Mental Health After an Ankle Fracture or Surgery
Helping your Spirit Shine
This happens, people don't expect it, and nobody talks about it enough.
FROM THE TRENCHES
As much as I can logically justify that I was depressed after my surgery, I still have some shame about it—that somehow, I should have been stronger, more resilient, more able to look past my pain and fear and see that the future wasn’t lost.
But when I made a comment about my struggles with mental health on my Facebook support groups, the response was immediate and overwhelming.
One mother recalled that she and her son actually laughed when he was sent home with a mental-health pamphlet — “Mental health for a broken leg!?” — only to realize later how relevant it was. Her normally strong-willed son barely left the house for about two months, withdrew from friends and at one point became overwhelmed when she persuaded him to go out in his wheelchair.
Another fracture friend said her family treated the injury as though it were “like a broken arm,” when her experience was anything but that simple.
Others described recovery as a “mental battle,” particularly when they hadn't been prepared for how long they would be incapacitated. One person found that pain medication made her unusually emotional and said regaining even some independence made an enormous difference.
And sometimes the experience can be summed up much more simply: another woman remembered crying through much of the eight weeks she was unable to put weight on her leg.
For me, seeing that I wasn’t unique – and uniquely weak—helped me to accept what I was feeling and fight through it. Hopefully, knowing that, and a little advice -- can help you, too.
The Emotional Side of Recovery
Recovering from an ankle surgery isn’t just a physical process; it’s also an emotional and psychological challenge. Anxiety, stress, and depression are common after surgery. From loss of mobility to prolonged healing times, the mental health impact of ankle surgery deserves just as much attention as the physical recovery… but usually, it doesn’t get it.
How common are depressive symptoms after surgery? In one study that followed patients for a year after surgery for ankle fractures or Achilles tendon ruptures, more than half experienced at least mild depressive symptoms at some point during recovery, while 22% experienced at least moderate symptoms and 7% experienced severe symptoms. (1)
Ankle surgery can lead to weeks or even months of limited mobility, leaving patients feeling isolated, frustrated, or helpless. The physical discomfort, the medications, and the lifestyle changes are a great recipe for mood disturbances and depression.
MY TAKE ON IT
I’m a very strong person. I’m independent. I’m tough. I’m a competitor, an expert at picking myself up after I’ve been knocked down.
But this… this was hard to recover from.
It meant my plans for my horses were out the window for who-knows-how-long. Forget the horse shows and how I was going to prepare for them. Forget taking my young horse, Raisin, off-property for practice; doing exercises for my own fitness; and setting gymnastics to help the horses be clever with their feet. But it went a lot deeper than that.
Many of the simple pleasures of my daily life were gone, too. Listening to the horses munch hay in the barn. Greeting Marmalade, my barn cat, in the morning. She’d trot out through the wet grass and meow at me. Seeing the sun creep over the horizon, and then feeling it warm my back. Laughing at my horse, ZZ, when he’d lift his hind leg up to beg me to scratch his belly.
Forget that. I had to turn the barn work and horse care over to someone else. I hated handing over the control. And the care wasn’t done like I’d do it. But I had to be grateful it was getting done at all.
Whenever my leg was down it would swell and hurt. It was difficult to do anything. Fixing food for myself was a major expedition. I’d grab food from the refrigerator and stick it in my knee-scooter’s basket, and then drag the scooter around to get to the stove. I’d alternate between kneeling with one leg resting on the scooter and standing on one leg. Neither was tolerable for very long. A lot of the time I’d just get a cup of cottage cheese or something else that I didn’t have to prepare because it was such a hassle.
Everything was a hassle. Going to the bathroom. Taking a shower. Getting dressed. I tried to go out for a meal or two with my husband but it hurt to have my leg down and wasn’t great having it up on a chair.
I work online—luckily—so I thought I could get a ton of work done. But even that was uncomfortable so quickly that it didn’t pan out like I thought it would.
The pain and lack of sleep didn’t help. My doctor prescribed opioids, muscle relaxants and advised Tylenol and ibuprofen. But they all came with issues. Constipation, an upset stomach, or a foggy head. And even when I took them all, it wasn’t always enough. I spent at least a week sleeping—or trying to—in the recliner in the living room. I’d literally sit there and cry. And I felt weak that I was crying over it.
Whenever I’d ask my surgeon for a timeline for when I could ride, she’d say ‘months and months.’ I think she was trying to protect me, but I felt there was no end in sight.
For me, fear was a factor, as well. Was I going to be okay, ever? I didn’t know.
It’s hardly any wonder I felt a little blue.
Your stories are different from mine, I’m sure. But there are commonalities: fear, loss of independence, pain, reactions to anesthesia. It’s hardly a wonder that many of us feel a little—or a lot—blue.
NOBODY TOLD ME...
I wasn’t warned about depression. If I had been, I might have been better prepared. Or maybe it would have blindsided me, anyhow. Because I wouldn’t have believed it.
Why Mental Health Struggles Occur After Ankle Surgery
Loss of Independence: If I hadn’t broken my right leg, I could have at least driven. I actually crawled in the car once and backed out of the garage when I was still in a cast. I tried to shove my knee scooter out of the way but failed and ran over its tire on the way out. Talk about frustration! When you can’t drive, walk, or perform daily tasks without help, well... it’s hardly a party. Almost everyone is impacted by this.
Pain and Discomfort: When you hurt all the time, or your leg is scaring you by turning purple or swelling up like a balloon, sleep and mood are going to suffer.
Physical Limitations: Using crutches, scooters, or braces can be tiring, inconvenient, and isolating. (Say it again!)
Social Isolation: Social events, work, and hobbies: your broken ankle doesn’t respect any of them. You may end up all by your lonesome a lot of the time, seriously denting your joy de vivre and sense of purpose.
Fear of Reinjury: Anxiety about damaging the ankle during recovery can cause stress and hesitation—and the fear can be debilitating. I fell down in the bathroom once when I got in a hurry and scared myself silly. Nobody wants to take a step backward, and nobody wants to go through the trauma again.
Surgical stress: Trauma to the body and strong inflammatory responses can have a huge impact. The physical is closely tied to the mental… and vice versa.
Anesthesia and medications: Anesthesia and some of the medications used during and after surgery can temporarily affect brain chemistry, sleep, and energy levels. Don’t underestimate the drugs.
Whip these together and you’ve got a potent recipe for sadness, anxiety, or even clinical depression.
How to Support Mental Health During Recovery
This is the important part. How can you help yourself feel better?
1. Stay Connected
Isolation can worsen depression. Make time for phone calls, video chats, or visits from friends and family. We need our buddies when we’re down. Try not to chase them away. Reach out.
2. Join Online Support Groups
Connecting with others who are going through the same challenges can be incredibly uplifting. Facebook support groups for ankle surgery recovery give you a place to share your experiences, ask questions, and receive encouragement from people who truly understand what you’re facing… the frustration, the lows, and the sweet victories like that first shower or starting to walk again. These communities can help reduce feelings of isolation, provide practical recovery tips, and remind you that you’re not alone in your journey. (Just remember that while peer advice is valuable, it should complement—not replace—guidance from your healthcare providers.)
3. Focus on What You Can Do
While mobility is limited, consider hobbies or activities that are accessible from home. Reading, puzzles, crafts, or learning a new skill online can keep your mind engaged and distracted from pain or frustration. For me, being productive is a big part of feeling worthy. I made a website, my first ever-- the Ankle Fracture Recovery Community. I researched the hell out of what I could do to recover better and faster, and then got to share it with my new Facebook fracture buddies.
4. Prioritize Physical Therapy
Physical therapy not only improves physical recovery but also supports mental health by giving you measurable progress. Achieving milestones, no matter how small, can restore hope and motivation. Even if you don’t go to PT, remember to move as much as you safely can. Lift weights. Walk. Walk on your knee scooter. It will help your mood, and give you a leg up (see what I did there?) when you’re allowed to do more.
5. Maintain a Healthy Routine
Good nutrition, proper hydration, and consistent sleep routines help regulate mood and energy levels. Avoiding excess alcohol or caffeine can also support emotional stability. This is big. It’s tempting to dissolve into a puddle on the couch, aided by a pizza and an adult beverage. But you have to help out your body. In turn, it will help out your mind.
6. Practice Stress-Relief Techniques
Mindfulness, meditation, deep breathing exercises, or gentle stretching (when approved by your doctor) can reduce stress and promote relaxation.
7. Seek Professional Support
If sadness, irritability, or hopelessness persist, it’s important to consult a mental health professional. Therapists and support groups can provide coping strategies, and in some cases, medication may be recommended.
WORTH KNOWING
Studies suggest that gratitude practices, such as keeping a gratitude journal, can improve mood and reduce symptoms of depression. Try writing down three things each day that you're grateful for. (2)
When to Seek Help Immediately
While mood swings are normal during recovery, seek immediate medical attention if you experience:
Persistent hopelessness or loss of interest in daily life
Thoughts of self-harm
Severe or worsening anxiety interfering with sleep and daily activities
A Final Thought
If I'd known that what I was feeling wasn't unusual, maybe I wouldn't have spent quite so much time feeling bad about feeling bad.
ASK YOUR SURGEON
Questions to take with you.
Before surgery: “Is depression or a significant mood drop common after this type of surgery?”
Before surgery: “Are any of the medications I’ll be taking known to affect mood?”
Early recovery: “How long is it normal to feel depressed, anxious, irritable, or emotionally overwhelmed after surgery?”
Early recovery: “Could pain, poor sleep, anesthesia, or being unable to exercise be contributing to how I feel?”
At a follow-up: “At what point should I be concerned that this is more than a temporary reaction to recovery?”
At a follow-up: “Could my restrictions be eased safely so I can get outside, exercise, or return to activities that help my mood?”
Any time symptoms are significant: “Should I talk with my primary-care doctor or a mental-health professional, and can you refer me?”
Immediately: If depression includes thoughts of self-harm or not wanting to live, that warrants urgent help rather than waiting for the next surgical appointment.
Source:
1. Davison R, Daniel J-PA, Idarraga AJ, et al. “Depression Following Operative Treatments for Achilles Ruptures and Ankle Fractures.” Foot & Ankle International. 2021;42(12):1579–1583. doi: 10.1177/10711007211020346.
2. Diniz G, Korkes L, Tristão LS, et al. “The Effects of Gratitude Interventions: A Systematic Review and Meta-analysis.” Einstein (São Paulo). 2023;21:eRW0371. doi: 10.31744/einstein_journal/2023RW0371.
Share your Story
Coping with the emotional side of recovery can be just as tough as the physical healing. Have you found comfort in support groups, meditation, or talking with a counselor? What strategies helped lift your spirits?
Share your tips in the comments below. Your experience could give hope to someone struggling right now.