Should I get the MRI?

[DasBlunt]

Bad ankle back at it's old tricks,

Yesterday, good pow day, sweet AM, great run on patrol bowl, at the bottom, small runout, traverse, slid out somehow, ended up with a BIG sprain ( swelling, local and reaction pain) with x-ray showing a small broken fragment this time….. I thought it was worse this morning, but X-ray showed only the new broken fragment, floater. There were two broken floaters , he assumed one was old, any way to tell? I remember one from before, but which one, I don't know.

Question, should I get the MRI to see how bad the tendon damage is? I have had career enders on this ankle already, when I was in my 20s, but now I just want to be able to rehab and rehab correctly to keep my current "quality"of dirtbagdom.

2 weeks in the removable metal cast thing ( first timer), I guess I want to know if I should go longer and wait to stress it.

[old goat]

I'm not an orthopedist, just a victim of multiple sprains, with bone fragments pulled off by the ligaments. The last one was 30 years ago--no mri's back then, and no removable fancy metal splints. I asked for a walking cast, instead they taped my ankle, which relieved most of the pain and I was able to walk around pretty comfortably. Orthopedist told me that sprains heal without immobilization and that the taping, cast, or whatever was for comfort, and he was right. It takes about 6 weeks to really heal though. No harm in an MRI if your insurance is paying for it, but I wouldn't pay for one myself if it were me. If you want to try taping it yourself get some good athletic tape and make sure you shave enough. Lots of pictures on the internet on how to do it.

[DasBlunt]

Thanks.

I have it taped now too. 450 out of pocket, so yeah, I might avoid. I am just curious what damage is done I guess and wondered if it matters.

6 weeks, shit….that is what the doc said too.

[Orthoski]

The reason to get an MRI is if you have a specific question to answer AND if answering that question is somehow going to change your management. For that reason we generally don't necessarily get them on new sprains, only sprains that have failed to get better for long enough to make one consider surgical intervention. One consideration if it's a very bad sprain is to get weight-bearing x-rays. What you ultimately want to make sure is that the ankle is stable (instability is one of the things that can lead to arthritis), and the way to know that is by verifying that the bones don't shift with the stress of weight-bearing.

Best of luck healing!

[DasBlunt]

thanks everyone, that for sure solves those questions…… not sure I will make it 6 weeks though….need pow fix.

PT is important for sure. Looking forward.

[old goat]

Can someone explain to me what PT will do for an ankle sprain?

[flyman683]

Can someone explain to me what PT will do for an ankle sprain?

If it's a bad enough one it can restore range of motion and help scar tissue go away. Plus strengthen to prevent reoccurring.

But you can basically do the exercises yourself.

Unsure if stim, ultrasound or fancy expensive pt is bs or not and I'm no dentist...

[jma233]

Can someone explain to me what PT will do for an ankle sprain?

A good pt will focus on helping you learn to stabilize and balance on your healing/healed ankle. You generally lose both stability and proprioception after a bad sprain. If you test someones balance a year after a bad sprain the results are often shocking. A ski boot can overcome a lot of the deficit though.

[old goat]

A good pt will focus on helping you learn to stabilize and balance on your healing/healed ankle. You generally lose both stability and proprioception after a bad sprain. If you test someones balance a year after a bad sprain the results are often shocking. A ski boot can overcome a lot of the deficit though.

How soon after the sprain would you start PT? I've had a bunch of sprains that healed fine without PT, but then my balance is terrible so maybe I can blame that on the sprains.

[jma233]

How soon after the sprain would you start PT? I've had a bunch of sprains that healed fine without PT, but then my balance is terrible so maybe I can blame that on the sprains.

Well, there are things a PT does at every stage of healing but the more advanced strengthening and balance drills don't generally happen until the swelling is gone. Often it takes a long time for the swelling to reduce and it can be difficult to detect without a measuring tape. A lot of people don't think that they can affect their balance with training but you can pretty easily and studies have shown it results in a lower reinjury rate. If your PT focuses on ultrasound then get a new PT.


Balance Drills:
Catch in narrow stance, tandem stance, and tanddom stance on foam.
Single leg stance clocks (touch nonaffected foot in clock pattern around you); same with eyes closed or foam pad.
Walk a line with 20' bungee around waist anchored to floor.
One leg on bosu, bungee around waist and play catch.

[old goat]

Well, there are things a PT does at every stage of healing but the more advanced strengthening and balance drills don't generally happen until the swelling is gone. Often it takes a long time for the swelling to reduce and it can be difficult to detect without a measuring tape. A lot of people don't think that they can affect their balance with training but you can pretty easily and studies have shown it results in a lower reinjury rate. If your PT focuses on ultrasound then get a new PT.


Balance Drills:
Catch in narrow stance, tandem stance, and tanddom stance on foam.
Single leg stance clocks (touch nonaffected foot in clock pattern around you); same with eyes closed or foam pad.
Walk a line with 20' bungee around waist anchored to floor.
One leg on bosu, bungee around waist and play catch.

A cop made me do all that once. Thanks for the info.

[DasBlunt]

thanks for all the info, good stuff above.I don't need to pay an actual PT necessarily, I can just do it myself i believe. I have the stretch bands and a balance board.

17 days later, swelling is down after a nights sleep. swelling comes back after a day out in the world.

still major instability, still get shooting pain when I move it "wrong". i feel like the brace I wear is not helping, but i don't know a lot.

[Orthoski]

DasBlunt...sounds like a pretty serious sprain, if that's what it is. Consider getting evaluated, ideally by an orthopedic foot and ankle surgeon, who's likely to get weight-bearing films and make sure this is "just a sprain". At the very least, you may need something like a walking boot rather than a simple ankle stirrup. I've been told by some experts that they think that it's not necessarily the original injury but, perhaps more importantly, the subsequent ankle instability that can lead to long term arthritis, so play it safe and see someone. This is something you really want to let heal.

Best of luck and keep us posted.

[axebiker]

How soon after the sprain would you start PT? I've had a bunch of sprains that healed fine without PT, but then my balance is terrible so maybe I can blame that on the sprains.

I spent about 6 weeks in a boot, and then went through 8 weeks of PT 2x week. It was worth every penny. Very gradual start, all the way to some pretty exhausting things toward the end. It helps with strength, balance, flexibility, etc.

When to start? Each case is unique, as is the type and location of sprain.

[axebiker]

thanks for all the info, good stuff above.I don't need to pay an actual PT necessarily, I can just do it myself i believe. I have the stretch bands and a balance board.

17 days later, swelling is down after a nights sleep. swelling comes back after a day out in the world.

still major instability, still get shooting pain when I move it "wrong". i feel like the brace I wear is not helping, but i don't know a lot.

Where is the "location" of the sprain? Medial? Lateral?
Do you feel any shifting or popping? Any visible ligaments moving? Other visible deformity?

So many factors. An MRI helps to see things the x-ray can't - mainly soft tissue issues.

PT for these is "easy", but only after a correct diagnosis, proper recovery, and well designed therapy plan. If the injury is bad enough, 17 days is just the start...hate to say it.

[spook]

i'm getting one on my shoulder after eating it hard on my last run yesterday. i've had long-term problems with both my shoulders after many years of getting them pried on and landing on them but yesterday's impact was as bad as any single one i can remember. my mris are covered by insurance though, so if the doctor wants one or i want one and he thinks it's reasonable, i get them. but i have a lot of long-term chronic issues, too.