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View Full Version : Any sports therapists or orthopedic surgeons on here?


thijs
07-18-2007, 09:24 PM
Okay I seem to have a bit of a problem: Two different diagnoses' for my injured ankle.

I twisted my ankle during a wakeboarding fall. My left foot came half out and my right foot came completely out falling after a left foot forwd fall. I instantly felt pain in my left ankle. I was able to weight bear immediately afterwards, but had difficulty walking on the ankle. After about 4 hours the pain was much worse so I went into a rural hospital where GP attend. The doc there seemed unsure about the xray, but said he saw a chip and pointed to where on a textbook pic. I went home to bust out one of my texts and it tells me the bone he was talking about was the talsus. I had pain inferior to my medial maleolus and some bruising there. I also had pain inferior/distal to my lateral maleolus (much less severe). The doc said he was going to have a doctor in the neighbouring town look at the xrays and he would get back to me how long the cast should stay on. He said what causes the fracture he saw was a compression, but there was no significant compression in the fall. He put a cast on for '6 weeks'.

Well after wearing a cast for four days in the blistering humid heat and not hearing back from this doc even after a call I go to the ER in the major trauma centre here in Calgary. He finds nothing in the xray after removing the cast. I will include a pic of the bruising. There was minimal sweeling today. Anyways I can weight bear without any pain and have booked an appointment with physio as directed. The only pain is proximal and superior to the lateral maleolus (only on palpation). So I am cast off and walking as tolerated. My range of motion is only restricted trying to touch toes to knee direction.

Well anyways, get a call from the original doctor saying the neighbouring doctor says 3weeks then reassess. I dont know where to go from here. I didnt look at the original xrays, but did at todays. I saw nothing obvious. No obvious fragmentation/cracks, but I am not a radiologist/Doctor.

What do I do. I have no pain and there is NO pain to where the original Doc says the fracture is.!!!?????

I think a very bad sprain/ligament tear?

ProTour X9
07-18-2007, 09:29 PM
sorry for your misfortune........wheres drbrainey when you need him :D

Maristar210
07-18-2007, 09:33 PM
BigMac is a trauma surgeon.

My buddies wife is an orthopedic surgeon. She is out of town, however.

BigMac will help you I bet. He's a good egg.

Looks like it hurts..... :(

Upper Michigan Prostar190
07-18-2007, 09:34 PM
ask Bigmac. he is a real doctor. OR.....


if you need or want surgery done, please call me. I will perform it for WAY cheaper than anyone else. I need the practice. AM I a surgeon? well, it depends on who you ask. if you ask the people at the college or medical board, they will probably say NO. if you ask the boys at the pool hall, or that tribe in zimbabway, they will say I am. The choice is yours thisvogelsang or how ever you say your name, but I was an amatuer taxidermist, and a mechanical engineer, so in some 3rd world countries, that makes me a surgeon. Talk to me.

thijs
07-18-2007, 09:39 PM
You're on ump. I'll be right down. You see, people in my position can't access what you call....quality health care.

André
07-18-2007, 09:57 PM
You're on ump. I'll be right down. You see, people in my position can't access what you call....quality health care.

Realy? And i thought it was only here...:rolleyes:

Get a third opinion.Good luck!

atlfootr
07-18-2007, 09:59 PM
:( for the pain, my previous orthopedic doctor is now retired.
If it's any help to you or others he wrote a book called 'Knee Pain',The Self-Help Guide
by Dr. John Garrett, M.D.

He made sure I got a copy, after he repaired both my ACL's.

trickskier
07-18-2007, 10:01 PM
That looks really PAINFUL...............Sorry to hear about your accident........

thijs
07-18-2007, 10:18 PM
Really it doesnt hurt anymore unless I poke it twist it or try to walk without my limp. Thanks though to everyone for their condolances. The only thing that make me sad is that I am going to miss out on being towed around for a few weeks/months. I missed a week of work and I am probably going to have to skip surfing in Ucluelet in a couple of weeks. :(

TX.X-30 fan
07-18-2007, 10:22 PM
I had a similar fall last year, one foot stayed in the other out and my body rotated around the foot still in the boot when it dug in the water. I knew something was wrong immediately crawled for the next few hours, then was able to put some pressure on the ankle. I had very little swelling as you said and not as much blood or bruising under the skin. Latter at the bar :rolleyes: we met an orthopedic guy who took a look and brief explanation of what happened. In his opinion I had a soft tissue tear in the ankle that he said would be slow to heal.

That was an understatement, off and on for 9 mo. I would hobble on the ankle, then it would be fine for a few days. Today I have no problems at all with the ankle.:D In my work I walk quite a bit and never had a chance to let it heal properly.

Hang in there and good luck with your ankle, just to let you know I still skied and it was fine locked in the boot.


I never strap my feet in those boots that tight anymore. :noface:

Upper Michigan Prostar190
07-18-2007, 10:25 PM
You're on ump. I'll be right down. You see, people in my position can't access what you call....quality health care.
My gosh, your name is giving me bed spins. are you swedish or something??? you must be viking.

OK, if you want me, all you got to do is say my name 3 times. just like beetlejuice. Hey!!!! I didint decide these goofy rules! dont blame me! I just work here. say my name 3 times.

ski_king
07-18-2007, 10:27 PM
My suggestion would be to go to a good orthopedic MD and have him check it out. In your profession I am sure you know who the goods ones are.

All I can say is it looks like it hurts, and I stayed at a Holiday Inn Express last week.

Upper Michigan Prostar190
07-18-2007, 10:34 PM
Really it doesnt hurt anymore unless I poke it twist it or try to walk without my limp. Thanks though to everyone for their condolances. The only thing that make me sad is that I am going to miss out on being towed around for a few weeks/months. I missed a week of work and I am probably going to have to skip surfing in Ucluelet in a couple of weeks. :(
OK, dont poke it. dont twist it. dont try to walk without a limp. by the looks of that injury, it needs time. things take a long time to heal man. Look at even a small cut. I cut my knee open while drunk on the mayors pontoon boat last monday. I have taken excellent care of the wound, and its still scabed over, not even close to being healed. its just a simple cut. when I sprained my ankle, I did EVERYTHING the doctor told me. EVERYTHING. no foolin. it took months for it to heal. but it healed great! I havent had an issue with it, and its been 6 years now. NO issues at all. but I didnt rush it. I followed directions.

Call me, I will cut'er up dude. I will sew it back together with spider wire, cuz I like nice things.

TX.X-30 fan
07-18-2007, 10:40 PM
Just saw your profile, 26 won't take as long as 46. :noface: :rant: :cry: :cry:

tex
07-18-2007, 10:42 PM
I've got a very bad knee and I've played doctor on numerous occasions. Sorry, I don't think I could help you. Good luck. See another doc!

tex
07-18-2007, 10:57 PM
I did decide to not use ump as my doctor and ended up having to have a 2nd operation!....I mean for what it's worth!

milkmania
07-18-2007, 11:02 PM
sorry,

I'm just practicing to be a Gynecologist:(
(if your wife needs any help, just hollar);)


but, I can prescribe ibuprofen like a madmanhttp://deephousepage.com/smilies/eusa_dance.gif

TMCNo1
07-18-2007, 11:03 PM
I did decide to not use ump as my doctor and ended up having to have a 2nd operation!....I mean for what it's worth!
You should have trusted UMP, he is also a Undercover OB/GYN!:D

Upper Michigan Prostar190
07-18-2007, 11:05 PM
You should have trusted UMP, he is also a Undercover OB/GYN!:D
Listen to this man Harold, he is a wiseman. He is also a wiseguy. but thats not important right now. Trust him. He is pre-law. :D Harold my brutha! how goes the studies? you get to the part about frumunda cheese yet???:confused:

Upper Michigan Prostar190
07-18-2007, 11:06 PM
I did decide to not use ump as my doctor and ended up having to have a 2nd operation!....I mean for what it's worth!
See? see what I mean?? Tex doesnt diss me. Give me a try, what can you lose?? a foot? :confused:

thijs
07-18-2007, 11:46 PM
My gosh, your name is giving me bed spins. are you swedish or something??? you must be viking.

Thijs, pronounced Tice, is a very old traditional Christian Dutch name (Short for Mathijs or in english Matthew) allthough my name is legally the shortened version. Last name is the rest of the leters, which means bird song.

lsupcar
07-18-2007, 11:56 PM
It never hurt at the supposed fracture site? I think the first diagnosis is probably bogus. Maybe a fracture or avulsion at the mallalus, but likely a sprain as you suspect. How long would you have to wait to get in to see an orthopedist? Good health. Bill Z

bigmac
07-19-2007, 12:08 AM
Certainly the swelling having gone down, no pain on weight-bearing and the equivocal xrays would make a fractured ankle unlikely.

Without seeing the xrays or being able to examine the ankle, I can't even help you as much as UMP, but fractures and sprains usually hurt a lot with weight bearing. If yours doesn't, I'd be be more inclined to suspect bruising from the binding rather than fracturing or substantially tearing any of the supporting structures of the ankle. I would take the ER doctor's advice. Ankle injuries are some of the most common injuries they see.

COboarder
07-19-2007, 12:30 AM
thijsvogelzang,
I am a Physical Therapist, or Physiotherapist as they call them in Canada. I am not sure how the referral process works with the Canadian socialized medical system, but I would consider requesting a review of the original and repeat x-rays by a radiologist or orthopod. The repeat x-rays in Calgary do not show a fracture or bone chip, but a review wouldn't be a bad idea. Not a knock against a general practitioner, but many an ortho has caught something that was missed by someone with less specific training.
If you do in fact have a fracture of your talas with a loose body in the joint you may or may not be a surgical candidate. An orthopedist would probably decide that based upon displacement of the fragment. The first MD mentioned a fracture due to compression. I might interpret that as - the compression on the medial part of you joint during the inversion movement could have compressed the medial aspect of the talas and chipped off the fragment. There are characteristic fractures that we started seeing in snowboarders with compression in the form of dorsiflexion and loading - casing it on a jump for example.
I am not completely surprised that you are not painful with weightbearing. If your foot was in plantarflexion and inversion and you actually DID suffer a fracture of the talas, it might not be in a weight bearing portion of the talas. Plus you said yourself that it only hurts if you try to walk NORMALLY.
With a sprain of that magnitude and mechanism, you undoubtedly disrupted your anterolateral ligaments (anterior talofibular and calcaneofibular ligaments). If there was enough leverage to separate your tibia and fibula (and it sounds like there was) you may have torn the syndesmosis between the two, a "high ankle sprain." A "spring test" may help to confirm this. I would guess that they would have made mention of it on the x-rays if it was grossly evident. The pain you have with palpation along the lateral maleolus could be due to a traction injury (strain) of your peroneus longus and brevis and the tissue along the lateral ankle. I have seen a stress fracture of that area that lingered for a long time as an "unresponsive patient", so if it does not go away, consider requesting a bone scan.
If you came into my clinic AND I trusted the interpretation of the second x-rays, treatment would probably be something like this - efflourage massage to reduce edema, taping with an open basket weave and compression to keep the swelling out, initiate stationary bicycle and or pool therapy ASAP to help with swelling reduction and return sagital plane range of motion. Being respectful of the (likely) disruption of your lateral ligaments we would probably begin gentle inversion/eversion movements (ankle alphabet etc.) to let them heal and scar down some before we get too aggressive with ROM. Encourage RICE, taping or bracing, and weight bearing as tolerated. Home exercise program would begin with open kinetic chain exercises and progress to closed kinetic chain balance, proprioceptive, and dynamic stabilization exercises. These can be done in a sports specific fashion bilaterally on a wobble board, but must include unilateral work. Train your dynamic stabilizers aggressively, most people give up on this stuff once they are feeling better and actually lack dynamic control of the joint.
If you have your options when you schedule your physiotherapy, request someone that specializes in sports injuries, or call the local orthopedist's office and see who they like for these types of injuries. Best of luck,

Shawn

Upper Michigan Prostar190
07-19-2007, 12:41 AM
Certainly the swelling having gone down, no pain on weight-bearing and the equivocal xrays would make a fractured ankle unlikely.

Without seeing the xrays or being able to examine the ankle, I can't even help you as much as UMP, but fractures and sprains usually hurt a lot with weight bearing. If yours doesn't, I'd be be more inclined to suspect bruising from the binding rather than fracturing or substantially tearing any of the supporting structures of the ankle. I would take the ER doctor's advice. Ankle injuries are some of the most common injuries they see.
See? what he said!! I just couldnt sit though all that class room time. I am a worker bee! hands on, thats me! I say we operate! one more blue hawaiian and I will be ready! how long does it take for thismovoglelsanz to drive here?? :confused:

Upper Michigan Prostar190
07-19-2007, 12:43 AM
Man you Canadians confuse me.!:confused: I thought all yous guys did was drink beer and play hockey, eh??

Upper Michigan Prostar190
07-19-2007, 12:46 AM
Thijs, pronounced Tice, is a very old traditional Christian Dutch name (Short for Mathijs or in english Matthew) allthough my name is legally the shortened version. Last name is the rest of the leters, which means bird song.
OK, I see. My name means Upper, as it northern. michigan, as in the state of confusion and joblessness, and prostar, which is an underground "legit" term for pornstar. you judge it how you see it, thizgovolegeansg!:cool: blue hawians make me not type your name very good. sorry.:o

Monte
07-19-2007, 12:59 AM
Man you Canadians confuse me.!:confused: I thought all yous guys did was drink beer and play hockey, eh??

What about the game where you sweep the ice in front of a big heavy stone with a handle on top???? THAT HAS TO BE CANADIAN:cool:

Co and Bigmac look to have the best answer, but I have no idea go with UMP!

fintek9
07-19-2007, 01:01 AM
havin a good night are ya UMP? You are on a role!!!!!
:uglyhamme

Upper Michigan Prostar190
07-19-2007, 01:08 AM
What about the game where you sweep the ice in front of a big heavy stone with a handle on top???? THAT HAS TO BE CANADIAN:cool:

Co and Bigmac look to have the best answer, but I have no idea go with UMP!
Oh you KNOW that game was born out of pure boredom!!! OK, lets see, we are too bored to *****, so lets slide these big a$$ heavy rocks down the ice rink and hollar alot as we sweep ice frantically infron of it, then hollar at the stone.

Who decided this??

who decided to make it a sport??

who actually produces the stones and brooms???

Move the doomsday clock forward two minues please....:o :o

Upper Michigan Prostar190
07-19-2007, 01:09 AM
havin a good night are ya UMP? You are on a role!!!!!
:uglyhamme
well, we are hangin in there..... time for bed soon.....

Upper Michigan Prostar190
07-19-2007, 01:14 AM
Hey, thisaljoveaong, warp that ankel in some guase pads and 3 in 1 oil! and maybe some quaker state anitfreeze. then call me in the morning. not too early!!!!! I may need to service the female in the AM, so dont disrupt me. your ankle can wait for that. I will fix that *****!!!!

thijs
07-19-2007, 01:15 AM
Thanks COboarder. I am going to have to try to get them reviewed. I just wish I had an absolute answer now. This is a lot of work and the healing has barely started.

COboarder
07-19-2007, 01:34 AM
Don't get discouraged! It does take time, but do it right and you will have the best outcome you can. I had a somewhat similar ankle sprain on my snowboard several years ago and had to recruit a fellow PT to help me get over the last nagging symptoms and dysfunction. It was a good learning experience for me. Helped me to better understand what some of my patients are dealing with.

bigmac
07-19-2007, 10:59 AM
Sounds like great advice from COboarder and UMP. I could probably been more helpful if you'd been shot instead of injuring your ankle.

chevy08bud
07-19-2007, 11:24 AM
A few years back, I f'ed up my ankle real good. My foot slipped off of the footpeg on a 4wheeler and I landed with all of my body weight on my foot sideways on the ground and then the back tire of the quad ran over my foot/ankle while it was sideways. Hurt real bad initially, thought I was going to pass out. Lots of swelling and bruising like what you have. Didn't end up going to a hospital because it was just before football season, so I got one of those lace-up ankle braces with the plastic inserts on either side of the ankle. They work really well and I played football the whole season with it on. It didn't totally heal for about 8 months, but with the brace, I could do whatever I wanted.

trickskier
07-19-2007, 11:59 AM
I could probably been more helpful if you'd been shot instead of injuring your ankle.

That's comforting to know......................:eek3:

thijs
07-19-2007, 12:04 PM
Well the ankle is a little more sore this morning after sleep, but I expected that. It seems injuries just get a little stiffer in the morning. I can really feel that I have been compensating in my gate. Well I think it will get better after some ice and non-weighted ROM exercize and mild stretching.

Tourney Team 197
07-19-2007, 12:19 PM
Ironically, I have almost the exact same ankle injury. Although, mine occured while skiing. I have similar bruising and quite a bit of swelling. The injury happened almost a week ago. I have an occasional pain in one of my leg bones (tibia or fibia...i dont know). Should this be a concern? I have not gone to see a doctor yet. I can put weight on my bad foot and walk on it with a slight limp. I have slight motion with not a whole lot of restriciton. Can any of you that helped thijsvogelzang give me some advice? Thanks!!!

bigmac
07-19-2007, 12:33 PM
Ironically, I have almost the exact same ankle injury. Although, mine occured while skiing. I have similar bruising and quite a bit of swelling. The injury happened almost a week ago. I have an occasional pain in one of my leg bones (tibia or fibia...i dont know). Should this be a concern? I have not gone to see a doctor yet. I can put weight on my bad foot and walk on it with a slight limp. I have slight motion with not a whole lot of restriciton. Can any of you that helped thijsvogelzang give me some advice? Thanks!!!\

Hey...if you need an orthopedist, call Leo, or his partner Diane (she's a Foot and Ankle specialist). But if youget shot, I probably would be the guy you end up seeing...

TX.X-30 fan
07-19-2007, 01:23 PM
Sounds like great advice from COboarder and UMP. I could probably been more helpful if you'd been shot instead of injuring your ankle.




So you are saying if he shoots himself in the foot your glad to take a look at it for him. :confused: 8p

Maristar210
07-19-2007, 01:32 PM
So you are saying if he shoots himself in the foot your glad to take a look at it for him. :confused: 8p


He could but I'd suggest a little higher aim for you ya Ham & Egger....

46 huh?

Your old 8p

TX.X-30 fan
07-19-2007, 01:47 PM
He could but I'd suggest a little higher aim for you ya Ham & Egger....

46 huh?

Your old 8p





That's not what Mrs TX.X-30 fan says. :D ;)

Maristar210
07-19-2007, 02:04 PM
That's not what Mrs TX.X-30 fan says. :D ;)

Does she roll her eyes :uglyhamme

TX.X-30 fan
07-19-2007, 02:13 PM
Does she roll her eyes :uglyhamme





During the first 20sec or the last 10. :confused: 8p

Sodar
07-19-2007, 02:15 PM
46 huh?

Your old 8p

TX and Tricker can almost get the senior discount!! :D :D

Maristar210
07-19-2007, 02:16 PM
During the first 20sec or the last 10.: 8p

Wow 30 seconds.
:worthy: :worthy:

That's some stiff competition :D

Like I said before the first 3 seconds is for foreplay the next 12 are business related and the last 15 seconds shall be spent telling her what I want on my sandwich - MAN LAW !!!!

Maristar210
07-19-2007, 02:17 PM
TX and Tricker can almost get the senior discount!! :D :D


Only four more years until the AARP application shows up in the mail Cam. (10 for me :o )

Maristar210
07-19-2007, 02:19 PM
Sorry about the threadjack.


VOgel - Drink heavily and .... well..... drink a lot

....It'll feel better

thijs
07-19-2007, 02:36 PM
VOgel - Drink heavily and .... well..... drink a lot

....It'll feel better

Yeah, I find that it does help. We did know we had to go to hospital (even after footin' and skiin' on it) when I told the father unit it hurt too bad to drink the beer he offered me!!

trickskier
07-19-2007, 03:18 PM
TX and Tricker can almost get the senior discount!! :D :D
Ahem..............That's Mr.Trickskier to you...............:D
And I can get the seniors discount..............AARP @ Five-O

Sodar
07-19-2007, 03:26 PM
Ahem..............That's Mr.Trickskier to you...............:D
And I can get the seniors discount..............AARP @ Five-O

So Sorry Mr. Trickskier.... please excuse my diss..... i mean my disrespect!! :D :D

fintek9
07-19-2007, 03:27 PM
During the first 20sec or the last 10. :confused: 8p
Ahhh, the old 28-29-30 I'm out of here:rolleyes:

Upper Michigan Prostar190
07-19-2007, 11:14 PM
I am here ready to do surgery! Black russianed up and ready to cut! BTW, I dont accept any insurances....

Maristar210
07-19-2007, 11:23 PM
[QUOTE=Upper Michigan Prostar190]I am here ready to do surgery! Black russianed up and ready to cut! BTW, I dont accept any insurances....[/QUOTE

Cash payments accepted with zip line stradegy alreadly configured..

Upper Michigan Prostar190
07-19-2007, 11:25 PM
[QUOTE=Upper Michigan Prostar190]I am here ready to do surgery! Black russianed up and ready to cut! BTW, I dont accept any insurances....[/QUOTE

Cash payments aceepted with zip line stragegy alreadly configured..
Well, I do a bit of horse tradin too. Whatcha got to trade? dont have to be money. Got a motorcycle? guns? Guitars? 4 wheelers? anything I can turn into cash.... I deal. Talk to me baby.

Maristar210
07-19-2007, 11:27 PM
Talkin smack again HAAAAAAAAAAAAAAAAAAAAAAAAAAAA

Why aren't you calling? 8p

Upper Michigan Prostar190
07-19-2007, 11:28 PM
Talkin smack again HAAAAAAAAAAAAAAAAAAAAAAAAAAAA

Why aren't you calling? 8p
Cuz you got caller ID and never answer when I call! :uglyhamme

Upper Michigan Prostar190
07-19-2007, 11:30 PM
Talkin smack again HAAAAAAAAAAAAAAAAAAAAAAAAAAAA

Why aren't you calling? 8p
or maybe because I dont want to disturb your game of hide & go **** yourself!8p ;)

Leroy
07-20-2007, 12:38 AM
Hey ump, my son has a stress fracture in his navicular bone in his foot, what do you recommend? The doctors are talking about SS screws, know you have those! We see another doctor here Sat at 9AM.

tex
07-20-2007, 12:42 AM
I got 6 in my left knee....do you need a couple?

Leroy
07-20-2007, 12:47 AM
This one may take him out of the high school soccer season.....one is enough!

I can't imagine having 6 :(

I got 6 in my left knee....do you need a couple?

COboarder
07-20-2007, 02:56 AM
Ironically, I have almost the exact same ankle injury. Although, mine occured while skiing. I have similar bruising and quite a bit of swelling. The injury happened almost a week ago. I have an occasional pain in one of my leg bones (tibia or fibia...i dont know). Should this be a concern? I have not gone to see a doctor yet. I can put weight on my bad foot and walk on it with a slight limp. I have slight motion with not a whole lot of restriciton. Can any of you that helped thijsvogelzang give me some advice? Thanks!!!

There are plenty of people who have managed to tough it through a severe ankle sprain and/or fracture. chevy08bud for example! What is probably the most prudent thing to do? Rule out a fracture.
That being done, you can go a couple of different routes. One would be to see a physical therapist or athletic trainer. There are hands on treatments that can help to expedite the healing and recovery process. If a patient is a young, healthy, motivated, and intelligent individual, I may only see an ankle sprain patient 2-4 times with treatment consisting of hands on work, taping, and education in home exercises. They can usually progress fairly quickly with that guidance.
There are also web sites with lists of exercises and suggestions to follow. The basics of RICE are a good place to start. Taping and bracing usually help your ankle feel more stable and therefore less painful. Don't forget to continue with the strengthening and dynamic exercises. An ankle sprain disrupts the inert stabilizers of the joint (ligaments) so it is even more important to have good strength and control of the dynamic stabilizers (muscles) that surround and control the joint.

thijs
07-24-2007, 11:33 AM
Well I was back at work yesterday. It was a pretty busy day, lots of walking. In my tight boot my ankle did very well. things are healing very nicely so far, still going to my first tomorrow afternoon. Thanks for all the input and advice. Sorry UMP looks like it isn't going to be a surgical operation. I am going on holidays and i am sure I am going to crash some way, some how; I'll keep you card.