The specific results from my MRI were as follows:
Findings. A small joint effusion is present. Sinus Tarsi is within normal limits. Fluid surrounds the flexor hallucis longus, which may represent communication with join fluid. However mild fluid also surrounds the flexor digitirum as well as the posterior tibiallis suggestiing mild tensosynovitis. No evidence of tendinous injury at this location. Peroneal tendons are intact as are Extensor Group. Achilles tendon and Achilles insertion are within normal limits. There is no retrocalcaneal bursitis. Superficially and deep fibers of the deltoids are within normal limits. There is a complete tear of the posterior tibiofibular ligament. Adjacent bony edema is seen within the distal tibia. This could represent a small avulsion injury versus contusion. No large fracture planes are identified. No displaced fracture fragments are noted. There is also poor definition of anterior tibiofibular ligament as well suggestion rupture. Posterior talofibular ligament is intact. Anterior talofibular ligament also demonstrates a striated appearance suggesting partial tear. There is also a mild laxity in the calcanofibular ligament, which partial tear cannot be excluded. There are no osteochondral defects within the mortise joint. The sprint ligament is intact. The remainder of the exam is unremarkable.
Impression:
1. Tears of the Anterior and Posterior Tibiofibular ligaments with possible Avulsion injury at the distal Tibia version contusion
2. Suspected Partial Tearing of the Anterior Talofibular Ligament and Calcaneofibular Ligament as Above
3. Small Join effusion
4. Tenosynovitis within the flexor group
5. Normal Appearance of the Achilles Tendon
This was a pretty bad sprain and I blew out several small ligaments around the back of the ankle. The injury happened on April 7th and I'm not at 100% yet. I've managed to do everything in training except for some selective ankle intensive movements like sprinting, lateral lunges, plyos, oly lifts and SL squats.
My Rehab has been a mixture of soft tissue work, stretching and joint mobility. This is what I found worked for me, results may vary.
Soft Tissue
Plantar Facial release - I use either a baseball or a metal foam roller I made. Placing all my weight on it with one food and using chair for balance. This really helps release the adhesion and knots in the bottom of the foot. It really makes my feet feel more lose and "alive".
I would also Foam roll the calf as well. My calf's are tight and need it anyways but I found this to help my stretching and ankle mobility drills.
I would also take a real smooth rock and gently massage the areas where the ligaments attach and are sore. This was used to target the specific areas where pain was present and help break up the scar tissue. Go light on this and as it hurts less ease into adding more pressure.
Flexibility
Calf Stretch - People have different ways of doing this. Ill post up a picture of what I have set up with the foam roller. this way I really can feel it in the calves. Keeping the knee straight of the leg being stretched will focus more on the Gastroc Muscle, while putting a bend in the knee will target the soleus and Achilles region. I do both.
This video can give you some ideas. Just make sure that you have good posture and alingment when strethcing calves.
Joint Mobility
The drills below are from Steve Maxwell, who has an excellent joint mobilization series. I noticed a big different in my feet after a couple days of doing this . Better control in the ankles and more range of motion. I try to do these every day now and it takes about 5-10 minutes and well worth it.
That is the first part.
After that Its time for circles and figure 8s.
After I have done my mobility I want to put my strength behind it. So this is when I use my traditional resisted band work for the ankles.
The following are two exercises I have as homework for AP.
Toe Pick ups
Arch Makers
I do these every day and collectively it takes about 15 minutes. The physical therapist was impressed with the mobility I had just 4 weeks out from the injury. I tried to use this experience as a catalyst for paying more attention to the function of my feet. This injury motivated me to learn more about the feet and go seek professional help so I can have better foot health.
MAKE SURE YOU DO BOTH FEET FOR THESE EXERCISES
P.S.
This is dedicated to my friend Andy. He is always trying to follow in my footsteps and he out did himself by spraining his ankle last week in soccer. This probably would of been prevented if he didn't skip the single leg training I put in his program.
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