I'd like to share my personal experience relating to an injury I had to my left ankle.
It started on the 1st of April, 2008[yes, April Fools' Day!]when I was unloading my truck with a pallet of freight weighing about 400kg. The drive was an unusual design from what I was used to, having a 'dip' in it, like a 'U' shape-very shallow but enough to cause me grief.
I opened the tailgate to horizontal like I'd done a hundred times before, dragged the pallet onto the tailgate and lowered it to what I thought was ground level tilting the edge towards the ground[people who have used a tailgate loader will understand]and raised the pallet jack just enough to have the pallet clear the ground. I walked backwards dragging the load but hadn't noticed the edge of the tailgate was still about 300mm above the ground because of the hollow in the driveway and my left ankle stepped off the edge into thin air! My full weight of 110kg rolled my ankle and then it hit the ground, with a very loud 'crack' and I fell to the ground. The pallet jack continued towards me but stopped after the leading wheels dropped over the edge of the tailgate[phew].
I was in agony, and a few passers by asked me if I was OK, I think my swearing gave them the answer!!
I really thought it[the ankle]was broken. After I composed myself I got up and found I could bear some weight on the joint so at least I could hobble around, I contacted my radio operator and he suggested I stay where I was and have someone else come out to complete my run but [stupid mistake #1] I said I could continue as that day wasn't a busy one.
I arrived back at the depot at about 6pm, around 8 hours after I fell and spoke to my Manager who called a Company OH&S officer to take me to the medical centre. As soon as removed my shoe the ankle puffed up like a balloon! The Doctor said it was a severe sprain, and would take up to three months to heal properly. The reating Doctor asked how long I wanted off work, and considering I had just had from October 2008 to February 2009 off on light[boring]duties due to a herniated disc and Sciatic nerve injury I said just two days plus the weekend would do so I wouldn't lose any hours from my weekly earnings[stupid mistake #2]
I returned to my usual job on the Monday, and worked every day experiencing a great deal of discomfort but ignoring it for the next eleven months[stupid mistake #3] At the end every day the ankle was noticeably swollen, and painful too. I remembered waht the Doctor had said about the injury taking a long time to heal and figured it was taking so long because I hadn't rested it really and had kept working when I shouldn't have. The ankle had been left very weak and unstable and any surface irregularities at all would cause it to 'invert' or roll outwards, with a resulting pain like an electric shock that took my breath away. I kept ignoring these symptoms until mid February this year until a new pain developed running up my calf muscle to the outside of my knee. It was at this point and at the ongoing insistence of my darling Wife I spoke to my Company Physiotherapist. Brad was very helpful and understanding, and a wealth of information too. He said that if it was a simple sprain it would have healed long ago, even without it being rested. I was at the stage when I wanted the continuing pain gone, and the instability problem fixed as it was impacting not only on my job, but everthing I did.
I returned to the original treating Doctor, who had the joint x-rayed again to rule out any fractures, and none were found. He scolded me for not coming to see him sooner and immediately put me on restricted duties at work[no truck driving]and ordered an MRI. I was lucky I only had to wait 4 days for the MRI to be done, then another 3 days for the results. Like most people I guess, I read the MRI results before I saw my Doctor again and was more than a little shocked at what it said.
I quote: "lateral collateral ligament is abnormal.
The anterior talofibular ligament is markedly thickened and of intermediate signal and there is an intermediate grade partial tear and avulsion of the anterior most fibres from the talus. There is moderate surrounding oedema which would be in keeping with an acute injury. The posterior talofibular ligament is moderately thickened with surrounding oedema in keeping with an acute strain. The calceneo-fibular ligament is moderately thickened though intact.
The anterior and posterior inferior tibiofibular ligaments are intact.
There is a longtitudinal split tear of the peroneus brevis tendon which extends from the level of the musculotendinous junction the level of the calceno-cuboid joint. There is mild oedema within the tendon sheath, though no significant fluid within the tendon sheath and there is minimal surrounding oedema, which is in keeping with a subacute injury.
There is moderate oedema within the distal fibula and there is a hypo-intense line seen within the anterolateral aspect of the femur which I suspect is a non displaced fracture.
The deltiod ligament is abnormal, anteriorly it is disrupted.The posterior deep fibres are intact. There is minimal surrounding oedema and I suspect this is a chronic injury.
There is small joint effusion with mild synovial thickening of the talofibial joint.
Small oedema seen posterior to the Achilles tendon though the tendon itself is of normal sign."
Phew! The Doctor referred me to a specialist, who on examination of my ankle, the MRI films and the report he suggested corrective surgery-especially give the time that has passed since I first injured it. As I write this I have eleven days to wait until my operation on the 31st of March. I just want it like it was before I hurt it, no pain with full movement and no instability. One of my loves in life is riding my motorcycles, and I need a healthy, fully functioning left ankle for that!
Lesson learned? Don't ignore your body's warning signs-every professional I spoke to said I should have treated my ankle properly in the first instance, no matter how inconvenient at the time. If your suffering undiagnosed pain or swelling, get it looked at!
Stay tuned........William.
