Rolled ankle injury ;)

[_Simon_]

I have never had a doctor tell me this. Staying off the foot makes the pain worse? So what about the pain you were feeling when you were walking around on it, and it got bad enough to go see the doctor?

Sometimes I wonder about doctors. I went to one because of really bad back pains. I literally had trouble walking and the pain would bring me to my knees. The doctor was a specialist and he told me that I had a degenerative spine disease and that's what was causing my pain. He said I would need surgery in order to provide relief. One night my back got so bad that I slept on the floor and woke up feeling better, so I bought a new mattress and the back pain went away. Turns out my mattress was the cause of the pain.

Sometimes I think doctors get into their little boxes so much that it doesn't occur to them that something else may be going on other than what's in their specialty knowledge

I think it was a matter of that my foot had already pretty much healed, but I was still keeping it motionless for too long after. So it'll just stiffen up and get more painful as it needed rehab. I think initially I needed to keep off it, but after a certain amount of time it's a bit detrimental. Of which, I was not aware that it was at that point and now okay to start working it more. So it's really unfortunate.. but hopefully now I can get some relief.

Ah wow... yeah it's a tricky one. I'm sure there are many misdiagnoses (like I'vealready experienced before), but there are so many variables to take into account it's hard to pinpoint it just with one modality I reckon. In my case with the pelvic pain issues, all of their diagnoses were what they were trained in, so it's all they knew. There was no collaboration between the hospital and pelvic pain clinics so there was just no scope for looking outside the box.

 

[_Simon_]

You don't really need a repeat CT. How long it takes to heal isn't really all that variable. Especially if they're saying it wasn't really a fracture to being with.



If it's still not back to baseline, you should keep it.

Ah okay fair enough. Yeah they weren't 100% about the fracture. Definitely a partially torn ligament, but who knows if that's fully healed..

I'll still keep the appointment (it's actually in their physiotherapy clinic at the hospital, which I'm not sure if the osteo specialists are a part of...)

 

[Dirty Dog]

I have never had a doctor tell me this. Staying off the foot makes the pain worse?

Sure it does. Take a perfectly fine joint and immobilize it for just a few hours. See how stiff it can get? Now immobilize it for weeks. Ouchy.
That's why casts and such are removed as early as possible. The bone is not fully healed, but it's healed enough to start using it again.

 

[_Simon_]

Sure it does. Take a perfectly fine joint and immobilize it for just a few hours. See how stiff it can get? Now immobilize it for weeks. Ouchy.
That's why casts and such are removed as early as possible. The bone is not fully healed, but it's healed enough to start using it again.

Ahhh, that's good to know. Just flexing and extending my foot now and it trembles like crazy XD (about 4 weeks on crutches). Just gotta make sure to not overdo it.

Ah and my physio appointment is with a karate-ka who I used to train with many years ago! He's still with my old style I used to train in. So he's the perfect person for a martial arts related injury, looking forward to it

 

[JowGaWolf]

Just flexing and extending my foot now and it trembles like crazy

If you can, massage your foot before you start exercising it. It doesn't have to be a rough massage, just enough to help get blood flowing in that area.

 

[_Simon_]

If you can, massage your foot before you start exercising it. It doesn't have to be a rough massage, just enough to help get blood flowing in that area.

Great idea, cheers mate. Also been massaging the calf as well. Range of motion is shocking, it all feels so stiff...

 

[Gerry Seymour]

I think it was a matter of that my foot had already pretty much healed, but I was still keeping it motionless for too long after. So it'll just stiffen up and get more painful as it needed rehab. I think initially I needed to keep off it, but after a certain amount of time it's a bit detrimental. Of which, I was not aware that it was at that point and now okay to start working it more. So it's really unfortunate.. but hopefully now I can get some relief.

Ah wow... yeah it's a tricky one. I'm sure there are many misdiagnoses (like I'vealready experienced before), but there are so many variables to take into account it's hard to pinpoint it just with one modality I reckon. In my case with the pelvic pain issues, all of their diagnoses were what they were trained in, so it's all they knew. There was no collaboration between the hospital and pelvic pain clinics so there was just no scope for looking outside the box.

I honestly don't know which is more frustrating your misdiagnosis or the one I had a few years ago, where a GP at urgent care failed to diagnose a break. He had me walking on it (no crutches or anything) and it kept getting worse. Two weeks walking on it, through airports, carrying luggage, etc., then they put me on crutches and referred to an ortho. Two weeks on crutches, the ortho takes one look at the X-ray, grabs my ankle right where it hurt, and I said, "Ow."

"Yep, that's broken." Shortest doctor visit I've ever had.

 

[Gerry Seymour]

Ah okay fair enough. Yeah they weren't 100% about the fracture. Definitely a partially torn ligament, but who knows if that's fully healed..

I'll still keep the appointment (it's actually in their physiotherapy clinic at the hospital, which I'm not sure if the osteo specialists are a part of...)

From what my PT told me when I was rehabbing a deeply torn muscle, part of the healing requires some irritation of the tissue. I don't understand it very well (I keep meaning to spend some time researching that), but my tear healed much faster once I was using it the right way a few times a week.

 

[Gerry Seymour]

Great idea, cheers mate. Also been massaging the calf as well. Range of motion is shocking, it all feels so stiff...

I hadn't had an interaction with a PT much until a couple of years ago. Now, if an injury puts something out of use for a bit, I go running to my PT to find out what I can safely do while not using that limb normally, and what I should do to restore ROM when I'm cleared.

 

[_Simon_]

I honestly don't know which is more frustrating your misdiagnosis or the one I had a few years ago, where a GP at urgent care failed to diagnose a break. He had me walking on it (no crutches or anything) and it kept getting worse. Two weeks walking on it, through airports, carrying luggage, etc., then they put me on crutches and referred to an ortho. Two weeks on crutches, the ortho takes one look at the X-ray, grabs my ankle right where it hurt, and I said, "Ow."

"Yep, that's broken." Shortest doctor visit I've ever had.

Oh wow that'd be incredibly frustrating..

And yeah I still at this stage have no idea if I even had or still have a fracture, if it's healed, if my ligament has healed... Just gonna see how physio goes..

From what my PT told me when I was rehabbing a deeply torn muscle, part of the healing requires some irritation of the tissue. I don't understand it very well (I keep meaning to spend some time researching that), but my tear healed much faster once I was using it the right way a few times a week.

Ah that sounds interesting.. I guess when the muscle etc is reminded of its function it can repair a bit quicker..? Without overdoing it obviously..

I hadn't had an interaction with a PT much until a couple of years ago. Now, if an injury puts something out of use for a bit, I go running to my PT to find out what I can safely do while not using that limb normally, and what I should do to restore ROM when I'm cleared.

Yeah for sure, and their specialty is in rehabilitating so they'd understand what it takes to get back to normal function. So I'm looking forward to getting physio and moving on. It's just been too long now... I'm thoroughly done haha...

 

[JR 137]

From what my PT told me when I was rehabbing a deeply torn muscle, part of the healing requires some irritation of the tissue. I don't understand it very well (I keep meaning to spend some time researching that), but my tear healed much faster once I was using it the right way a few times a week.

Several different reasons why using it will speed up the process...

Disuse atrophy sets in. If muscles aren’t being used, they break down. Like a bodybuilder stopping lifting, he loses muscle mass, or if someone’s arm is in a cast guard while, that arm will be smaller. Use it or lose it philosophy. Bone density too, only not as much; and weight bearing bones not carrying weight will have the effect more, obviously. Bone density is probably the lowest on the list though.

Nerve function. The longer something’s not being used, the less efficient nerve function. The chemical mediators in the inflammatory process also block some nerve function, so getting those out helps.

Scar tissue and tissue remodeling. The body heals tissues by laying down scar tissue (collagen 1). The body overdoes it, and scar tissue is thick, inelastic, and the fibers are in a random pattern. Proper stress on the structure speeds up turning the scar tissue (collagen 1) into functional tissue (collagen 3). The fibers line up to the stress lines and become appropriately elastic, and turn into the correct tissue faster.

Having done PT for your bicep (that’s the muscle you tore, correct?), the PTs probably did friction/cross friction massage at some point. Rubbing the hell out of it and irritating it pretty good. It does several things - most notably helps break up the excess scar tissue, and increases local blood flow to bring nutrients in and get rid of garbage.

I’ve found of the most important things to do in an ankle injury rehab is balance work. Forcing the nerves to fire properly helps immediately and for the long term. Studies have shown the quicker the patient starts (appropriate) balance work in ankle injuries, the less susceptible to reinjury later on. Sometimes clinicians focus too much on ROM and strengthening early on; I did too until I read the research and started implementing it more. My athletes typically got better and game-ready faster and stayed injury free longer. Not drastically, but definitely more than enough to say so.

 

[Gerry Seymour]

Scar tissue and tissue remodeling. The body heals tissues by laying down scar tissue (collagen 1). The body overdoes it, and scar tissue is thick, inelastic, and the fibers are in a random pattern. Proper stress on the structure speeds up turning the scar tissue (collagen 1) into functional tissue (collagen 3). The fibers line up to the stress lines and become appropriately elastic, and turn into the correct tissue faster.

This was the part the PT discussed. Thanks for filling in the blanks in my memory!

EDIT: I forgot to reply to the other part - it was a forearm muscle, but yes they did that hard, painful massage with something that looked like a bit out of the scrap bin in my workshop. It worked wonders, and I hated it.

 

[JR 137]

This was the part the PT discussed. Thanks for filling in the blanks in my memory!

EDIT: I forgot to reply to the other part - it was a forearm muscle, but yes they did that hard, painful massage with something that looked like a bit out of the scrap bin in my workshop. It worked wonders, and I hated it.

I used to use the eraser end of a fat pencil. It worked just as well as anything fancy, and kept it low-class like myself

My mentor in college was very big on cross-friction massage. I think he enjoyed the torture as much as the results. Actually, I’m pretty sure he enjoyed the torture more than anything else. Because I did it so much as an undergrad, I became the go-to cross-friction guy in every training room I subsequently worked in. That and “milking massage” which is fancy for squeezing the swelling out of the joint. Most of my colleagues came to me to do that to their athletes too. They always tried, usually failed, and then said “JR will get it out.”

My athletes hated both of those, but they figured out the method to my madness when I was done.

 

[jobo]

So, yet another twist (feeling like a dramatic soap opera now!)...

I'll skippity skip through. Have been waiting around for the hospital to contact me. Didn't hear back so went back to docs, she put through urgent referral. Got a letter to make appointment, I called, soonest appointment was 4 weeks, which was too long a wait.

Went to emergency as the doc said I need a cast on, and if I couldn't get in soon to just go to emergency. Did that tonight.

VERY busy in emergency... after a 4 hour wait, I chatted with the doc. He went to discuss with some orthopedic doctors, and he basically told me that I won't need a cast at all.

!

He said perhaps when I first got the injury I may have, but at this point he thinks it's definitely healed, and that I should be using it as much as possible. Working on range of motion and that I should do physio. Further to that, he called back later and the orthopedic docs he spoke to (after looking at my CT scan results again) weren't even convinced that I HAD a fracture.

...

Needless to say... we were at first quite disenchanted... and p***ed off.. The initial doctor really said that I'd definitely need a cast, and that I did indeed have a fracture, yet this doctor was saying that's not the case and that I should have been working on rehabbing it.

After asking why my pain had been getting worse, the doc at the hospital even said that it would have made the pain worse by not using the foot at all, that keeping off it was making it worse.

So even though we were quite angry as I could have been rehabbing it months ago probably, I feel relieved. It means I can start moving again, get back into working, and also start training properly again, which is awesome. It's just been an incredibly challenging and painful few months.. and I had already mentally prepared myself that I would have another 6 weeks or so of being at home, and further to that not being able to drive.

So will call a physio tomorrow and go from there. Isn't the first time there's been a miscommunication or misinformation, but everyone is only going off what they know and doing their best, so will try to move forward and slowly ease into rehabbing.

*exhausted*

isn't that what I told you right at the begining of this thread, the longer you avoid the pain the worst it will get,,,work the flamming thing //+

 

[Gerry Seymour]

isn't that what I told you right at the begining of this thread, the longer you avoid the pain the worst it will get,,,work the flamming thing //+

The right answer, but mostly for the wrong reasons.

 

[_Simon_]

isn't that what I told you right at the begining of this thread, the longer you avoid the pain the worst it will get,,,work the flamming thing //+

Hehe.. it was first assumed that I had a fracture, in which case it's not the best idea to work it or put weight on it. That sucker needs to heal! So it wouldn't have been the best idea at the start.

Now we're at the stage where I either never had a fracture or it healed up, and I can start working it again. (I'm still confused as to what's going on if I'm honest...)

If it was only the partially torn ligament I'm not sure what the recommended course of action would have been.

 

[jobo]

Hehe.. it was first assumed that I had a fracture, in which case it's not the best idea to work it or put weight on it. That sucker needs to heal! So it wouldn't have been the best idea at the start.

Now we're at the stage where I either never had a fracture or it healed up, and I can start working it again. (I'm still confused as to what's going on if I'm honest...)

If it was only the partially torn ligament I'm not sure what the recommended course of action would have been.

by the time we had our chat, it was always going to be at least partly healed, if you had one at all
the treatment for a partially torn ligament, ? plenty of movement to get good blood flow and stop the joint from seizing up and having muscle wastages,

 

[_Simon_]

I’ve found of the most important things to do in an ankle injury rehab is balance work. Forcing the nerves to fire properly helps immediately and for the long term. Studies have shown the quicker the patient starts (appropriate) balance work in ankle injuries, the less susceptible to reinjury later on. Sometimes clinicians focus too much on ROM and strengthening early on; I did too until I read the research and started implementing it more. My athletes typically got better and game-ready faster and stayed injury free longer. Not drastically, but definitely more than enough to say so.

Ah right that's super helpful, yeah will see what the physio gets me working on, but will definitely incorporate some balance work. How about 100 left leg mae geris hehe

 

[_Simon_]

by the time we had our chat, it was always going to be at least partly healed, if you had one at all
the treatment for a partially torn ligament, ? plenty of movement to get good blood flow and stop the joint from seizing up and having muscle wastages,

Yeah true, I just didn't know the extent of the injury and the appropriate way forward. Doc tells me it's a fracture (which she did) I'm going to trust them (which from now I'll try to get a second opinion or specialist opinion). Will now be rehabbing it (physio starts tomorrow) and putting more weight on it. Cheers

 

[_Simon_]

Had first physio session today (had to be moved from yesterday), it went so, so well . Have an incredibly knowledgable physio, he basically told me to throw my crutches away haha! He said that absolutely my fracture would have healed, and that for sure he would have had me doing physio ages ago. He also said about docs not always knowing much about the muscular side of things so often just seeing something and putting them in a cast.

He tested out my ligament/tendon strength and he was really happy with them. My ROM is lacking obviously. So just need to work on getting more range of motion, strength and stability. He's really excited to work with me and he's gonna tailor our work together in a martial-arts based way to get me back to training, so even throwing kicks etc. I am so darn looking forward to it...

And I can walk again . Such a weird feeling...

Have got some exercises to do every day (include a balance/proprioception one) and seeing him next week. So happy and incredibly relieved...