Concerns about healing broken foot/lower leg and limited mobility while traveling in Europe

Mobility challenged travelers sometimes do best on guided his tours. The option would be travel by car but many people cannot navigate long rental car trips over such long distances. Even getting through airports and train stations can be tough.

I have been fortunate never to have suffered a broken bone, but I have a recent history of taking significant falls in Europe that damaged one knee and gave me a couple of severely sprained ankles. The worst ankle injury affected me for over a month because I kept aggravating it. I now realize that I set foot on unpaved paths at great peril and know that cobblestones require great care. Some of my issues have occurred on less risky terrain when I was looking at the historic buildings around me rather than paying attention to what was down at foot level.

Rules 1 and 2: Do not hurry. Pay attention to where you are walking.

I think your mom can do this, but it will help if others here offer suggestions of nice cities and towns along their path that are flattish and don't have large cobblestoned historic districts.

She should strongly consider using a cane. If museums are on the itinerary, she could inquire about the availability of a wheel chair. If your parents enjoy museums, that will be something very workable for your mom since there are no indoor cobblestones. Historic churches should generally be OK as long as they skip things like crypts and bell towers.

There are lots of places in the London Underground and the Paris Metro where you need to go up or down steps, so they may need to stick to surface transportation. The other warning is that restaurants in older buildings often have the toilets either up or down a flight of stairs, and hotels in historic buildings may have no elevator (common for small budget properties) or may have an elevator but also some stairs needed to reach at least some of the rooms.

Will your parents be driving or taking trains/buses? Where is the wedding? How much time do they anticipate spending in Europe? That it's a summer trip will help a bit because it will probably be less rainy then than it would be in the spring.

Your parents should definitely be sure they have good medical coverage in Europe. Medicare will not apply, so they may need a short-term medical policy. And especially with your mom's history, medical evacuation coverage is essential. Heaven forbid she takes a bad fall and cannot travel back home in a normal airplane seat. The cost of a medical-evacuation flight (or even for a full row of last-minute one-way first-class seats) can be extremely high.

A lot of travel policies have exclusions for pre-existing conditions. Sometimes there is no exclusion if you buy the policy immediately after you make the first payment related to the trip. The website insuremytrip.com is often recommended as a place to investigate policy options.

Not sure of the folks age or fitness level, but bike tours are usually easy terrain and a great way to sight see. We love them!

Kate, I know this is not what you asked but I am going to suggest something that might ( or might not) help her manage her pain. I use the MELT Method by Sue Hitzman. She uses 4 balls of different sizes ranging from soft to hard and has you roll your feet ( or hands) in a specific pattern. Her theory is that this helps rehydrate the fascia thereby decreasing pain thru your frrt, legs and into your upper body. I have used her program successfully with plantar fasciitis pain which was likely not as severe as your Mom’s pain from the fractured leg. She has an instructive DVD which I did for a few times to learn the pattern but now I do it on my own and it takes about 10 minutes. She suggested I do it at night just before bed after drinking a glass of water an hour before and another one right after. I think the balls and program are about $60(maybe a bit more?) now so not inexpensive but if it helps decrease her pain and maybe increase mobility that would be worth it.

https://www.meltmethod.com/store/product/kit-bundle/

I have no connection to this program other than being a satisfied user. There are some videos on Youtube of some interviews and talks with Sue so your Mom could see if it sounds like something she would want to try.

She is very mobile, but she experiences major pain in her ankle and lower leg after walking long distances

What is 'long distances'? 3 miles per day? 200 yards per hour?

Give the forum a bit more info/details on what is already on their itinerary and how much time you are looking to fill, and the parameters of how much is 'too much' walking and you will likely get more helpful advice.

Pam's post reminded me that I overlooked the obvious: shoes. I'm sure your mom will want something at least passably stylish to wear to the wedding, but she should otherwise be in sturdy shoes with thick soles that are relatively grippy on wet pavement. I take only lace-up shoes to Europe these days, because it's all too easy to roll an ankle on cobblestones. The klutzier the shoes look (the bulkier they are), the more contact you have with the pavement and the more stable you are likely to be.

Comfort in shoes is a very individual thing. I hope your mom will not assume that shoes will be right for her just because someone else raves about a particular manufacturer and style.

Oh yes, thumbs up for acraven’s suggestion about shoes. I have to have lace ups, I would never be able to manage in a slip on or a clog.

She is very mobile, but she experiences major pain in her ankle and
lower leg after walking long distances--especially on uneven ground
like cobblestones and rocky areas.

I will echo Joes question. How far is a long distance for your Mom - on level surfaces? And can she manage a flight of stairs? Without knowing that, it's hard to give advice.

Before my knee replacement, I couldn't walk more than half a kilometer without taking a break, and even a flight of stairs, while doable, caused pain. Yet DH and I managed quite a few trips in Europe. I always used a cane (still do) to help with changes in grade or steps. And DH was always there with a hand or arm when I needed it. The biggest trick was to manage our expectations and not try to do too much. We love museums and churches, and they always have benches to rest on. Many museums have wheelchairs and some now have folding stools that you can carry along and sit wherever and whenever you need to. A brilliant idea. We would usually plan one site for the morning and one site for the afternoon with a long lunch break in between. We minimized walking by learning and using the local buses or metros, and occasionally splurging on taxis. Unless the airports were small, we arranged wheelchair assistance to the gate.

Your mom should probably ask her doctor for his advice about activity restrictions and pain relief measures (pharmaceutical and otherwise). My greatest help was from my physiotherapist. He knew that travelling was important to me and came up with several helpful suggestions. And yes, he was the one who drilled in the importance of the proper shoes. In my case they were properly fitted walking shoes with custom orthotic inserts- they made a world of difference. Perhaps your mom can ask about a physio consult to address her particular needs.

If you can be a bit more specific about her limitations, as well as where exactly they want to go and what types of things they want to see, maybe we can be of more help.

The suggestion about using a cane, even if she normally does not, was excellent. This can reduce the pressure on the healing joints/bones significantly and aid stability.

There are many ways to travel and still have it be fun. First of all, schedule rest breaks from walking or standing. This doesn't mean you aren't sightseeing, but it does mean to be strategic in your planning. Follow a time that involves standing/walking with a one hour river cruise or bus tour. You can sit and rest while still seeing and learning about the area. It can be incredibly enjoyable to sit at a cafe table and watch the world go by for a bit.

Prioritize what is really important to you. Don't go see things that you don't really have an interest in, just because it is the expected thing.

Finally, treat yourself to a taxi frequently. Yes, you may pay more money, but you will pay less in pain and that it a priority.

Amsterdam is a great city for limited mobility. It is pretty flat- even the bridges over the canals are gentle. Plus, there us excellent transit with trams and buses going most everywhere.

With regard to "...she experiences major pain in her ankle and lower leg after walking long distances...", perhaps a consultation with the doctor who treated the broken leg (or at least her personal doctor) would be in order. I'm not medical person at all, but I know from personal experience that the aftereffects of some injuries can be mitigated with certain exercises. Just a thought, and I hope they have a great trip.

A couple of ideas to consider, and - very important - to try out at home before ever going on that trip:

• Most mobility impaired people I know are not terribly fond of canes any more. Depending on the degree of impairment, many prefer a wheeled walker which will give them a much more solid and reliable support for walking, leaning on, and even sitting down whenever and wherever they need it. These devices are great. I've known people who hadn't been leaving their houses for months (and who wouldn't have used a wheelchair if you paid them a million Dollars), suddenly out and about again once they got that thing. And in my part of Europe at least, you see people with those things all over the place. Nothing to feel ashamed or self-conscious about, like most people feel the first time the use some kind of assistive device. Nobody is going to stare at you for using that thing.
• I know some people with a less serious impairment who are a bit self-conscious about the aesthetics of a cane. So what they use instead are hiking poles (they make you look like you're doing sports, not like you're mobility impaired :-) ). With four legs, you have a lot more stability than with two, and it helps take a bit of weight off the knees and ankles. You'd have to find out what works for your mom.
• You may want to find out if there is such a thing as a temporary disability ID. If your mom happens to be eligible, that might be incredibly helpful. Depending on what kind of ID she can get, that might help with parking, or it might help her get reduced tickets for transportation or for museums etc.
• Now here's something really important: Make sure she has travel health insurance that will cover pre-existing conditions. Just imagine her twisting her ankle or some other mishap on the tour, or her having some kind of issues with that injured leg... she would be stuck with all doctor's and hospital bills, plus possible follow-up costs like for a missed return flight etc. etc. etc. ... not something I'd want to risk.

If, under recommendation of her health care provider, she decides to use a cane or hiking sticks, she needs to start using them now, particularly if she can go over uneven ground with them. There is a skill level with using them and it's better to practice on home territory than in a new setting!

First, I'm very sorry to hear about your mother's traumatic accident.

When you talk about long distances in which she feels pain, does that include those long 'hikes' in the airports themselves? Has she considered arranging wheelchairs with her airline both at departure and arrival? That might make things a little more comfortable for her.

Next, would it be easier to fly into the city in Spain where the wedding is to take place? If she were considering intra-European travel, again, those long airport treks might be something she might want to limit. Or does she plan to take trains? Maybe rail travel is more comfortable for her.

Being accident prone, I sympathize with your mother’s pain and how it can ruin a trip. Agree with the above suggestions, particularly using trekking poles. Does she have a leg brace to ease the pressure?
Finally, I suggest looking at tours offered by Road Scholar, formerly Elder Hostel, because they take people’s physical limitations into consideration, though they can increase the activity level for those without limitations.

If your mom does opt for a cane, try to find one of the ones that fold out into a tripod seat. Then if she needs to stop (or wait in a long line) and there is no nearby seat, she has her own. Also, three or four prong canes are safer than the single ones. If her doc will complete the handicapped parking form for the US, I understand that it is honored internationally, so if they do drive some, they will have access to handicapped parking.

If she opts for a walker there are great folding, wheeled ones. My mom uses a 'tricycle' type that is very compact and the cloth 'basket' holds a good amount, too, but it does not have the seat that some do. My mother-in-law uses a 4-wheeled one with the seat and the under-seat storage it good, too,

handicapped parking form for the US, I understand that it is honored
internationally

Not necessarily legally, but in practice, I am pretty sure they will honor it. Make sure you put it where local disabled drivers put it: In the US, it's usually hung on the rearview mirror, in many countries of Europe it's placed on top of the dashboard below the windshield.

In my experience, the Underground in London is much easier for a person with mobility issues than the Metro in Paris. Here is the guide to the London Underground that lists stations that have alternatives to stairs. It might come in handy depending on what they decide to do.

With my bad knees affecting my mobility, I've learned some things that help me. If your mom does take the advice to see a professional there may be others that could help on this trip. These are in no particular order.

1. Shots in my knees done by my orthopedist (a sports medicine guy) about 2 weeks before I leave.

2. Keep up with my regular daily dog walking.

3. Take or buy over there a mild cream for pain. I only use it if I'm really in need.

4. Wear Sockwell circulator support socks when out walking around. They help with circulation and especially with ankle support. They come in lots of colors and patterns. Oddly, the ones with the stripes work best for me. I use the medium compression of 15-20 mmHg.

5. Use some decent orthopedic inserts. I got mine at the Walking Company store using their analysis machine. They are not expensive and work like a dream.

6. Put them in some shoes or boots with decent ankle support. I swear by Ahnu Montara boots and have worn them on many trips. I'm hoping to swear by Teva Delavina lace up boots for my next trip. These boots make walking much more stable.

7. Change to other sensible shoes like these Abeo flats in the evening.

8. Remember that no matter how great the footwear, with all the walking and standing, your feet and legs will get tired and hurt. Take a break!

9. Also remember to move at your own pace and that you don't have to rush anything. At almost 72, I'm slow, particularly going up and down stairs or slopes.

10. Many have recommended tours. Based on my experience, tours can be physically problematic. Sometimes the group goes too fast and I have trouble keeping up. Sometimes they go too slow, and we have to stand around with no place to sit or lean to listen. By the way, I've seen people of all ages have difficulty with a fast pace or standing for a long time.

11. I took walking sticks to Greece, but only used them once. So I left them at home for the UK and Italy. Big mistake. Next trip I'm taking them, along with a note from my orthopedist to avoid any TSA hassles when I carry them on.

I like Lo's advice "move at your own pace" -- mine includes a LOT of bench stops. And looking at towers from the bottom, not the top.
(One nice thing about being 70+ is that there are sometimes senile and discounts in museums.)

One nice thing about being 70+ is that there are sometimes senile and
discounts in museums.)

This made me LOL. As a 65+ myself, I sure hope you meant SENIOR discounts. :)

Wow--I am overwhelmed by your responses! Thank you all so much for taking the time to respond to my concerns! I mentioned many of your responses to my mother, and we are both starting to feel much better about traveling. I appreciate your encouragement and advice!

Several of you requested more specific lengths of time and distances she is able to walk without major pain. She can walk for about 45 minutes to an hour on flat surfaces before completely wearing out, which at her pace is about two miles.

We're definitely investigating the shoes that were recommended and looking into hiking poles. Perhaps using these items on a more daily basis would help build up her endurance and stamina before the trip, as well.

I also appreciated the recommendation of Amsterdam for the flat walking paths. Thank you, too, for mentioning metro systems that are more navigable than others. Have you encountered any other cities that seem particularly walking-friendly? They have not nailed down a particular itinerary, as they are wanting to build their trip around accessibility. However, they are looking to explore England (particularly London), and possibly the Netherlands, France, Spain (for the wedding), then possibly fly out of Portugal.

Again, thank you so very much!

Kate

Where are your parents headed in Spain? Did I miss that elsewhere in the thread?

Once we have a better idea of the path they might take, it will be easier to think of flattish stops along the way. Is it a given that they will take trains down through France to get to Spain, or might they fly?