Chronic Ankle Pain--Frustrated and Looking for Answer
I've never posted here before, however I'm looking for any suggestions that I can try.
SUMMER 2004
I started having ankle pain along the front of my ankle in the summer of 04'. I was a competitive soccer player and decided to ignore the problem and just keep playing. Once the fall rolled around, I was frustrated enough that I went to an orthopedic surgeon.
I was told that it was just tendonitis along my anterior tibialis tendon and to just not push it as much as I had been and to take naproxen to try and get it calmed down.
That didn't work, however I kept playing with the pain and didn't see a doctor again until the spring when it was beginning to really impact my play.
The whole time I had been seeing an athletic trainer at my high school who was doing ultrasound and taping before every practice or game to try and help with the pain as much as possible.
SPRING 2005
Once I saw a doctor in the spring of 2005, I was referred to have physical therapy multiple times a week and also received orthotics. During this time, I also underwent iontoforesis. However, none of these really ever made things get any better.
FALL 2005
I was referred back to a different specialist in the fall. He then requested a MRI and it came back showing chronic inflammation along the course of the tendon, but nothing else significant.
I was in the hunt for a college scholarship though and didn't want to miss out on any opportunities to be seen by a college coach so I received my first cortisone injection.
This temporarily helped with some of the pain, but never completely made it go away.
I held off seeing a doctor again until the fall season was over and then went back to the specialist where he referred me for more physical therapy.
WINTER 05'-06'
During the Winter of 05'-06', we tried pool therapy to see if that would help strengthen my ankle without putting so much pressure on it. However, the extra activity was only making it worse.
I was frustrated enough by this point that was I was released by my physical therapist saying they didn't know what more to try, that I decided to try and keep playing through it during my whole spring season without seeing a doctor.
FALL 2006
Finally in the fall of 2006, it got to a point where I couldn't walk or perform daily activities without having a lot of pain. This is when I finally gave in and went back to the doctor. He requested another MRI which showed that the tendon had thickened since the last MRI and was chronically inflamed, and had fluid around it. He tried one more cortisone injection, which again didn't help much.
I was then referred to another orthopedic surgeon who is "the ankle guy" in the area that I live in. He decided to place me in a walking boot for 4 weeks and see if that helped get it out of the cycle of inflammation that my ankle is in.
The boot helped with the pain while I was walking in it, but as soon as I went without the boot after 4 weeks, I was quickly back to where we were before.
DECEMBER 2006
He decided at that point it was time to try surgery. When he got in there he took out a section of my tendon that he described as looking "moth eaten" and very deteriorated. He cleaned up that portion of my tendon, but decided not to do anything with my tendon sheath, since he had already done major work and didn't want to disrupt it anymore. However, he described my sheath as being in "really bad shape."
I was placed in a cast for approximately 6 weeks--2 weeks on crutches the other 4 in a walking cast. He then removed the stitches and placed me in a boot for another 6 weeks and started me on rehab.
We rehabbed my ankle for about 2-3 months. After 3 months, I was allowed to start running again and after another 3 months, I was going to be allowed to start playing soccer again.
MARCH 2007
Once I started running, my ankle started bruising and I had a pocket of fluid along that tendon that would never go away. My surgeon drained it on multiple occasions, and each time he had a syringe full of blood.
I again was placed back in the boot, where it still filled up with fluid and was still painful. After wearing the boot for over a month, we decided to try a second surgery to strip the tendon sheath and clean up any scar tissue.
AUGUST 2007
When he performed the surgery he found that the sutures hadn't fully dissolved in some places so he removed those and did everything else as planned. I rehabbed it and still had pain. My surgeon said this was the last thing he knew to try and didn't know anything else to do.
Current
I have currently been dealing with the pain as best as I can, however it is affecting how I walk and I can no longer stand for long periods of time without paying for it for the next couple of weeks. I haven't seen my surgeon for about a year because he said the last surgery was the only other thing to do.
I have gone back to wearing my walking boot because it is the only thing that helps with the pain and lets me move around much and I have an appointment to see my doctor again in about 2 and 1/2 weeks.
What can be done?
My question is: Have we missed any options to try? Is there anything else that can be done, or do I just have to live with the pain? When I have done research on my own, I haven't come across much. Has anyone seen this before or have any new ideas to try? Was I possibly misdiagnosed and we've been missing something all along?
Where is the pain?
Along the course of the anterior tibialis on the front of my ankle.
The tendon is painful to the touch and also when I move my foot (hurts the most when I pull it back towards my body)
What does the pain feel like?
Can be sharp during activity, but most of the time a dull achy pain.
How bad is the pain?
Bad enough that I can no longer run or play soccer (had to give up my soccer scholarship because of this injury).
It's even painful to walk or stand
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