Ankle Inversion Injury- A First Hand Experience. PART FIVE

 

Having had Anna have a look at my ankle and give me my homework to do, all was going well until I had an incredibly frustrating set back! A van driver, who clearly has never even heard of the Highway Code, decided to pull into the cycle lane in front of me and then suddenly slam on his breaks.  This caused me to skid into the back of the van and fall onto my left hand side (typical!).  As it all happened so quickly, I was unable to get my left ankle out of the clips and I landed on my left knee.  I did feel my ankle twist as I tried to yank it out of the clip to save me from falling but there was no immediate pain in the ankle but it did feel odd for the rest of the evening.  I don’t think the fall has set me back with the actual ankle but my left knee must have struck the pavement at the attachment of my tibilalis anterior, because that has been very painful ever since.  This therefore hinders my attempts to get the remaining swelling out of my ankle, because pumping my foot back and forth whilst elevated seems to stir up my Tibialis anterior pain!

There seems to be something a little unusual going on with the fascia over the distal ¼ of my lateral fibula. Any attempt to even move the skin around the area leads to a red hot sharp pain as if the skin is ripping.  It feels like the exact pain you get when you rip of a plaster but multiplied to about 8/10.  Having discussed this with Anna, we concluded there’s likely some scarring and neural irritation that in this area.  I am struggling to do any form of self-deep tissue massage to the area, just because it is so painful and it doesn’t seem natural to inflict such pain on yourself with your own hands! So I have to rely on the foam roller to work its magic.

I am really struggling to get the remaining swelling out of my ankle.  I have been using the cryocuff every evening and applying voltarol gel to the ankle as frequently as I can throughout the day, but this doesn’t seem to permanently shift the swelling.  Particularly the swelling directly over the ATFL, that doesn’t seem to ever go. I am also applying Volaterol gel at night and then wrapping the foot/ankle in Clingfilm. I’m focussing particularly on the Sinus Tarsi since Anna was a little concerned that this was so irritable on assessment. I think being on my feet all day is partly to blame for the persistent swelling but there’s not really much I can do about that.  I have noticed that now the swelling is reduced though that it is MORE painful (possibly because I have greater range of movement so am able to take it further into the strain/stretch zone).  I keep getting random aches in the ankle throughout the day, especially now I am stretching the ankle into plantar flexion to try and regain the normal ROM.

I have also noticed that my whole left leg hurts in random places when walking.  A combination of my generally reduced ankle range of movement and new injury to the tibialis anterior must mean I am walking differently because the pain in my ITB and gluteus medius seems to be worse and more frequent.  Although even though I have these pains I am continuing to use the cross trainer, which I don’t think is helping, (but I need to do some sort of exercise for my sanity!). I am trying to mobilise into dorsiflexion too, as that was highlighted as reduced in my assessment with Anna, but I really feel the swelling is hindering any improvement as at my end of range the pain is very specific to the ATFL area where that stubborn bit of swelling is situated, and it is very painful to try and push into the movement to gain any more range.

So the summary for week 4 is that I am getting rather fed up of this ankle injury now! I can’t believe it’s only been 4 weeks as it feels like a life-time.  Not being able to run or play football is getting tiresome especially as it is summer (well supposed to be) and the cross trainer seems to be the most boring machine ever invented.   I also appear to be collecting injuries.  But the word for week 5 will be PERSEVERANCE!! I am foam rolling everything that can be foam rollered. I am really going to give the lateral aspect of peronei and ITB a hammering over the weekend. And spend as much time as I can with my foot elevated to get the swelling down.

On the plus side, my single leg calf raise is feeling pretty good, and I feel pretty comfortable standing on one leg.  I even tried a hop the other day and it felt pretty good.  I can tell though that any dynamic challenge thrust upon the ankle would be very difficult at this time as it feels “slow to react” to changes of direction.