I sustained what is referred to as ankle distortion trauma in September 2019 – meaning, I twisted my ankle. It happens, and then it fixes itself…? Indeed, things did noticeably improve with some TLC. But in early December 2019, I had experienced the same injury again while jogging. With devastating consequences that I had not suspected.
They sent me to MRI in the radiology department, and I was diagnosed with overuse reaction. Painful! Very painful! On this diagnosis, my GP referred me to an orthopaedic surgeon. The orthopaedic surgeon prescribed an ankle brace – an Aircast. I’m a medical practice coordinator and instructor, which involves a lot of standing and walking for extended periods; the brace became an essential helper in my life, but it was annoying. The situation still didn’t improve after more physio and shockwave therapy intended to stimulate tissue healing.
Around a year and a half had passed at this point. They put me through another MRI exam with evidence of partial tendon rupture – a torn tendon – to the inner stabilising muscle, the M. tibialis posterior, and a stress reaction or bone bruise in the inner ankle. Still very painful!
This led to a very lengthy and unsatisfactory situation, and the orthopaedic surgeon proposed tendon surgery. An operation? Even with the pain and the restrictions that kept me from engaging in sports, surgery had not been an option for me up to this point. On his recommendation, I went to the FIRST practice in July 2021.
The clearly existing swelling and the pronounced pressure pain in the area of the ankle certainly did not pose any particular challenge in the examination. But using ultrasound, blood vessels in the injured tissue could be visualised.
My attending physician explained the significance of neovascularisation in the tendon and the bone bruise that appeared in the MRI, together forming a kind of healing “overreach” as the reason for the chronic pain and restrictions involved.
This root cause assessment for my longstanding symptoms led to a list of treatment options that were explained to me in detail. Together with my doctor, I ultimately selected a combination of treatments that was right for me. The treatment methods involved were relatively new, but experience with them at this practice had been highly encouraging. My methods of choice were:
- PhotoBioModulation, a treatment method using predefined light energy (laser light in my case) to activate the cells involved in the healing process right down to the bone.
- Targeted application of platelet-rich plasma (PRP) was applied using ultrasound imaging with pinpoint accuracy for powerful cell stimulation in the regeneration process.
I’d already heard of these methods although I wasn’t familiar with them, and some came with varying expectations on outcome. Even so, I wanted to go through with it. I noticed slight initial pain relief just after the second laser application. The pain died down significantly the very next day after PRP infiltration on the tendons and nerves. I slept soundly throughout the night for the first time in ages and was able to get out of bed without pain the second day after infiltration. This felt incredibly good.
I underwent laser therapy within two and a half weeks with intermittent PRP treatment. A second round of PRP infiltration was actually planned but they advised me against it as I was almost completely symptom-free at this stage. I was then advised not to have the PRP infiltration again. In the weeks after the treatment series, I was still supported to build up the load, and the splint was no longer necessary. 4 weeks after my initial presentation, I still had 10% residual symptoms from 100% initial symptoms! According to my doctor, these should still have a chance to disappear in my own physical activity.
And indeed, they’re gone. After almost two years of abstinence from exercise, I can finally enjoy physical training, sports, and free time as much as I want, and I’ve happily recovered my work-life balance.
Thank you so much for all your support!