If there are a few misspelled words in this post, forgive me, the 13 hour days with not even a break for lunch or dinner are warping my brain a little, but here I go...
A very thought provoking study coming out of Japan, published in this month's AJSM.
The authors took a look at 28 athletes with a history of at least one previous ankle sprain & had sensations of instability, even though none were present clinically. They did an arthroscopic study on one ligament, the anterior talofibular.
The results? Ankle sprains are brutal. Get this: 9 had partial lig tears with scarring (ok, to be expected); 3 where the ligament was no longer present at all- it was replaced with scar; 4 cases where the ligament had calcified; 5 cases where it was filleted right off the bone (yet no clinical signs of instability? Eric Naussbaum, care to comment on that?); 2 where it had narrowed, 2 described as having an "abnormal course" at the talus or fibular attachment; & 3 normal cases. AND THIS WAS JUST ONE LIGAMENT! Who knows what the others looked like? Not to mention the osteochondral interface.
For some reason, it's not "sexy" to do research on ankle sprains. The knee ACL gets all the attention. But, it's all the way at the end of the kinetic chain, and boy can it reek havoc on the rest of the body. Instability or loss of motion here usually effects the knee, hip, low back, and if you throw, even the shoulder. As part of your injury history, always enquire about old ankle sprains. Hopefully, this will be my first of hundreds of posts on the ankle joint.