Advice on multiple ankle issues

Having suffered a recurrent right ankle sprain over the years, I went to the consultant for an MRI after the latest episode to find I have "a rupture of the ATFL with injury to the CFL.  There is also a contusion to the anteromedial aspect of the deltoid ligament and a small OCL on the lateral talar dome with some mild bone marrow oedema surrounding it."  In layman's terms, I think this translates to a detached lateral ligament and a partially torn medial ligament with some damage to the cartilage.   The view was that I would need surgery in due course but, given family duties, may need to wait a while until I could find the time for it given recovery requires immobilisation for a while. The consultant seemed to think I could run a bit, but would need to rein it in.  Certainly spring marathon training has been stopped.

I was wondering if anyone had dealt with something similar and was able to keep running?  If so, how did you approach it?  Research seems to point to people in a similar position heading straight to surgery and I am struggling to find evidence of anyone able to keep going, but this may just be the nature of what you find online (and those who cope fine, are less likely to be writing about it online).  Thanks for any insights.

Comments

  • IMO it sounds like you're searching for evidence you want to find, and discounting evidence you don't want. (This is called motivated skepticism). Let's face it, it's hard to find evidence of people using doors successfully with the hinges broken. If it were some vague ache there might be a lot of room for interpretation, but in this case the best advice would be to listen to the consultant.
  • MsEMsE ✭✭✭
    Thanks for your reply, SteveCRunner.  I suppose what I am looking for is how others in a similar situation dealt with it, if surgery wasn't immediately available.  There is nothing out there I can find, let alone material I can find but am discounting.  I am not disbelieving what the surgeon says, merely trying to find examples of what worked for people and where they found the limits to their abilities. I'm after some tips as it were!  I realise this is a bit like asking how long your particular ball of string is, but without any prior experience of working with a ruptured ligament (I have worked with rehabbing damaged tendons and partially torn ligaments) I thought this might be a starting point.  By the lack of responses it does seem, rather unfortunately, as if it isn't that common to deal with however.  Anyway, thank you.
  • Well if it temporary coping you could look up how orienteers tape an ankle to make it stable, using non-stretchy tape, basically making stirrups round the foot so that the ankle doesn't collapse either way. I saw a video on youtube for runners like this the other day.
  • MsEMsE ✭✭✭
    That's a good idea. I'll have a look.  I already use KT tape to help support on trail runs but orienteers or fell runners will have some good tips.  Thank you, SteveCRunner.
  • FootmechFootmech ✭✭✭
    Compex NMES may be useful in conditioning the muscles around the ankle to help auto-support.
    Foot mobilisation, and soft tissue work can help foot alignment and proprioceptive feedback from the foot. 

  • MsEMsE ✭✭✭
    Footmech - I haven't heard of compex NMES.  Your other suggestions sound spot on.  Can you explain a bit more please?  
  • FootmechFootmech ✭✭✭
    Ankle joint mobs can be done by a Podiatrist trained in soft tissue work and mobilisation. 
    Physios should be able to do this as well. Although the techniques may vary. 
    The NMES is a device which we use a lot in clinic as part of our rehab protocols.
    it uses a range of frequencies to make the muscle behave in different ways. 
    Low frequency programs can reduce tension in tissues, and increase circulation. Higher, can lead to strong muscle contractions and are great for local and focal strengthening. Even better when combined with exercise, to achieve results. 
    This is called CCMT, Compex combined muscle training.
    the Compex can safely stimulate 100 percent muscle fibre recruitment , which exercise cannot do. The body has its own built in safety mechanism that does not allow 100 percent contraction and this prevents injury. 
    The Compex can recruit all muscle fibre without  stressing the joint hence the outcomes are far superior than exercise alone. 

    You up can read up about this online www.compex.info

    and if you are interested, let me know I can get you a good rate.

  • MsEMsE ✭✭✭
    Thanks, footmech.  Interesting reading.  I am assuming NMES stands for neuromuscular electrical stimulation from what you say.  I will read more and get back to you.
  • JMW15JMW15 ✭✭
    Hi MsE, You don't mention whether you have had much rehab or what you have tried to help get your ankle better. If you are keen to avoid the surgery route, I would suggest finding a good local physio who has experience of working with chronic lateral instability (basically repeated ankle sprains) to devise a long-term rehab program for you. There are lots of us out there who are happy working with these and understand the need to keep running!
    These kind of ligament problems do respond well generally, but it can take a long time. I would also suggest thinking again about the KT tape, it can be good for stimulating or relaxing muscles (don't ask how it can do two opposite things!) but it will not provide any structural support to the ankle itself. To do this you would need something more rigid (ankle support or zinc oxide tape).
    Hope that's some help!
  • MsEMsE ✭✭✭
    Thank you for your advice, JMW15.  I have rehabbed (verb?) for a year or more now.  It made sense to learn I have ruptured the ligament as I was never feeling the connection despite the work I did.  The problem is there are three things going on and with the CFL partially torn, I am inclined to think it is because I lack the structural support from the ATFL.  I know I can do a certain amount of shoring up with strengthening the peroneal tendon. Mine is stable and strong. As are my gastrocnemius and all the other bits that can help (I think!) The bone spur is prompting me to go for surgery.  Having had a long think about it, I think it will help if I can have the ligament reattached and, at the same time, the bone spur dealt with.  
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