# Sprained ankle - question (X post)



## HappyHamster (Jun 3, 2004)

HI everybody!

Being the queen of grace that I am, I sprained my ankle riding over a seemingly innocuous piece of trail, but apparently a wet root was lurking under the leaves. No problem over the technical stuff on the trail, but a sudden slam to the side with the foot still clipped in over what seemed to be nothing! Go figure. Well, this happened about 6 weeks ago. It appeared mild, because I had minimal swelling, no bruising, and could put weight on it. As such, I began the home course of treatment - RICE, range of motion exercises, stretching. It appeard to be coming along OK, I started spinning on my trainer with light resistance, but I wasn't sure about when/if I could start doing standing climbs or use heavy resistance, or start lifting leg weights. So I made an appt. with a podiatrist who is also a triathlete, and got in to see him last Monday. Upon physical exam, he was fairly certain that I had ruptured the anterior fibular ligament! I was shocked - here I was looking to get some advice on when to resume normal activity, only to find things were a lot more serious. He sent me for an MRI, and I will know the results next week. It's strange, I can do just about everything except stand on my tip toes, and am not sure about the twisting motion of clipping out of the pedals, so have stuck to the trainer. I do still nave some mild pain though.

I'm posting for two reasons. First, the doc said the course of action would be either physical therapy to strengthen the surrounding muscles and tendons, thereby stabilizing the joint, or possibly surgery to sew the ligament back together again. Has anyone here ever had this situation, and if so, did you do rehab, or have surgery? I'm certainly not relishing the idea of surgery (long layoff from the hamster wheel), and would appreciate any input based on your experiences. Secondly - just as a heads up to everyone - sometimes a seemingly mild injury could have something more substantial going on. Apparently, I couldn't have changed anything by going to the doc sooner except get going faster on the treatment option, but when in doubt - see the experts!

Thanks so much for any beta you can offer. I hope you all are enjoying your holiday season!

Ciao,
Hamster


----------



## Lucky (Jan 12, 2004)

Major bummer. Sorry to hear you're off the hamster wheel for a while. If your doc thinks PT has a significant probability of stabilizing the ankle and making it useful, and not doing additional damage, I think I'd try that before I'd go under the knife. At worst, it won't work and you'll have to have surgery, anyway, and you'll have lost some time. However, if you can avoid surgery and get a good result, that'd be way better.

I've been through surgery and rehab twice for a badly broken wrist. It's a lot of pain and work, but if ya' need it, ya' need it. But I'd only do it again if I really needed it and nothing else would work. I'd give PT a try first.

That's my $0.02. Heal well!

Kathy


----------



## chad1433 (Apr 5, 2004)

Hamster,

For the time being, I'd recommend some hydrotherapy to help the healing process. Ligaments can be a bear to heal because they don't have a natural blood supply moving thru them like muscles and other tissue (skin, adipose) do. 

Start with ice on the affected area and leave it on until it's numb. This effectively flushes the area of fluids. Then apply heat, no more than 110 degrees for no more than 20 min. This will bring new fluids into the area. Go back to ice, same as above, then heat, then ice.

This creates a pumping action of nutrient fluids to help the ligament.

Massage therapy as well as PT is a good practicle option to surgery, if you injury is no so severe. CMTs are doing great things these days with Neuromuscular therapy.

Good luck!


----------



## Gnarlene (Jan 13, 2004)

*aaah!*

I feel your pain! 

Last year at this time, I was on crutches due to surgery for my ankle. I had two things done in the surgery: (1) I had some repairs done to a break in my Talar Dome (bone way on the inside of the ankle), and (2) I had my Posterior Tibialis tendon reconstructed. There was some sort of stablizing ligament that I managed to tear that wasn't repaired and is just gone from my foot. The doctor decided to focus more on the PT tendon, since that is really a major stabilizing point for the ankle.

I went into the doctor when my ankle felt so weak, that I had to wrap it to go on any sort of bike ride and the pain in my feet was so great that I just couldn't go rock climbing at all. When I couldn't keep skis flat on the snow, and didn't even know how to send signals to my legs to make that happen, I knew something was up. And parties, yes, going to parties was shere torture, because I just couldn't stand for more than 15 minutes or so, though I could still do fairly long hikes if I was willing to deal with some pain. (odd, huh?) I had expected a prescription for PT to strengthen my ankle, because it felt weak -- "weakness": that was my complaint when I saw the doctor.

When the doc saw me, he decided to put me in a cast right away. I complained: "can't you just send me to a physical therapist, and I can learn some stretching or strengthening? Please?" Anyway, I spent almost an entire summer in a boot cast, prior to the surgery, in hopes that my body would heal the PT tendon on its own. (We didn't even know about the break in the Talar Dome at that point.)

Finally, with no healing taking place, I decided to go on with the surgery. At the same time as the surgery my life fell apart, (I was in a somewhat serious traffic accident, a friend of mine (with the same first name and birthday as me) was killed in an accident right after mine, my mother was diagnosed with cancer and she passed away -- all while I was hobbling around on crutches and in a cast.) I seriously regretted getting talked into the surgery (these are life events that you really don't want to deal with on crutches.)

But now, I'm doing so well and I don't at all regret the surgery. It has taken almost a year since the surgery of slowly, slowly, oh so slowly ramping back up..but I have been able to do things that even the doctors didn't think would be possible. And I'm almost totally pain free...I've been dealing with painful feet for years upon years now, so that is huge! I am still not where I was a few years ago, before my foot problems really took hold...but I'm doing so much better than a couple of years ago! It is fabulous.

I'm faced with potentially 4 more surgeries....and I'm dragging my feet (pun intended). Partly because they are to solve another condition, and that condition is not affecting my mountain biking (it does affect my rock climbing and XC skiing, however.) I'm trying a totally new approach -- accupuncture. It is still too early to say if this is working, but my podiatrist says that accupuncture has shown great promise for the condition that's still outlying (seasamoiditis) and my insurance is covering it!

Oh gosh, so now that I've given my life story....even though I had a great result from my surgery, I would still recommend doing anything that could potentially help before going under the knife. Surgery itself sucks. It is risky, no matter what. And the recovery process is terribly slow. But if the PT doesn't show results, and it comes down to surgery or hobbling around for the rest of your life, I'd take surgery in an instant.

Good luck!


----------



## HappyHamster (Jun 3, 2004)

*Thank you....*

Thank you all for your responses. As it turns out, I did tear my anterior talofibular ligament, but the MRI was inconclusive as to whether it was a complete or partial tear. The doc, however, suspects a complete tear due to the degree of movement of my foot. My feet somewhat resemble flippers to begin with.....  So, I'm going to give the PT a go, since my pain so far is very mild and I can pretty much do anything (haven't tried leg weights, standing climbs on the bike, or clipping out of the pedals yet though - being conservative for the moment) except stand on my toes with force or wear heels. He did say that if I injure it again, that surgery would be basically the only option (makes sense). So we'll see, hopefully with a little luck I'll get back to normal in time. I truly appreciate your advice, and am intrigued by the hydrotherapy and accupuncture options!

Gnarlene - I truly hope all is going better for you! What a terrible chain of events - that had to be so hard for you. I don't know why, but things always seem to happen that way. Best of luck to you in getting those feet taken care of. Did you have a fall, or were all of those previous underlying conditions? I'm sending well-wishes your way!

Again, many thanks, and I'll keep you posted if I learn anything that might be of value to you all through my PT.

Cheers,
Hamster


----------

