My Doctor said that the ankle is stable but weak. His theory is that I re-injured the deltoid ligament when I sprained the lateral side of my ankle. Probably not as bad as before but enough that with my ramping up my trail mileage it is irritated and causing swelling which is leading to the pain.
He tested it in all directions and only found issues along the deltoid ligament (slight pain but no indication of a complete tear). He said my ankle is basically not strong enough to manage the minor tweaks of trail running without it complaining by swelling and hurting. Apparently the deltoid ligament helps stabilize the ankle against plantar flexion, external rotation and pronation and prevents external rotation and valgus stress to subtalar joint (he said some of this but I got the rest from a presentation on Deltoid ligament injuries, way beyond my limited understanding of the body). So running on the trails was causing too much rotation and by increasing the trail mileage it just added to more wear and tear that the ankle couldn't handle. All of that aside, the good news is that it is stable so I can run on it.
He tested it in all directions and only found issues along the deltoid ligament (slight pain but no indication of a complete tear). He said my ankle is basically not strong enough to manage the minor tweaks of trail running without it complaining by swelling and hurting. Apparently the deltoid ligament helps stabilize the ankle against plantar flexion, external rotation and pronation and prevents external rotation and valgus stress to subtalar joint (he said some of this but I got the rest from a presentation on Deltoid ligament injuries, way beyond my limited understanding of the body). So running on the trails was causing too much rotation and by increasing the trail mileage it just added to more wear and tear that the ankle couldn't handle. All of that aside, the good news is that it is stable so I can run on it.
Ok, there were a couple of caveats, he said I need to run in the ankle brace for the next 6 to 8 weeks and I should pretty much wear it all the time over the next few weeks while I work on tightening up and strengthening the ankle by using a wobble board or a boso ball. He wants the swelling to go down (no unsupported and/or unnecessary ankle rotations). Since I just bought a wobble board, guess what I will be using? I would be remiss to point out that I can't stand on it without hanging onto something so I have some balancing work ahead.
He also said I could get a MRI and it should confirm his beliefs but he didn't think it was necessary and mentioned it might show some other issues such as early arthritis or other soft tissue issues concerning cartilage and the ligaments. He said it was up to me, I asked what would change by knowing and he said assuming no surprises probably nothing. So I skipped it for the time being, he said if after a few more months of following his instructions, if there are still issues then he will want a MRI.
So my ankle brace and wobble board are my prescription, I just need to follow his orders and I will be back to normal soon enough. Looks like I will be shooting for the Chester Woods 50k followed by the Afton 50k. If it takes me longer than I will just focus on Afton. If it takes even longer, well than Surf the Murph but I am betting on Chester Woods.
So my ankle brace and wobble board are my prescription, I just need to follow his orders and I will be back to normal soon enough. Looks like I will be shooting for the Chester Woods 50k followed by the Afton 50k. If it takes me longer than I will just focus on Afton. If it takes even longer, well than Surf the Murph but I am betting on Chester Woods.
4 comments:
That is really good news!! Hope it gets stronger quickly!!
Yay for a diagnosis and treatment plan!
Hope things progress well and you are back on the trails soon. I guess you could take Mother Nature's insistence on a cold, wet spring as reinforcement of the need to stay off the trails ;->
Drs. can sometimes help but keep on listening to what your body's telling you. I've yet to find a Dr. who's figured out how to help me yet. Sounds like you're getting good advice & on the right track.
Be seeing you at an ultra one day . . . . .
Thanks for the comments everyone. I hope that if I do the exercises that maybe my ankle will work on trails by summer.
Ed - I agree with you, I have never gotten along too well with doctors, probably has something to do with me not following their advice or even seeking it most of the time.
Look forward to seeing all of you on the trails.
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