Ankle Ligaments And Tendons

Introduction
Burman in 1931 scoped 3 ankles using a 4.Omm sheath without distraction, he found it too tight for satisfactory visualisation. Ankle arthroscopy really came of age in the 90′s with the development of 2.5mm arthroscopes, noninvasive distraction techniques and irrigation systems.

Historical developments
Tagaki was the real father of the arthroscope. He developed a 2.7mm arthroscope. However Watanabe developed matters further producing a self-focusing 1.7mm arthroscope and arthroscoped 28 ankles, describing the standard portals and normal anatomy.

Andrews wrote one of many texts on the subject in the late 80′s. Guhl developed a skeletal distracter for the ankle and wrote an excellent text.

Yates was the first to develop a non invasive distraction technique.

Advantages and Contra-indications
ADVANTAGES
Arthroscopy allows direct articular inspection + assessment of ligaments and synovial change. One can perform intraoperative stress testing.

The following diagnoses can be made. OCD – 23.5%, Impingement – 21.3%, Chrondromalacia – 7.9%, Instability – 7.2%, DJD – 7.2%, Acute Fracture – 6.5%, Arthrofibrosis – 4.8%, Loose Bodies, Osteophytes, Synovitis, Ossicles, Torn ATFL, Cryptogenic Pain, Cyst, Chondral Fracture, Peroneal Subluxation, Torn Peroneal Tendon.

The following procedures can be performed. Debride lateral gutter – 21.8%, Excise/Drill OCD – 19.4%, Chondroplasty – 13.3%, Excise fibrous bands – 6.8%, Loose bodies – 5.7%, Rx of fracture, Diagnostic, Synovectomy, Osteophytes, Ossicles, Arthrodesis, Stabilisation CONTRA-INDICATIONS – Relative – DJD, Oedema, Impaired vascularity.

Absolute – Soft tissue infection, Advanced DJD.

Instrumentation
Ankle arthroscopy developed from the principles of knee arthroscopy and hence initially the same instruments were applied. However as experience developed with smaller instruments, distraction, and fluid management systems, arthroscopy evolved.

Irrigation – Gravity, Gravity assist, Pumps.

Athroscopes – Hopkins 2.3mm, 2.7mm and 1.9mm diameters, 30 & 70 degree.

Distraction – Non invasive.

Instrumentation – Spinal needles, Probes, Dissectors – elevating OCD lesions, ossicles, Graspers – flat tipped or pitbull for small or large loose bodies (2.7-3.Omm), Basket forceps – straight, right and left, up and down angles (2.53.00mm), Knives, Curettes, Osteotomes, Power Instruments, Thigh/Ankle Holder, Aiming jigs.

Diagnostic Arthroscopic Examination of the Ankle
Ankle arthroscopy is a useful diagnostic modality to evaluate pathology and determine correct treatment. It should not be used as a substitute for careful history taking, examination and investigation. Its main advantages are that it allows direct inspection and probing of all intra-articular structures and their dynamic assessment. As such it is virtually 100% accurate in diagnosing intra-articular disorders.

The ankle is first distended with approximately 30cc of saline. Then the anteromedial portal is established just medial to tibialis anterior at the level of the joint line carefully avoiding the saphenous nerve. Then the anterolateral portal is established using transillumination, avoiding the superficial branch of the lateral popliteal nerve. A full diagnostic inspection of the anterior compartment is then carried out. Then the posterolateral portal is made localising the entry point with a spinal needle. Then a full inspection of the posterior compartment is made. Using these three portals a full 21 point systemic ankle examination can be carried out.

SOFT TISSUE LESIONS OF THE ANKLE
These are difficult to diagnose without arthroscopy despite careful assessment and investigation. They represent some 3050% of lesions found within the ankle joint and are diagnosed and treated by arthroscopy.

Patients with such lesions present with a combination of pain, swelling, tenderness, locking and giving way.

On examination one finds a combination of tenderness, wasting, swelling, restricted range and instability.

Investigations include XR, CT, MRI, Arthritis tests. These all may be negative.

CLASSIFICATION
Congenital – Plicae / bands – excise

Traumatic – sprains, fractures, prior surgery – excise generalised synovitis, excise localised bands, excise meniscoid lesions secondary to impingement.

Impingement lesions
Lateral ligament injuries are very common, with 1 ankle sprain per 10,000 occurring per day. Some 1-50% have some chronic pain.

Anterolateral impingement is the commonest soft tissue impingement lesion and cause of pain after ankle inversion injury – Wolin coined the term “the meniscoid lesions” for the arthroscopic appearance of the lateral gutter in these patients.

Arthroscopic treatment is very successful in alleviating chronic pain in 84% both subjectively and objectively.

During dorsiflexion of the ankle the malleoli are separated and the syndesmosis is stressed, syndesmotic injuries are undoubtedly underestimated. Syndesmotic injuries are best diagnosed by a localised tenderness and a positive squeeze test pressing the tibia and fibula together proximal to the syndesmosis half way up the calf. Syndesmotic impingement is also associated with a separate distal fascicle to the anterior talo-fibula ligament. The incidence of syndesmotic injury is 3% of all ankle sprains.

Posterior impingement can occur and was first described by Hamilton with posterior “meniscus” displacing inferiorly. Also a labrum on the posterior lip of the tibia can hypertrophy when injured.

Inflammatory Lesions
Rheumatoid arthritis, X-tal synovitis, PVNS and Synovial Chondromatosis can all affect the ankle. Rheumatoid arthritis has been reported to have an arthroscopic cure. A 95% synovectomy is possible, and early synovectomy is better than later.

Frequently Asked Questions

  1. QUESTION:
    How do i build up the tendons + ligaments in my ankle?
    I rolled my ankle about 6 or 7 months ago, and after that ever 3-4 weeks i twisted it again. its been about 6 weeks since the last time, but my ankle is still really weak. Like if i try to stand on the outsides of my feet. i use to be able to, and still can with my left foot, but that pressure kills it, and it seems there is no support at all. Are there any exercises i can do to help strengthen my ankle?

    • ANSWER:
      Well your reading from a guy who has had at least 15 ankle sprains. Most were sports related. I truly believe that a sprain is worse than a break. Also, I feel your pain. I know what it is like to roll your ankle on the slightest surface glitch.
      Here is what helped me recover the quickest. This advice came from a coach who had experience in the medical field. Set aside approximately 15 minutes twice per day for a week. Start with a bucket of cold water (as cold as you can stand). Place your entire foot and ankle into the cold water. After a minute, add ice to the water. Keep soaking your ankle for 5 minutes. After 5 minutes, immediately place your ankle into a bucket of hot water (pre-made prior to soaking in cold water) for 3 minutes. Then back to the cold water for two minutes, then back to the hot water for 3 minutes. Finish by placing your ankle into cold ice water for 3 to 5 minutes. Do this twice per day for 5 days.

      The method seems to work the tendons and ligaments in a contraction / expansion way that will help strengthen.

  2. QUESTION:
    I broke my fibula and tore the ligaments and tendons in my ankle 9 months ago. Will I be able to start MMA?
    I have done breakdancing, parkour, and Capoeira in the past and I have had no problems since my recovery, but Im not sure about MMA.
    I breakdance, do parkour, and train Capoeira. I havenmade a full recovery, but it still has a small bit of pain from time to time…so I don’t know about MMA

    • ANSWER:
      Did you break your leg/ankle jumping off something for parkour?

      If your doctor clears you, give it a shot. Just realize that only a small fraction of people training actually fight pro.

  3. QUESTION:
    Question about torn ligaments and tendons in ankle?
    Hopefully someone on here can help me…

    So I went to the doctors about 9 days ago because I fell and my ankle basically folded up under me. The doctor told me that I tore all the ligaments and tendons in my right ankle. He put me in a walking cast boot thing and told me that in 3-5 days I should be able to stop using crutches and put some pressure on my leg. It has been 9 days and I still can’t put any pressure on my foot.

    Could it be damaged worse than the doctors think?? Like maybe there is more there than just the torn ligaments and tendons…

    The reason I ask this on here is because my doctors office won’t answer their phones so I’m running out of options to get some answers.

    • ANSWER:
      It sounds like you damaged your ligaments and tendons. It takes a lot longer for those to heal than 3-5 days. You need to get an X-Ray. I recommend you use the crutches and walking cast for at least 4 more weeks. You should also setup an appointment with an orthopedic surgeon because your Dr. doesn’t know what he’s talking about. Not getting this treated promptly or incorrectly can cause permanent damage.

  4. QUESTION:
    How can i cope with my physical imperfections when iam vain perfectionist in my mind ?
    without feeling extremely depressed?
    im bald, have a crooked little finger from an injury ( mallet finger)
    damaged nerves in my right knuckle, where i cant hit anything because of shooting pains.
    torn ankle tendons, ligaments…where i can easly twist my ankle and go over easily, if i slightly invert my ankle.
    i have 2 missing teeth, at the front, bottom row..

    how the hell will i get an attractive partner..this is whats worrying me.
    im 30 years old and im convinced no attractive girl will want me because im not physically perfect.

    does anyone else cope with disfigurements or imperfections? how do you cope when you wanna feel liked and attracted to?

    • ANSWER:
      I think the secret to attracting people is confidence and the ability to look past ones physical and other limitations. I would concentrate on being someone who is of good character and integrity than worried about my flaws.

      I would look also for a good person rather than a gorgeous partner because scientific studies have proved that as some one becomes more familiar to you, the better they look. Someone who truly cares about you will always be that way while looks fade with age (in most cases).

  5. QUESTION:
    how can i cope with my physical imperfections without feeling extremely depressed?
    im bald, have a crooked little finger from an injury ( mallet finger)
    damaged nerves in my right knuckle, where i cant hit anything because of shooting pains.
    torn ankle tendons, ligaments…where i can easly twist my ankle and go over easily, if i slightly invert my ankle.
    i have 2 missing teeth, at the front, bottom row..

    how the hell will i get an attractive partner..this is whats worrying me.
    im 30 years old and im convinced no attractive girl will want me because im not physically perfect.

    does anyone else cope with disfigurements or imperfections? how do you cope when you wanna feel liked and attracted to?

    • ANSWER:
      Well, the bottom line is that it’s the situation you face and there isn’t anything you can do about it. You have the choice to either dwell upon the fact and let it ruin your life, or make the best of the situation.

      Baldness is in the eye of the beholder, there are plenty of confident bald men who meet good looking women, buy a wig if it really bothers you. Missing teeth can be fixed at the dentist.

      As far as meeting an attractive girl, any intelligent guy should know that while looks do matter, they are a pretty small piece of the puzzle. In general, a guy’s appearence is less of a dominating factor in attraction as a girl’s is to us. If you present yourself confidently and meet the right girl, it won’t hurt your chances and if she’s the type that would reject you based upon certain aspects of appearance alone, then you shouldn’t want her anyways.

      Attractiveness is subjective. Maybe you’re the one who has rediculous standards and expects to attract some supermodel looking lady and won’t settle for anything less. There’s so much more to finding the right girl than just meeting someone pretty.

  6. QUESTION:
    tendons and ligaments in my ankle?
    sometimes the tendons or ligaments from my leg to my ankle feel really tight, so tight that it causes discomfort. i stretch my foot up to relieve the discomfort, doing this i think maybe stretches them and at the same time, it makes a cracking popping sound, and after doing so it feels so much better and looser. can someone tell me what is happening and direct me to information about it.

    • ANSWER:
      I would suggest going to see an Orthopedic Surgeon, I don’t think you need surgery, but it’s a good idea to get things looked at.

      I have the exact opposite problem as you, but the same pain. I have http://en.wikipedia.org/wiki/Ligamentous_laxity

      More info on you can be found under:

      http://en.wikipedia.org/wiki/Ligament

      Physical Therapy sites have info, but they are all going to say you need more flexibility, I would suggest doing yoga (you can do localized yoga moved, but everything is connected so why not do your whole body), with out yoga I would be in a lot more pain then I am.

      http://www.abc-of-yoga.com/info/seated-poses.asp

      Best Wish’s,
      Nolwe

  7. QUESTION:
    Othopedic Surgeon Ankle Sprain torn ligaments and tendons help pls?
    I have bad ankles, i know this because i keep spraining them..Recently i sprained my left one..I went to urgent care and they did a x ray on it and said that I had sprained it, a few days later i recieved a call that stated I had calcium deposit spurs in the bone.. i wore a air brace for 3 days and was released to go back to work, after 2 weeks the swelling has not went down and still hurts, i followed up with my doctor who sent me for an MRI, it showed i torn both lateral ligaments and a tendon, walking is difficult and my ankle rolls very easily ( i have fallen 4 x) I am now on crutches and air brace and was told not to work, I lost my job (temp agency) as a result, I have an appointment with orthopedic dr wednesday however i start a new job ( all standing ugh) tuesday- what to do? What will orthopedic dr do and how long til I can go back to work, the toes turn reddish purple and now i am experienceing slight discoloration (4wks later) of the affected leg?

    • ANSWER:
      You may need surgery if all conservative care has already been exhausted. The problem with your ankle healing is your job requires you to weight bear on it. This causes tremendous pressure. You may want to try orthotics to help give the foot and ankle more support.

      Good luck.

  8. QUESTION:
    i fell at work and had ankle surgery should i get a lawyer. ?
    had surgery done on my ankle ligament and tendons, also shaved off some cartilage .

    • ANSWER:
      I would contact a lawyer. WIth this type of claim they will work on a contingency basis (they get a percentage of what you win. If you win nothing they get nothing). However, you will be contacted by the Workman’s comp medical people and their insurance company. You need to know what to say and what not to say, the attorney will tell you. Get one that specializes in Work mans Comp cases, they all become experts when they see a chance to make money. In these times nothing is clear cut and you cannot afford to make a mistake.

  9. QUESTION:
    Ankle Sprains?
    i tend to sprain my ankles a lot because i skateboard and i have bad luck so i was wondering if there are any exercises that can strengthen my ankle tendons or ligaments to make them stronger. or is there any proteins or supplements that can help them heal or become stronger. additional information is greatly appreciated. thanks

    • ANSWER:
      Here’s a terrific article on ankle strengthening exercises and how to do them:

      http://www.aofas.org/i4a/pages/index.cfm?pageid=3330

      Also read this, it should help:
      Injury-Proof Your Ankles

      http://www.lifescript.com/channels/diet_fitness/fitness_tips/bad_ankles.asp

      Also try vitamins that are geared towards bone-building. Vitamin A is good for bones and muscles and naturally calcium supplements.

  10. QUESTION:
    Help! Ankle Tendon injury!?
    Ten days ago, I fell down some stairs and twisted my ankle. I almost blackled out with pain then. The xrays came clean (no bones broken) but there was a lot of swelling on my outer ankle and I was in agonizing pain. The doc put me in a cast from toes to knee and said I had seriously injured my tendons and ligaments in the outer ankle. I just wanted to know how long would it take before my cast comes off?
    I probably wasn’t able to explain the cast properly…it’s like a boot, enclosing my foot (but my toes are open) extending top beneath my knee. The xray was taken abt 1-1/2 hours after the injury, but yes, there was a lot of swelling.

    • ANSWER:
      It is very rare for a fracture not to be demonstrated on an x-ray even if the area is grossly swollen.

      A very severe sprain can be just as disabling as a fracture; the pain and swelling can be worse and the recovery time can be just as long. Wearing an immobilisation splint for a short period of time is unlikely to lead to severe atrophy and they may decide to leave the splint on for a couple of weeks.

      You will find when it is removed that there is likely to be discomfort and swelling for a good period of time (sometimes 3 – 4 months)
      Make sure that you elevate the leg whilst resting and take anti-inflammatory drugs as required.

  11. QUESTION:
    Tendons and ligament damage in ankle?
    What kind of doctor is best to diagnose and treat damage to tendons and ligaments in the ankle from an accident?

    • ANSWER:
      Definitely an orthopedist/orthopedic surgeon. However, you may need to be seen by your primary care physician or an emergency room physician to obtain a referral to an orthopedist/orthopedic surgeon. You could call around to places in your area and see if they’ll accept you as a new patient without a referral, or you could call your primary, have a quick appoinment with him/her, and receive a referral from them – this would make it a lot easier to find an orthopedist who will accept you as a new patient.

      Also, you may not need an orthopedist yet. By speaking to your primary they may order an x-ray (won’t show ligaments, but they may do it anyway), and then might recommend that you try physical therapy (they’ll give you a referral if this is what they want you to do). Then, if you don’t show improvement from therapy, they could recommend you to an orthoepdist for further testing (MRI’s, and stuff), and treatment.

      Hope this helps. :-)

  12. QUESTION:
    Did I break my ankle (should I get x-rays)?
    Four weeks ago in a football game, someone fell into my ankle and it rolled (what seemed like) completely over. I was barely able to limp off the field but I did and I had the trainer tape it up. I tried to go back in for a play but that was a terrible idea–it hurt like hell. So I sat for the rest of the game. I went to the doctor and he checked it out and said it was just a sprain. He said x-rays were not needed because I could walk “fine.” Let me add, I have an extremely high pain tolerance as I have finished a game with a fractured femur and a wrestling tournament with a torn ACL. Anyways, it was hugely swollen and bruised for a couple weeks. Now, I have tried to come back to playing and it is still swollen (not as bad) and deformed around the outer bone (and inner but not as bad.) I now have a calcium deposit on my very lower shin towards my ankle. My tendons/ ligaments have tightened up in my ankle and it still hurts (but not as bad.) Do y’all think I should go get x-rays just to rule it out?
    What does PAD mean?
    I also have lost range of motion. I cannot extend my foot all the way down, out, in, or up.

    • ANSWER:
      Yes you shoulda got an exray the trainer isnt trained in this.

  13. QUESTION:
    Grade I ankle sprain- 6months still in pain?
    Hi, I sprained my left ankle in Oct 2010. Still in pain. XRay is normal, but MRI says “Small bony contusion within the medial aspect of the talus. Mild soft tissue swelling about the left ankle. Grade I sprain of the anterior talofibular ligament and the deltoid ligament complex. Left ankle tendons are intact”
    Must admit that I did not rest initially.. but have been resting since the past 2months other than coming to work (mostly sedentary). But the pain is not getting any better, and I am having sleepless nights over it. It’s a kind of piercing/ stabbing pain.. and I have a tingling sensation that radiates through my entire foot. I ice it regularly and that gives me a bit of relief before the pain starts coming back again.. The discomfort is always there.
    Not much help from the orthopedists either.. Was suggested Physical Therapy.. it almost killed me. I am wearing a custom sole now with a slight incline. Anti- inflammatory pills haven’t helped.
    Any suggestions/ tips would be greatly appreciated.

    • ANSWER:
      Altered dynamics of the sural nerve are common after ankle sprains. The “tingling” sensation you describe radiating through the foot may be such an indication. I would try to find a PT in your area who has taken a course in neruodynamics…it’s likely an easy and simple solution that you might not have gotten in “traditional” physical therapy (ie, the range of motion and balance exercises). While the tradiational physical therapy is certainly important, the neurodynamics is often overlooked…then the nerve gets either adhered down or remains hypersensitive. I’d really see about getting back into PT with someone who can address this for you.

  14. QUESTION:
    Any doctors, nurses, or MRI specialists want to help?
    Okay, so i got my MRI results back for my ankle, and apparently I need surgery? I’ve hurt this ankles NUMEROUS times including partially torn ligaments and I’ve NEVER needed surgery. Any way, I hurt it during one of my cross country meets 2 weeks ago and I went in for an MRI and to a new foot/ankle doctor for the first time. I mean my ankle hurt, but it didn’t hurt like it did when I first tore/partially tore my ankle. I thought it was just a really bad sprain. It’s been 2 weeks since the incident and I can kind of walk on it. I don’t think I need surgery, because it doesn’t hurt that bad and i know I will be able to walk fine in about 2 more weeks. I can write down the findings of the MRI and could you please explain it to me? There are a lot of words I don’t understand. I’m afraid he just wants to do surgery so he can get money.

    MRI Findings –
    The ATFL is not optimally visualized and additional sequencing will be performed and an addendum to this report generated. based of the sequences obtained, the ligament appears slightly thickened with a question of focal increased signal at its fibular attachment which may indicate a partial tear. The other ankle ligaments look intact. There is mild thickening and increased signal with the peroneus longus tendon as it passed around the lateral malleolus, the other ankle tendons are intact. There is mild fluid within the tendon sheaths of the posterior tibial and flexor digitorum tendons indication tenosynovitis. Bone marrow signla is normal with no evidence of acute fracture. There is no osteochondral injury. Trace ankle joint fluid present.

    THANK YOU!

    • ANSWER:
      The ligament in question was not well visualized as stated in the first sentence there should be an addendum, do you have that?

      There may be a partial tear. There is fluid around the tendons which is indicating that there is inflammation of the tendon.

      Excerpt from Medscape Reference:

      Surgical Intervention:
      Primary repair of acute lateral ligament tears is rarely indicated. Open repair seems to offer no advantage over closed management at the time of the initial injury. Delayed repair may be necessary in patients with chronic mechanical instability on clinical examination and functional instability; however, surgical intervention in these cases should only be considered after an aggressive rehabilitation program has been unsuccessful.

      Based on this reference you may want to seek another opinion to see if you need surgery. You may also ask if physical therapy would be beneficial and if it may help you avoid surgery.

      Good luck!

  15. QUESTION:
    can anyone tell me about how long it takes for an ankle to heal after surgery to repair tendons/ ligaments?
    I know you are probably not doctors and I will not hold you responsible for any information. So don’t worry, many probably have experienced this injuries before and I would rather hear from you than the Army “doctors”. My husband went to get an exam and he says it’s and MRI of his left Ankle and the Army wants him to get the surgery ASAP to deploy to Afghanistan, even though he was supposed to get out in October…. I am worried for him since they are trying to do everything possible to deploy in the next couple of months and he might not be completely healed after surgery.Here are his results:

    There is some fluid surrounding the extensor digitorum longus tendon anteriorly consistent with tensynovitis. The Achilles tendon is intact.

    The medial and lateral tendons are intact.

    There is a partial tear of the deep portion of the deltoid ligament. The superficial portion is intact.

    The anterior and posterior tibiofibular ligaments are intact.

    There is thickening of the anterior talofibular ligament with irregularity suggesting chronic tears with scarring. The posterior talofibular ligament and calcaneofibular ligaments are intact.

    The sinus tarsi appears intact.

    Conclusions:

    1. Partial tear of the deep portion of the deltoid ligament.

    2. Chronic tears with scarring of the anterior talofibular ligament.

    3. Mild tenosynovitis of the extensor digitorum longus tendon.

    • ANSWER:
      The injuries aren’t that bad to start with, and with surgery to help fix them, I would say about three months.

  16. QUESTION:
    Plz help!!! Pain,swellin under fibula bone around ankle joint help possibly torn peroneal tendon!! Plz help?
    i had sergury on my achilles tendon 2months ago and recently i was carryin a heavy object while on crutches and accdently put full weight on my ankle..my achilles tendon was fine but under my fibula bone on my ankle joint around peroneal tendon area was swollen PAINFUL and a straigh lump around curve!! Now i need to kno what the problem is??? Peroneal tendon tear or ankle ligaments or peroneal nerve???????? Plz helpeal nerve???????? Plz help

    • ANSWER:

  17. QUESTION:
    what would be the possible outcome of Torn ligaments/tendons in iraq?
    Ok first I am going to give the medical history of my problem and try to educate whoever is reading this based off of what I know through research on the internet and previous doctors (Majors in the army). When i was in A.I.T. in 2007 I tore my Anteriro talofibular ligament while spraining my ankle. This is very common and with enough rest ice and physical therapy it will eventually heel. After 9 months and improper use of a profile and me being hard headed and listening to shitty NCO’s making me do shit i shouldnt have done physically, like PT and things my ankle was never normal. After about 8 months and complaining of pain, i had completed three sessions of physical therapy, they finally gave me an MRI. When i initially rolledmy ankle and it was swollen black n blue they just gave me tylenol and a profile and crutches, so this was the first MRI. 8 months later. This is when they found out i had the anterior talofibular ligament torn in my right ankle, i was put in a cast for a month, than the major said i might need surgery but its a big step cutting people open, so we decided it was never going ot be normal but it wasnt pain ful. I decided to resume with no profile. About a year later i deployed to iraq. I left in august and in early september in Kuwait, i rolled it running on rocks. At this time i had on n off pain everyday. I did not tell anyone. I started doing missions in iraq and clearing fields and what not as the pain got worse. In November i complained to the doctor and he literally said take tylenol for 11 months and than get surgery in the rear after the tour, because he needs me on the line(im a 35 m i do source ops and interrogations) I go out with the infantry but im not infantry and i wasnt in his company i was attached, so i told my nco. He than told our chain of command and they thought (OH HES INJURED LETS SWITCH HIM OUT) but didnt take my injury serious. So i went to our PA and he said ok listen lets do physical therapy and take naproxin, celebrex, tylenol, wear a brace. so i did this, come december i was going on leave and asked if i could get a second MRI(The first was in korea 8 months after initial injury nov 1 2007.) so i was authorized an mri in december, i got back late december and i have the mri cd and the typed report from a doctor at ucla. I now have three torn ligaments and a torn peroneal brevis tendon, with fluid in 2 different areas. after igot back they pushed back me seeing the PA because he moved fobs. So i did nothing, still in pain and fighting sleep and being comfortable everyday i kept my mouth shut and patiently asked every week “will i see a doctor soon to go over my MRI” so i finally get to go next week and see the doctor who is a major and his field is physical medicine. I researched this problem and my pain everyday and warmthness in my foot, instability is all coming from the torn ligaments and tendon. Everything i research online says the tendon tore because i have a pre existing injury which makes my ankle loose and unstable. the tendon frayed apart and unlike ligaments needs surgery to repair. The research says the pain will not go away and only get worse if i dont have the tendon surgically repaired. now to my questions

    1. What will happened when i see thePA and go over MRI results? (will he make me do more physical therapy and tylenol? make me wear a cast?) even though everyone knows if u tear ur peroneal brevis tendon u can only heel it and make it better by surgery.

    2. Do you get sent to the rear for surgery if it is needed?

    3. If he tells me i wont have surgery and theyn wont send me home, and i have to finish 6 months of my tour in pain because its not serious, what should i do? is this malpractice?
    thanks

    • ANSWER:
      listen man if you see a good doc they will tell you that surgery is normally the last resort but this surgery you will recover ok from. Yes you need to go back to the rear and get this fixed I personally feel you are stupid for not pushing this harder. I don’t know how new you are to the military but you are a replacable asset. from what I got above you have some garbage NCO’s and they are not doing there job by looking out for the Soldier. If your PA tells you tylenol and wait you need to go see another doc. if you can find an ER some where close go there you should be able to see a different doc.

      Really you need to push this issue because you let them fuck you up and the Army will not have a problem kicking you out on a Medical board and you won’t get shit other than some compensation.

      And no you can not claim Malpractice on the military sorry.

  18. QUESTION:
    Need help with tight tendons/ligaments in my ankles following injury…?
    I broke both of my heels falling off a building 2.5 months ago. I was in a wheelchair for 2 months and just got my casts off and started walking about 2 weeks ago. I was supposed to go to rehab to help with the recovery, but my insurance was pretty much maxed out so I thought I would try to rebuild myself at home, just walking and stretching a bit. I severely underestimated the recovery process because I still cannot walk very well. My right foot is OK, but the break in that one was supposedly about half as bad as the break in my left foot, and I’m still having ongoing problems with that one. There is no bone pain, and I can take slow “full range” steps for the most part, but the tendons and ligaments are still incredibly tight from not being used for so long, and I can feel them getting “pulled” when I walk and up and down stairs or when I try to take an “aggressive step” (like jogging). My question is: Does anyone know a good way to stretch these tendons/ligaments? And also, am I in danger of potentially permanently harming myself by walking while they are still “tender”? Thank you all very much…

    • ANSWER:
      Stretching them is the wrong thing to do. The best strategy is to change the tension through focused relaxation, it’s an indirect method vs a direct method but there is no possibility of damaging anything.

      Walking carefully will not cause further damage. Try this http://www.hubpages.com/hub/Speed-healing-of-trauma-injuries-through-self-directed-regeneration

  19. QUESTION:
    What are the symptoms of a torn tendon or ligament in ankle/foot?
    I was in a car accident, the EMT’s , the Er Doctor and the family doctor and the orthopedic surgeon have all treated my foot as a sprain, but it’s been since 8/14 that i was in the car accident. The swelling has gone down, but as soon as I’m on my feet my foot hurts (like I have a spur or something) and the swelling goes around the back of my ankle and pain travels up the front of my shin and goes to my knee.
    I had an M.R.I yesterday, and that takes 3 days for results.
    I was wondering if they could still see if there is a tear or could it just be a real bad sprain?

    • ANSWER:
      Why did your doctor wait so long to send you to the MRI? I am sitting here in a cast for 3 weeks. I have another 3 left before they remove it and then another 3-4 weeks of phys therapy. I fell off a ladder and likewise the er doc and orthopedist thought it was a sprained ankle. After 3 visits to the phys therapist, the swelling was going down but my range of motion was poor. The phys therapist was the one who suspected the Achilles tendon and referred me back to the orth doc, and finally the MRI. This confirmed the tendon was torn and I was given the option of surgery or a cast.

      I’m not a doctor, but I would think that a sprain would have been healed by now. From what I understand, if it is the tendon, you need to have it surgically reattached or immobilized, (in a cast,) so it has the opportunity to reattach itself. I would also think that this would show up on the MRI.

      My question would be why your doctors waited so long to diagnose this, unless you didn’t bring this to their attention. If the MRI doesn’t show anything and you’re still in pain, you might want to seek another opinion.

  20. QUESTION:
    What can be done to hasten healing of a sprained ankle?
    I sprained my ankle on 4/18. An x-ray has confirmed it is not broken. I can put all my weight on it. The ankle is still larger than it was before the injury and tendons or ligaments from the ankle to about 6 inches above the ankle are very tight. What can I do to soften those tendons and increase movement in my ankle comfortably?

    • ANSWER:
      R.I.C.E.

      Rest – keep off it!

      Ice – for 15-20 minutes a day until swelling is gone.

      Circulation – Stretch it daily, but only as far as comfortable.

      Elevation – Keep it up on a pillow when you’re able to. putting weight back on it slowly increases your chances of healing it without causing further complications.

      good luck!

  21. QUESTION:
    I tore a tendon and most of my ligaments in my ankle?
    How long will it take to recover fully? and i have these pains about three inches above my ankle, going into my calve. is that normal?

    • ANSWER:
      Do you know this because a doctor told you? If so, I’m confused as to why you wouldn’t have talked about recovery time. If you actually completely tore everything around your ankle, that would be a pretty bad injury. I think it’s more likely that you strained or stretched them, and so I’m confused about whether or not you’ve seen a doctor.

      The tendons going to your ankle originate from higher up, so it’s understandable to have pain going into your calf.

  22. QUESTION:
    Recovery time (est) for severe ankle sprain?
    I have both an eversion and inversion ankle sprain of my right ankle (ligaments on both sides of the ankle as well as on top). Didn’t hear a popping sound but there was extreme pain when I went down on my ankle in the driveway from ice. Couldn’t walk at all. Did RICE and stayed off of it for 2 weeks. Now at week 3 and I can walk some with a single crutch and an Aircast stirrup brace with a little pain though the ankle is still weak. Definite improvement though. I have some movement up/down and side/side. Bruising is still there but is gradually fading. Given I injured pretty much all of the ligaments possible in my ankle (and I assume tendons to) what kind of recovery time am I looking at? Minimum of 6 weeks? I understand everyone heals differently and my age (48) doesn’t help but looking for ballpark figure. Thanks all

    • ANSWER:
      I know that bone takes 6 weeks minimum to heal so, yeah, I would think you will be looking at least 3 more weeks.

      P.S. I checked with NetDoctor.co.uk and that article did say up to 6 weeks…so there you go.

  23. QUESTION:
    How long does it take for either a dislocation, break, torn ligament or tendon, in the ankle to heal?
    My friend fell of a bounce house and either one of these things happened. In a week we’re supposed to go to a theme park will he be able to manage?
    BTW he’s 14 and plays baseball so he’s really fit.. in case that matters with healing time.

    • ANSWER:
      Yes, I’m sure his broken ankle will be just fine in a week.

  24. QUESTION:
    My dogs’ injured ankle or foot?
    I was playing fetch with my small dog the other day at the park. Before she reached the ball, she stopped abruptly and had obviously hurt her front right foot.

    My wife took her to the vet and the diagnosis was a loose knee cap. No X-rays were taken. The doctor said that he has seen this condition many times and recognized it immediately. We were told not to worry and were given a oral pain reliever and glucosamine. We were instructed to only give her the pain releiver if she appeared to be in a lot of pain.

    Long story short, she is still limping around and doesn’t appear to be improving. I feel that her injury is something more like a slight tear, sprain, or twist her ankle or related ligaments/tendons.

    What should I do?

    • ANSWER:
      Hum. I’ve heard about rear kneecap problems (patella luxation) but never in the front!!! Bottom line – if this hasn’t resolved, and she’s still limping, take her back to the vet. He may well go for x-rays as often they start out with the ‘least possible’ first. Have you been restricting, if not cutting out, her exercise to give this injury a chance to heal? The problem with pain relief is the moment they feel no pain, they will be up and running again, which is counter productive. Soft tissue injuries can take time to mend so all may not, yet, be lost.

  25. QUESTION:
    My daughter had a serious ankle injury 5 weeks ago. When can she resume sports?
    She hyper extended her ankle and the tendons/ligaments on the top of her foot were injured (it was xrayed, no breaks). It has improved, but she still has some pain when trying to run. Should she stay off of it until she is pain-free? or can she gradually resume activity with an ankle brace, but try not to over do it? She is being pressured by her soccer coach and PE teacher to resume participation, but I don’t want to cause further damage so that it would take even longer to heal! She is also getting rehab treatment from the high school trainer…but she doesn’t seem to be able to tell her whether she can play or not.

    • ANSWER:
      The major trama from soft tissue injuries usually heals in 3-7 days. The minor injuries; small tears, ossification, bruising, etc can take up to 18 months sometimes more to heal properly. If she’s still having pain after 5 weeks she should see a doctor and a physiotherapist.

      An Athletic Trainer is suppose to be a diagnositically trained professional. If there is one who can’t identify the nature of an injury or treat it then they are suppose to refer the patient to a sports medicine doctor or another type of doctor if there is not a SMD in your area.

      Is the athletic trainer at her high school professionally trained and accredited? If so and she’s not sent your daughter off to a more highly trained professional by now I’d say she’s not doing her job.

      Also if the swelling was severe it is possible that they were unable to find a small fracture in an x-ray.

  26. QUESTION:
    Not a question. Im so down I don’t know what to do. Ive seen all types of doctors.?
    I abuse pills, Im 29, my father that I never really knew Is now sleeping on the living room floor. He’s a alcholic. Not a drunk, but beer Is part of his breath smell and hygen Is like really bad. I cant work and havent for over two years. I broke my left heel and right ankle. Ligaments and tendons are torn and I can bairly walk. I dont sing karoke anymore or play my guitar for the lack of truth. Im 250 lbs and only 6′ 1″. My girl has changed drastically towards me. Frinds or shall I say friends I thought I had dissapeared. Im very Intelligent but cant get over depressed feelings. My mom hit two people walking 2 months ago, where the guy almost died from head trauma and now my mom Is mentally shot. She’s 64 yrs young, yet old If you know what I mean. My family Includeing my sisters have been abused all our lives. Even my sisters have been devistated by him. Broke, lost my mustang that I loved. Writing on this website cause Im lost. God exist. My name Is Steve,and Im sorry you know….

    • ANSWER:
      Others have it worse! You do wake up every morning! Remember Steve, you can only control what you do….not what any one else does or feels!
      Your only looking at the bad things in your life….turn it around! I 100% know how you are feeling, I’m 32 yrs old, I was married then divorced 7 yrs later…I’m now a single mother of 4 little girls….I drive to Mexico to get pills every other month….men approach me and say, “I cant believe you don’t have a man..your beautiful!”…But I cant put my guard down!…..I had 2 yrs of a abusive relationship….finally got out, things where looking good…then 2 months later, I had a major stroke…who has a stroke at 32??? I’m healthy…It doesn’t run in the family….just a damn blood clot in my Left side of my brain….I was a veggie for 2 months….that was 7 months ago….i wished I was dead!! But my girls need me….Now, I go to the gym twice a day, and wake up every morning thanking God for another day!! So stop thinking about all the bs…focus on the positive and have faith!! Snap out of it!!! Keep your head up….we will still have some bad days, but the good days will make up for those!!

  27. QUESTION:
    I am wanting to start up a company… but can you explain these laws…?
    Hello

    I am wanting to start up a web based company. Number of employees: 0. I will register the company as a Ltd. however, I may know all there is to know about this web based company, but I don’t understand the laws.

    I am unable to work due to a disability. I currently get help (money) from the state to live on. However, I was able to work for some time till it got too much and have a little put by. I am currently getting Disability living allowance and Income support. I do not work, but as I have a little bit of money put away, I would like to use this and start up a web business.

    I know what I need to do, to sell the products, but I don’t know the taxes, however this can be overcome with an accountant.

    I need to know, if I start up this company, will I need to inform the job centre that I am doing this? I plan to put 100% back into the company to make it expand, however I need every penny from the state, for example, I need specialist things made to help me get around. These are not cheep, they cost nearly £500 for 1 leg, I need 2, thats nearly £1,000, this is not including the other 4 areas where I need to spend big on.

    However, this is just a start of my years ahead. I now say, enough is enough. I want to use the money I have saved up to start a business so I can look forward to a brighter future, but I can not lose the benefits… what is my best solution?

    I have problems with the following, both big toes, ankle ligaments and tendons don’t work, this means that I walk for a few meters and I fall over. If I stand still it feels like my knee is going to snap, this is due to weakening ligaments to the knees. However physio wanted me to force myself to walk like normal people do. I walk with my feet pointing either behind my, left leg pointing at 8 and the right leg pointing at 4 (yes, this is the easiest for me) I also walk with my legs pointing at 10 and 2. As the physio wanted me to walk with both feet pointing 12, this has caused more problems with my hips and now lower back. I spend most of my days in bed as I can not move due to too much pain.

    This is why I want to set up a company now, so I have a future to look forward to, something I am good at… which this is perfect.

    I am told this problem will be with me for life, unless I get 2 surgery options. These are 5-10 years away at the moment, as I am too young, I am in my lower 20′s.

    Please help…

    • ANSWER:
      There is an amazing charity called the Shaw Trust which I think you will find invaluable as their sole aim is to help disabled people who want to do some kind of work. They can sort out grants, courses and just basically give direction and introduce you to a network of assistance. The number is on the internet and also when I was going to start my accounts from home business they said that as it was in the starting stages it would not affect my benefits as there was effectively no income.

  28. QUESTION:
    Help!!!!!! 10pts for best answer i promise!?
    Ok Im a varsity soccer athlete and soccer season is coming up. I was also just recently asked to also play on a select soccer team. Last season I tore one of my ankle ligaments or tendons (I always get the two mixed up) so i haven’t really ran until recently. Ok Im sad to say im not really self motivated. Like if i tell myself i’m gonna run one mile today and two tomorrow I probably won’t run the two tomorrow but cut if off again at one. But if I have a set workout that someone gives to me then i follow it even if it kills me! So i was wondering if someone would make me a workout (mainly cardio). I mean it doesn’t have to be anything fancy but i would like a easy day, medium day, and hard day and then i would just rotate them. If u have any exercises that could help increase speed please include them as well. Thank you all in advance!

    • ANSWER:
      Easy — one mile, 200 crunches, 50 v-ups, 20 push-ups, 50 calf raises. ( speed comes from calf’s and thighs)

      Med.– one mile, 15 flights of stairs (sprint–any stair case you find), 50 lunges (25 each side), 300 crunches, 25 push-ups, 50 calf raises.

      Hard– two miles, 300 crunches, 50 push-ups, 100 calf raises, 50 lunges

      each day when doing the long runs try to incorporate your sprints to increase speed. i dont know what kind of facility you have so i made it simple. if you have a gym or track do multiple very short sprints to get your speed up. stairs and lunges are great for legs which will increase speed.

  29. QUESTION:
    Need Help! 10 pts for best answer I promise!?
    Ok Im a varsity soccer athlete and soccer season is coming up. I was also just recently asked to also play on a select soccer team. Last season I tore one of my ankle ligaments or tendons (I always get the two mixed up) so i haven’t really ran until recently. Ok Im sad to say im not really self motivated. Like if i tell myself i’m gonna run one mile today and two tomorrow I probably won’t run the two tomorrow but cut if off again at one. But if I have a set workout that someone gives to me then i follow it even if it kills me! So i was wondering if someone would make me a workout (mainly cardio). I mean it doesn’t have to be anything fancy but i would like a easy day, medium day, and hard day and then i would just rotate them. If u have any exercises that could help increase speed please include them as well. Thank you all in advance!

    • ANSWER:
      A tendon is an extension of the downstream end of a muscle and a ligament is tough band-like material that holds joints together. You need to strengthen your ligaments and tendons in order to avoid a strained or sprained ankle. Aerobic (oxygen up take) exercises won’t do it as they will most likely weaken the joints with all the pounding. The best thing is to do anaerobic (no oxygen) exercises that are slow, low repetitions, heavier resistance which will build up muscle,.as aerobic will not only break down fat but muscle
      also. In fact, anaerobic exercises will increase your basal metabolic rate and you will burn off fat even when you are sleeping.

      Speed isn’t going to help you if you tear and damage tissue in your ankles, which you have already done, and once you have such an injury it will never heal the same and will always be weak and you may have a greater tendency to injure them again.

      The body has both fast-twich and slow-twich muscle and you must exercise both of them as they are completely different. So quick, fast, instantaneous, short distance movements and exercises are the best for that, but not hard, heavy, strenuous exercise. Cardio-aerobics won’t help these because you are using large muscle masses for aerobic cardio.

      Anaerobic exercise uses your stored creatine which is an amino acid (C4-H9-N3-O2) is initially used up within the first two minutes of exercise then your body shifts into aerobic metabolism exercise. The by-product of creatine is creatinine. Creatine does not use oxygen to provide the first spurt of energy. Aerobic exercize uses oxygen to burn glucose to produce carbon dioxide and water and energy as it creates ATP (Adenosine Triphosphate) for the muscles to use for movement and strength.

      You need to rest your ankle injury for a minimum of 6 to 8 weeks or it will get worse and cause permanent irrepairable damage.

      In soccer, aerobic-cardio exercise will only increase your “wind” or endurance, NOT your fast, quick movements nor your strength.

      For an exercise regimine you need to alternate 3 different exercises: 1- first day start off with the slow, low reps, heavier weights or in this case putting your ankles through full range of motions= back and forth, up and down, side to side and lifting your body up and down bending your ankles using your toes and balls of your feet. 2- then second day exercise your fast twich muscles with quick, fast, light-weight thrusts, darting to and fro and up and down sort of like a quick dance with block and parry and darting here and there. 3- then the 3rd day do your cardio-aerobic exercises. BUT, start off slow, gentle and easy the first 3 weeks. DON’T injure your ankles doing exercise.

  30. QUESTION:
    What are the Ligaments and Tendons for the specific joints?
    1. Elbow
    2. Ankle
    3. Cranial Sutures

    Thanks :)

    • ANSWER:
      Tissue that hold the bones together.

  31. QUESTION:
    Torn ligaments and tendons?
    Hey, So i torn ligaments and tendons in my foot and ankle… and it was bad but its getting worse the whole foot is black and purple..and cramping really bad i went back to the dr. he said it could be broken but wouldnt take xrays… what now?

    • ANSWER:

  32. QUESTION:
    Is it possible to have weak tendons and ligaments?
    I always seem to be having problems with my joints. I have wrist, ankle, hip and knee injuries all the time, but when I go for x-rays, the doctor tells me there’s nothing wrong. The pain is there, though, and it’s very real. I’m not overly active, I just engage in average work and daily activities. I do walk for exercise, however (when I’m not in pain). So what could be causing all these injuries?

    • ANSWER:
      it sounds like you have loose ligaments and or tendons. i do, and didnt figure it out for years. i have it in my ankles, hips, knees, wrists, elbows, and my shoulders. if you have it in your shoulders, you should have some heart tests done, because it may be affecting the tissues. i know it seams stupid, but trust me.

  33. QUESTION:
    Treatment for torn ankle ligaments?
    I went over on my ankle 2 weeks ago playing basketball and have been using crutches for around 7 days. It felt like it was starting to get better however, my Achillies tendon and the area on the outside of my left anle has started to feel much worse!
    Can anyone suggest ways to treat this and speed up recovery?
    Thanks
    Thanks for the advice. I’ll go for the physio for a while. See if it helps.

    • ANSWER:
      A speedy recovery from sports injuries requires that you have all the adequate amounts of natural anti-inflammatory substances in your body. These consist of vitamins, minerals and other nutrients that are vital for your cells to function optimally and to heal faster following an injury.

      The following nutritional supplements are scientifically proven to shorten recovery time from sports injuries by up to 50% and are totally side effect-free:

      - Chondroitin
      - Glucosamine
      - MSM
      - Ginger root extract
      - Coenzyme Q10

      The nutrients listed above have the following effects:

      - Effective pain relief after only a few days of supplementation.
      - Enhance muscle strength, mobility, speed and preceision.
      - Enhance tendon and bone strength.
      - Reduce risk of chronic injury.
      - Stimulate cartilage growth including density.

  34. QUESTION:
    Torn ligament or tendon in ankle?
    About 2 months ago, I decided to try snowboarding. On my first run, I really biffed it hard, but I thought that I only sprained an ankle or something minor. It swelled to like twice the size and was bruised for over a week. Since then, the pain has gotten worse and has spread further around my ankle and is into the bottom of my heal, around the ankle and above the ankle. I cannot put very much pressure on my one ankle, but I can if I use my toes instead. If I place the two of my feet together and slowly lower my ankles to the ground, I can do it with no problem with the other ankle, but not with the injured one. Whenever I am on my feet for more than a little while (which is all the time), my ankle gets stiff and sore. What is the problem? I’m not an expert, but I would guess it is something like a partially torn or bruised ligament or tendon (Achilles?). What can I do about the pain and healing process? Do I need to see a doctor? Thanks lots.

    • ANSWER:
      It sounds like you have a bad sprain or strain. You could even have a fracture, but you would need x-rays to be sure. Go see a docotor to find out what is wrong.

  35. QUESTION:
    Torn ligament in ankle.?
    According to my MRI, I have 1 ligament completely torn (anterior tibiofibular ligament) and partial tear of the posterior tibiofibular ligament and tibialis anterior tendons in my ankle.

    It’s been months since I’ve injured it and the doctor said if it was going to heal on its own it would have healed by now. He suggested that i have surgery.but I have had no problems out of my ankle, i can walk and run on it and it doesn’t hurt at all. So would it hurt me if i continue playing sports with it and just wear an ankle brace?
    Also, the main issue I’m worried about is recovery time. How long would it take to recover from this surgery so i would be able to play sports?

    • ANSWER:
      I know a kid who tore a ligament in his ankle. He did not get surgery and like the previous answer, whenever he walks his ankle bends to the side and repeatedly gets sprained. If I were in your position I would get the surgery let it heal properly. Happy I could help.

  36. QUESTION:
    Horrible ankle pain? Please help!?
    So 3 years ago, I had torn all my ligaments and tendons in both ankles ( I was 13 and it was soccer related) I continue playing without the aircast recommended but not needed and finished the season in great pain but quit after that (boy do I miss it). Along the years, I’ve had a few pains in my ankles and feet but never thought much ofnit besides taking aspirin and walking it off. Now I have a horrible shooting pain that’s random (usually at night or sitting down) that makes me like… Cry it’s so bad. Doubled over in pain. It’s from the center of my ankle to my knee. (left leg) when I walk fast which is a lot it killllllls and feels very stiff. I’ve had trouble falling asleep because of the pain at night. Hurts hurts hurts. I’m a minor and can’t fo to the dctors myself and my paents are like “we took you for your ankle before. Take aspirin and get over it” (3 years ago!) rahh. What should I do/ any ideas/ tips/ suggestions/ similar stories? Also, if I do go to the docotrs, would I possibly get a walking boot (I’ve always wanted one! (: ) ? Thanks a bunch! (: ( no rude comments or spam please!)

    • ANSWER:

  37. QUESTION:
    How to strap up my ankle and what to use?
    I quite severely damaged ligaments and tendons in my ankle 4/5 weeks ago whilst our running. Although it ‘twinges’ slightly when I moved it to either side, it feels about 85% better and there is only minimal swelling left around the outer ankle bone.

    I want to get back to running this week, I know it will be lighter/shorter initially, but I’m just wondering the best course of action as I don’t want to risk re-injury as i’ve read can happen if you start training again too early.

    I don’t have gym membership as I find it a bit of a waste of money as I can run for free anywhere I like, and don’t really do anything other than running and sit-ups at home, so I can’t use ‘other equipment’ or anything…just FYI!

    Can I strap it up safely with a tube bandage or a ‘wrap around’ type might be better, or maybe I was thinking the long (knee length) running socks might help?

    Or is it too early to start running again?

    Thanks in advance :)

    • ANSWER:
      I have dodgy ankles from 30 years of amateur football an ex-pro told me to put large studs on the outsides of my boots and small ones on the insides, it has the result of raising the outside of my foot and lowering the inside because your ankle always buckles outwards. Use a crepe bandage and wrap it so as your pulling the outside of your foot up. Strap it every time you go running. Hope this helps :0)

  38. QUESTION:
    There is a pain in the back of my ankle. What is it?
    I sprained my ankle playing basketball and the ligaments on the outside were torn. I’ve been walking on it and the back of my ankle, where the achilles tendon is and it hurts. What could that possibly be?

    • ANSWER:
      You have probaly hurt your achilles tendon. I have that problem and I have to stretch it everyday. Stand on the steps with your heals down. You will feel a stretch. Hope this helps… if it doesn’t I would go to your doctor.

  39. QUESTION:
    How long after this injury should I get back playing football?
    Ok so here is the story: I was playing football when I broke my fibula, dislocated my ankle and done all the ligaments, tendons etc. How long after doing it should I get back to playing football?

    • ANSWER:
      It will likely take at least two months, probably more.

  40. QUESTION:
    Will a turned ankle make the arch of your foot and the top of the foot to the toes hurt?
    That wouldn’t have anything to do with tendons or ligaments would it? When I have turned my ankle before only the ankle hurt, not my whole foot.
    Will an ace bandage help?
    It is swollen and hard to walk on and I don’t have insurance.
    Any tips would be appreciated. And I do have to walk on it – I can’t stay off of it all of the time.
    Thank you.

    • ANSWER:
      yes it has everything to do with ligaments and tendons
      if you have a stage one ankle sprain you can use an ace bandage
      but if you have a stage two or three you may need a boot
      or even surgery. I’m no doctor but have been a professional athlete
      and a high school coach in my younger years
      since you say you have twisted it before you may have torn a ligament
      since you don’t have insurance, you could go to emergency rooms
      or you could ice it down for a couple of days stay off it and keep it wrapped
      then see how it reacts, ankles are touchy they can heal quickly
      they can also take several weeks to heal.hope this helps
      good luck, and stay off of it. oh and with the ice 20 minutes on 20 minutes on
      for a couple of cycles then wrap an elevate

  41. QUESTION:
    Pain in my right ankle, could something be wrong with my tendon or ligaments?
    I fractured my ankle (fibula) about 9 weeks ago. I was placed in a fiber glass cast for almost 7 weeks (no surgery). It has been 2 weeks since the removal of the cast. I started exercising my ankle, and then walking on it with crutches, and I have just started walking on it with a cane. Sometimes while I’m walking and put too much pressure on my right ankle, or when I haven’t walked for a while and just get up to stand, I get this sharp pain on the side of my ankle where it was broken. It isn’t a throbbing pain, it doesn’t last, it comes and goes. When I touch it, it does not hurt, and I can move my ankle pretty well now without any pain. There is some minor swelling around my entire ankle, which the doctor said would be normal for up to a few months because I was immobilized in a cast for so long. But why the pain? Can someone with any experience help me out. I cant see my ortho. for 2 more weeks and I would like to know if this is something serious…???

    • ANSWER:
      This pain can be normal after a fracture as well as a sign for some problem like injury of your ligaments or a remaining dislocation at the site of the fracture, but none of these problems are so serious that you couldn’t wait for the meeting with your specialist, only if the pain is so severe that you couldn’t stand it. When you see the doctor do not hesitate to say him or her about your complaints.

  42. QUESTION:
    Quickest way for ligaments/tendons to heal?
    i fell and sprained my ankle twice within one month, it hurts like hell, no bones are broken, i ice and elevate it, is there something else i can do, eat, drink so it heals faster? doc says it might take up to 4 months to heal completly.. HELP! (i’m using crutches)

    • ANSWER:
      The fastest and safest way to treat and cure torn or strained ligaments is the Homeopathic Remedies ARNICA MONTANA and RHUS TOX in 30X or 200X potency. You will love the way they bring relief fast,lasting and totally free from side effects and complications.

      Take Care and God Bless You !

  43. QUESTION:
    Severely damaged ligaments in ankle. Doctors, do you have an opinion?
    History:
    2 years ago I severely sprained my left ankle, I had a complete tear in my ATFL and a partial tear in my CFL. I am also born with an accessory bone on my Navicular which then fused to the Cuneiform next to it via cartilage. That sprain was treated on my own since I didnt have health insurance. I used crutches for 3 weeks while using RICE. The ankle and its ligaments healed, yet I had developed Posterior Tibial Tendinitis and was experiencing an aching pain on the medial side of my foot (where that fused lump is located) in the mornings, after exercises, and after standing up over 20 minutes.

    After nearly 9 months of that pain, I took 6 weeks off from any physical activity as hand surgery prohibited my participation in any sport. That sore/dull pain went away.

    I now have been able to play basketball, football, and soccer completely pain free for about 14-15 months. Now that is that is the ankles history, lets move on to where it gets tricky.

    1 month ago I incurred another ankle inversion on that same ankle while coming down awkwardly off a rebound in a game of basketball. This time I have insurance and made an appointment with my local Podiatrist. He ordered an MRI and it showed:

    -Bifid os tibiale externum and slight edema at the synchondrosis associated with midfoot pronation and posterior tibial paratendinitis.

    -Peroneal tenosynovitis with slight adhesion’s within the peroneal tendon sheath, an os peroneum, and mild peroneus longus tendinosis proximal to and within the cubital tunnel, but no morphologic high grade tear.

    -Anterior Talofibular ligament is torn.

    -Mild Achilles tendinosis without tearing or advanced tendinopathy.

    -Tibiotalar and posterior subtalar joint effusions with synovitis and/or hemorrhage. Mild talonvaicular and naviculocuneiform degenerative changes.

    (Speaking with my podiatrist and doing my own research on these terms I completely understand what is going on with the ankle.)

    The ankle was mildly swollen, no discoloration, and I was able to bear weight on it with a slight limp the very next day; however that old aching dull pain came back. Im thinking tendinitis again. After being in a Cam-walker for 1 month I was ordered for physical therapy and didnt need the boot anymore. My physical therapy was mainly just for the tendinitis so it involved a lot of stretches and electro-stimulation therapy.

    Since I was in the cam-walker for a month, the pain went away. So I decided to tape my ankles up and get back to running and getting back on the basketball court. Well after 2 days of 70% basketball, the ankle felt perfectly fine during and after the game. On the 3rd day of basketball, I inverted my ankle while jumping up off an opponents foot and re-tore my ATFL and possibly my CFL as well.

    This is the 2nd ATFL tear in the last 35 days, and the 3rd in its lifetime. Also, that fused bone on the medial side of my foot is aggravating the tibialis tendon trying to enter into it.

    I am going to see my podiatrist tomorrow morning, but wanted to see if anyone else has an opinion on what I should do from here on out.

    My questions are:

    1. With two grade 3 sprains in the past 35 days, does this diagnose me with Chronic Ankle Instability?

    2. Should surgery be an option to repair the ligaments that have been torn a few times and to shave that accessory bone deformation down to relieve stress on the tibialis tendon?

    3. If healing conservatively, is there a chance to get back to full strength if rested the proper amount of time (several weeks) followed by a more intense physical therapy to help strengthen the muscles and ligaments damaged?

    4.Can the ATFL naturally heal after two severe injuries to it within 35 days, or is surgery a must?

    5. Since I was able to play going about 70% with 0 pain during and after, was this last inversion simply bad luck, or was it because the ligament wasn’t fully healed?

    • ANSWER:
      1. Yes, absolutely. Chronic Ankle instability is more of a subjective diagnosis based on your ability to function, but it sounds like your ankle is pretty jacked.

      2. An orthopedic foot or sports med specialist can perform a bronstrom repair to re-attach your ATFL and tighten your CFL. While they were in there, they could probably deal with the accessory navicular. It would be a significant surgery and require some serious PT and rest, but it would eventually get you back on your feet. You’re talking about roughly 4 weeks of non weight bearing followed by another 4 in the boot. This would probably help with the posteior tibialis tendonitis eventually.

      3. Typically when an MRI reports that a ligament is torn, that means it’s torn all the way through and basically gone. Your ATFL may scar down to a certain degree, but would always be very loose. I think at a bare minimum, you’d be doing regular ankle exercises, like daily, and wearing a quality brace for many years. While it’s not an easy decision, I’ve seen some good results from the Bronstrom repair, including one girl playing Div. I college volleyball.

      4. See the first part of answer 3

      5. Once you have a few good sprains, you’re always more likely to sprain again. In addition to having very loose ligaments, your peroneal muscles (which are responsible for protecting against inversion sprains) tend to have reduced reaction time and poor proprioception. A lot of the PT exercises they made you do were to re-train your peroneals.

      One other thing that stands out in your MRI is the “Mild talonvaicular and naviculocuneiform degenerative changes.” This basically states that you’re starting to develop some arthritis in the ankle. The fact that you’re not hurting right now is good, but that’s the sort of injury that catches up to you at 55 or 60 years, sometimes earlier.

      I’m assuming you’re a younger person so you have to think about the long term health of your ankles. All in all, you might have to transfer your care to an orthopedic foot/ankle surgeon. I don’t know what surgical procedures your podiatrist does. You kinda got delt a bad hand, good luck with everything.

  44. QUESTION:
    Partially torn ligaments in ankle, pain in the back of the foot above the heel?
    I severely sprained my ankle about 4+ weeks ago and the diagnosis was that i had partially torn 2 ligaments. I was prescribed a walking boot which i wore for about a week. My foot is still painful but i can walk and even run I do however still feel pain in the back of my foot above the heel. There’s pain when i extend the foot full length and when i rescind it back. There is also pain in the area where i tore the ligaments (the outside of my right ankle) when i try to stretch that area. Doctor told me my achilles tendon was in place and there were no fractures, i had x-rays done. What could be causing pain in the back of my heel?
    Could it be a stress fracture in the heel?

    • ANSWER:
      Call the doctor that diagnosed you and gave you the boot. Sounds like it’s your ligaments to me.

      Best of luck to you!

  45. QUESTION:
    Tendons and ligaments again?
    I had my foot squashed with a forklift. A minor break in the ankle but I am having problems with the tendons and stuff being very tight and also some pain in different parts of my foot. What is the difference between a Sports Medicine doctor and an Orthopedist? Can I expect full recovery or will I have problems with my foot from now on?

    • ANSWER:
      A sports medicine doctor specializes in the treatment of athletes and those with athletically related injuries. They ususally focus on non-surgical management.

      An orthopedist is a surgeon. However, they may also have a speciality in sports medicine…they can focus on both the surgical and non-surgical mangement of these injuries. They can also see people who are “non-athletes” with ortopedic problems.

      Crush injuries are very difficult, usually because there are several different types of tissues injured. Many are left with chronic pain, however, this is something you need to discuss with the doctor who examines you.

      Good luck

  46. QUESTION:
    I have very elastic tendons & ligaments?
    I have had numerous reconstructions on my joints, including shoulder, knee, ankle and lots of dislocations. My doctor tells me I have lax joints, but I want to know what I can do to fix it. I’m sick of having to have reconstructions every few years. I”ve stopped playing sport, but the problems continue.
    did not mean to post this in mental health

    • ANSWER:
      You can do exercises to strengthen the muscles around your joints, which will help to keep them more stable. This is best done under the supervision of a qualified exercise therapist or physiotherapist.

  47. QUESTION:
    Is it better to break your ankle or sprain your ankle?
    I once had a really bad ankle sprain when I was playing in the NBA. I went up for the shot and landed badly on my left ankle. At the ER, the doctors told me it wasn’t broken. Since then, my ankle just hasn’t been the same. Would it have been better if I’d broken my ankle instead? That way, the bones would just heal, rather than screwing up my ligaments and tendons.

    • ANSWER:
      It depends. If you were on the Minnesota Timberwolves, it would be better to sprain your ankle. You’d have to go to a vet for therapy, and usually their nurses are hotter.

  48. QUESTION:
    (Ankle)anterior talofibular ligament (ATFL) Reconstruction – one year post op!?
    I had a ATFL injury and had reconstruction a year ago, which ment that I had to wear cast for 9 weeks (3 weeks non weight barring, 3 weeks with small weight on and last 3 weeks full weightbarring), and after that I as in physio for about 6 – 8 months.

    I don’t have a full inversion movement which I understand that was the whole idea of surgery, My only concern is, now and again my ankle keeps getting tendon and shape pains now and again and I often get more stiffness untill I move my ankle around so I can feel it crack, sometimes it goes better after that! Also, in the cold weather it hurst aswell, is that normal and is there anything I should fo to prevent this from happening?

    • ANSWER:
      Follow the direction of your doctor is the best advice . Good luck

  49. QUESTION:
    quickest way for ligaments/tendons to heal?
    i fell and sprained my ankle twice within one month, it hurts like hell, no bones are broken, i ice and elevate it, is there something else i can do, eat, drink so it heals faster? doc says it might take up to 4 months to heal completly.. HELP! (i’m using crutches)

    • ANSWER:
      I wish I could tell you something about assisting the healing..I can’t. But I will suggest asking or seeing a physical therapist, or of course your MD. By personal experience, I can tell you that it is the muscles and tendons and ligament type injuries that can take a very long time to heal, especially if they are not being appropriately treated. Don’t risk an injury that may never go away. As unfortunate as it is, the Doc is no doubt right in letting you know “it’s going to take a while”.

  50. QUESTION:
    Is It Okay to Ditch Crutches Early?
    I Have a bad Grade 2 sprain on my left ankle, tore ligaments and tendons on both sides and front of the ankle. In an aircast for 4 more weeks.
    The doctor wants me to use crutches for 2 weeks, It has been a week and a half.

    But my right ankle which was always my worse ankle is starting to really hurt and I almost sprained it again yesterday when using the crutches when it landed wrong. Now I am afraid to keep using the crutches as the pain is getting worse in the right ankle. So I just want to stop using them now instead of Monday,

    Now I know I should call the foot doctor and explain, but I never told him about the pain in my right ankle. I have lived with it so long that it is second nature to me. I also did not want tests on it as I am paying for it out of pocket. I get insurance in June so I am hoping that I can avoid get hitting with a pre-existing condition. I also know that in either July or August I will hurt the ankle I always do and then I will get it checked o
    I know who to use the crutches, it is just that the pain in my sort of uninjured ankle is getting worse. My right ankle hurts whenever I do too much on it. But I normally just bear with the pain and keep going.

    • ANSWER:
      The majority of the load bearing is on the good leg when you use crutches, the crutches are not load bearing. So it is normal for your load bearing leg to become sore. If you do not want to talk to the Dr. about this stay off both of your feet, access a wheelchair when available and hang in there until Monday. Use the crutches don’t ditch it and this is about all I I can say if you won’t tell your doctor.