First off my injury occurred while bouldering (a form of rock climbing with no rope typically 5-20 feet off the ground with landing pads). I did a move that had me fall from about 8 feet or so off the ground on a 45 degree angle landing apparently quite hard on my right ankle. The pain from this was unlike any ankle sprain i have ever had and i have had many playing basketball and soccer most of my life. xrays the next day were negative and about a week or so later after having no loss in swelling (softball size with complete black blue green coloring) i went to an orthopedic. he recommended an MRI and the results are summarized below:
1) Bony contusion fo the lateral talar dome with miled overlying articular cartilage irregularity. A definitive OCD not currently noted.
2) Bony contusion with subchondral fracturing of the medial aspect of the talus. Bony contusion of the calcaneus, prticularly medially, again with subchondral fracturing near the anterior subtalar joints. this does extend to the articular surface in this region, although the articulation of the anterior subtalar joint appears relatively maintained. however there is moderate amount of edema in this region
3) tenosynovitis and tendinopathy of both peroneal tendons, with a small longitudinal rent of the peroneal brevis tendon. tenosynovitis of the tendons at the medial compartment without a rupture. mild tendinopathy of the anterior tibial tendon.
4) partial tear of the anterior talofibular and the anerior tibiofibular ligaments as well as sprain of the calcaneofibular ligaments. sprain of the deltoid ligaments.
there is abnormal marrow signal and edema seen of the talus particularly at the lateral talar dome. currently OCD is not noted. the patient is noted to have edema of the medial most aspect fo the talus near the subtalar joint as well as the medial aspect of thecalcaneus. most pronounced at the anterior subtalar joint with the patient noted to have subchondral fracturing present. also bony contusion of the posterior malleolus.
the patient has prominent tenosynovitis of both the peroneal brevis and longus tendons with tendiopathy of both tendons. no full-thickness rupture noted though. there si some longitudinal splitting of the peroneal brevis tendon distally. the patient also noted to have moderate tenosynovitis of the flexor hallucis longus flexor digitorum and the posterior tibial tendon sheath. there is tendiopathy of the anterior tibial tendon as well. the anterior tibiofibular ligament is thickened and irregular. the posterior tibiofibular ligament is intact. the anteriaor talofibular ligament is thickened, with partial tearing. the posterior talofibular ligament is in tact the calcaneofibular ligament is edematous. the deltoid ligamnet demonstrates endema.
So from what i gather, i basically injured nearly every tendon and ligament of the joint as well as the doing damage to the talus bone: apparently a bone you dont want to mess with.
i was in a boot for 10 days after the MRI and then started PT. PT began 2/23 and the injury occurred 1/12. PT started as 3x week for 3 weeks and has been 2x a week ever since. i am now nearly 3 months out and though the swelling is nearly gone, it isnt fully down. I still see swelling on the outside of my ankle that comes and goes. i have been walking around "normally" and have refrained from any lifting weights or running or biking. thing is that the right side below the bone has been pretty damn sore the last week or so... i have a high tolerance for pain so i would put it at annoying or irritating but it has me a bit worried.
im beginning to wonder how long this may take to actually get better. am i in need of some kind of surgery at this point? i have another MRI scheduled in about a week to see if the healing of the bone is helping and i am sure that will help clear some stuff up but i was curious if this length in rehab is normal for the amount of damage i have and if i can expect to be out for several months more?
thanks for taking time to read this long message and any advice / comments are appreciated.
I would be persistant and get it looked at again- if my original injury had been scoped earlier - i would still have cartlidge on my lesion
I have a small lesion that i just had surgery on ( the mri and cat scan xray bone scan all showed stage 1 osteochondral lesion- but one and haf years later when i finally was scheduled for a scope( and they would not have done this if i had not pursued it they were shocked to see that there was no cartlidge left so no longer a stage 1- no longer on a scale) they often take a wait and see approach but i am pretty active and want to be for a long tome ( sounds like you are too) Read a little about hese lesions- they can castyour foot for a little longer and or do some microfracturing to help it heal - better sooner than later though. Good Luck