Back on my feet, a little floppy though

Its been almost a year since I tore my ligament. I am 99.9% Ok, and that is good enough.

Things are a bit different now after I tore my talo-fibular ligament on my left foot in a game of squash,

1. I can't run as fast as before. (pretty sure it is not the old age that has caught up). I think it is the confidence level. Can never be the same

2. there is still a small bump around my ankle. Doesnt hurt; not sure what it really is.

3. I can play squash now, but an ankle guard really helps with the confidence.

4. There is still a teeeny weeny limp when I climb down stairs; it looks like I am happy and hopping along; but when you see me do it all the time, it doesnt look quite so natural. 

5. I have stopped visiting this blog!

Ankle Rehab Exercises

check out these videos

Week 11 onwards - Gymming to Walk

I go to the gym regularly after removing the cast. The trick is to get the confidence back in you foot. Mine was hopelessly lost.

I limp and do not walk normally. There could be 2 reasons that have resulted in the limp
- Hamstring and calf muscles are atrophied and very weak
- Mind over body. I don't believe in my foot

My guess is that it is a bit of both and they continually are a function of each other. So as I strengthen my muscles, my confidence builds.

I wear an ankle guard while gymming. Really helps. And better to play safe.

In the gym,
- I do 10-15 minutes session on the treadmill. During this session, I walk at a slow speed (between 2-4) trying to ensure that I walk without a limp. Looking at your feet while walking is good feedback to the brain and helps walk steadily. (it is not a good idea to try and beat the mile-in-4minutes record on day 1!)

- 10-15 minute session on the cross trainer. Doesn't require too much ankle movement but helps put some weight on the ankle. Additionally helps strengthen hamstring and calves.

- 10-15 minute session of cycling. helps in ankle movement and really helps strengthening the muscles. This felt like the easiest of the 3 sessions.

After a few sessions, I also started doing some simple weights on the legs (especially the victimized one).

After each gym session, my foot is invariably slightly swollen. This is probably due to all the soft tissue and bone injury; and not the ligament tears. Over days though, the swelling after exercise has been coming down (very very slowly). Bit of rest again makes everything look normal!

After each gym session, I have some protein supplement to give the muscles all they need to grow.

Is ankle surgery helpful?

In cases of severe injury and sportmen, surgery is recommended.  the link below shows pictures of a ankle surgery (cadaver tendon used to replace the torn ligament) 
http://www.footankleinstitute.com/ankle-instability/

The complications which may occur after a ligament reconstruction operation include:
· pain in the ankle, either because of damage at the time of the original injury or
because the ankle is now tighter than before
· numbness or tingling down the side of the foot due to stretching of one of the
nerves either at the time of the original injury or the operation
· persistent swelling of the ankle
· Stiffness of the ankle, restricting the range of movement
· In 5 to 10% of people the surgery does not work, and the ankle remains
unstable

http://alexwee.com/en/information/Ankle_Ligaments_AW.pdf

Remember - Surgery related infections are always a risk!

Week 10: Removing the cast - Its not over.

Finally, I got my cast removed in a small clinic in Delhi. Removing the cast is an experience in itself. My cast was a fibre cast - quite tough. A scissors or something sharp won't do. You need something sharp PLUS high frequency, about 1000 Hz (just a guess).
http://www.youtube.com/watch?v=BACimEbps8k

You need to drill through the cast, make a clean cut. When the drill is going through your cast, its better to keep still. And it feels like an earth quake centered in your bones.

Once a single cut was made, the dude in the clinic just used his bare hands to rip apart the cast (not the most elegant way to do it - also painful, like Lord Narashimha).

What I then saw was quite ugly - my leg looked like the Rann of Kutch

the skin was completely broken and I could peel out layers at will (very itchy). Good idea to use 

- Lots of cold cream 

- Famous coconut oil from Kerala (India) (solves all problems Malayalees ever faced)

Everything feels weird on the 1st day. Basically the muscles feel quite weak and need to be strengthened. 

Also, there might be some swelling - which will persist ON/OFF for about 2-3 weeks. 

Time for physio. 

Will I keep having trouble with my ankle?-The majority of ankle injuries get better completely and cause no longterm problems.

 -Unfortunately occasionally there is permanent damage to the ankle. The ligaments may fail to heal properly and become weak – leading to ankle instability, or there may be damage to the joint itself or some other structure nearby leading to ankle pain and swelling.

Week 9 : Some tips on home physiotherapy

6-8 weeks of immobilization can mask many things that you taken for granted.

• Dunno why, I cannot get myself to put any weight on my left leg (with the damaged ankle). Everytime I try to put some weight on my leg, I automatically start limping, jumping, skipping - basically anything to avoid putting weight on my left leg.

After you remove the cast

http://physicaltherapy.about.com/od/orthopedicsandpt/ss/anklerehab_2.htm

http://www.thechildren.com/trauma/_pdf/en/leg.pdf

Week 8: Some useful links

About ankle sprain recovery/rehab
http://sprainedanklerehab.blogspot.com/

My favorite one, about a guy who ruptured his Achilles tendon - the whole process
http://www.achillestendonblog.com/

Another blog about ruptured Achilles tendon, with the writer desperate for a quick recovery (me too!)
http://rupturedachillestendon.blogspot.com/