  2. 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.
  3. 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.
  4. 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.
  5. 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.
  6. 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.04FB7C0D-C218-4852-9BEF-D4A8E6AE7DC9

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?



  1. Kerry
    July 26, 2017 / 5:42 pm

    Hi – I love your blog – beautifully written 😄I am 6 months post ankle fusion op and agree wholeheartedly re shoe obsession- all heals (beloved, beautiful heals) given away and I’m now on a constant quest for glamorous, un-frumpy flats!
    I disagree re knee length skirts though – I had my accident 10 years ago and have some brilliant scars, as well as the shrivelled calf you mentioned – I say embrace the shrivel! I’ll post some pictures when I get round to shaving my legs! Congrats on making a clearly excellent recovery- it’s no walk in the park – you are an inspiration.

    • Bryonie
      July 26, 2017 / 6:38 pm

      Thanks Kerry. Embrace The Shrivel – I love it!! I totally need to embrace the shrivel. I am definitely going to write more about shoes, I obsess about them. I have Pinterest boards galore! Do you have any insights into what to expect 10 years down the line? Does anything change? Bryonie

      • Kerry
        July 26, 2017 / 7:20 pm

        Hi, thanks for replying, I had my ankle fused 6 months ago by Ian Sharpe at the RD&Exeter, following a car accident 10 years ago, it was like my ankle was fused anyway because of the osteoarthritis and the pain that restricted movement, so now I’m in a better place as the pain is gone, however, as you mentioned it is very strange having my foot in that fixed position! I too avoided the inevitable for years, although Ian recommended it from the start – it was a big ‘step’ to take! I am happy, over all, and SO relieved not to be in pain anymore. I am still finding out my limits excercise wise, I love body pump and can do all the exercises (struggle with lunges) but I am wary of trying anything which is higher impact – like HIIT, being unable to jump or run. Can I ask what happened to you? I can see from your blog that you are active – do you manage anything that is high impact?

  2. Bryonie
    July 26, 2017 / 7:33 pm

    I have avoided high impact due to my knee – it certainly wasn’t in any fit shape to do anything much before this most recent op. The surgeon did say I could run now if I wanted to as the ankle would be fine, but I would wear the knee out prematurely and as I will have to have a knee replacement at some point, I don’t want to expedite that at all. I used to do HIIT before the car accident but I think it would be too difficult now (but never say never!). I swim, cycle, do Pilates and I am going to keep trying new things to see what is possible. I really do have to commit to exercising as my quads and hamstrings on the bad leg are seriously underdeveloped due to the amount of time I was non weight bearing. I find if I do something I can usually tell a few hours later if it was a good idea – there is a definite difference between a good muscle ache and a bad joint ache from jarring or overworking.

    • Kerry
      July 26, 2017 / 7:54 pm

      Do you think you could run with the fusion? If it wasn’t for the gammy knee? I’ve tried but just can’t get momentum! I’m like some kind of lolloping weirdo! Well done for keeping the motivation, It’s hard work especially if you’re still suffering from pain. I like Pilates too, but don’t do enough. Would you consider having an ankle replacement if it was an option? I think you have to be getting on a bit before they consider it.

  3. Bryonie
    July 26, 2017 / 8:08 pm

    I think you need to experiment with shoes – have you tried the Hoka One trainers? They are supposed to be great as they have a rocker bottom at the front to mimic a natural running gait. I could probably jog without the knee problem, not flat out run like the wind! I was told ankle replacement is no longer an option post-fusion.

    • Kerry
      July 26, 2017 / 8:46 pm

      Ah! I didn’t realise re ankle replacement. I’ll look into the shoes – rocker bottoms have been recommended before but Ive shyesbaway for vanity reasons! (Stupid really as I’ll look less like a lumbering weirdo in the right shoes)
      Really great to connect with you Bryonie, I’ll certainly look forward to your posts.

  4. Bryonie
    July 26, 2017 / 8:49 pm

    Stay away from the full rocker bottom shoes, they are uncomfortable and look absolutely hideous, partial rockers are a little bit more acceptable looking (for sports at least). Good luck Kerry!

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