Rolled ankle injury ;)

Discussion in 'Health Tips for the Martial Artist' started by _Simon_, Sep 25, 2018.

  1. _Simon_

    _Simon_ Master of Arts

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    I think it was a matter of that my foot had already pretty much healed, but I was still keeping it motionless for too long after. So it'll just stiffen up and get more painful as it needed rehab. I think initially I needed to keep off it, but after a certain amount of time it's a bit detrimental. Of which, I was not aware that it was at that point and now okay to start working it more. So it's really unfortunate.. but hopefully now I can get some relief.

    Ah wow... yeah it's a tricky one. I'm sure there are many misdiagnoses (like I'vealready experienced before), but there are so many variables to take into account it's hard to pinpoint it just with one modality I reckon. In my case with the pelvic pain issues, all of their diagnoses were what they were trained in, so it's all they knew. There was no collaboration between the hospital and pelvic pain clinics so there was just no scope for looking outside the box.
     
  2. _Simon_

    _Simon_ Master of Arts

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    Ah okay fair enough. Yeah they weren't 100% about the fracture. Definitely a partially torn ligament, but who knows if that's fully healed..

    I'll still keep the appointment (it's actually in their physiotherapy clinic at the hospital, which I'm not sure if the osteo specialists are a part of...)
     
  3. Dirty Dog

    Dirty Dog MT Senior Moderator Staff Member

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    Sure it does. Take a perfectly fine joint and immobilize it for just a few hours. See how stiff it can get? Now immobilize it for weeks. Ouchy.
    That's why casts and such are removed as early as possible. The bone is not fully healed, but it's healed enough to start using it again.
     
  4. _Simon_

    _Simon_ Master of Arts

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    Ahhh, that's good to know. Just flexing and extending my foot now and it trembles like crazy XD (about 4 weeks on crutches). Just gotta make sure to not overdo it.

    Ah and my physio appointment is with a karate-ka who I used to train with many years ago! He's still with my old style I used to train in. So he's the perfect person for a martial arts related injury, looking forward to it :D
     
  5. JowGaWolf

    JowGaWolf Grandmaster

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    If you can, massage your foot before you start exercising it. It doesn't have to be a rough massage, just enough to help get blood flowing in that area.
     
  6. _Simon_

    _Simon_ Master of Arts

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    Great idea, cheers mate. Also been massaging the calf as well. Range of motion is shocking, it all feels so stiff...
     
  7. gpseymour

    gpseymour MT Moderator Staff Member

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    I honestly don't know which is more frustrating your misdiagnosis or the one I had a few years ago, where a GP at urgent care failed to diagnose a break. He had me walking on it (no crutches or anything) and it kept getting worse. Two weeks walking on it, through airports, carrying luggage, etc., then they put me on crutches and referred to an ortho. Two weeks on crutches, the ortho takes one look at the X-ray, grabs my ankle right where it hurt, and I said, "Ow."

    "Yep, that's broken." Shortest doctor visit I've ever had.
     
  8. gpseymour

    gpseymour MT Moderator Staff Member

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    From what my PT told me when I was rehabbing a deeply torn muscle, part of the healing requires some irritation of the tissue. I don't understand it very well (I keep meaning to spend some time researching that), but my tear healed much faster once I was using it the right way a few times a week.
     
  9. gpseymour

    gpseymour MT Moderator Staff Member

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    I hadn't had an interaction with a PT much until a couple of years ago. Now, if an injury puts something out of use for a bit, I go running to my PT to find out what I can safely do while not using that limb normally, and what I should do to restore ROM when I'm cleared.
     
  10. _Simon_

    _Simon_ Master of Arts

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    Oh wow that'd be incredibly frustrating..

    And yeah I still at this stage have no idea if I even had or still have a fracture, if it's healed, if my ligament has healed... Just gonna see how physio goes..

    Ah that sounds interesting.. I guess when the muscle etc is reminded of its function it can repair a bit quicker..? Without overdoing it obviously..

    Yeah for sure, and their specialty is in rehabilitating so they'd understand what it takes to get back to normal function. So I'm looking forward to getting physio and moving on. It's just been too long now... I'm thoroughly done haha...
     
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  11. JR 137

    JR 137 Senior Master

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    Several different reasons why using it will speed up the process...

    Disuse atrophy sets in. If muscles aren’t being used, they break down. Like a bodybuilder stopping lifting, he loses muscle mass, or if someone’s arm is in a cast guard while, that arm will be smaller. Use it or lose it philosophy. Bone density too, only not as much; and weight bearing bones not carrying weight will have the effect more, obviously. Bone density is probably the lowest on the list though.

    Nerve function. The longer something’s not being used, the less efficient nerve function. The chemical mediators in the inflammatory process also block some nerve function, so getting those out helps.

    Scar tissue and tissue remodeling. The body heals tissues by laying down scar tissue (collagen 1). The body overdoes it, and scar tissue is thick, inelastic, and the fibers are in a random pattern. Proper stress on the structure speeds up turning the scar tissue (collagen 1) into functional tissue (collagen 3). The fibers line up to the stress lines and become appropriately elastic, and turn into the correct tissue faster.

    Having done PT for your bicep (that’s the muscle you tore, correct?), the PTs probably did friction/cross friction massage at some point. Rubbing the hell out of it and irritating it pretty good. It does several things - most notably helps break up the excess scar tissue, and increases local blood flow to bring nutrients in and get rid of garbage.

    I’ve found of the most important things to do in an ankle injury rehab is balance work. Forcing the nerves to fire properly helps immediately and for the long term. Studies have shown the quicker the patient starts (appropriate) balance work in ankle injuries, the less susceptible to reinjury later on. Sometimes clinicians focus too much on ROM and strengthening early on; I did too until I read the research and started implementing it more. My athletes typically got better and game-ready faster and stayed injury free longer. Not drastically, but definitely more than enough to say so.
     
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  12. gpseymour

    gpseymour MT Moderator Staff Member

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    This was the part the PT discussed. Thanks for filling in the blanks in my memory!

    EDIT: I forgot to reply to the other part - it was a forearm muscle, but yes they did that hard, painful massage with something that looked like a bit out of the scrap bin in my workshop. It worked wonders, and I hated it.
     
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  13. JR 137

    JR 137 Senior Master

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    I used to use the eraser end of a fat pencil. It worked just as well as anything fancy, and kept it low-class like myself :)

    My mentor in college was very big on cross-friction massage. I think he enjoyed the torture as much as the results. Actually, I’m pretty sure he enjoyed the torture more than anything else. Because I did it so much as an undergrad, I became the go-to cross-friction guy in every training room I subsequently worked in. That and “milking massage” which is fancy for squeezing the swelling out of the joint. Most of my colleagues came to me to do that to their athletes too. They always tried, usually failed, and then said “JR will get it out.” :)

    My athletes hated both of those, but they figured out the method to my madness when I was done.
     
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  14. jobo

    jobo Grandmaster

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    isn't that what I told you right at the begining of this thread, the longer you avoid the pain the worst it will get,,,work the flamming thing //+
     
  15. gpseymour

    gpseymour MT Moderator Staff Member

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    The right answer, but mostly for the wrong reasons.
     
  16. _Simon_

    _Simon_ Master of Arts

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    Hehe.. it was first assumed that I had a fracture, in which case it's not the best idea to work it or put weight on it. That sucker needs to heal! So it wouldn't have been the best idea at the start.

    Now we're at the stage where I either never had a fracture or it healed up, and I can start working it again. (I'm still confused as to what's going on if I'm honest...)

    If it was only the partially torn ligament I'm not sure what the recommended course of action would have been.
     
  17. jobo

    jobo Grandmaster

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    by the time we had our chat, it was always going to be at least partly healed, if you had one at all
    the treatment for a partially torn ligament, ? plenty of movement to get good blood flow and stop the joint from seizing up and having muscle wastages,
     
  18. _Simon_

    _Simon_ Master of Arts

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    Ah right that's super helpful, yeah will see what the physio gets me working on, but will definitely incorporate some balance work. How about 100 left leg mae geris hehe ;)
     
  19. _Simon_

    _Simon_ Master of Arts

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    Yeah true, I just didn't know the extent of the injury and the appropriate way forward. Doc tells me it's a fracture (which she did) I'm going to trust them (which from now I'll try to get a second opinion or specialist opinion). Will now be rehabbing it (physio starts tomorrow) and putting more weight on it. Cheers
     
  20. _Simon_

    _Simon_ Master of Arts

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    Had first physio session today (had to be moved from yesterday), it went so, so well :). Have an incredibly knowledgable physio, he basically told me to throw my crutches away haha! He said that absolutely my fracture would have healed, and that for sure he would have had me doing physio ages ago. He also said about docs not always knowing much about the muscular side of things so often just seeing something and putting them in a cast.

    He tested out my ligament/tendon strength and he was really happy with them. My ROM is lacking obviously. So just need to work on getting more range of motion, strength and stability. He's really excited to work with me and he's gonna tailor our work together in a martial-arts based way to get me back to training, so even throwing kicks etc. I am so darn looking forward to it...

    And I can walk again :). Such a weird feeling...

    Have got some exercises to do every day (include a balance/proprioception one) and seeing him next week. So happy and incredibly relieved...
     
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