Relearning to walk and ride a bike after Lisfranc surgery
This article is fifth in a series that chronicles my experience following Lisfranc injury.
Part 1: Learning about the scary life-altering potential of a Lisfranc fracture
Part 2: Setting goals for Lisfranc recovery gives optimism, determination and purpose
Part 3: Surgery day and learning about the Arthrex InternalBrace
Part 4: Lisfranc recovery is slower and tougher than imagined
Part 5: Relearning to walk and ride a bike after Lisfranc surgery
Part 6: The 215-mile Lisfranc recovery test
Part 7: Looking back a year later. What’s fixed and what isn’t.
Part 8: Did the iWalk crutch speed my recovery?
The first day of August was my first literal step toward recovery. That’s the day I visited my doc, who examined X-rays and granted permission to throw the crutches and iWalk aside. I would be restricted by a heavy plastic walking boot for at least another four weeks, but it was time to learn to walk again.
“Take it slow,” she said. “You don’t want to overdo it. A few people choose to walk out of here, but it’s a long way back to the parking lot.”
With more excitement than apprehension I handed the iWalk to my wife, went out the door and limped to the elevator. I’d spent six weeks in a kind of limbo where recovery was about what you didn’t do. Now I was back in familiar territory, where achieving was the result of action. With each painful step I knew my foot would grow stronger. Each step was a workout. With each step I was one step closer to recovery.
Pearl Jam in Seattle required almost nine hours of activity, most of it standing. It was a solid test for my new foot.
Pearl Jam and the nine hour standing test
Nine days later my foot was feeling pretty good as long as it was inside the walking boot. I walked into and out of the office and easily took the dog around a couple blocks in the morning. But I still didn’t know its limits. Could it withstand, for example, one of Pearl Jam’s 2019 Home Shows? I was about to find out.
My wife and I loaded up the car in Boise late Friday afternoon and sped across the Columbia River Basin to the Cascades where we camped in the back of her Subaru along the Cle Elum River above Roslyn. The next morning we drove into Seattle and visited with family before taking an Uber to Invesco Field. The ride into the city was the moment of no turning back. Once downtown, I’d either have to tote the iWalk around all night or be committed to walking under my own power regardless how badly my foot hurt. I decided to leave the iWalk behind.
As anyone who lives in and around a city can attest, the amount of walking you do can add up. The Uber driver dropped us off on the wrong side of the stadium, so the evening began with a walk to the other side, which was followed with a walk to a local restaurant for some food. We were fortunate to be hooked up with VIP passes from my uncle—who’s apparently friends with someone who’s friends with Eddie Vedder—so we entered the stadium early and didn’t have to wait in many lines. We had seats on the infield where the idea of seats seemed a little silly because everybody stood for the entire show. By the time it wound down, though, I finally sat for a few songs. At that point we’d been on our feet for six or more hour. My foot was sore, but there’d been no catastrophic damage. I was definitely getting better.
Getting back on the bike
Getting ready for my first ride on a road bike, a 16-mile spin around McCall, Idaho.
Throughout the recovery process I adhered 100 percent to my doctor’s orders except for one. With the 200-mile, 20,000-vertical-foot, across-the-West mountain bike ride to train for, I needed to get my heart and lungs pumping harder again. I needed them to have the ability to move more oxygen by early September, and the only way to train those organs is to put in the time. There would be no quick shortcut the final week before the trip.
Starting August 1 the doctor gave me permission to ride a stationary bike indoors using flat pedals while wearing my walking boot, something I’d actually started doing about a week earlier. I decided to stay a step ahead and began riding a road bike while wearing the walking boot.
The air from west-coast wildfires was nasty, but August 23 was my first day back on a mountain bike using flat pedals and my walking boot.
To be clear, I didn’t push very hard and went out for long, gentle cruises on flat terrain along uncrowded roads. It was liberating just to feel the wind on my cheeks and travel under my own power through pastoral neighborhoods that got away from the hustle and bustle of the city. My foot hurt a little passing bumps in the road or pushing over small hills, but I’d become in tune with my foot. It wasn’t damaging pain, just the uncomfortable sensations of progress.
Using the flat pedals and walking boot, I continued to go out for road rides every two or three days for a couple weeks. Then I rested for about a week and on August 23 swapped the pedals over to my mountain bike. It was a painful push to the summit through air stained thick with wildfire smoke, but it was an outing that established I was nearly ready for a return to more intense activity.
I didn’t build a program or follow a prescription, but used my body as my guide. If my foot, ankle or any other part of my body hurt, I slowed down or stopped for a few days. I came to understand my doctor’s concern about riding a bike to be about controlling uncontrollable variables. The activity of riding a bike was actually fine (and probably really good for my foot). Falling, however, could have been catastrophic.
On August 28, nearly three months after injury and 10 weeks after surgery, I visited the doctor, who examined X-rays and proclaimed I no longer needed to see her. Among her comments, concerns and advice:
The foot was still pretty swollen, but day-to-day use would get the blood flowing and help relieve the swelling.
She prescribed a custom insole that I’d swap between different shoes and use, particularly, for various forms of activity.
I should use pain as my guide for the duration of my recovery.
I had her blessing to attempt the 215-mile mountain bike ride from Telluride to Moab but should set contingency plans in case I got hurt along the way. She wasn’t worried about the integrity of my foot but about my ankle, calf and other muscles and tendons that hadn’t been used for three moths. The odds of spraining an ankle or pulling a hamstring were considerably heightened.
She had little question (in fact scoffed at the notion, somewhat) that I’d be able to ski by the time it snowed in November or December.
Click here to read part 6 about riding a mountain bike from Durango, Colorado, to Moab, Utah.
Disclaimer: I am not a medical or mental health professional. I'm not even current on my CPR or first aid certifications. Do not substitute any information found here for a visit with a knowledgeable doctor, preferably one who specializes in foot and ankle problems.
