Jelly for Ankles

[Preposterous_Ponies]

Okay COTHers, I need your help. I am having a very difficult time with my ankles, both in and out of the saddle, though riding is my main concern. Basically, it’s like I have jelly for ankles - there is no support!

The backstory:
-My ankles have always been weak, but weren’t too bad
-A few years ago I had to do an emergency dismount at a gallop, fearing the horse was going to run threw a fence. I landed on my feet and severely damaged my ankles. It was about 6 months before they stopped being swollen, and about 3 before I could walk somewhat normally most days.
-In November of last year I trashed my ankle left ankle dismounting from my mare. Was on crutches for a few weeks, badly torn ligament.
-About a month or two ago I badly tore the ligaments in my right ankle, when my mare refused a fence: I almost came off, my flexi stirrups bent and my ankle “collapsed” in on itself. That was a few weeks on crutches too.
-I have fibromyalgia
-I have never broken a bone.

And now I’m left with two very wonky ankles, which are often swollen. They both hurt, all the time, and take turns being the worse ankle. At night they get iced, a topical ointment is put on and they are wrapped. I’ve even been forced to take sleeping pills (prescribed for fibro pain) on occasion because the pain is so bad. At work I often put a heating pad on them and have them raised.

I only ride max three times a week right now (previously it was more like 6). When I ride, they hurt like the dickens. I can’t support myself properly and they constantly just give out. I feel like I’m always reaching for my stirrups.

I have been riding for 15 years so it’s not a matter of don’t know how, it’s a matter of can’t. I can wtc gallop jump 3’ without stirrups, but on my green hunter, stirrups are required for over fences work.

Help me!

[Zuri]

Have you done a course of physical therapy? Ice is your friend, not heat. Can you apply Bio Freeze to your ankles for pain relief?

[wsmoak]

I hesitate to recommend anything without a doctor/PT involved, but… are you doing ankle exercises like ‘drawing’ the letters of the alphabet with your pointed toes? Balancing on one foot on an unstable surface (start with a towel, move up to a foam pad)?

Tendon issues are tough, they don’t seem to ever completely go back to normal once stretched, so compensating by strengthening all the muscles around them can help.

I have bad ankles too – if I don’t watch how I put my foot down, sometimes one will just roll and I’ll be on the ground. They will also do it sometimes in the saddle, if I’m tired. The muscles/tendons just seem to give up.

With the issues you describe, I’d be tempted to ride without stirrups a lot!

[red_mares]

I’m all for PT, but I think you need to see a good ankle specific orthopod. There are some really, really good ones in Baltimore. They are worth a road trip.

Never broken a bone doesn’t mean much. The ligament &/tendon damage is worse than broken bones. Besides you may have broken a bone with that last sprain. I pulled off bone chips with one sprain, just standing still. Didn’t know it for a month.

The docs consider 1 sprain/month enough to do surgery; sounds like you are pretty close to that. The surgery sucks, but it’s better than wondering if your foot will give out while crossing a busy street or whatever.

BTDT, I would be careful with the painkillers - it’s really easy to just drug yourself up so you can keep going, and in the process really do some damage.

Ice is good for new injuries; heat for old, nagging ones.

[Preposterous_Ponies]

Thank you, you’ve given me some things to think about:

Both recent injuries were x-rayed and (unfortunately) not broken. The doctors could not believe the bone didn’t break the last time around, and checked my x-rays multiple times.

I recently went into my GP to let her know the right ankle was not healing as expected - I will be getting x-rays done again and an ultrasound as well. I have a prescription for phsyio as well, but I’m not sure how much longer I will be under my parent’s benefits.

After the initial Very Bad injury to both ankles, I was in physio for roughly two years, addressing that and myriad of other issues. I, being a teenager at the time, was not very good about doing the exercises.

The fibromyalgia complicates things as well, as it’s sprain pain on top of fibro pain.

I’m very good about not abusing painkillers, and I don’t have anything of worth to be taking right now anyway - aside from my fibromyalgia medication, I only take tylenol 1s or robaxacet. (can’t take advil due to other meds)

I ditched the flexible stirrups and got a pair of wide MDC stirrups which have helped a bit.

ETA: I am in Ontario, Canada.

[red_mares]

If I were you, I’d skip the GP and see a real ankle doctor. If she’s ordering ultrasounds and x-rays, you need someone who really knows what they’re doing. Get that stuff, but call and tell her you want a referral to an OS. IME, GPs are ok if you’re healthy, but not with actual problems.

I didn’t mean ‘abusing’ pain killers per se. I did enough damage just with OTC naproxen (Aleve). It was enough to let me do more than I really should have and pretend there wasn’t a big problem. Then I ended up with a really big problem.

Look at it this way - if you had to do as much to keep your horse sound, as you do for yourself, would you still be riding him?

[Zuri]

Did you see an orthopedist when you first injured your ankles? Did you have to have surgery when you tore the ligaments? Your GP certainly can do the work up and refer you to an orthopedist if you have not seen one. Sooner than later. It sounds like you might need an MRI and an US to determine if the ligaments have repaired themselves. Did you tear the ligament off the bone?

[Preposterous_Ponies]

No surgeries, no real ankle doctors. Unfortunately, being the idiot that I am, I waited two months before going in after the initial double ankle injury. “Hey, I haven’t been able to walk for two months and my ankles are super swollen still…” my poor GP almost had a heart attack. And of course I was still riding…

No idea if the ligaments were torn off the bone.

My GP is fabulous, but I think you guys are right in saying I need to see a specialist.

[Zuri]

Oh my! No wonder your GP almost had a heart attack! You really should get this addressed ASAP. The longer you wait, the more difficult the repair. You sound young and I would hate for you to suffer through this for the rest of your life. IMO

[Preposterous_Ponies]

I am young - 23. The original incident occurred probably 5 years ago and my ankles have definitely been messed up since then, but bearable. After the recent incidents, not so much.

[Resilient]

I would see a foot/ankle specialist and try some PT stuff.
My left ankle is in terrible shape, so saw a specialist, who said to try PT to strengthen everything in my ankle, so that’s what I did. 4 months later, ankle is much improved. I still have to take it easy on the ankle, but I can do so much more than I could previously and my ankle is much stronger than it used to be.

[canadianbacon]

Get in with an Ortho and Physio as soon as possible. You may have to wait a bit to get in with an Ortho, be sure to request one who specializes in ankles, but your family doc can write you a scrip for PT. A good sports oriented PT clinic is best, ask your doc or look at the local universities, sometimes they will have a clinic in the athletic buildings. You are young, don’t let this go unattended because in another 10-20 years it will REALLY give you troubles.

Feel better soon!

[wateryglen]

Just to add what others have said:
-Use a mounting block for ALL dismounts/mounting. The goal is to prevent concussion to all your joints.
-Lose weight if needed
-limit your salt intake for awhile and see if the swelling goes down. Elevate your ankles when resting.
-Avoid concussive shoes; wear sneakers everywhere especially wide track running shoes to provide foot stability.
-avoid ambulating on uneven surfaces like grass/rocks
-wear hiking boots or ankle supporting boots/shoes when at barn or out in the country.
-try some ankle wraps/supports when up on your feet or riding. Often lace up paddock boots or field boots are great for bad ankles. Can even use ace bandage wraps under your boots for super support. Kinda like a “soft cast” when riding.
-ride w/long stirrups to avoid stress on ankle…think dressage/western length
-research this subject on this forum and you’ll find we’ve discussed this many times before
-good luck!

[Preposterous_Ponies]

I haven’t been in to see the doctor yet, but that is in the cards for the near future. Physio I can start at anytime, I just need to give my physiotherapist a call and set up an appointment.

I have been doing the alphabet with my ankles - it’s surprisingly tricky!

I took the stirrups off my saddle, and had two pain free rides! I actually ride better without stirrups (can’t get away with my bad habits), so I’ll leave them off for a month or two and then re-visit the issue.