I am the classic heavy legged runner turned swimmer. I was fortunate enough to come across a swim coach around 2004 who transformed my swimming by focussing on my stroke / body rotation. I lost touch with her before 2010.
I did a SwimSmooth weekend course at the Manchester 50m pool in about 2007 which really helped fine tune my bottom half … but it was mainly to do with improving my streamlining rather than propulsion. No idea if those courses are still running.
To be clear I don’t really kick - I was always focussed on OW swimming and kicking is much less important in a wetsuit.
If you’re slower kicking with both legs, I would wonder whether your technique on the leg with the fused ankle is poor? Is that leg as strong as your good leg?
I missed this link previously so just read the research over breakfast.
They don’t make things easy to understand so without delving into how some of the outcome measures are calculated, it’s hard to fully appreciate all the measures and differences between the two procedures.
It appears to me from the analysis that TAR is slightly better than AF, although there is only a small difference.
I spent some time looking at the FAAM Sports results (FAAM = foot and ankle movement) and (annoyingly) there looks to be some errors in the reporting. Table 3 shows scores that are above the maximum of 32 - I think they have transposed the mean/change and SD numbers.
If we assume that the SD numbers are the actual results, then TAR shows a big improvement to almost the maximum score after 12 months, whilst AF has both a lower score and smaller improvement.
The sample size is small and 95% CI is pretty rubbish but I would normally take a sample of 37 people as being a good number to be sure of a trend (just unclear what the exact size of that trend is).
Of course, having more movement is not necessarily the most important outcome and there’s the question of longevity.
I think it’s also fair to point out that hip and knee replacements have improved rapidly with increasing numbers of patients and better procedures and products - TAR is years behind but this report seems to indicate that it’s now more worthy of consideration and, in my opinion, only likely to get better.
FAAM details:
Foot and Ankle Ability Measure - Physiopedia.
Wow @Pete_Bac a great story and it gives me hope. Why do you say after a TAR you won’t be active in sport? I have read the opposite. @Cobbie thanks for the extra research will delve into that later.
I have my op booked in for the 13th Sept and they wont know if its going to be a AF or TAR until they open me up and look at the medial ligaments, initially I was hoping for a TAR but now will happily take a AF.
I had an Anterior Talo-Fibular Ligament (ATFL) reconstruction back in 2010, my surgeon says that they should have also looked at the medial ligaments as well, they didn’t and so it created instability and meant that my ankle has been collapsing inward on my Talus and has worn away the cartilage amongst other damage.
So the long and short is if they can repair the deltoid ligament and the others are good then they will do a fixed bearing TAR if not a TAR would be pointless as I would still be collapsing inwards as the ligaments cant support it so then a AF is the best option.
I’m really in a quandary which I want TAR is newish and fairly rare and AF is commonplace, worst case is I get a TAR if no improvement they can remove it and then do a AF.
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Fingers crossed the op goes to plan.
My reading is that TAR is probably the best option, just the data isn’t deep enough to fully support that conclusion at the moment.
However, AF is a sound procedure to stop pain and is a good long term solution to remain active.
Steve - good luck with the operation…
Sounds like my initial situation was pretty different to yours - I had a big fall and shattered the bottom of my tibia, so maybe that meant a TAR was no good for me. My surgeon told me that if I wanted to be fully active then I would probably “wear out” the replacement ankle joint within 5-10 years - he said the TAR was more designed for people who were older and would not be doing much in the way of sport. But again, my initial injury was very different to maybe it was a different type of replacement joint they were looking at putting in.
As you say, worst case is they end up having to do a fusion later on, or putting in another replacement ankle joint…
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