Ankle injury - ongoing for almost 2 years

[Weismayr42]

Hello all

It's my first time posting in here, and any help would be hugely appreciated. The story is rather long winded but I'm hoping to whittle it down to the key points...

Around 2 years ago, I rolled my ankle playing football and have been having problems with it ever since - occasional pain when walking, but mostly pain when attempting to play football or exercise again. However, it has only really escalated in roughly the last 11 months, so I finally decided to go to an NHS physio earlier this year. It took until September before he finally decided I should have an MRI scan, since the earlier suggestions were not helping me. I had to wait two months for the results of the scan, and was then due to have physiotherapy - but my last 3 appointments have all been cancelled. I'm at a loss as to what to do, particularly since in the last couple of months the pain has been a lot more prominent in day-to-day walking (I haven't done any running exercises since the summer so I am trying to avoid further aggravation). So despite having MRI results back, my worry is that the results do not fully reflect the state of my ankle as it is now, since the more frequent pain has only started after the MRI scan, and it seems quite impossible to get an actual appointment with my NHS physio again.

I have been sent the diagnostics from the MRI - I'm hoping that posting them here might mean that somebody can offer some advice on therapy in order to avoid me having to go private (something I simply cannot afford)

CLINICAL INFORMATION
Lateral ankle pain and instability,? Occult fracture or lesion.
FINDINGS
There is minor plantar fasciitis with swelling and a plantar calcaneal spur with minor bone oedema in the spur. Normal Achilles.
Minor anterior osteophyte formation at the ankle in keeping with minor anterior impingement. The talar dome and tibial plafond and appear Intact. No significant ankle effusion.
Thickening of the ATFL in keeping with old healed Injury. The calcaneofibular ligament and AITFL appear intact.
Normal medial tendons. There is a 2 cm ganglion lying at the lateral margin of the sinus tarsi of adjacent to peroneal tendons.
There appears to be a longitudinal split of the peroneus brevis tendon on a background of tendinosis.
CONCLUSION
Several abnormalities demonstrated:
Plantar fasciitis, features of anterior impingement, Old lateral ligament injury and peroneal tendinosis


Any help would be hugely appreciated. As I say, the pain is occurring everyday now and I just need some advice/exercises I can work with in order to start making some progress.

Please let me know if you need any further information.
Thanks in advance
Dan

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[anka_nikoleta]

Dear Dan,

What kind of exercises were you given in the physio sessions you attended?

You do not have any cartilage damage taking in consideration the MRI results, therefore that is good news. Did they recommend physiotherapy following your MRI results or did they suggest any alternative to this?

Usually if they recommended physio then the best thing would be to have an assessment so that any biomechanical fault can be assessed and designed a tailored exercise program.

I would recommend as first to work on your hip control ( glutes activation- exercises such as clamshell, bridge exercise) and progressive ankle stretching-strengthening-stability -proprioception exercises.

Do not exercise against pain and my best advise would be to see a physio for an assessment and have clear direction on what to focus exactly.

- - - Updated - - -

Dear Dan,

What kind of exercises were you given in the physio sessions you attended?

You do not have any cartilage damage taking in consideration the MRI results, therefore that is good news. Did they recommend physiotherapy following your MRI results or did they suggest any alternative to this?

Usually if they recommended physio then the best thing would be to have an assessment so that any biomechanical fault can be assessed and designed a tailored exercise program.

I would recommend as first to work on your hip control ( glutes activation- exercises such as clamshell, bridge exercise) and progressive ankle stretching-strengthening-stability -proprioception exercises.

Do not exercise against pain and my best advise would be to see a physio for an assessment and have clear direction on what to focus exactly.

- - - Updated - - -

Dear Dan,

What kind of exercises were you given in the physio sessions you attended?

You do not have any cartilage damage taking in consideration the MRI results, therefore that is good news. Did they recommend physiotherapy following your MRI results or did they suggest any alternative to this?

Usually if they recommended physio then the best thing would be to have an assessment so that any biomechanical fault can be assessed and designed a tailored exercise program.

I would recommend as first to work on your hip control ( glutes activation- exercises such as clamshell, bridge exercise) and progressive ankle stretching-strengthening-stability -proprioception exercises.

Do not exercise against pain and my best advise would be to see a physio for an assessment and have clear direction on what to focus exactly.

[Weismayr42]

Hello Anka

Thank you for your reply. I haven't been given any exercises so far unfortunately. After I had the MRI scan, I was told I would have to book in for a session to recommend physiotherapy, however my booked sessions were cancelled by the physio, so as yet I have not been given any exercises.

Would the hip control exercises that you suggest help with the hip/back problems which I'm also experiencing?

In addition, would exercises on a rowing machine or bike machine be a problem? I thought these might be okay, since there isn't too much pressure on the ankles with these exercises. I just need some cardio which I can do.

Many thanks again
Dan