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My Orthopedic Food/Ankle Doctors aren't giving me answers. PLEASE HELP
Age and Activity History: I am a 33 year old male, 5'9", 170 lbs.
I played sports (tennis, hockey, ski racing, running, biking, hiking) my entire life and I have lead a very active lifestyle. So, I have put my ankles and feet to use over the years. I played these sports at a high level and ultimately went to college to play (point being, I was constantly and aggressively using my feet and ankles). I continue to maintain an active lifestyle (biking, tennis, hiking, running), but my ankle/feet pain has gotten to the point where I cannot run or seemingly walk for long distances without waking up the next morning in agonizing pain (which lasts for weeks - and at the worst, I am crawling on my hands and knees because I cannot put any weight on my feet).
Medical History: I have flat feet that pronate inward. I broke my left fibula near the ankle in 2009 (I was placed in a boot, and I probably started walk on it too early - the left calf muscle atrophied slightly and it has never been the same as my right calf). I have sprained my left and right ankles twice each over the last 20 years, but nothing serious. I had damage to my right lis-franc ligament in 2010 - not a complete tear but strained. I started to develop a bunion on my left big toe in 2015, my right foot is fine.
Problem: For the past five years, I have had on/off flare ups of ankle and feet swelling. Initially, the pain would start during the first hike or trail run after ski season in the spring - I would come down on my left foot (as a reminder, I broker my left fibula in 2009) and and if the ankle went to far in EVERSION I would get a stabbing pain under at the bottom of the lateral malleolus. The ankle would swell, and the pain and swelling would spread to the top of my Talus then move down the forefoot on the top of the foot. Over time, the "flare ups" have occurred more frequently and and this past year I began having intense pain in my right ankle/foot (following a moderate hike), in addition to the pain/swelling in my left ankle/foot. In my right foot, I do not get the significant stabbing pain under my lateral malleolus, but the top of my Talus at the base of my shin will become extremely painful and the pain would spread to my forefoot. On both the left and right foot, when the pain spreads from the ankle to the forefoot, it is usually on the outer 4 metatarsals (never on the big toe metatarsal).
Most recently, in addition to the areas of pain mentioned above, the pain is now presenting itself under the medial malleolus (mostly on my left foot, but my right foot is also having issues).
To Date, Doctors have told me:
- in 2019, a doctor casually glossed over the fact that he thought he noticed slight bruising at the bottom of my lateral malleolus. He said I probably just rolled me ankle and sent me on my way.
- Sinus Tarsi Syndrome. In 2021, I had an MRI done and a doctor noticed a cyst growing in the sinus tarsi, so he gave me a steroid injection. It really didn't help, as my symptoms have continued to get worse.
- Gout. In 2022, I was just tested for Gout and Rheumatoid Arthritis, and my bloodwork came back negative for both. I eat healthy and drink moderately. I had X rays done with the doctor, and it showed I have bone spurs on both Talus. I had to mark up the X Rays myself and ask the doctor specific questions, after he told me my X Rays look fine and that he thinks I have Gout (which I do not have).
- Loose ligaments. In 2022, I went back to the doctor that injected my sinus tarsi and I asked if he could scope my ankles to remove bone spurs, look at shaving the bottom of my left lateral malleolus, and clean up scarring/soft tissue issues in my sinus tarsi. He pulled on my left ankle once and said I should get "internal bracing" surgery where he would cut my ligaments and tighten them, in addition to scoping the ankle joint and cleaning it up. He came to this conclusion without reviewing an MRI. He was with me for 3 minutes and left. I do not want to jump to such a significant surgery after such a casual examination. I asked if he would just scope the joint, and he recommended against it and that I should do the full surgery in addition to the scope.
I have been going down rabbit holes and researching different causes of pain, like what I am experiencing. Because I have bone spurs on my taluses, my best guess is that I might have:
- osteoarthritis aggravated by bone spurs
- improperly aligned ankles (caused by bone spurs and my broken fibula), leading to joint grinding
- sinus tarsi syndrome
- some type of degenerative disease causing my ligaments to micro tear (I have found nothing to support this, but who knows).
Photos attached. I am opening this up to to see if anyone is willing to take more than 1 minute to look at my X Rays and MRI, compare to the symptoms I am describing, and tell me what they think might be causing my problem. It looks like I can't post the X Rays MRI here, so I can send it to anyone via email.
Thanks for any feedback.
My Orthopedic Food/Ankle Doctors aren't giving me answers. PLEASE HELP
PRP isn’t covered by insurance afaik and is pricey w dubious results. My pod friend thinks it’s snake oil
Hard to know what treatment is best without knowing the root cause (and does it really come from the ankle)
See what the Ortho has to say and ask their experienced working on feet/ankles. I’d prob try to find a podiatrist that does a lot of ankle work and see them as well just for reference.
