Triple Jump Cartilage Damage

[TJ05]

I am a National level Triple Jumper who recently moved from QLD to Newcastle at the end of 2004 to train with the aim of qualifying for the Commonwealth Games in Melbourne. In December I landed awkwardly at the end of the "hop" phase which caused some pain, however it didn't seem bad enough to worry about. By january I could not train other than some gym work and easy running so saw a specialist in Sydney who said the x-rays showed an ankle spur at the end of the tibia (anterior) and I was told that it wasn't too bad and it should settle down.

I continued trying to train and jump with some good and some bad days. The last comp I did was QLD States where I decided the pain was too much and I wanted an arthroscopy done. When this was performed it was discovered that I had dislodge cartilage from my joint and also had "flaps" of cartilage in my ankle. This was all removed and cleaned up and I was told not to do any impact stuff (including running) for 12 weeks. I did this and saw the Doc again and he said I could start running but no jumping just yet. At first there was some niggles but they quicky went away and I was doing PB's in the gym and sprinting as fast as I ever had.

This week I did my first jumps session (6months post op). The Doc had said I could have started in June but I thought I'd give it longer. I did 3 jumps off 4 strides with the pain only a little noticeable then on the fourth jump I tried a little harder, landed pretty hard and was in pain! That was the end of the session... It is 2 days since it happened and the pain is still noticeable. I haven't trained and have iced the joint.

I am on a mission to find info on this as my Doc is in Darwin at a conference or something so can't get answers from him. Does anyone know if this is a normal response to high impact work? Will it get better? Is there anything I can do to help it? Should I take up Chess???!!

Any help will be great!

[injuryupdate]

Hopefully it will settle down and you'll eventually get back to being able to put full load on. However, it is the sort of injury (lining cartilage damage) that can lead to retirement from elite sport, particularly track & field. A football player could 'carry' something like this long term by not training hard, but for you guys it is train hard or don't bother at all.

[mikelott]

Hi, I had surgery 7 weeks ago to remove a small flap of cartilage and drill small holes in the bottom of the tibia to try to generate some fibro-cartilage (I think the terms my surgeon used were microfracture, chondral debridement, keilectomy (forgive the spelling)) I was partial weight bearing on cruthes for 6 weeks and now I am off the crutches. I am getting physio with a range of exercise from standing on one leg, tip toes, stepping up and over a step - keeping my bad leg on the step (I don't have complete control when I step down.

I have 3 questions:

1. I have seen references to glucosamine which seems to be something
that I should be taking, is this right?

2. I am getting some swelling and mild pain when I do these exercises, is this probably because I have done a bit too much.

3. When I flex my ankle joint up and down (plantar flexion and the opposite) I am getting a loud click/crack that doesn't really hurt but feels uncomfortable. Is this a potential problem?

[sydunisportsmed]

This is a pretty severe problem that will probably take 6 months to get over. Glucosamine is worth trying, as it seems to work well for similar conditions in the knee (even though not well studied for ankle). I wouldn't get too worked up about swelling and pain 7 weeks after surgery. Take it easy until 2006 and then you'll hopefully feel the ankle is a lot better.

[Unregistered]

I had the exact same surgery on July 14th. I started to walk again on the treadmill after 8 weeks. The pain came back after .5 mile. I still can't get rid of the pain. It's as if the surgery didn't help at all. I'm worried that I started to walk on it too soon and it's re-injured the areas. Has your pain gone away? My Dr. may do an MRI. What have you found on yours.



Hi, I had surgery 7 weeks ago to remove a small flap of cartilage and drill small holes in the bottom of the tibia to try to generate some fibro-cartilage (I think the terms my surgeon used were microfracture, chondral debridement, keilectomy (forgive the spelling)) I was partial weight bearing on cruthes for 6 weeks and now I am off the crutches. I am getting physio with a range of exercise from standing on one leg, tip toes, stepping up and over a step - keeping my bad leg on the step (I don't have complete control when I step down.

I have 3 questions:

1. I have seen references to glucosamine which seems to be something
that I should be taking, is this right?

2. I am getting some swelling and mild pain when I do these exercises, is this probably because I have done a bit too much.

3. When I flex my ankle joint up and down (plantar flexion and the opposite) I am getting a loud click/crack that doesn't really hurt but feels uncomfortable. Is this a potential problem?

[mikelott]

I had the exact same surgery on July 14th. I started to walk again on the treadmill after 8 weeks. The pain came back after .5 mile. I still can't get rid of the pain. It's as if the surgery didn't help at all. I'm worried that I started to walk on it too soon and it's re-injured the areas. Has your pain gone away? My Dr. may do an MRI. What have you found on yours.

Under the direction of the Dr I was given crutches and told to put partial weight on the ankle straight away. I was also given some non-weight bearing exercises to mobilise the joint and also went swimming a couple of times.

The physio then started increasing my weight bearing from 4 weeks which began with various exercises including therabands, standing on 1 leg, standing on tip-toes, walking in the swimming pool. I went down to 1 crutch on week 5 and saw the Dr at week 6 when I lost the second crutch.

Over then next couple of weeks the weight bearing increased with standing up from crouched position stepping up, stepping down and stepping up and over on the bad ankle at the same time I was encouraged to walk a lot which caused me no great problems other than a bit of swelling. I did play a round of golf at week 8 which went very well although my heels were not used to the long walk ached a lot.

I then progressed to a 5 minute run on a matress along with my 10 minute stepping regime in week 10 which I increased by 1 minute per day along with a 15 minute cycle on exercise bike with a low resistance level. in week 11 I progressed to 5 minutes running on grass increasing by 1 min per day with the bike and stepping regime. Week 12 saw me return to 5-a-side football on 1 day alternating 5 on with 5 mins off for an hour. This did not result in much swelling at all.

It is now week 15 and I played 5-a-side twice last week (5 mins on 5 off for an hour), cycled for 30 mins another day and played 30 mins in my first 11 - a - side match since the op.

I am generally finding that my ankle seems to be better after exercise
than before. I still get a loud crack almost every step I take which the physio says might be the tendon. I do get a small amount of discomfort occasionally which I am hoping will go away but it is not anything that is stopping me from doing anything. For instance, last friday whilst sitting on the floor for an hour my ankle was quite stiff and causing me some discomfort but an hour later I was playing football and after the football the ankle felt great.

I feel that the ankle is still healing and will take a few months to fully settle down but it is certainly a lot better than before the op where I was playing football (soccer to you lot) but with what must have been a lot of subconsious compensation because when I had the op the physio measured my calf muscles and the calf on my bad leg (my favoured leg for kicking) was 3cm in circumference smaller than my left leg.

I hope this is helpful for you.

[EddieO]

Thanks for the helpful info, Mike. My process was less intense then yours. I was non-weight-bearing for 5 weeks. Then, I started therapy in week 6, but it was just stretching. In week 7, I started some elipitical machine workouts, only 5-10 minutes. All of this was with no pain. Week 8, I started the treadmill and that's when the ankle started to hurt.

My doc gave me a cortison shot around week 11, which had minimal impact. I'm at week 14, now, and therapy has helped this week. Therapist thinks that i have an impingement, so he's working on making the ankle more mobile and flexible. It seems to be helping. I can't do any activity besides the stationary bike.

It sounds like you're much further along then me, and that activity helps your ankle feel better. I played golf one day (used a cart) and the ankle felt better the next day. I think I'll try to get more activity, low impact, though.

Do you know what cause your flaps on the cartilage? Was there one incident where you had sharp pain? I was jogging on the treadmill 20 months ago when I first felt pain.

Thanks for the info. I hope your ankle continues to improve. It isn't fun dealing with this pain. 2006 will be our year.

[mikelott]

My injury was caused in a football (soccer) match when I was tackled from behind. My left leg was taken out from under me and my right ankle gave way when I landed. apparently my foot hit the bottom of my tibia/fibula and caused the damage. At first I saw a physio who treaated it as ligament damage but when the ankle was still swelling after 3 months I saw a specialist who is apparently very good with ankles.

It seems to me that the partial weight bearing is the difference between us.

I would suggest lots of low impact movement in the joint.

I have just spent the last 2 days regretting the post I made because on Tuesday during 5-a-side i was tackled so that the ankles was stretched. After 2 days with a little stiffness/very mild paid I was concerned, however, after 1 hour of 5-a-side tonight the ankle feels fantastic.

Still a small amount of movement is restricted by very mild swelling but other than that it is great.

2006 is going to be my year, hope it is yours too.




Thanks for the helpful info, Mike. My process was less intense then yours. I was non-weight-bearing for 5 weeks. Then, I started therapy in week 6, but it was just stretching. In week 7, I started some elipitical machine workouts, only 5-10 minutes. All of this was with no pain. Week 8, I started the treadmill and that's when the ankle started to hurt.

My doc gave me a cortison shot around week 11, which had minimal impact. I'm at week 14, now, and therapy has helped this week. Therapist thinks that i have an impingement, so he's working on making the ankle more mobile and flexible. It seems to be helping. I can't do any activity besides the stationary bike.

It sounds like you're much further along then me, and that activity helps your ankle feel better. I played golf one day (used a cart) and the ankle felt better the next day. I think I'll try to get more activity, low impact, though.

Do you know what cause your flaps on the cartilage? Was there one incident where you had sharp pain? I was jogging on the treadmill 20 months ago when I first felt pain.

Thanks for the info. I hope your ankle continues to improve. It isn't fun dealing with this pain. 2006 will be our year.

[EddieO]

What day was your surgery? Mine was July 14th, and I still can't do anything on it. I can't even walk more then 100 yards without having pain. I think you're moving in the right direction. You can play football! I must have re-injured mine or it didn't heal correctly. The pain feels just like it did before the surgery. I'm hoping the doc will do an MRI in the next couple weeks.

I hope yours keeps improving. Keep me updated on your progress occasionally. Good luck.

[Gem]

I have 3 questions:

1. I have seen references to glucosamine which seems to be something
that I should be taking, is this right?

2. I am getting some swelling and mild pain when I do these exercises, is this probably because I have done a bit too much.

3. When I flex my ankle joint up and down (plantar flexion and the opposite) I am getting a loud click/crack that doesn't really hurt but feels uncomfortable. Is this a potential problem?

Hey Mike,

I'm a long-term sports injury sufferer - just as I pick up from one, I get another, over and over again! My ankles have always been the bane of my existence, but now my knees have decided to go out in sympathy as well! After my second serious knee injury, my physio suggested I get on the glucosamine, and I cannot begin to say how much it has helped me! The chronic swelling has decreased in both my knees and my ankles, they don't hurt after activity anymore and I've actually been able to get back to playing sport seriously for the first time in almost 6 years without injury or pain! And that's only taking 1 tablet a day (the bottle says take up to 3). So YES I thoroughly recommend it, but bear in mind that's only from my personal experience - I have heard of others who have had nothing helpful from it, so I'd suggest buying a bottle, trying it out, and see how you feel as you near the end of the first bottle.

As to the swelling, I still get massive amounts of swelling in both ankles - one is a side-effect of surgery I've been told, the other is partly related to a knee injury which still swells, and also to the general irritation in the ankle itself. I find things like wearing high heels or crappy shoes for sport cause mine to swell up big time - I'm guessing because of the general strain. Have you tried doing some of your exercises in water sometimes? Although you should be weight-bearing, sometimes having a good session in the water can be really helpful in that it can help strengthen your ankle, but can take the weight-bearing strain off it. I've found doing that sometimes for my ankles and knees really helps them.

As to the clicking, there's another topic on that one already! It's probably not the best thing, but I get it all the time, and have just been told its a side-effect of the damage I've done, and is nothing more than an indication that there's probably something needing a bit of fixing in there!