All things ankle related (turns, twists, sprains etc)

[Fiona-Jane]

i have one like THIS it does a pretty good job although as i got my orthotics from the podiatrist and the brace from the orthotic people i couldnt have the orthotic insole built into the brace- i have to wear it in addition to it which isnt too comfy but i know now that once either brace or insole dies i should just go to the orthotic people for both.

my left ankle is so unstable that it rolls inwards almost to the floor and i dislocate bones often.... i was initally given a brace with a plastic spica but i broke it on my first test stand in the office with the orthotic lady... it took 4 attempts to give me this one, and each one had a 6 week wait for it to come into stock so i had my foot held together with tape and cohesive bandage for most of this year, sooo glad this brace works!

fi xx

[trekster]

Cheers fi, good luck sheepy with the orthotics specialist.

[Jooolz]

I have a problem I would like your views on >.....
a couple of years ago I had an operation on my L ankle to stabilise it ( and clear it out) after a fall - The ankle was in a walking boot thing instead of plaster for about 9 months before they finally operated ( private op) .

I have fallen again after I turned my L ankle - just because of instability... didnt trip - but turned ankle both ways fully - went to a & e and was told they could see an avulsion fracture - compared xrays from 2008 ( pre op) and doc 1 says he couldnt see it on those xrays so it was a new fracture. Backslab plaster on it dont walk on it - use wheel chair etc

Saw doc 2 next day and he said he could see it in previous xrays and so it was an old fracture and i have just got soft tissue damage- put leg in boot again ( couldnt give me crutches as shoulders would dislocate) so said i need to go to physio asap... waiting for physio appointment - he hasnt made a follow up appointment - said I dont need to see him unless doesnt heal after 6 weeks time.

Letter recieved today says that i "can walk on it".... ( i dont know if that is fact or instruction )

hurts when i walk on it and toes going numb ...
I have asked for a referral to the doc who is foot specialist who did last op - but gp ( not my regular one) said not a good idea as he wouldnt do anything different ( so cant do it on private health insurance).

My query
[list=]IF it is in fact a fracture rather than just tissue damage - could i do harm to it by walking on it and could i do harm to it by having physio so soon ?
if my toes are going numb couldnt that be a problem as time progresses.[/list]

I have left a message with surgeons secretary to call me back so i can find out whether she thinks suitable for me to see him and how much will a private appointment be as I would need to pay myself without gp referral...

I imagine that when they cleared out the ankle in teh op they took off any extra bone - I ampretty sure thats what he said - so surely if avulsion00 fracture was there he would have renoved the extra bone
any thought gratefully received.

-----------
Joolz
EDSIII

[paw]

Joolz, I am sorry you are injured again. I have had a very serious fracture of the Left ankle myself. I wouldn't let them just pass you around from person to person and tell you nothing.

You don't know at this point if it is an old fracture or a new one.
You don't know the extent of the soft tissue damage.
You don't know if you need a surgical repair of the ligaments. (They are not likely to heal on their own if you have torn them and they are not attached like they should be)
You don't know if you are allowed to weight bear.
You don't know if you should do physio.
You don't know why your toes are numb.

That is a lot of things you don't know about how to get back on your feet. I would type it all up and hand this to your GP. Be calm and tell him/her that you deserve to see the specialist due to the previous injury and also due to the conflicting opinions. Point out that you really want to do your very best so you can walk again. EDS ligaments have poor collagen and they tear easily and heal slowly. Wrong treatment choices will impact you for years. All of this is absolutely true.

If it doesn't get you the appointment, I would pay to see the specialist. It really is your best shot at recovering from this injury. My personal thoughts are that you should wear the boot and that the numbness in the toes is due to swelling. The swelling doesn't have to be really evident right at the toes, the nerves could be compressed higher up toward the ankle. My toes were purple and numb after the surgery for a couple of months at least and the surgeon said it was just swelling. It lasted longer in me than most people. I swelled up when walking for several years, long after I was out of the cast. Stay off your feet as much as possible. Use the wheelchair if you can when you go out. You don't need to strain it any more than necessary right now.

Physio made me much worse with my shoulder. Exercise after my ankle had time to heal, just careful walking made my ankle worse. It was very weak and it just turned and sprained and reinjured. Right now it is a huge risk (my opinion) that it will make it worse. Give it a lot of time and if you do physio take it very slowly and carefully with the physio. "Just soft tissue damage" can be as bad an injury as a fracture according to the foot surgeon I used to work for. Bone heals in about 8 weeks. Torn ligaments can take a lot longer to heal depending on the exact injury. Don't let them send you away with no answers. That would mean you would be stuck off your feet in a lot of pain for no good reason. I would expect that you should have a good ankle brace or support after you are out of the boot and supposedly healed. Expect it to be weak and turn very easily.

I really am sorry you are injured. I just went through my whole injury and it wasn't any fun at the time. I also have had injuries since then but mostly in the foot. I get stress fractures and dislocations due to the unusual way my foot is now with some things pinned and fused that normally wouldn't be the way they are. One positive point, my foot is nowhere near my worst joint. I did heal fairly well but it took years to get there. Once you have your specialist appointment work with them and make a treatment plan.

[trekster]

After twisting my ankle for walking a short distance last November I decided 'that's enough im getting a wheelchair',
I haven't looked back and feel more independent with my wheelchair than without.

[DeeNJai]

Hi
I don't know what I have done to my left ankle but its painful and swollen. I am not sure if I twisted it when I was using a crutch to get to the cash out and do a little bit of shopping. As I don't any feeling or sensation in the lower body I didn't feel that I went over on it. I hope it improves in a few days.
Dee

[trekster]

My left ankle has also been a pain today, i must have twisted it when i tried to move my wheelchair whilst i was still sat in it yesterday.

[sheppeyescapee]

I'm wondering if the instability in my ankles is exacerbating or causing the problems with my achilles tendons? I can't put any weight on my feet now without being in excruciating pain

[trekster]

Ah hadnt thought of that, thanks will mention to my physio and rhemy next time.

[Spireite]

Sheppey, yes definitely possible. As I've tightened and stabilised my ankles, so has my achilles trouble gone. The achilles attaches to the heel bone so any instability in that region is going to upset the fragile achilles tendon. My talus bone (ankle bone above the heel bone) used to sublux and jam and that injured my achilles.

[Jooolz]

Hi Paw
Thanks for responding. I appreciate that very much. I decided to go see another GP - my own - ( I was told I needed to wait for a week to see him but after I eventually spoke with him on the phone he offered me an appointment that night) he has referred me back to my foot surgeon who has taken xrays and said that i have no new fracture.

The consultant got me to walk- weight bearing on the foot ( out of the boot) and it was reasonably ok for 2 steps... but then had sudden pang of pain and loud click which was apparently ligaments catching on a bone. He said he wanted to be cautious because of the EDS but that I should take it out of the boot & I would be ok to start walking on it.I have been booked in for an MRI scan this coming saturday and will see him again 2 weeks after that.

He says I have bruised the nerves and that is why my toes are feeling painful.

It feels very tight and painful - sleeping was really dificult last night - i put it on a soft pillow and eventually got to sleep.

I tried to put astretchy ankle suppport on today ... but it was too painful- too tight.

So I am feeling a bit cautious about walking on it - will need to look for different ankle supports I think... I suppose any of the ones mentioned in this thread would be ok...

[madmum]

The story sounds like my son is going through. He injured his 5th metatarsal in october. Initially it was diagnosed as a sprain and he was told to walk on it. Four days later I had to take him back due to pain,bruising and swelling. This time he was diagnosed as an avulsion fracture. Two weeks later we were told a soft tissue injury and to mobilise and only tubigrip. A few days back to see another doctor and once again a fracture and back in plaster. Two weeks later plaster off and mobilise. Pain and swelling returned. Subsequent visit to casualty said back to clinic. Surgeon then disbelieves everything,denies fracture and said to go to casualty and see a registrar if we are unhappy(he had already said we were banned from seeing a registrar). His physio has seen what happens. Yesterday a second opinion. This one says the piece of bone is an extra found in children and if he did sprain it it would be better by now and that his pain amplification is to blame(we have a letter from our local hospital that says he has a fracture but an old one,he had not had an xray before so how did they say that?). His advice to rub it,tap it and walk normally on it. My son is upset and angry and feels disbelieved. I feel the pain card was played too easily. What are we supposed to believe? No scan was offered. No account taken of his hypermobility and pronated flat feet. So today I have a son with ibs stress related,a painful foot he says he should not complain about as it is nothing and a frustrated mum. Where to go? I spoke to his physio and she will see him next week. I have emailed his rheumy,no reply yet. Cannot ask gp for another opinion as it will go down I am looking for something to be wrong and I have been accused before of mental illness(not true). Is he doing harm trying to walk up and down loads of stairs at school? He struggles to walk round sainsburys. He cannot use a wheelchair at school as there is no lift or proper facilities. His grades have dropped at school and I have had his english teacher be very nasty about it. Any one got any advice.

[paw]

Joolz I am glad you saw another doctor and that they are doing an MRI. I hope there is no fracture. As you know ligament and tendon damage can cause a lot of problems for us. I agree that you need a good support for daytime use. I used those stretchy supports and they are not that good really. Their positive feature is that they fit in your shoe. Their negative is that if your foot swells they get too tight and they really hurt. Also, just getting them on can cause you to bend the ankle and aggravate things. I am a female with an average size foot but I needed to buy the size for large men. My daughter sometimes wears two of those supports one on top of the other for more support.

I strongly suggest that you wear some type of support at night. I can't count how many times the blanket pulled the ankle or foot into a bad position and I would wake up later in severe pain. I found out that those pillows with microbeads make a good support to elevate the foot for sleeping. Even if you are told to exercise and weight bear during the day you need to protect the ankle at night.

You really need some type of support for daytime too. Every step I took after the cast came off was a new chance to roll the ankle. And it wanted to roll each time too. I had to be so careful. I should have gotten a better support but I didn't know what was out there. It was before the days of everyone being online and now we have so many more options and choices.

The advice I posted is what I would do for your injury. Your doctor might have different ideas. Consider everything and make up your own mind about what works best for you right now. I hope you feel better soon. Don't forget to use ice for swelling.

[paw]

Madmum, there is a lot going on with your son's foot. You ask if he is doing damage walking up and down stairs. My thought is maybe. He would know instantly if he is pulling on the ligaments and the foot is turning as he walks. If he complains of that he needs to get someone to listen to him and get him some proper support. Also, if the bone is moving around too much and the joints of the 5th toe/metatarsal area are coming out of position that would slow healing too. It could lead to stress fractures if the weight is put on the wrong part of the foot and he lands on it wrong. After the ankle fracture I ended up with a spot in my foot that gets stress fractures easily and they always seem to happen when I step down the big step out of my door. He does need to be extra careful on stairs.

My suggestion for your son is to get orthotics made that support his foot well. Have him wear the stretchy foot/ankle support. He could wear two of them layered for added support if that works better for him. I suggest getting him some of those socks for runners. The coolmax fiber blend absorbs sweat and decreases the amount of rubbing on his skin. They are much better for me than plain cotton socks.

He will likely need bigger shoes for the orthotic and some type of ankle support. My foot surgeon boss always told people to get leather as they stretch with the foot a little and they breathe a little. He suggested high top shoes like Basketball shoes for people with ankle problems. There is a lot more support. You could try lightweight hiking boots if he would like those better.

I suggest he also wears at least a stretchy support at night till it has healed and it is stronger. The blankets pull us into bad positions and we don't notice till we wake up in a lot of pain. He should use ice on his foot and put it up when it swells.

Like I said above, this is just what I would do with your son's injury. If the doctor gives different advice (or no advice!!) you should consider it all carefully and see what works best for your son. I hope he starts feeling better soon. It makes everything so hard when you can't get around well and you are in a lot of pain.

[madmum]

My son saw a different doctor last week. He complicated matters. He said there is no fracture and what is seen is an extra bone children have. He also said if it were a soft tissue injury he would have healed by now. I said I thought that could often take longer and he dismissed that. However if hms involves lax ligaments then surely they would take longer. I trawled the internet and found out there is such a bone but can only be confirmed by checking the other side. This article also mentions ligament and tendon injury to the area and if done can take up to 12 months to heal in those not affected by collagen disorders such as eds and longer in those with. It also said at the beginning it should have been 2 weeks cast and non weight baring which it never was. This injury also allows this small bone to move which can cause inflammation. He has orthotic insoles and ankle boots from orthotics. When he sees the physio on friday she suggested the orthotist check they are not aggravating. This article also said orthotics to take pressure off. He finds tubigrip aggravates and so far I cannot see supports for the fore foot so will ask there. The doctor did not recommend support,he even said no when I suggested he uses his crutches when in a lot of pain. My son finds ice hurts,his own cold feet hurt. I will look into the socks you suggest as his feet sweat heavily. If I can get my printer working I will take a copy of the article on friday.