Ankle Surgery Insomnia: 4 Days And Counting

Sleep is an important part of recovery after any surgery, but it can be difficult to get a good night's rest following an ankle operation. Factors such as pain, swelling, bruising, and limited mobility can all contribute to sleep disturbance. However, there are several strategies you can use to improve your sleep quality during the recovery process.

Sleep on your back to avoid abnormal bone fusion

Sleep is often disturbed after ankle surgery due to pain, swelling, fever, bruising, and limited mobility. To avoid abnormal bone fusion, it is recommended that you sleep on your back with your legs elevated. This keeps the ankle in a neutral position and avoids abnormal fusion of the bones. Ankle support or a cast may be used to keep the ankle immobile.

Sleeping on your back is the best position to sleep in after ankle surgery. However, if you are a side sleeper, you may be able to sleep on your unaffected side a few days after surgery. When doing so, place a pillow or foam block between your legs for support and switch back to the supine position if you experience any pain or discomfort.

Adjustable beds can help you sleep with your leg elevated and make it easier to get in and out of bed. Air mattresses can also reduce painful pressure points and decrease the risk of developing bedsores and pressure ulcers.

Elevate your leg to reduce swelling

Elevating your leg is one of the most effective ways to reduce swelling after ankle surgery. It is recommended that you elevate your leg above the level of your heart. This can be done by placing a few pillows beneath your ankle and leg. You can also place your leg on a table while sitting. Using an adjustable bed can also make this process easier. Elevating your leg helps to drain fluid from the limb, reducing pain and speeding up the healing process.

It is important to follow your doctor's recommendations for resting and elevating your leg after surgery. Staying in bed too long can increase the risk of a blood clot forming. However, getting enough rest is crucial for reducing swelling. Aim for at least eight hours of sleep per night and take naps whenever possible.

In addition to elevating your leg, there are several other strategies you can use to reduce swelling after ankle surgery. These include applying ice packs, wearing loose-fitting clothing, using compression socks, and avoiding smoking and alcohol. Following these tips can speed up the healing process, improve mobility, and enhance overall comfort.

It is also important to follow your doctor's instructions regarding weight-bearing and exercise. Walking too soon after surgery or engaging in intense exercises can cause pain and additional swelling, preventing proper healing.

Use an air mattress to reduce pressure points

Sleep can be difficult to come by after ankle surgery, with pain, reduced range of motion, swelling, fever, bruising, and limited mobility all contributing to sleep disturbances. To improve your sleep quality during this time, you may want to consider using an air mattress to reduce painful pressure points.

Air mattresses are designed to provide proper rest and comfort while minimising the risk of pressure wounds and bedsores, which are a serious concern for individuals recovering from surgery who have limited mobility. Bedsores occur when constant pressure restricts blood flow to the skin and underlying tissues, resulting in tissue damage.

Here's how air mattresses can help:

Alternating Pressure Technology

Air mattresses utilise alternating pressure technology, with air-filled cells that inflate and deflate in cycles. This redistribution of pressure ensures that no single area of your body remains under constant pressure, reducing the risk of developing pressure sores.

Microclimate Control

Maintaining a healthy microclimate around the skin is crucial for preventing pressure sores. Airflow mattresses help manage moisture and temperature, preventing moisture buildup from sweat or humidity. This is important because excessive moisture can soften the skin, making it more susceptible to damage.

Moisture Management

Airflow mattresses often include low air loss systems that circulate air, keeping the skin cool and reducing moisture. This is critical to reducing the risk of pressure ulcers, as dry skin is less susceptible to damage.

Pressure Relief and Shear Reduction

The air-filled cells in airflow mattresses provide a cushioning effect, reducing the forces of shear and friction that occur when the skin moves against the mattress. This not only helps to relieve pressure on vulnerable areas but also protects the skin and promotes healing.

Repositioning and Pressure Relief

Regular repositioning is essential in preventing bedsores, and airflow mattresses complement this strategy by providing effective pressure relief. This reduces the need for frequent manual repositioning, making it more comfortable for you and easier for your caregivers.

Enhanced Blood Circulation

Proper pressure redistribution with an airflow mattress improves blood flow to tissues, which is crucial in reducing the risk of pressure ulcers and promoting healing.

Pain Relief

The alternating pressure of an air mattress provides pain relief by alleviating pressure on sensitive areas.

Reduced Caregiver Strain

Airflow mattresses reduce the frequency of manual repositioning required, easing the strain on caregivers.

Customisable Firmness

The firmness of an air mattress can be adjusted according to your comfort level by changing the amount of air in the mattress. This allows you to find the right balance between support and softness.

Compatibility with Adjustable Bases

Air mattresses are often compatible with adjustable bases, allowing for customisation to suit your specific needs and conditions.

Trial Periods

Many air mattress brands offer trial periods, so you can test them out to ensure they provide the support and comfort you need during your recovery.

Compliance with Healthcare Standards

The use of airflow mattresses for pressure relief is supported by healthcare standards and guidelines. The National Institute for Health and Care Excellence (NICE) recommends pressure redistribution devices, such as airflow mattresses, for individuals at high risk of developing pressure ulcers.

In summary, using an air mattress during your recovery from ankle surgery can provide numerous benefits, including improved blood circulation, pain relief, pressure sore prevention, and enhanced comfort. The customisable firmness and compatibility with adjustable bases make air mattresses a versatile option for your sleep needs during this challenging time. Be sure to consult with your healthcare provider to determine if an air mattress is the right choice for your specific situation.

Take painkillers before going to bed

Sleep can be difficult to come by after ankle surgery, with pain, swelling, fever, bruising, and limited mobility all contributing to sleep disturbance. Pain management is crucial for getting a good night's rest, and this often involves taking painkillers.

A nerve block is typically administered during surgery to numb all pain sensations, and this usually lasts for 24 to 48 hours. Once the effect of the nerve block wears off, pain can become worse, and the first few days can be particularly challenging. To manage this, your doctor may prescribe analgesics (painkillers) to take before the nerve block wears off.

There are various types of painkillers available, and your doctor will determine which is most suitable for you. These may include opioids such as tramadol, codeine, methadone, fentanyl, and morphine. Opioids can cause side effects such as sedation, constipation, nausea, dizziness, and dependence, so it is important to discuss these with your doctor. To counteract constipation, it is advised to increase fluid and fibre intake.

Other types of painkillers that may be prescribed include naproxen and diclofenac, which have a potent pain relief effect and can also be used to treat swelling. In the professional opinion of Dr. Babar Naeem, taking a long-acting painkiller at bedtime is advisable to promote a good night's sleep. This can be supplemented with cold therapy to further reduce pain and swelling, as well as lower the required dosage of painkillers.

It is important to remember that painkillers should always be taken as directed by your doctor, and you should consult your doctor if you experience any problems with the medication. Additionally, it is crucial to follow your doctor's recommendations for rest, elevation of the leg, and the use of compression and ice therapy to aid in your recovery.

Gradually start physical therapy

Your doctor will let you know when you can begin physical therapy, which will typically be as soon as possible after your surgery. Physical therapy is key to postsurgical care and will help you ease into physical movement.

During your first physical therapy session, your therapist will perform a physical exam and discuss your recovery goals. They will also conduct an assessment to determine your starting point. This may include testing the strength, range of motion, and flexibility of your ankle, as well as your overall function and mobility.

The first phase of physical therapy will include non-weight-bearing ankle motion exercises and stretches to counteract the negative effects of immobilization. Once your doctor clears you to exert weight on your ankle, your physical therapist will guide you through more challenging exercises.

• Ankle Range of Motion (ROM) Exercises: Gently bend and straighten your ankles like stepping on and off a gas pedal. You can do this lying on your back with your leg elevated, on your stomach, or seated.
• Calf Stretch: Loop a strap or towel around the toes of your foot and gently pull your toes toward you to stretch the calf.
• Hip Abduction Straight Leg Raise: Lie on your side with your hips stacked and raise your top leg straight up without letting it move forward or your hip rotate back.
• Hip Extension Straight Leg Raise: Lie on your stomach with a pillow under your hips and lift your involved leg off the bed without arching your back.
• Arm Strengthening: Take an elastic band and tie a single loop at one end. Close the knot tightly in a doorway. Sit in a chair holding each end of the band and bring your shoulder blades together, allowing your arms to follow along.
• Shoulder Extension with Band: Attach a knotted resistance band to a doorway. Sit in a chair holding the band in front of you and pull the band down and back towards your side.

Physical therapy usually starts two to four weeks after ankle surgery, with sessions two to three times per week, and can continue for six to eight weeks. However, it's important to remember that everyone's healing journey is different, and the timeline for physical therapy will depend on various factors such as the type of surgery, age, and any underlying health conditions.

Frequently asked questions