Torn ATFL, further sprains

Hey! I'm hoping someone has some experience with this - it seems like it would be a fairly common injury (although you never know!).

1.5 years ago, I had a complete tear of my ATFL. I went through 6 weeks of PT, and the ankle was still unstable. I met with the ortho surgeon, who recommended surgery - and I was to call to schedule it that day. I ended up having appendicitis and never got it scheduled (what luck, right?!). I didn't have any problems with it for a while - I had a run of medical 'bad luck' and couldn't run again for a while.

A month ago, I went for a run and my ankle flipped. I heard a familiar 'pop' - this time in a slightly different place - and basically the same symptoms I had with the complete tear of the ATFL just slightly lower on the outside of the foot. I of course stopped all exercise, and my ankle felt more wobbly than ever. Fast forward to about 2 weeks ago - walking - slowly - to my daughter's bus stop, I fell again. This time I felt another familiar pop - though a little quieter - behind the bone. The bruising was worse than my other two (I do not bruise or swell, I assume because I clot easily - Factor V Leiden), and behind the bone and a little up my leg.

Now I hear a weird pop when I walk. I can feel my gait is really off in that foot... It hurts way worse than either of my previous injuries - and it goes up my leg a little on the outside. And it burns...

My doctor suggested possible additional ligament tears and tendon tears. :( I see an ortho, but it takes a while to get an appointment (hey, people like me must be all over the place!).

Is an ATFL injury really enough to make your ankle that unstable? I figured it would heal after a year and a half, but a friend told me complete tears never actually heal - is that true?

I'm just ready to start running again... but can't even walk without pain right now.

[Dr Vinod]

Hello!

I would suggest you some scans to diagnose your soft tissue injuries at your ankle joint. You can go for an MRI and get the report from a radiologist or you can do this after the orthopedic appointment, this is done as you have chronic non healing ligament problems.

The anterior talo fibular ligament and calcaneofibular ligament has maximum risk of injury when your flexed foot gets forcefully inverted due to tripping, etc. I would also suggest you to rule out bony injuries by an X-ray.

With Grade III injuries a brace should have been worn all day to assist healing during the previous injury.

It is in general agreement to try a 6 week period of conservative management, including early, controlled mobilization and rehabilitation before considering surgery.

Discuss in detail with your orthopedician.

Take care!