Sport-Related Ankle Injuries " Jason a 23-year-old recreational ultimate frisbee player "

Case study ( 7562 views as of April 22, 2024 )

Jason is a 23-year-old recreational ultimate frisbee player who visits his physician, having sprained his left ankle five days ago in a game. He stepped into a hole on the field, and was unable to continue. He limped off, and went to the local walk-in clinic, and had an x-ray, which showed no fractures. He was put into a tensor bandage and crutches. Jason has had several injuries like this before, but none this bad.

On exam, his left ankle is swollen around his lateral ligament complex. There is no bony tenderness. He has some pain on testing ankle stability, in particular on his drawer test. He is able to bear weight, but with some pain if he tries to turn while walking.

Jason would benefit from seeing a physiotherapist to reduce pain and swelling, and to eventually work on strength and balance, to prevent future injury. He likely requires an ankle brace, to provide compression to reduce swelling, to provide stability, and to reduce pain. If he continues to have significant ankle instability, surgery may be considered to repair the torn ligaments, and he would be referred to an orthopaedic surgeon in this case.

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Conversation based on: Sport-Related Ankle Injuries " Jason a 23-year-old recreational ultimate frisbee player "

Sport-Related Ankle Injuries " Jason a 23-year-old recreational ultimate frisbee player "

  • Open ankle fractures, also known as compound fractures, occur when the broken bones puncture through the skin. These injuries require surgery to clean the wound, remove any debris or foreign objects, and repair the fracture. However, not all ankle fractures require surgery. If the ankle fracture is stable and in a good position, it may be treated non-surgically using methods such as immobilization with a cast or splint, pain management, and physical therapy. This approach allows the body to heal the fracture naturally over time. In some cases, surgery may be deemed too risky if the patient has a severe medical condition. The decision to proceed with surgery is usually based on a careful assessment of the patient's overall health and the potential benefits and risks of the procedure. Factors such as age, underlying medical conditions, and the extent of the fracture will be considered by the orthopedic surgeon when determining the best course of treatment. It's important for patients with ankle fractures to consult with a medical professional who can evaluate their specific situation and recommend the most appropriate treatment plan.
  • The severity of a sprained ankle can vary from mild to severe, depending on the extent of ligament damage. Symptoms of a sprained ankle typically include pain, swelling, bruising, and difficulty walking or putting weight on the affected foot. Treatment for a sprained ankle usually involves the R.I.C.E. method, which stands for Rest, Ice, Compression, and Elevation. Resting the ankle, applying ice packs, compressing the area with a bandage or brace, and elevating the foot can help reduce pain, swelling, and inflammation. In more severe cases, medical intervention, such as physical therapy or immobilization with a cast or splint, may be necessary. It's important to seek medical attention if you suspect a severe sprain, as it may require further evaluation, such as X-rays or other diagnostic tests, to rule out a fracture or other serious injury. A healthcare professional can provide a proper diagnosis and guide you on the appropriate treatment plan for your sprained ankle.
  • Adductor Longus: This muscle is located in the medial compartment of the thigh. It originates from the pubic bone and inserts onto the femur (thigh bone) near the linea aspera. The adductor longus primarily functions to adduct the thigh, meaning it brings the thigh closer to the midline of the body. Adductor Brevis: The adductor brevis lies deep to the adductor longus. It originates from the inferior pubic ramus (part of the hip bone) and inserts on the linea aspera of the femur. Like the adductor longus, it contributes to thigh adduction. Adductor Magnus: The adductor magnus is the largest of the adductor muscles. It has two parts: the adductor and the hamstring part. The adductor part originates from the inferior pubic ramus and inserts onto the linea aspera. It assists in thigh adduction. The hamstring part, on the other hand, originates from the ischial tuberosity (the "sitting bone") and functions as a hip extensor and a knee flexor. These adductor muscles play essential roles in various movements, such as bringing the legs together, maintaining balance, and stabilizing the hip joint during activities like walking, running, or jumping.
  • Achilles tendon repairs can be tricky as there can be wound healing challenges and the tendon must be set at the right length to ensure proper use of the muscles. Achilles tendon tears can wait to be treated with little effect on the healing and recovery process. An Orthopedic surgeon will reattach the two ends of a ruptured tendon with stitches, ensuring tendon length is correct and muscles can therefor function properly.
  • Patients suffering from ankle arthritis can also have several other joints in the foot effected by arthritis at the same time.
    • After foot and ankle surgery a patient should expect to get the full range of motion back once healing has taken place.
    • Ankle arthritis is more common than having arthritis in the hip or knee.
  • The most common type of injury is an inversion-type injury or twisting over on your ankle. That’s frequently seen with running, with any soccer, football, rugby, tennis and racquet sports as well when people twist over on their ankle. MRI is the best modality to look at the ligaments and the tendons around the ankle and also to look for bone marrow edema, which can’t be identified with CT or ultrasound.
    • Patients that have bad injuries to the foot and ankle can suffer from pain and deformity. Surgery may be needed to correct the deformity and take the pain away.
    • If a patient with ankle arthritis has tried shoe modification, shoe inserts and braces and still suffers with ankle pain they can then consider seeing an Orthopedic surgeon.
    • Apart from the ankle joint, the other joints in the foot are to small to perform arthroscopic surgery.
    • Arthroscopic surgery allows a surgeon to see inside a joint more effectively and perform necessary procedures in a minimally invasive way.
    • Arthroscopic surgery in the foot and ankle has improved healing time due to fewer incisions, swelling and pain.
  • He's lucky he didn't injure his ankle further. I stepped in a hole and chipped the bone, severely stretched the ligaments and was left with a lifelong weak ankle.
  • I think the ankle brace and strength training exercises will go a long way in helping this patient.
    • Don't forget about stretching exercises! You want to make sure the ankle retains full mobility and doesn't stiffen up
  • Julianne Petersen, R.Ac and I have had great success working together to speed up the recovery process of ankle sprains by reducing the localized swelling at the site of injury. In addition to implementing mobility exercises, proprioceptive exercises, strengthening exercises, and soft tissue work, I evaluate your talar and subtalar joints. Often they become "jammed" and this can impede the ankle's ability to achieve the end range dorsiflexion and plantarflexion required for full mobility.
    • I've never thought about asking my chiropractor to adjust my ankle. I've only ever worked with a physiotherapist.
    • @KMichael the best way to ensure you ankle joint stay mobile is to stretch and strengthen the muscles crossing the join and have a Chiropractor adjust them.
    • How can one prevent their joint from becoming jammed while recovering from an injury ?
  • Acupuncture works very well for ankle injuries. We have special points that directly affect the ankle and it also improves long term by promoting circulation to the area. In the long run, improved circulation will strengthen the ankle.
    • This is very interesting. I will have to speak to my acupuncturist about this. I have lingering ankle issues from a fracture 20 years ago.
  • What exercise will help strengthen your ankles to assist in avoiding ankle injuries ?
    • Almost 20 years after my ankle injury and it's still incredibly difficult to stand on one leg. I'll have to incorporate that in to my workout to build up strength.
    • Three words: Single Leg Balance Other ways to strength the ankle muscles and leg proprioceptors are unilateral exercises ie. the lunge. The lunge is very versatile because you can modify the leg position and can add weight and add a ploy metric component to it.
    • I was given a number of exercises in physiotherapy after an ankle fracture. Most of them are stretching exercises to increase my mobility. I
  • I find that I can be walking in flat shoes (even running shoes) and I will turn my ankle. It does not cause pain it is just a weakness I feel for a second or two, stumble and keep walking normally. Is this common or is it a sign of an underlying ankle injury ?
    • Most likely you have ankle instability. Have you had a previous ankle injury? It's possible that you're ligaments are naturally more lax and less stable and therefore you will need to address this problem with ankle strengthening exercises. Walking is an activity that involves being on foot with every step, therefore, you should attempt single leg balance exercises with guidance from a physiotherapist.
  • I sprained my ankle running up a wet hill as a teenager. To this day I still feel slight pain in that ankle when walking for a long distance.
    • Have you considered therapy to help relieve the stress on your ankle ?
    • Theo do you find that walking on uneven surfaces also aggravates your ankle and causes pain ?
  • At one point in my life, I had a number of ankle injuries. I did not realize that surgery can address ankle instability. However, I did initiate the exercises suggested by my physician to strenthen my ankles.
  • I would strongly suggest this young man seek out a physiotherapist to work with to fully rehabilitate his ankle before he returns to exercise. Since he has had several ankle injuries in the past, it points to significant ankle instability. It will be very easy for him to re-injure his ankle if he does not properly work on building his ankle strength with a physio.
  • I stepped in a hole and tore the ligaments in my ankle 20 years ago. I still have some instability and pain. I did not require surgery but did see a physiotherapist - which helped gain some strength back
    • I have a friend who had the same experience as you @Kimberley. She too benefited from physiotherapy to strengthen the muscles around her ankle. She noticed a marked difference in her stability after several sessions of physiotherapy followed by repeating the exercises at home.
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