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      10-06-2010, 01:57 PM   #1
Heinzftw
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Ankle Sprain

So long story short semi hammered jumped a flight of stairs thought my ankle was for sure broken. Trip to the ER, severe sprain. It is now 3-4 weeks later and I now have an ankle brace for when I workout. But, I start up morning PT this friday again and am very worried. (Army Rotc @ school)
Haven't ran at all for obvious reasons just been doing upper body and arms lately. Anyone have any recommendations?
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      10-10-2010, 05:53 PM   #2
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Originally Posted by Heinzftw View Post
So long story short semi hammered jumped a flight of stairs thought my ankle was for sure broken. Trip to the ER, severe sprain. It is now 3-4 weeks later and I now have an ankle brace for when I workout. But, I start up morning PT this friday again and am very worried. (Army Rotc @ school)
Haven't ran at all for obvious reasons just been doing upper body and arms lately. Anyone have any recommendations?
How old are you?

Back in my "youth" as a 30 yr old I had a grade 2-3 sprain of my ankle. First time I ever heard the dreaded "popping" sound that can be heard/felt when a tendon completely ruptures. I've always been active, still am, so I've had my share of injuries but that was the most painful, longest recovery I ever experienced. Someone rolled into my lower leg while playing flag football.

Injury happened in early September and I was not able to play the rest of the year. The ankle was weak for about 6 months and painful for an entire year after. 15 yrs later and it still occassionally hurts and is noticeably less flexible than the uninjured one.

Sorry for the bad news. Maybe you'll heal faster than I did.

Now for the good news:

I was able to squat and deadlift about 1 month after the injury. Yeah it hurt like hell but the Doc told me I couldn't further injure it since the two tendons were already torn. Just try your best to control the swelling to help limit possible calcification. Bottom line is that you are unlikely to injure it more considering that it sounds like you already tore 1 or 2 of the three major tendons.

You can probably return to full body workouts (except for any calf work) but your mobility will probably be severely compromised for several more months yet.

Sorry.
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      10-10-2010, 06:32 PM   #3
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sick call...profile.../thread
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      10-10-2010, 08:12 PM   #4
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Torn tendons heal. It takes time. Months. After 3 months, it should be healed enough to jog. It may be "lax" and hyper mobile, so will have a tendency to resprain easily. Wear an ankle elastic wrap to help strengthen.

Like this.
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      10-10-2010, 08:21 PM   #5
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Some ankle sprains can take a while to heal. The key is to ease into your therapy and not push it. Bottom line is you torn one or more ligaments, which, take time to heal. I would continue to ice, especially after working out and/or physical therapy. You should be concentrating on strength of the entire ankle joint. Not just calf raises. You need to build up the muscles on the inside and outside of the ankle joint. This is typically not done with everyday weight training. Therabands, those colored "rubber bands," are an excellent choice. Your therapist should be able to give you some to use at home. Work on inversion and eversion (moving the ankle out and in). An ankle brace will def help but some of the over the counter ones are garbage. I would look into something that provides more support. Again, your therapist should be able to point you in the right direction. Hope this helps! It will get better over time, just be patient. Easier said than done, i know!
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      10-12-2010, 10:35 AM   #6
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It is definitely gonna hurt, but if you are just running straight you shouldnt be too bad. If you go from no activity at all to trying to make sharp cuts by planting that foot thats when you will start to slow the healing process and possibly re-injure it.
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      10-13-2010, 02:36 AM   #7
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PT went suprisingly well the other morning. Mostly just sprints and circuit training, but damn it sure hurts to go in push up position due to the position my ankle is in even with my brace. Will battle through it and hopefully be back to optimum health in no time!
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      10-13-2010, 07:13 PM   #8
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Quote:
Originally Posted by J BONE View Post
Some ankle sprains can take a while to heal. The key is to ease into your therapy and not push it. Bottom line is you torn one or more ligaments, which, take time to heal. I would continue to ice, especially after working out and/or physical therapy. You should be concentrating on strength of the entire ankle joint. Not just calf raises. You need to build up the muscles on the inside and outside of the ankle joint. This is typically not done with everyday weight training. Therabands, those colored "rubber bands," are an excellent choice. Your therapist should be able to give you some to use at home. Work on inversion and eversion (moving the ankle out and in). An ankle brace will def help but some of the over the counter ones are garbage. I would look into something that provides more support. Again, your therapist should be able to point you in the right direction. Hope this helps! It will get better over time, just be patient. Easier said than done, i know!
Excellent advice. Prior service physical therapy tech and this is in the right direction of what you need to do. Motion is lotion as we used to say so don't baby that ankle. Get it moving and work on your range of motion (ROM) as well as incorporate the band exercises mentioned above. Not knowing what or which tendons you have torn it is hard to give exact instructions. I too would go see your "DOC" physical therapist if you have one to better get you back on track and not injure yourself anymore than necessary because you did something stupid like running too soon. It will take time to heal but the therapist can get x-rays to determine healing as well as follow up examinations. Go get seen as soon as possible. Hope you get better.
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      12-01-2010, 12:54 AM   #9
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What does physical therapy involve? Should you overcome slight pain remaining in the tendons or wait until its completely gone and start training?
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      02-06-2011, 06:35 PM   #10
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Quote:
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Excellent advice. Prior service physical therapy tech and this is in the right direction of what you need to do. Motion is lotion as we used to say so don't baby that ankle. Get it moving and work on your range of motion (ROM) as well as incorporate the band exercises mentioned above. Not knowing what or which tendons you have torn it is hard to give exact instructions. I too would go see your "DOC" physical therapist if you have one to better get you back on track and not injure yourself anymore than necessary because you did something stupid like running too soon. It will take time to heal but the therapist can get x-rays to determine healing as well as follow up examinations. Go get seen as soon as possible. Hope you get better.
See an orthopod.

Xrays won't tell you anything about tissue unless its swollen, xrays are usually for bone or air/fluid levels.
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      02-06-2011, 11:13 PM   #11
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Before I left for Iraq I had a medial ankle sprain (and a sprained wrist) during our final Fall League Soccer game. I eventually went to the doctor and x-rays were negative. He told me to get Motrin (Ibuprofen or generic brand didnt matter) to help with the internal swelling (apparently there is still swelling present even if you cannot see it...LOL) and gave me a special ankle brace:


He said that the ACE bandages are decent for general extra support but that for a bad ankle sprain you need something that immobilizes the lateral movement of the ankle. A partial tear cannot heal properly without that support..you are just restraining the ligament. This injury happened in Late October and it is now February and the ankle is still not even 85%
Longest injury I have EVER had to deal with and it scares me that I may not be able to run, play soccer or basketball at the level I did before. What do you guys think?

BTW I am in Iraq now and getting any type of real medical attention (contractor) is a PITA.
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      02-06-2011, 11:32 PM   #12
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remember that immobilization is good while healing and initial training, but the goal is to return you to your prior level of function. Meaning without the brace. Aside from strengthening, your PT should also have some balance and proprioceptive training incorporated into your exercise program. Proprioceptive receptors are almost always compromised as well when an ankle sprain is incurred. Without the ability to feel where your foot and ankle are in relation to your body your muscles won't be able to react and prevent another ankle sprain (most likely plantarflexion-inversion/toes down and in). Also, when working said therabands, do not go to your end range initially. At least that's what I do with my patients. Work mid range and in a pain free range. Allow your muscled and proprioceptors to know where your midrange is, it's already been taken to end range and most likely beyond that.

If PT doesn't seem to improve your mobility and stability after 4-6 weeks I would suggest the MRI and for sure an orthopedic consult, one that specializes with ankle injuries, I'm not a fan of podiatrists, never recc them and I'm not going to start now. As stated earlier, X-rays only show bone and joint integrity, and MRI will show soft tissue integrity where in this case tendons, ligaments, and muscles. If there is some sort of soft tissue integrity trauma, most likely you'll find yourself in a walking boot for a few weeks then will resume PT again, but at least you'll have the proper papers to excuse you from any high level physical activity required by ROTC. Most tissues tend to heal in about 4-6 weeks with rest and some type of immobilization. Weight bearing joints, like the ankle, can take a bit longer and you can continue to have intermittent swelling. I've seen some ankles swell off and on for up to 1 year.

Good luck with your rehab and hopefully you return to your full prior level of funtion
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      02-06-2011, 11:42 PM   #13
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This is the shitty part about being in the military. I was in iraq, and got run over, I fractured my skull and had to get my head stapled shut. I got medivac'ed and all that good stuff. I got to LRMC, and had to battle with my doctor (whatever the navy's 0-5 is) to get off 800mg ibuprofin and upgraded to 325mg percocet. My skull was broken, and they were telling my to buy otc pain killers.

Get a profile, LLD, waiver, whatever the army calls it.
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      02-06-2011, 11:55 PM   #14
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Quote:
Originally Posted by geneatals View Post
Aside from strengthening, your PT should also have some balance and proprioceptive training incorporated into your exercise program. Proprioceptive receptors are almost always compromised as well when an ankle sprain is incurred. Without the ability to feel where your foot and ankle are in relation to your body your muscles won't be able to react and prevent another ankle sprain (most likely plantarflexion-inversion/toes down and in). Also, when working said therabands, do not go to your end range initially. At least that's what I do with my patients. Work mid range and in a pain free range. Allow your muscled and proprioceptors to know where your midrange is, it's already been taken to end range and most likely beyond that.

If PT doesn't seem to improve your mobility and stability after 4-6 weeks I would suggest the MRI and for sure an orthopedic consult, one that specializes with ankle injuries, I'm not a fan of podiatrists, never recc them and I'm not going to start now.
Any online resources for specific guidance when it comes to these theraband exercises? My doctor also told me that a MRI might become necessary if it does not seem to get any better after anti-inflammatory's, bracing, and rest.....
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      02-07-2011, 12:03 AM   #15
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Any online resources for specific guidance when it comes to these theraband exercises? My doctor also told me that a MRI might become necessary if it does not seem to get any better after anti-inflammatory's, bracing, and rest.....
a quick google search should get you some good pics, I've even watched a few vids on youtube...

here's one I found pretty quick..

http://www.performanceorthopedics.co...AnkleRehab.pdf

it's pretty straight forward, there's only 4 directions the ankle is supposed to move...
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