Going Back: Fear of Reinjury After an Ankle Fracture
Getting back on your feet is one thing. Going back is another.
FROM THE TRENCHES
If you've had a strong reaction to remembering your accident, you have plenty of company. In fracture support groups, people describe reactions that can be surprisingly physical. One woman said simply thinking about her fall made her skin crawl and her ankle hurt. Another said she could "almost puke" when she thought about hers.
For some, particular places become difficult. A woman who broke her ankle after falling while pumping gas hadn't returned to that gas station. Another broke hers on the wooden stairs in her own house. She could manage other stairs—slowly, gripping the bannister and sometimes moving sideways "like a crab"—but wasn't ready to tackle those particular stairs yet. Still, she could feel her confidence returning week by week.
Sometimes the trigger isn't the place at all. People talked about being unable to watch someone twist an ankle on television, becoming nervous around wet grass, rocks and other loose objects on the ground, or seeing potential broken ankles everywhere when friends climbed ladders or did other perfectly ordinary things.
One climber broke her ankle bouldering during a type of fall she'd made safely thousands of times before. She continued teaching climbing afterward, but looked away when someone jumped or fell from the wall. What stayed with her most vividly was the sound her ankle made when it broke.
The more severe injuries can leave even more persistent memories. One roller-derby skater described an especially traumatic open fracture and said that for a while simply remembering it could make her vomit. Eventually she was able to look at photographs of the injury, although memories could still intrude unexpectedly.
Not everyone reacts that way. One woman who slipped in her own kitchen found the circumstances more absurd than frightening and had no trouble walking the same route again. Interestingly, what frightened her afterward wasn't the ankle fracture at all—it was the pulmonary embolism she developed after surgery. For weeks, every little ache or pain set off alarm bells.
That may be the most useful thing these stories tell us: there isn't one "normal" response to a serious injury. Some people want to get right back to the place or activity. Some need time. Some aren't particularly bothered by the accident itself but are deeply affected by something that happened afterward.
And sometimes progress looks remarkably unremarkable: you take the stairs while hanging onto the bannister for dear life. You go back to the gas station. You watch someone jump off the climbing wall without looking away.
Or you don't—not yet.
The Scene of the Crime
There is a peculiar milestone in ankle-fracture recovery that doesn't show up on an X-ray: going back.
Back to the sport, the stairs, the trail, the horse, the gym, or the innocent-looking curb where everything went spectacularly wrong. Sometimes it means returning to the actual place where you were injured and discovering that your ankle isn't the only part of you that remembers.
Fear After an Injury Is Common
After months of concentrating on protecting an injured ankle, it can be surprisingly difficult to stop protecting it. For weeks or months, you've been told some version of: Don't step on it. Don't twist it. Don't fall. Be careful. Protect the repair.
Then one day you're expected to walk down a flight of stairs, step off a curb without thinking about it or return to a sport where falling is part of the deal. Your surgeon may be pleased with your X-rays, and your physical therapist may be happy with your strength and range of motion. Your brain may have some catching up to do.
Fear of reinjury is well recognized in sports medicine, but you don't have to be an athlete to experience it. A person who broke an ankle walking the dog may become nervous on uneven ground. Someone who slipped on stairs may find herself gripping the railing months later. A fall on ice can change the way you walk through a parking lot the following winter.
After a serious injury, some extra vigilance makes sense. You know something now that you didn't know before: how quickly an ordinary day can turn into surgery, crutches and months of recovery. The goal isn't necessarily to become fearless again. It's to reach the point where fear isn't making your decisions for you.
When the Place Itself Becomes Part of the Injury
Sometimes it's not just the activity that gets tangled up with the accident. It's the place.
You may know perfectly well that the arena, hiking trail, staircase or intersection didn't cause your injury, but that doesn't mean returning there will feel ordinary. Sights, sounds and other details associated with a frightening event can bring back surprisingly strong reactions. You may feel anxious before you even arrive, replay what happened or suddenly notice details you haven't thought about in months.
That doesn't automatically mean you have post-traumatic stress disorder. PTSD is a specific diagnosis involving a particular pattern of symptoms that persists and significantly affects a person's life. But people can have very real reactions to a traumatic injury without having PTSD.
A serious fracture can be frightening in ways that are easy to forget once the worst is over. There may have been the fall itself, the pain, seeing your ankle in a position it shouldn't be in, lying on the ground unable to get up, an ambulance ride or the realization that you were headed for surgery.
The bone heals. Those memories may take a different route.
MY TAKE ON IT
I was at World Equestrian Center (WEC) when I broke my ankle. The short version of the story is that I made a mistake on my young horse while jumping a course. Every day of my life I pay for that poor decision.
The trauma certainly affected me when I started riding again, but I didn’t realize how the place was also tied up in that swarm of black memories until my husband and I went to WEC to watch a big Grand Prix jumping event. I actually started crying. I was back where it happened, and the last time I was there I left in an ambulance. I was surprised how emotional it was.
I was able to relax and enjoy the event after a while. But given my initial physical response to just being at WEC—shaking, crying, terrible memories—I wondered what actually competing there again was going to feel like.
For me, the answer was to go back anyway—not recklessly and not before I was physically ready, but when I was ready enough. And it’s been good. I’ve had success. I get more used to it every time.
To this day, when I’m in a similar situation as the one in which I had my accident, it’s hard not to overreact. But I’m getting there.
The Fear of Doing It Again
There is also a difference between remembering an accident and losing confidence in your body. After an ankle fracture, you may become acutely aware of every misstep. A tiny stumble that once wouldn't have registered can produce an instant shot of adrenaline.
You may watch the ground constantly, hesitate before stepping down or distrust the ankle even after you've been told it's structurally sound. And if you participate in a sport or activity where another fall is entirely possible, the calculation gets more complicated. Returning doesn't mean convincing yourself that nothing bad can happen. It means learning to separate reasonable caution from fear that has become bigger than the actual risk.
That confidence usually isn't restored because someone tells you, "You're healed. Don't worry about it." More often, it comes from experience.
Confidence Comes Back by Doing
Gradually returning to the thing you're afraid of can help rebuild confidence. That doesn't mean throwing yourself into the deepest end of the pool or doing something before you're physically ready. But you don't necessarily have to wait until every trace of fear disappears before you begin.
It might mean walking on grass before tackling a rocky trail, riding quietly before jumping again, taking the stairs slowly before carrying a laundry basket down them, or returning to the gym for an easy workout before attempting what you were doing before the injury.
Rehabilitation can help here in ways that have nothing to do with degrees of dorsiflexion or how many heel raises you can perform. Balance work, strength training, agility exercises and practicing the movements your real life requires can help you trust the ankle again. Physical confidence and psychological confidence tend to build together.
Sometimes confidence comes first. More often, you do something carefully, discover that you can, do it again—and somewhere along the way, confidence follows.
Going Back to the Scene
Returning to the place where you were hurt can deserve its own step in recovery. It doesn't have to be dramatic, and you don't have to stand there and ceremonially conquer anything.
The first visit may not even need to involve doing what you were doing when you were injured. You might walk around, watch, have lunch or go with someone you trust. The next time, perhaps you do a little more.
You aren't trying to erase the old memory. You're giving that place some new ones.
When Fear Isn't Fading
Some fear after a serious injury is understandable, and there isn't a deadline for getting over it. But if fear is keeping you from activities you want to return to, it may deserve the same attention you've given the physical parts of your recovery.
Consider getting professional help if memories of the accident are intrusive or overwhelming, you're having nightmares, you're avoiding places or activities you genuinely want to return to, or anxiety is interfering with everyday life. A therapist experienced in trauma, injury recovery or sports psychology may be helpful.
The point isn't for someone to convince you that your fear is ridiculous. You did get hurt, and perhaps you could get hurt again. The goal is to keep what happened once from controlling what you're willing to do now.