AnkleS Injury. 25' Free Fall.

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Splater

climber
Grey Matter
Oct 4, 2015 - 06:12pm PT
Your injury does not sound as bad as most. Here are some from other friends of mine:
1) Broken decades ago, no long term huge impact, but some pain & never as flexible.
2) Broken fast roping at night, some permanent damage.
3) Military parachuting impact bad break had to be fused. Guy still somehow climbs.
4) Recreational parachuting break, fully healed.
5) Smashed heel trying to lead Werners at Woodson. Limped for a couple years, never climbed again, mountain bikes now.
michael hayes

Trad climber
san francisco, ca.
Oct 4, 2015 - 07:22pm PT
I took a fall in Yosemite about 3 years ago, and slammed my heal into the wall. Had it xrayed, and it showed no fractures. I walked around for a year with some swelling, and could not do moderate hiking without pain. I finally bit the bullet and went to a Kaiser specialist who said I had damaged the cartilage, and that I was bone on bone. He recommended ankle fusion and swore there would be no more pain, and that I would be able to do most of the things that I enjoy. He was right. Other than a loss of range of motion (can only point my toes 30 to 40 degrees as opposed to 90 degrees), I can still surf, mountain bike, road bike, climb, and hike. I am on my feet all day as a contractor, so I recommend getting shoe insoles custom made to compensate for the fusion. My doctor put me on a machine that photographed how I weight my feet and had custom inserts made for me. A couple of things that I have noticed that are a bit annoying: my stride is shorter, and I can't walk as fast as my girlfriend who is 9 inches shorter, and hiking down a steep slope is tricky because my foot doesn't flex far enough. So, I compensate and compromise, and am currently climbing in Kalymnos having a great time. Two things that kept me sane through 4 months of casts and boots was having a scooter that I rented from a pharmacy, and being able to top rope in the gym using one foot. I put a knee pad on the injured side and a climbing shoe on my good foot and climbed jug routes
Good luck!
Moehass

Boulder climber
Laguna Beach
Topic Author's Reply - Oct 5, 2015 - 04:13pm PT
Michael Hayes, how can cartilage damage be found out?

Ron gomez, I got your email. Thanks! I was curious about your ankle injury and recovery.
Moehass

Boulder climber
Laguna Beach
Topic Author's Reply - Oct 5, 2015 - 04:26pm PT
Also, learning about how others hurt themselves have definitely helped me cope. I am, and I'm sure many are equally interested in finding the best ways to regain full functionality. I mean ways to induce actual full physiological and biomechanical recovery in the safest and shortest time possible.

Let's get our own RITE (Rapid Iterative Testing and Evaluation) going right here on this forum.
BAd Wife

Sport climber
Tehachapi
Oct 6, 2015 - 09:32am PT
RICE is dead. Even the guy who developed and promoted it, Dr. Gabe Mirkin, reports that ice inhibits healing. Here's his article about it, and you'll find that the top sports injuries sites agree: http://drmirkin.com/fitness/why-ice-delays-recovery.html

Ligaments and tendons are poorly supplied by blood, hence nutrients. Heat is better at bringing whatever blood supply is available to the site.

As a holistic nutritionist, I also advise either getting (and eating) some gelatin from grass-fed cows (check Amazon) or, since you probably have plenty of time to do so, get yourself some bones from grass-fed cows and make some long-simmered bone broth: toss bones in water to cover; add splash of vinegar; simmer for 48 - 72 hours. The vinegar leaches the minerals from the bones, plus you also get dissolved connective tissue. Probably sounds gross but these are healing nutrients, and the broth is pretty delicious. Use as a base for soups or warm and drink as-is. Cheaper and better than supplements and good counter balance to chips and beer.
Brandon-

climber
The Granite State.
Oct 6, 2015 - 09:57am PT
Dude, you're going to be fine. As you regain mobility, it's going to hurt. Breaking scar tissue or some such. Ankles hurt, and sprains are worse than breaks. Be strong and learn to love the pain. FWIW, I've broken each ankle twice, sprained my left twice, and my right three times. This was a while ago (10-15 years), and I'm functioning just fine now with minimal professional care. I'm dealing with what seems to be a broken metatarsal right now and it's a pain in the ass. Basically, don't worry so much. :)
michael hayes

Trad climber
san francisco, ca.
Oct 6, 2015 - 12:38pm PT
Moehass,

According to my doc, damaged cartilage does not show up on X-rays. What did show up after a year of walking around in pain was bone on bone. There was no space between the ankle bones which indicates loss of cartilage. Fusion scrapes away any left over tissue and screws the bones together so that they grow together as one solid piece. He did not recommend a rebuilt ankle because they are still working out problems with them, and he said I would not be able to do the things I do because they are more delicate. My only worry is problems with other parts of my body such as hips or knees in years to come,, but there have been no signs yet.
Good luck
Moehass

Boulder climber
Laguna Beach
Topic Author's Reply - Oct 6, 2015 - 02:18pm PT
So, michael, that damaged cartilage would have shown up had you gotten an mri at time of injury, no?

Bad Wife, I'm familiar with gelatin soup (that's what we're talking about, right?), superhero stuff. It's somewhat of a delicacy in some cultures where they use calve's feet--feet soup! :) I never thought about it for my case, but it makes perfect sense!!! And no, it doesn't sound gross. I've hade feet soup, aka kaware3 with my egyption friend in Anaheim few months ago, and I miss it.
Re icing, I've followed Kelly Starrett of Mobility WOD since 2009, and he pointed out the same thing in a 2010.

Brandon, I think this will turn out to be a blessing. By next spring, my hands and arms will be a helluva a lot stronger, I will have strengthend and reconditioned my ankles and feet to superhuman level, and I will have the balance and coordination of an olympian. I'm going to take my time and I'm going to win.
Ksolem

Trad climber
Monrovia, California
Oct 6, 2015 - 02:21pm PT
I've broken three ankles, all in bouldering falls. Ankles healed well. It sucks because you are unable to hike, walk around etc. 'till it heals. I'll take an upper extremity injury over a lower any day. Still, it sounds like you got off easy.

As was said, see an ortho. Hopefully he/she can get you into PT when the time comes? Even if you can only go a couple times be inquisitive and learn the exercises. In these early stages keep it elevated as much as possible.

FWIW Yer gonna die!
Ksolem

Trad climber
Monrovia, California
Oct 6, 2015 - 02:25pm PT
BADwife I'm really curious about RICE but your link takes me to an investment firm...
ron gomez

Trad climber
fallbrook,ca
Oct 6, 2015 - 02:32pm PT
Moe,
Kris is very knowledgeable in this area as well, hope our conversation this morning clarified some things for you, but like Solem says, ankles heal up....just do it right.
Peace
JEleazarian

Trad climber
Fresno CA
Oct 6, 2015 - 02:57pm PT
Something im thinking about only now, is A) whethet there is a way to determine EXACTLY what soft tissue was damaged, and the best way help it heal swiftly AND optimally. Even if it can't be pinpointed , I'm sure it can be rehabbed to pre injury functionality--how?!![Empahsis added]

Unfortunatley, optimally is not always swiftly. Despite taking some impressive bouldering falls, I was never injured climbing enough to require medical attention until after I'd been climbing for 44 years, and I severed an achilles tendon in a bouldering fall. Although the physical therapist said I healed far quicker than anyone else she'd seen - including patients a third of my age - with that injury, my doc did not want me to climb for a full nine months. I followed his advice and healed (I'm tempted to pun here) completely.

I was sixty when that happened, and in the four years since, I've done at least as much climbing and bouldering as I did in the ten years before that, so I wouldn't be so certain that you're going to want to stop at 50. In any case, do what the professionals tell you, and your chances of an optimal recovery improve. I hope you're completely recovered with plenty of time to enjoy the rest of your life.

John
Moehass

Boulder climber
Laguna Beach
Topic Author's Reply - Oct 6, 2015 - 03:33pm PT
Aren't I glad to have found this forum!

Ron, I can see you're an asset to this community. Your call came in when I was whining about all I could whine about to a friend, and you really put my mind in ease. Thank you again.

Ksolem (K?ris), this is actually from 2012https://www.mobilitywod.com/propreview/people-weve-got-to-stop-icing-injuries-we-were-wrong-sooo-wrong-community-video/ Let me know if the link does not work. There's actually been a renewed discussion re icing lately. https://www.google.com/search?q=effects+of+icing+an+injury&oq=effects+of+icing+&aqs=chrome.3.69i57j0l3.6738j0j4&client=tablet-android-att-us&sourceid=chrome-mobile&ie=UTF-8


John, I understand the apparent dichotomy, but that's what it's all about, if you're good enough/put in the work, you can have your cake and eat it at the same time. That's why I didn't say 'quickest'.
And a severed Achille's after 44 years of injury free climbing must've been a true bummer. At 50 I'm just gonna take a break for a couple of decades b4 I get back on the wall. Because I'm not going to die :)
healyje

Trad climber
Portland, Oregon
Oct 6, 2015 - 06:02pm PT
I had congenitally weak ankles and have sprained my ankles like a dozen times, broken one and a broke a talus one time when a guy I didn't know tries to give me an unasked for spot out of nowhere. Next day I'm on crutches for the heel even though the front of my foot is fine.

We were in Eldo on a trip and going to do T2 that day so I hobble up to the base with my two friends to watch them do it. The one leads p1 fine, the other can't do the bottom moves. I figure, what the hell, I'll be on the front of my foot the whole time so I second it. Wrong!!! Had to do the entire descent backwards, face-to-the-rock, by starlight. It took so long we were the last ones there and old man Fowler was giving us hell raving up to us in the dark.

Don't be as stupid as me - give it a rest. That was close to forty years ago and I'm still climbing at a decent level, I just have to pay attention to every footfall on trails and descents.
Delhi Dog

climber
Good Question...
Oct 6, 2015 - 06:24pm PT
I'm sitting here at the gate in Bangkok getting ready to fly home to Delhi after ACL reconstructive surgery and a whittled down meniscus. I feel your pain. Spent the last 4 days in the hospital drugged up on morphine.
Being wheel chair bound sucks, but what the hell else can you do.
I'm looking at 6-8 months recovery time. But people better than me have been through a lot worse. Hang in there bro.
Mine wasn't even from climbing...Ultimate Frisbee. "Pop" goes the weasel...
monolith

climber
state of being
Oct 6, 2015 - 07:24pm PT
Wierd, BAD wifes's link takes you to the wrong destination. Copy and paste it into your browsers url field instead.

drmirkin.com/fitness/why-ice-delays-recovery.html
Moehass

Boulder climber
Laguna Beach
Topic Author's Reply - Oct 7, 2015 - 07:15pm PT
"It turns out that I didn't need the ACL in the first place due to my skeletal anatomy."

What does that mean?
Delhi Dog

climber
Good Question...
Oct 8, 2015 - 02:10am PT
I didn't mean to add a thread drift to this, but I appreciate the info.
BAd Wife

Social climber
Tehachapi
Oct 8, 2015 - 06:06am PT
Moehass, yes, gelatin soup, though you can make it with a combination of knuckle and marrow bones. Feet aren't required, but they're a nice addition. It's the 48-72 hours of simmering that's super important.

The link I posted works when I use it, so I agree, try copying and posting into your browser, or simply check out drmirkin.com.
Frozenwaterfalls

Ice climber
California
Oct 8, 2015 - 06:35am PT
I can't stress enough how important an excellent PT is for soft tissue damage when you get to that stage of healing. I dislocated my heel (yes, you can dislocate your heel) when my foot went down between two bouldering pads. I reduced it immediately right on the spot and then got hauled off to the ER because I couldn't weight it at all. The docs there didn't believe anything was wrong because a) they didn't believe I had reduced it myself and b) they couldn't see anything in the x-ray which was because my foot was the size of a baseball and they didn't get good resolution. They sent me to a podiatrist?!?! who put me in a boot and told me to stay on the crutches and said I would be fine in 6-8 weeks. I thought this was total BS so searched around for the best foot orthopedic surgeon Kaiser has and forced them to give me a visit with him. He was horrified at the diagnosis and after MRIs said I did have a small break and that I needed to be in real PT, not what Kaiser offered. He wrote a note for me so I could go out of plan and I went to the place where every other climber I know gets treated. Very long story short - 3 months of Kaiser PT still had only 50% range of motion. 1 week of excellent PT had 80% range of motion and by 2 weeks had 95% back. I am still careful now but did waterski on it 2 months out of injury (not smart) and was windsurfing to try and improve my proprioception (with the blessing of my good PT) and doing 50 km hikes (also with her blessing) within 5 months. Crack climbing was 7 months later. I really credit where I am at with the correct diagnosis by the right doc and the excellent PT (Sports Orthopedic Specialists in Oakland). And in the meantime, while still in the boot but off crutches, I did a lot of "hiking" in the pool. Doesn't hurt when you faceplant ;). Also used a hand erg and hang board. There are still ways to stay fit! Good luck and heal up well!
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