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Ankle instability.. What should I do ?


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Old 12-06-2008, 02:15 AM   #1
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Ankle instability.. What should I do ?

Hello everyone I am a 20 year old division 1 soccer player which is basically my life. In 2006 i badly sprained my ankle and didnt wait for recovery and since then i have had about 25 sprains. I got an MRI,xrays and the surgeon said that i dont have enough damage for surgery but i keep continually spraining it. Would you guys recommend going with PT or should i get the surgery. If i do surgery will i be able to play at normal level within 4 months and brace-less ? Im scared i will have no results with PT and end up losing money and time. what do you all recommend ?

 
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Old 12-06-2008, 09:02 PM   #2
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Re: Ankle instability.. What should I do ?

Do you have a Tarsal Coalition? If so, PT will not help you, only surgery. My step-daughter has this and just went through all of the options. She was told it would be a month NWB and a month in a boot. She is not having surgery yet, but was warned that waiting and continuing to turn the ankle is risking greater damage. With all the foot trouble I've had, I suggested she go ahead with the surgery and be done with it but she's just not ready to do it. She would have ligaments tightened which I would guess that's what they would do with you?

Given the fact that soccer is very important to you, and continuing to put it off could result in more devastating injury, I would have the surgery. Youth is in your favor so you should probably heal quickly.

emmie

Last edited by emmie54; 12-06-2008 at 09:05 PM.

 
Old 12-06-2008, 10:35 PM   #3
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Re: Ankle instability.. What should I do ?

I did some research and i think that is some sort of hereditary deffect correct ? Im sorry to hear you daughter has this problem and i hope all goes well. I have never had any problems before a couple years ago and the doctor saw xrays and MRI's and said there wasnt significant damage which is weird because i have sprained it 25-302 times. It doesnt even swell anymore when i sprain it and it takes maybe 3-5 days and its painless again. I can go weeks of soccer games without spraining it and all of a sudden it happends again which is so depressing. After having surgery do you know if people can continue back to activities at the rate they were before or is that rare or are we doomed for life ?

 
Old 12-07-2008, 08:17 PM   #4
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Re: Ankle instability.. What should I do ?

The usual surgical treatment for instability is what's called a Brostrum repair. If the ligaments are too long, the surgeon shortens them. Most people who've had it are much better afterwards. However, if the ligaments aren't too loose, there's no point.

You will absolutely not be playing soccer 4 months after a Brostrum, or any other ligament repair. Walking, sure. Running and dodging on grass? Try 6-12 months.

Try the PT for a month or two. See what happens. Rest the ankle for a while. The idea is, the ligaments need to tighten up, which they won't if you're constantly running on the foot. If the PT doesn't seem to help, or if you continue to have problems, see an orthopedist who is a board-certified foot and ankle surgeon.

I had dreadful ankle problems for months and months, eventually it got to the point that I could barely walk at all. I had an MRI, first doctor said the MRI was normal, but then the surgeon who eventually treated me looked at the film and found evidence of a problem. My problem turned out to be something called anterior impingement syndrome, a key symptom is pain when squatting. I was lucky, it was repaired with a very easy surgery and I was basically fine 2 months later.

And GET A BRACE so you don't have any more sprains. With or without surgery, you might want to wear a brace every game from now on. Something light, that you can move in, but, support is your friend.

 
Old 01-22-2009, 02:49 AM   #5
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Re: Ankle Impingement

I have recently been diagnosed with anterior ankle impingement. After seeing many doctors, PT's and chiropractors I researched my ankle issues and informed the doctor that I may have impingement. After an MRI, my theory was right. I received a cortisone injection which helped and made my ankle finally feel "normal" again. The problem is that it only worked for 2 days. I have had 2 more cortisone shots and they didnt help all that much.
I play professional ice hockey in Europe and this injury impedes my play, as I have trouble with dorsiflexion and stability. I am going to have arthroscopic surgery at the end of the season, but I am wondering if there is anything I can do in the meantime to help decrease the inflammation in the joint. Is there any alternative treatment besides joint mobilisation and rest?

Regards,
Chris

 
Old 01-22-2009, 07:21 AM   #6
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Re: Ankle instability.. What should I do ?

There aren't a whole lot of other options. Ice and elevate every day, that'll decrease the swelling. Try to make sure the skate isn't pressing on the lesion. Don't get any more cortisone shots, it might weaken something important, like the ligaments holding your foot and leg together.

For stability, careful exercises can help strengthen the muscles around the ankle, and teach your body to balance properly.

Oh, yes, you could also try a topical anti-inflammatory creme. You might need a prescription.

Last edited by janewhite1; 01-22-2009 at 07:22 AM.

 
Old 01-23-2009, 10:42 AM   #7
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Re: Ankle instability.. What should I do ?

Thanks for the reply. The PT's here in Europe do not recommend ice. They say I should have heat to circulate good blood throughout the ankle. I have always thought ice as well to decrease the inflammation. I had a homeopathic injection today and acupuncture last night. It helps a little, but after one hard practice, the joint is usually stiff again.

 
Old 01-23-2009, 04:26 PM   #8
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Re: Ankle instability.. What should I do ?

For some problems, maybe heat is best, but a huge part of anterolateral impingement syndrome is swelling. Icing after practice could help a lot.

 
Old 01-23-2009, 04:39 PM   #9
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Re: Ankle instability.. What should I do ?

Should I apply heat prior to playing?

 
Old 01-23-2009, 07:38 PM   #10
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Re: Ankle instability.. What should I do ?

Try it and see if it works. For me, the MRI missed it. By the time I was diagnosed, my condition was so bad that sports of any kind were out of the question, and I needed a cane just to leave my apartment.

 
Old 01-24-2009, 07:13 AM   #11
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Re: Ankle instability.. What should I do ?

One more question.....how do I know where the lesion actually is?
Thanks you very much for the help, I really appreciate it. I really thought it was all in my head for a while, and I think every PT, Ortho and Chiro I saw thought the same.

Chris

 
Old 01-25-2009, 09:44 AM   #12
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Re: Ankle instability.. What should I do ?

I was actually able to see a tiny swollen spot leaning up against the lateral malleolus, the bone. I asked the doctor, she said it was a normal fat pad. I said, "How come I don't have one on the other foot, and I didn't have it here before?"

She didn't really have an answer for that.

Mine was about 2 o'clock if you were looking at the foot from the side. Less than 2 weeks after my surgery, when the splint came off, I could already tell it was gone.

 
Old 01-26-2009, 02:38 PM   #13
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Re: Ankle instability.. What should I do ?

I am sorry to be asking so many questions, but I feel like someone finally understands my injury. I have been dealing with this injury for about 5 yrs. How did the meniscoid lesion feel with everyday usage of your foot? Did you have specific stiffness just on the outside of the ankle joint or was it the whole anterior section? Did your impingement/mensicoid lesion cause pronation?

Thanks,
Chris

 
Old 01-26-2009, 07:39 PM   #14
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Re: Ankle instability.. What should I do ?

How did it feel? Well, on the really bad days, I could hardly move my ankle at all. The lesion swelled up to the point that the joint just didn't have any space to move more than about 10 degrees up and down.

On the kinda-bad days, I could walk for a few minutes at a time without pain as long as I didn't pronate or supinate at all. I also couldn't descend stairs normally, because I couldn't dorsiflex that far.

I learned to walk with my right foot held stiff from the knee down. I learned to descend stairs with my ankle stiff by rocking off the edge of the step on my heel. After I had the surgery, I had to learn to walk normally all over again. And my peroneal muscles still get stiff sometimes, since I abused them so badly.

On the better days, say maybe a year before my surgery, I could walk all right, but I had discomfort running, walking on uneven ground, or wearing footwear that pinched me near the lesion.

From my last ankle sprain 16 months before my surgery on, I never had 100% dorsiflexion or plantarflexion.

Believe me, I am glad to share.

 
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