Sunday, March 24, 2019

Still Can't Run 6 Months After An Ankle Sprain

R ankle
My last patient yesterday suffered an osteochondral injury in her right ankle last July after spraining her ankle while taking part in a trail running camp. Part of the reason may be wearing a new pair of shoes she wasn't used to.

Almost half a year later, she was still hoping to do a 50 km trail race earlier this month, but she definitely wasn't even ready to be running yet.

Many of her running friends and colleagues (she works in a hospital) can't believe an osteochondral injury can be that serious. In fact, some of the physiotherapists in her hospital don't even know what an osteochondral injury to her talus means. They definitely do not know how to treat her.

Hence, you have a runner who works in a hospital, yet comes to Sports Solutions to get treatment.  Just like the physiotherapist from another hospital who sees us after her microfracture surgery.

In the picture above, you can see where the talus is in the ankle. It is the bone that is below your tibial (shin bone). In the scenario where there is an injury to the articular cartilage (which lines the end of our bones to allow for load bearing and friction free movement), there will be both swelling and pain.

The main goal of non operative treatment is to allow the injured bone and articular cartilage to heal. Since articular cartilage has poor blood supply, this is not going to happen quickly.

Sometimes, crutches or a rocker boot may be necessary to take load off weight bearing. In severe cases, surgery is needed to ensure recovery. After three articles on the operative management on articular cartilage injuries, I think I've covered the topic enough. Just in case you're keen, drilling can be done like the picture you see below to stimulate healing.
Drilling is done
I've told my patient she can still volunteer at the race whether it's manning a water station, handing out medals or directing runners at checkpoints in the race. She can also lend support and cheer for her friends at the race. Meanwhile, she has also found "a distraction" or another way to motivate herself. She's been going to the gym regularly and her upper body is much more muscular than before.

I've told her to keep the long view in mind. If she wants to keep running for the rest of her life it's not worth risking it now. There will be other races for her in future definitely.

Have an osteochondral injury? Come see us in our clinics.

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