Ankle keeps buckling

[Northendzone]

Originally Posted by Otto-matic

Doh!



Thanks for the link though, gonna check it out tonight!

^ a perfect/timley reference - thanks nice lady!!!!

[cracher]

Originally Posted by TheSutterDynasty

I might suggest something conservative before jumping to an ortho referral. Besides, if it is what the majority of ankle sprains are, ortho won't touch you unless you're a teenage gymnast.

Like my answer in most of these things, go see a physio. GPs don't have specific training in musculoskeletal and won't be all that helpful.

Not sure why you would suggest seeing someone who isn't legally allowed to render a diagnosis as a front-line option.

Some GPs are incredibly good with MSK stuff, some are not. GPs generally have bigger fish to fry so I would give them a pass on breezing over ankle injuries. Ortho would know what's up for sure, but the practicality aspect (long waits to get in, they may not be focused on something unless it leads to a "glorious" surgery). I think the correct answer here is podiatry/podiatric surgery department. They will cut it to you straight.

[TheSutterDynasty]

Originally Posted by cracher

Not sure why you would suggest seeing someone who isn't legally allowed to render a diagnosis as a front-line option.

What is this supposed to mean?

Originally Posted by cracher

I think the correct answer here is podiatry/podiatric surgery department. They will cut it to you straight.

Just my opinion here, but from what I've seen the majority of podiatrists just want to sell you custom made orthotics for $500, regardless if it will help or not. I'm sure there are good ones out there but I haven't heard of one.

Besides, many surgeons who see something they think they can cut will do so. Maybe try some other avenues first.

I mean this is true of other practitioners as well; there are plenty of poor ones for every good one.

I'll stick with my physiotherapy recommendation.

[cracher]

Originally Posted by TheSutterDynasty

What is this supposed to mean?



Just my opinion here, but from what I've seen the majority of podiatrists just want to sell you custom made orthotics for $500, regardless if it will help or not. I'm sure there are good ones out there but I haven't heard of one.

Besides, many surgeons who see something they think they can cut will do so. Maybe try some other avenues first.

I mean this is true of other practitioners as well; there are plenty of poor ones for every good one.

I'll stick with my physiotherapy recommendation.

It means exactly what it says. As Nuke stated, you need to figure out what it is exactly first before you treat. "Ankle instability" can be a number of things. Everything from partial/complete lateral ligament damange, to varying degrees of peroneal damage, to something in the STJ/AJ itself, etc. Some treatments can be harmful if you don't nail down the right thing. Nailing down the right thing is a diagnosis. PT cannot make a diagnosis.

There is truth in the 2nd half of your statement. There are scumbags in every profession. But at least see somebody who can diagnose the problem first.

[TheSutterDynasty]

Originally Posted by cracher

It means exactly what it says. As Nuke stated, you need to figure out what it is exactly first before you treat. "Ankle instability" can be a number of things. Everything from partial/complete lateral ligament damange, to varying degrees of peroneal damage, to something in the STJ/AJ itself, etc. Some treatments can be harmful if you don't nail down the right thing. Nailing down the right thing is a diagnosis. PT cannot make a diagnosis.

There is truth in the 2nd half of your statement. There are scumbags in every profession. But at least see somebody who can diagnose the problem first.

I still don't know what you're referring to. A physiotherapist will diagnose the problem. Why do you keep saying the can't make a diagnosis? In my experience, they, along with sports medicine doctors and sport chiropractors are the best at diagnosis.

[NuclearFart]

Originally Posted by TheSutterDynasty

I still don't know what you're referring to. A physiotherapist will diagnose the problem. Why do you keep saying the can't make a diagnosis? In my experience, they, along with sports medicine doctors and sport chiropractors are the best at diagnosis.

Judging by your comments, you are well out of your league on this one.

If he has legitimate instability, then by definition this is not just some "sprain", and you would be very wise to seek a surgical opinion before you do even more damage.

Physiotherapists may have better clinical acumen than the average GP who doesn't routinely do sports injuries, but they really don't know what they don't know.

Also, most sports chiropractors are a joke. Talk to any Orthopedic surgeon and you will hear a barrage of horror stories.

[Sr. Mints]

I had custom boots made that prevent my ankles from rolling. They were made by a guy out of Red Deer (but he comes to Calgary once a week): http://steenwyk.com/

As I recall, you need a prescription for the shoes from a doctor for Blue Cross reasons.

edit: While helpful, they were not cheap! $2200 for one pair (after insurance I paid $500)

[DoubleF]

If you use those elastic ankle support sleeves and certain ankle braces/ankle supports with laces, I suggest getting some heel slips for comfort. It will help to offset the space difference of having fabric under your foot but nothing on your heel.

For sports, the ankle sleeve/brace will be bulky. Loosening your shoe laces to fit it usually fixes it up nicely. I also find I tire easier without the heel slip if wearing a brace (possibly because my foot is rocking back and forth to deal with the space difference?). For sports, I'd suggest the lace up ankle support but the neoprene ones will work fine. For regular day, you might be able to find a neoprene ankle sleeve that might fit decently in dress shoes. If not, you might want to consider just buying looser fitting dress shoes or loafers to accommodate it. I wore one underneath dress socks before no problem. Was snug, but wasn't horribly unbearable or obvious (assuming your pants covers to the shoe).

I used to wear ankle sleeves the day of playing sports and sometimes the day after if my ankle felt tired/weak. I rarely wore it outside of those time frames. I used to be prone to rolling my ankle, but after reading this thread I just realized that these last few years, I haven't worn the ankle sleeves when playing sports.

I've also been told wearing shoes with ankle support on a regular basis helps as well. This might not work for dress shoes, but perhaps wearing basketball shoes on a regular basis/for sports could be beneficial vs regular runners.

I think ankle sleeves range between $10-30 bucks. Lace up ankle support 30-50 bucks. I bought mine years ago, so no idea on current prices. Sorry. These may interest you:

http://www.amazon.ca/Airflow-Support...=ankle+support
(Daily work one? This one seems a little flimsy for sports even though the pic shows a soccer ball)

http://www.amazon.ca/Shock-Doctor-Ul...=ankle+support
(Similar to one I use for sports)

Don't have these ones, but they look close enough to what I used to use.

[OMG!WTF!]

This is generally bad advice, but I've been to physio for a few things and there is generally nothing really ground breaking about it. I've youtubed my issue and found the same stuff I got at physio and more in videos by therapists. You have a common problem and can probably get a great start on rehab exercises that way. Write the alphabet with your foot, balance on one foot for 1 minute, stand on a balance board etc.

[Locke]

Originally Posted by OMG!WTF!

This is generally bad advice, but I've been to physio for a few things and there is generally nothing really ground breaking about it. I've youtubed my issue and found the same stuff I got at physio and more in videos by therapists. You have a common problem and can probably get a great start on rehab exercises that way. Write the alphabet with your foot, balance on one foot for 1 minute, stand on a balance board etc.

While true, theres a very finite limit on how much good thats going to do depending on the extent of the damage.

[OMG!WTF!]

Originally Posted by Locke

While true, theres a very finite limit on how much good thats going to do depending on the extent of the damage.

Yes, you'd likely want a diagnosis first that referred to physio before you jump in. But given that, I actually like having a bit more ability to help myself via generous youtubers.

[Huntingwhale]

Maybe you are in love and just can't hide it?

[cracher]

@Sutterdymasty - to be completely fair, though, I really can't think of many ankle instability situations that don't -ultimately- end up at PT. The first visit, however, should not be there. Legally, they are not allowed to diagnose.

[TheSutterDynasty]

Originally Posted by cracher

@Sutterdymasty - to be completely fair, though, I really can't think of many ankle instability situations that don't -ultimately- end up at PT. The first visit, however, should not be there. Legally, they are not allowed to diagnose.

In what context? Disability and insurance companies use physiotherapy diagnoses all the time. Oftentimes the GP or specialist can over rule a physio decision but physios are involved with legal diagnoses often.

[TheSutterDynasty]

Originally Posted by NuclearFart

Judging by your comments, you are well out of your league on this one.

If he has legitimate instability, then by definition this is not just some "sprain", and you would be very wise to seek a surgical opinion before you do even more damage.

Physiotherapists may have better clinical acumen than the average GP who doesn't routinely do sports injuries, but they really don't know what they don't know.

Also, most sports chiropractors are a joke. Talk to any Orthopedic surgeon and you will hear a barrage of horror stories.

I'll agree there are a lot of bad ones out there, but a good physio is your best bet for anything musculoskeletal.

I understand the sentiment, but 1) nothing in his history gives ANY hint at a true instability ie (most commonly) an ATFL or calcaneal fibular ligament rupture and 2) they will rarely, if ever, perform the brostrom procedure unless you're a teenage gymnast (repair for lateral ligament rupture as mentioned). In fact, "giving way" is more often a symptom of an inflamed talocrural joint as there is a neuromuscular inhibition of sorts that occurs, but again he doesn't really have a history that suggests that.

Regardless, impossible to say without assessing.

[cracher]

You know what? My bad, I'll own this one. According to Alberta's Health Professions Act, PT can diagnose here. This is not the case across Canada. They are not listed in the CHA, but it seems to be administered on a province to province basis.

Edit: But to my understanding, not all PT can order imaging. So how does that work? An ankle is not easy to figure out clinically, rads is your best friend in this area.

[taco.vidal]

Originally Posted by cracher

You know what? My bad, I'll own this one. According to Alberta's Health Professions Act, PT can diagnose here. This is not the case across Canada. They are not listed in the CHA, but it seems to be administered on a province to province basis.

Edit: But to my understanding, not all PT can order imaging. So how does that work? An ankle is not easy to figure out clinically, rads is your best friend in this area.

Most clinics will have at least one practitioner that can order imaging. Every clinic I have used in Alberta has had that setup but I can't say if they all do. That one practitioner will sign for every other partitioner in the clinic.

[taco.vidal]

Originally Posted by cracher

You know what? My bad, I'll own this one. According to Alberta's Health Professions Act, PT can diagnose here. This is not the case across Canada. They are not listed in the CHA, but it seems to be administered on a province to province basis.

Edit: But to my understanding, not all PT can order imaging. So how does that work? An ankle is not easy to figure out clinically, rads is your best friend in this area.

Whats you occupation or role? It seems like you have a little knowledge. Id guess you somehow work on the periphery.

I have a good family doc who treats and understands athletes. Im active and compete in sport so I have both chronic and acute injuries. My physio is almost always my first visit. If I think Ive busted some bones then I might seek some urgent care. Otherwise, a visit to the doctor as a first stop is really a waste of time. Usually I have a pretty good idea of whats injured. (I have decent knowledge of the body and have good body awareness of my own body.) The doc would do some basic tests and recommend to go see a physio. Or the doc might order imaging and then have you back to discuss and then recommend physio.

A physio will also take more time to diagnose your issue. Go to a doc and you're in and out in 5 minutes on your first appointment. A physio might do 20 or 30 minutes of assessment or longer.

[cracher]

^ I'm the guy that goes into an unstable ankle to fix the ligaments with sewing/tendon transfers/bone anchors... and then I send them to PT for the rest.

[taco.vidal]

Originally Posted by cracher

^ I'm the guy that goes into an unstable ankle to fix the ligaments with sewing/tendon transfers/bone anchors... and then I send them to PT for the rest.

Are you in Canada? How long for the OP to wait to see you. He calls his family doctor tomorrow and gets an appointment next. The family doctor does some tests and concludes something is going on with the ankles. How long until he sees you through a referral? Whats the waiting time for an initial appointment with a specialist like yourself?