Ankle Inversion Injury- A First Hand Experience. PART SIX

 

Weeks 5 and 6

Over the last 2 weeks there has been much more of an improvement than previous weeks.  My ankle is finally starting to look normal again! The swelling has continued to reduce, first thing in the morning my ankle looks almost exactly the same as my right ankle, but it will be swollen by the end of the day.   My rehab has been focused around trying to regain full active range of movement (AROM) and foam rolling the areas that have developed tightness through alterations to my gait and the healing process taking place at my ankle.

At the start of week 5 I was still lacking a significant amount of weight-bearing Dorsi-flexion comparative to the other side;

​Knee-to-wall measurement - how far I can get my toes away from the wall with the knee in contact and the heel down- left compared to right

 

I had a treatment with Anna where she mobilised (loosend) the talocrural joint (part of the anle joint complex) which was significantly stiffer than the other side,  and also used a technique called Mobilisation with Movement (MWM) to encourage normal tracking of the ankle joint. I have carried on using a self-administered version of this technique at home and have significantly improvement.

Plantar-flexion is almost the same as my right side but I have found that when I am stretching into Plantar-flexion I can feel resistance in my Tibialis Anterior throughout the muscle into the insertion.  I’ve therefore been focused on foam rolling my Tibialis Anterior and that does seem to be getting slightly easier each time.

With regards to my balance, standing on one leg is really quite good and now comparable to the other side.  I have therefore been trying to challenge myself a little more by adding some knee bends, in order to challenge my entire lower limb on a more functional level for getting back to running.  I have also been doing calf raises, making sure that my technique is perfect and trying not to deviate from the mid line.  

The main aspect of my recovery that I am most please with is that I can finally RUN!! This has not only been a huge boost for me in terms of my rehab, but psychologically too! Initially I did a 2 mile trial run at the end of week 5, which was fairly sore to begin with but after about 5 minutes felt quite comfortable.  However, any deviation in the incline of the path, from side to side especially, would feel quite uncomfortable, but if the surface was perfectly flat I had no pain at all.  Since then I have done two 4 mile runs, and was even able to increase my pace on the second of the 4 mile runs to more my normal running pace.  So I am very happy! I can still feel the ankle would be uncomfortable with quick changes of direction, but I will gradually start to challenge the ankle more.

The main part of my ankle that continues to hurt is around the insertion of Peroneus Brevis and around my Sinus Tarsi.  I have continued to treat this with Voltarol gel, and before I go to bed have also been applying Voltarol to the area and then wrapping my ankle in cling film, in order to try and aid absorption.

I am now feeling confident that my ankle is improving.  I will continue to try some runs this week and foam roll my ITB in order to address the twinges that I have been feeling over the last couple of weeks.  I am now going to start using the Bosu, (balance tool which looks a bit like a half a gymball with a flat side and a domed side- a favourite rehab tool of ours!). This will provide a significant proprioceptive challenge that I feel my ankle is ready for now, and I’m going to try and increase my running speed with my 4 mile runs to find a comfortable pace that I can try and increase the distance with over the next few weeks.