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1262 Views 9 Replies Latest reply: Jul 29, 2014 1:00 AM by ydiez
ydiez Pro 134 posts since
Nov 7, 2011
Currently Being Moderated

May 19, 2014 8:45 AM

Need help understanding what happened to my ankle.

First of all, I have to say that I will go see a physiotherapist (and maybe a doctor too) regardless of what is said here (already made my appointment with the physio). I also realize that it is not possible to diagnose over the internet. What I would like are some general ideas on what might be going on in my ankle so I get to understand it a little better and maybe help prevent the same type of injury in the future:

 

THE INJURY

 

I was running a mountain race yesterday. It was a half marathon and I was doing pretty well (I had been training extensively). The race was uphill up to km 8 and then it alternated up and downhill for the rest of the 21 km.

 

At km 10 (so I had been running downhill pretty fast for 2km after a long climb) i got injured. In a curve I had my right foot firmly (I thought) in the ground but when I shifted the weight, the ankle gave way and I felt (and heard) a loud crack. I believe it was the articulation (all my articulations do this only this time it was louder as I usually cannot get my ankles to crack). I started feeling pain inmediately, not crushing but definetely uncomfortable. The pain was a little intense in the anterior part of the ankle and was only felt when I put weight into it.

 

THE REST OF THE RACE

 

I have a history of sprained ankles (used ot play handball and that happened all the time) and this one did not look too bad so I thought I could run slowly till the finish line (I also have to add that there were not many other options short of getting a helicopter to pick me up at that moment). About a km later they gave me some anesthetic gel (reflex) and I felt the pain subside inmediately .

 

I kept at it, and I even could go "fast" in the uphill section. I was not forcing the articulation, I just could keep running without having to walk or even slow down because of pain (of course I never run too fast uphill in any case, I am more than happy if a can keep a slow steady pace). Sadly, in the following (and very steep) downhill section I did have to ask more of the injured part and the pain went back. I stopped running, hopped on the other foot until I was back on the plain (crossing my fingers so I did not sprain the other ankle as THAT would have been a laugh) and abandoned the course (in which was effectively the first "easy" ocasion I had since the injury). This means I still had to run about 3 km but this time on level ground and without any hills. At this point I was walking but I realised I could run again with only very slight dicomfort (no pain).

 

"THE DAY AFTER"

 

After getting to the finishing line I was given some more reflex so I could make it home. A Physiotherapoist friend who was also running had a look at it and told me it would swell and probably bruise but that by the way I was able to move it did not look too bad. When I got home I started putting ice on it and also took some ibuprofen. Now roughly 24 hours have passed, the sweeling has subsided slightly (it still looks huge) and all shades of purple have started appearing around it. I had to go to work so I am not "resting" completely but I am trying not to move it too much (it does only feel a little "tender" when I go down stairs). I am also wearing an ankle brace in order to move it as little as possible.

 

WHAT MIGHT BE GOING ON?

 

As I said, this is "not my first rodeo", I have had quite a few ankle sprains and I would not even consider this to be one:

 

- It is swollen bad, and it looks terrible (see attached image, I fear I might be kindaped by my girfriend and taken to the hospital against my will)

- I got scared by the cracking sound, it was pretty loud (and at the first moment someone would had to carry me out)

 

but

 

- It does not hurt. When I did sprain an ankle in the past it usually hurt (quite a lot) and this time I do not feel any pain. Even at the worst moment during the race the pain was there but it was bearable. I stopped because I did not want to hurt myself, not because I could not stand it. I realise the ibuprofen might be helping but I am not taking much and when the effect wears off it still does not hurt (to be fully precise, it aches just about the same as the rest of my muscles after running a mountain half marathon yesterday).

- I can move the ankle "normally" (yes it does feel tender, yes it does feel weird because of the swelling).

 

So, whay do you think might have happened?

 

My guess: The violent motion (speed, wrongly placed weight) produced the ankle to move in an "unexpected" way. The muscles around it held it together but got hurt in the process. The swelling comes from the increased blood flow produced by my body trying to heal itself. The damage to the aforementioned muscles just happens to be less than that of my previous sprains.

 

Thanks for reading this. Yes, I now I am overthinking it but I had to do something with my time now that I will have to stop running for a while. Any comments or suggestions will be most welcome.

Attachments:




Current PB:

5k: 20:12 (December 31st 2012)

10k : 42:30 (March 9th 2014)

Half Marathon: 1:35:27 (February 3rd 2013)

After completing my 10th HM it's marathon time. To be totally honest now it's recovery time due to an ankle injury, THEN I'll think about the Marathon.

  • shipo Legend 499 posts since
    Aug 9, 2013
    Currently Being Moderated
    1. May 19, 2014 9:12 AM (in response to ydiez)
    Need help understanding what happened to my ankle.

    It's hard to say for sure, but my guess is that when the X-Rays come back the doctor is going to find a fracture.

     

    FWIW, I've fractured both of my legs down near the ankles (28 years between the two events), the first minor enough I could still walk on it and had a walking cast from day-1, the second was severe and required surgery to screw me back together (I went non-weight-bearing for six months on that one due to all of the soft tissue damage).  A broken leg/ankle isn't something I'd wish on any runner, however, if the choice is a fracture or soft tissue damage, I'll opt for the fracture as they typically heal in six weeks or less.





    Fat old man PRs:

    • 1-mile (point to point, gravity assist): 5:50
    • 2-mile: 13:49
    • 5K (gravity assist last mile): 21:31
    • 5-Mile: 37:24
    • 10K (first 10K of my Half Marathon): 48:16
    • 10-Mile (first 10 miles of my Half Marathon): 1:17:40
    • Half Marathon: 1:42:13
  • lenzlaw Community Moderator 10,422 posts since
    Jan 18, 2008
    Currently Being Moderated
    2. May 19, 2014 5:28 PM (in response to ydiez)
    Need help understanding what happened to my ankle.

    The last time I heard this (almost exactly identical) story, a friend of mine broke his ankle.  That would be my bet too.





    Len

  • JamesJohnsonLMT Legend 1,163 posts since
    Aug 23, 2009
    Currently Being Moderated
    5. Jun 5, 2014 5:56 PM (in response to ydiez)
    Need help understanding what happened to my ankle.

    I am not satisfied with what I've read so far, either. I'm hoping you are still resting, and have found a way to immobilize this joint to prevent potential damage to the syndesmosis, if that is what is injured. A stretched syndesmosis will de-stabilize the ankle and make distance running a dangerous pastime. If there are suspicions it is damaged, do not risk damaging it further. It keeps the lower leg bones aligned over the tarpal bones of the ankle, and really can't be used without stressing it somewhat. I expected to hear about a boot or cast, but instead, you are walking around on it. Not good.

     

    BTW, the word "fracture" is used to describe other separations beyond simple breaks in bone. A stress fracture is invisible until it calcifies during healing, and an avulsion fracture happens when the skin around the bone (periosteum) is pulled off by a tendon. Tough tissues like tendon, and ligament (such as the syndesmosis), can be stretched or snapped, but a lot of cracking and popping noises come from temporary separation of joints. "Cracking" of knuckles and spinal or other joints are examples of this.

     

    Chances are good there is no broken bone, but there are so many shades of gray between a break and healthy tissue. I wish the best of luck with yours, but please make doubly sure the syndesmosis is given a clean bill of health before considering any distance running, especially marathon training. Your numbers are respectable enough to demand the greatest respect for the anatomical gifts that allowed you to achieve them.

  • shipo Legend 499 posts since
    Aug 9, 2013
    Currently Being Moderated
    8. Jul 23, 2014 6:22 AM (in response to ydiez)
    Need help understanding what happened to my ankle.

    Thanks for the update; keep on with your conservative exercise routines and you'll be back in form in no time. 





    Fat old man PRs:

    • 1-mile (point to point, gravity assist): 5:50
    • 2-mile: 13:49
    • 5K (gravity assist last mile): 21:31
    • 5-Mile: 37:24
    • 10K (first 10K of my Half Marathon): 48:16
    • 10-Mile (first 10 miles of my Half Marathon): 1:17:40
    • Half Marathon: 1:42:13

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