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HepCat
Dec 12, 2007, 6:21 PM
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Has anyone had a bouldering/climbing related ankle sprain result in an osteochondral lesion of the talar dome (talus)? An orthopeadic surgeon is recommeneding arthroscopic surgery to debride (clean out) the lesion. I'm worried things could be worse after. Right now I can climb as well as ever, without pain or weakness, yet normal walking and hiking are painful after about 20 minutes. My doc seems to think it will either remain this way or get worse. Any thoughts?
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jdefazio
Dec 12, 2007, 6:40 PM
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Since you have loose debris it won't get better just left alone, but you have to decide whether or not you can live with it.
My question is: Why are you worried that it could be worse after, I mean, besides during the recovery period? The whole point of surgical intervention is to make an improvement to a problem that could not be achieved otherwise. If your orthopedist doesn't think he/she can improve your condition, then he would not be suggesting surgery. If he gives you a shitty prognosis and still suggests surgery, then find a new orthopedist!
All that said, you are talking about arthroscopic surgery, which is minimally invasive and should not result in a long recovery time, probably a few weeks at most.
-jd
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squarf
Dec 12, 2007, 6:40 PM
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Sorry in advance if this sounds too common knowledge advice for you.
I have not had this injury, but just did a little research on it.
The main thing i would do to you is give your doctor a call and ask to speak with him about treatment options. Say you don't feel much pain right now and are wondering if surgery is really the best option available at this point. (He/she will likely say yes), but you can press further about physical therapy and what would happen if you waited longer, if that would lead to more complications or not.
I would discuss this with your doctor more than trusting anyone else's opinion just for the simple fact of your doctor having access to the diagnostic information about your particular situation. (mention that you are very active, even with the condition, and you don't want a surgery to hamper that.)
Anyone would feel pain after 20 miles of hiking, yours is likely just more painful! :-) I wish you the best of luck.
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onceahardman
Dec 12, 2007, 7:27 PM
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HepCat wrote: Has anyone had a bouldering/climbing related ankle sprain result in an osteochondral lesion of the talar dome (talus)? An orthopeadic surgeon is recommeneding arthroscopic surgery to debride (clean out) the lesion. I'm worried things could be worse after. Right now I can climb as well as ever, without pain or weakness, yet normal walking and hiking are painful after about 20 minutes. My doc seems to think it will either remain this way or get worse. Any thoughts?
As described, you have two distinct injuries (both coming from a single trauma.)
A sprain is a ligament tear, of which there are several different types and severities. They are very common in the ankle, most often the result of beyond end-range inversion of the ankle.
An osteochondral lesion of the talar dome is damage to the articular surface of the most-weightbearing part of the ankle joint. DO NOT TRY to "train through the pain" of this injury. You are likely to worsen it, and may end up with arthritic changes (bone spurs) in the joint space as a result.
WHAT I WOULD DO IF I WAS YOU:
1) avoid sustained weight-bearing (hiking, etc). functional walking, 5 min or so, is probably OK.
2) TONS of ROM (range of motion) exercise, in non weight bearing positions. dorsiflex and plantarflex, side to side, and circles in both directions, 20-30 minutes daily.
3) If you feel better within a week, SLOWLY add partial weightbearing exercises (seated calf raises, walking/running in a pool, etc)
4) If you are worse, or have no improvement within 2 weeks, see the surgeon. Make sure your surgeon treats athletes, not just old ladies with broken hips. Find someone from a pro or major college sports team, if possible.
(This post was edited by onceahardman on Dec 12, 2007, 7:29 PM)
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adamoutdoor
Dec 20, 2007, 3:29 AM
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I work in a gym so i have lots and lots of time to climb which in turn can lead to more injuries. I recently set up a killer dyno and biffed it after estimating the deadzone to short and when i came down i tore most of the muscles on the inside of my left ankle. It has been four weeks now and there is still some pain. i went to the doc and his medical advice was " If it hurts you need to stay off of it till it doesn't". In your case i would suggest to surgery seeing that there is no way that your ankle will digest the debris and the pain will continue thus will further cause injury you.
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gunkiemike
Dec 20, 2007, 3:42 AM
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HepCat wrote: An orthopeadic surgeon is recommeneding arthroscopic surgery
Well big surprise there. Never ask a barber if you need a haircut.
Maybe seek a second opinion from a non-cutter.
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theclimbergirl
Dec 20, 2007, 6:15 AM
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Not the same injury, but I have experience with bouldering falls. About a year ago, I took a fall from near the top of the bouldering wall at our gym, so it should have been a "safe" fall -- but my landing was less than optimum. The sprain didn't resolve with RICE, so I went in to my general MD and then followed up about six weeks later for an MRI when I was still having pain and reduced range of motion. Diagnosis based on MRI was bone bruises -- no treatment other than to avoid concussive activities, and to wait for six to twelve months. I'm just about twelve months in and the pain is greatly reduced but my range of motion is still not back to normal -- so I would second onceahardman's recommendation of ROM exercises.
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HepCat
Dec 22, 2007, 4:56 AM
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Thanks for your responses! Because I was not 100 percent sure if getting the procedure done was the right thing to do, I wrote in. Well, a few days later I made up my mind. I had the surgery on Wednesday. All I can say for now, is that I am not in any pain. However, I am on crutches, and have not dared to move it. My doc said the damage was worse than expected and there was a bone fragment present which was also removed. I feel good about having the surgery and hope that the 85 percent chance of a good to excellent outcome is on my side. Thanks again.
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