Hello. I'm new to this board--thank god I found it.

I was injured (slip and fall) going into my job this past May. I severely sprained my left wrist, elbow and ankle. Did pretty extensive therapy on my wrist/elbow but its still very painful. I just recently received a cortisone shot in my ankle (one week ago today) and I still have pain and swelling. I'm taking Vicoden for the pain but it does nothing. I'm not one to take pain medication all the time but after 4 months of taking advil and motrin and tylenol with no relief I finally went to something stronger--still no relief.
My podiatrist said I had a severe sprain in the ankle and possibly ruptured some tendons.
I have no clue what any of this means but he's telling me that its something I'll have to pretty much deal with the rest of my life--he said we could see if surgery will help but its no guarantee.
Does anyone have any advice for me--what steps should I be taking??

Thanks,
Cindy P.S. Workmans comp is handeling my case.

Welcome, even though it is unfortunate that you are in a position to having to write to the board, but we are here to help if we can.

Ruptured tendons - not a good thing. I'd request an MRI, if you have not had one yet, to see if there is any damage to your tendons. If there is damage, it may require surgery to repair. If surgery is called for, get a second opinion and educate yourself on the procedure and post-surgical recovery. Ankle tendon surgery is not pleasant and recovery can be long depending on the extent of your injury.

I had a Brostrom repair just over a year ago and there are others on this board who have had different procedures. The best advice I can give you is to be your own advocate, push for answers, even though working with workers comp can be a pain.

Take care and hope things get better soon.

-eko

P.S. Don't do anymore cortison shots, you can end up with more damage.

Thanks for the response. I've heard negative things regarding the cortisone shots--I'm supposed to be getting one in my wrist soon too--should I not do that??? I've had one in my knee before which did nothing--it appears that they never do anything for me.

thanks,
Cindy

A few cortisone shots are okay, but too many in one joint (especially if they aren't doing anything for you) can weaken the tissues and cause further damage. So if this is the first one in your wrist, and the doctor thinks it will help, go ahead and try it.

I am sorry to hear that you are having problems with you ankle... I just want to mention a few things about ankle anatomy that may help you figure out what is wrong. There is a big different between ligaments and tendons. Ligaments, the tissue that is repaired during a bronstrom, evans, or c-s procedure, are responsible for connecting bones to bones. They aid in stability, and an injury to them often results in localized pain and a feeling of "giving way". Examples of ligaments in the ankle are the anterior talofibular ligament (most commonly injusted), calcaneofibular ligament, posterior talofibular ligament, and the deltoid ligament. Tendons, on the other hand, connect bone to muscle, and an injury to them often presents as acute general pain in the area, and in old injuries, local pain during inactivity, and extreme weakness and general pain during activity. Complete ruptures can leave the connected muscle useless. Examples of tendons include the posterior tibial tendon, peroneal brevis and longus tendons, and the achilles tendon. Cortisone shots, which are just steroids injected directly into the site of pain, help to reduce the swelling around injured soft tissue. If the injury is not to soft tissue, or the pain is caused by something such as a hairline fracture, cartilege damage, or loose bodies, the shot may not help. I would also recommend an MRI so your doctor can pinpoint the exact source of your pain. Good luck!

The only thing I would add -- If the doctor wont give you an MRI or discuss the possibility of surgery. I would get a second opinion. Not saying that surgery is the answer (that decision should not be made lightly), but you do want a doctor that is looking at all of your options.

Hi--

Welcome to the ankle injury fraternity!

I just had ankle surgery, and I am hoping for a good outcome. An MRI is a good idea, but my Orthropedic surgeon suggested that he could have told that I would probably need surgery from the stress Xray. I probably should have gotten a second opinion, but I really couldn't walk much of the time and kept reinjurying my ankle (6 resprains in 4 weeks)

As far as I can tell (and I did a bunch of medline and internet research) 80% to 90% of patients who have ankle reconstruction surgery feel that they had a good to excellent outcome. And thatis one of the reasons I went ahead and did this.

The other reason I had surgery is that no one seemed to have any other options--rehab therapy wasn't working for me at all (I didn't seem to have problems with proprioception and had good ankle strength etc), I managed to sprain my ankle while wearing a brace, my OS didn't think that casting would help.

I was feeling pretty hopeless from all of this, and it sounds like you do too, and I really understand and I am sorry.

It isn't unreasonable to try to push your Dr. to come up with some sort of treatment plan for you.

Did you have PT for your ankle? Do you ice it (I love ice)? 4 months is a long time.

The folks here have been unbelievably kind to me and I found this to be a really great place for information and support. I am a professional researcher, and there is a ton of information out there about ankle surgery etc, but this is the best place I have found for people really telling you how it is and I feel really grateful for this board.

Good luck, and if there is anything I can do, or a question I can answer, please let me know.

Rose (isarose)

Hello. I'm back. I went for my follow up appointment yesterday with my doctor and he is going on to the next step--a bone scan. Whats that like?? I've never had one. He said I'm 95% sure that I'm going to end up needing surgery--he is thinking that I have injured the ATF (??)
He also wants to do another cortisone shot shot next week when I see him--I'm a little leary of that but at the same time I don't want to "refuse" the shot because this is a workmans comp case and I don't want to mess anything up.
Anyways, can anyone tell me about this particular surgery and what I should expect?? I'm a teacher and I'm curious how long the recovery time will be--meaning how much time will I miss from work?? Is this surgery done on an outpatient basis?? Will I need to stay over night??

Thanks,
Cindy

Hi Cindy--

An ATF is one of the ligaments in your ankle. I have just had surgery to repair two ligaments. There are several types of surgery. The simplest repairs the ligament by tightening it up. The other kinds, including the one I had, are more complicated.

This is going to sound weird but this is what my doctor did:

My doctor took a tendon from my leg and then drilled some little holes into the bones around my ankle and then threaded the tendon in place to substitute for the ligaments so my ankle will not invert anymore.

My surgery was three weeks ago and was done outpatient, although I could have stayed in the hospital overnight if I wanted to because of pain, or complications. I however, believe in the healing power of cat hair (I have three cats) so I had to get home :)

The first week I had a splint and couldn't bear any weight on it. It was pretty painful and I was pretty out of it from the drugs. My doctor was pretty liberal with the percocet, which works better for me than the vicodin. My husband stayed home with me that whole week, and I am very grateful for that as I am not very good on crutches. But the first week was definitely the worst.

For the last 2 weeks, I have had a cast, and was told to walk to tolerance. I am finding that I am definitely getting better everyday. I had some problems with the cast (the back flattened out and the cast became too tight and was awful), but I am only taking pain pills (1 or 2) at night now, and am up cooking some meals/doing some chores as opposed to in bed all the time. I still am icing. I am also having a very hard time sleeping with a cast. I hate being in a cast.

In 10 days, they will put me in a removable cast and I start PT again. From everything I have read about this, I think my Doctor has me on a pretty aggressive schedule as far as up walking, PT etc.

I am self-employed, and I plan to return to work starting tomorrow. I still keep my let up whenever I am sitting down, but it doesn't really hurt unless I overuse it. Oh and it itches under the cast like crazy

Because I am only 1/2 way through this whole process, I can't give you the full story but if my ankle stops spraining (I even managed to resprain my ankle wearing a brace!) and I can go back to walking to do my errands, and taking the bus instead of driving, I will be very satisfied with this.

I was very scared about the whole process, but I am at this point glad I went through it.

Good Luck, and please let me know how it goes.

all best,

Rose (isarose)

Hi, I'm new here too. I would suggest looking into prolotherapy. I had carpal tunnel sydrome in both hands/wrists. Had surgery in both. Came back, also ended up with ulnar nerve problems in my elbows. My dr. gave me several prolo shots, which are basically a dextrose and glycerin that are injected where muscle connects to the bone at the injured area, which is usually torn and/or frayed causing the pain. The prolo inflames the injected area, causing your body to heal itself and deposit new collagen which ultimatly strengthens the ligaments.
It did wonders for me. I am now getting them in my back. I have a good dr. that is experienced in giving and getting prolo injections. It can be rather costly, as most insurances do not cover prolotherapy. I read where a woman did research and documented it and sent it to her insurance company and she said they then covered it after seeing the documents. Most reports are on how fast prolo works and how it builds strong ligaments without costly surgery.

Maybe research it, and if it sounds like something you might try, discuss it with your dr.. Hope this helps you.

Welcome Cindy!
We have all had our "great" experiences with ankle injuries and surgeries! So this is the place to be if you have any questions!
I tore my ATFL and CFL 2 years ago and had 2 surgeries to repair them. My last one was in May of this year. Like EKO, I also had a Brostrom. Now, 5 months later I'm still having some pain but not like I had before.
But I went though several treatments for about 6 months before I had my first surgery. My OS said that it's best to try different therapies before undergoing surgery. Have you tried PT?
I never had cortosone shots in my ankle. My doctor didn't want to try that. But I have had them in my other foot for Plantar Faciitis (sp? early in the morning!) It worked for a while, but I kept having to go back in to have more. I finally just tried orthotics and that worked.
Good luck on the bone scan. I never had a bone scan because my OS said that it doesn't show soft tissue injuries. I had an MRI instead.
Good luck and let us know how it goes.
Karen :)