By
Carol Davis
16:10 EST, 15 July 2013
|
17:53 EST, 15 July 2013
Thousands of Britons suffer long-term pain and instability after spraining an ankle. There is a procedure that can help, as 24-year-old Imogen Cairns, from Portishead in Somerset, found.
Here, the gymnast, who has won three Commonwealth Games gold medals and represented Britain at the last two Olympics, tells her story.
Back on form: Olympic gymnast Imogen Cairns
THE PATIENT
Warming up before a gymnastic competition in Wiltshire five years ago, I somersaulted into the air and landed awkwardly. Both feet were twisted to the side, so my ankles hit the floor and made a loud snap, sparking gasps from the crowd.
The pain was horrendous and I was taken to hospital in Bath, where X-rays revealed nothing was broken.
Doctors diagnosed an ankle sprain, which is when your ankle turns while the foot is bearing your weight. This can tear soft tissue, creating a sprain, or can break one or more of the ankle bones.
That snap we’d all heard was my ligaments and tendons literally snapping.
The doctors warned they could take time to heal and recommended rest, ice packs and painkillers.
I couldn’t walk – my ankles were very painful and had swollen like balloons – so I had to be carried out the hospital.
I went to my parents’ house in Devon for a week to rest. I couldn’t even get out of bed and felt incredibly frustrated at not being able to train.
I then went home but still had to spend the next three weeks in bed. I used icepacks and took painkillers but nothing helped.
Over the next five months I tried acupuncture and physiotherapy. I could limp after six weeks but my ankles were incredibly painful and even tripping over a little stone hurt. I walked slowly, using crutches.
Because I was in bed so much, I gained over half a stone and became depressed. I thought I’d never train again.
As my ankles weren’t healing, my physio referred me to Mark Herron, a foot and ankle orthopaedic surgeon.
Mark sent me for MRI scans which showed that as well as having scarring in my left ankle where the ligaments (which join bone to bone) had healed, in my right ankle there was a hollow in my bone and cartilage.
To fill this out, Mark said he could try microfracture, where fine wires are drilled into the cavity. This would make bone marrow containing stem cells ooze out from underlying healthy bone – and because stem cells can grow into any cells in the body, they would eventually form new bone and cartilage in my ankle.
Going for gold: As a result of the operation, Imogen was able to compete in the 2012 London Olympics
I didn’t like the idea of surgery, but went ahead because my ankles weren’t healing.
In March 2009 I had surgery under general anaesthetic. Mark cleaned up some of the scar tissue in my left ankle at the same time.
I wasn’t allowed to put weight on my right ankle so used a wheelchair for a short time. I then spent six months on crutches while my ankles healed gradually.
That September, I had another operation to remove more scar tissue which had built up after the operation as part of the healing process.
After that I had my full range of movement back and slowly built up my fitness through walking and jogging. By early 2010 I was training again, though it was hard after a long break.
Competing in the London Olympics last year made all the pain and hard work worthwhile. It’s an experience I’ll never forget.
While I still need physio a few times a week and my ankles hurt when I’ve been dancing for hours, I’m really back on my feet now.
THE SURGEON
Mark Herron is a consultant orthopaedic foot and ankle surgeon. Formerly at the Royal Orthopaedic Hospital, he now practises at the BMI Priory Hospital in Birmingham. He says:
Each year, around 300,000 Britons sprain an ankle. The ankle is a very mobile joint with large forces passing through it and a long lever (the leg), and so sprains are common – particularly from jumping, running, moving on uneven surfaces and contact sports.
While most sprains repair with rest, ice packs, painkillers and physiotherapy, in 5 per cent of cases the pain and instability continue after this area’s healing process is ‘turned off’ at around 12 weeks.
This continuing pain can be caused by an osteochondral defect – a bone and cartilage cavity, similar to a large dental cavity except it’s on the surface of the ankle joint surface, which should be smooth.
Towering figures: Each year, around 300,000 Britons sprain an ankle
Usually this occurs as a result of injury, although less commonly, it can occur spontaneously.
When Imogen saw me, she told me her ankle injuries were not settling despite months of conservative management.
Both ankles needed surgery but the real problem was her right ankle, where she had an osteochondral defect.
This can be helped with a technique called microfracture, which has been around for decades but was popularised by U.S. surgeons in the early Nineties.
It involves drilling the defect with fine stainless steel wires (with diameters of 1.2 to 1.4mm) to create a blood clot, releasing bone marrow and stem cells and kick-starting the body’s healing process.
Afterwards the body will continue healing over six to 12 months. This is successful in 80 to 85 per cent of cases, depending on the body’s healing capacity. Smoking probably reduces the chance of success.
The operation takes 30-40 minutes under general anaesthetic and is done as a keyhole procedure. First I make two 3-4mm incisions at the front of the ankle, one for the camera and the other for the instruments.
I clean out any loose bone and cartilage in the defect using curettes (like sharp surgical spoons), and drill into the base of the cavity with sharp wires or metallic picks.
I drill deep enough to release bone marrow and stem cells – usually up to 0.5cm though it can be up to 1cm, depending on what the MRI scan shows and when blood and bone marrow bleed back into the cavity.
I create as many holes as needed to fill the cavity with blood clots to form new bone and cartilage: around half a dozen in Imogen’s case.
I also dealt with the ligament damage and scarring in her left ankle, by removing scar tissue.
The incisions are then stitched and covered with a compressive bandage to prevent bleeding. The patient goes home that day with crutches to keep weight off that ankle for five weeks while new bone and cartilage form.
Patients occasionally need a second operation to remove scar tissue.
The operation carries a 15 per cent risk of failure. DVT (deep vein thrombosis) and ankle infections are rare risks. In 5-10 per cent of cases the scars can be slightly numb.
The operation costs £3-3,500 privately. It is also available at specialist NHS foot centres.
Share or comment on this article
-
GRAPHIC CONTENT: Pensioner shoots dead black neighbor, 13 -
Bill Maher booed for Zimmerman joke -
Korean woman filmed being abused in nightclub by westerners… -
Chinese dance students perform ballet gymnastics display -
Beyonce to fan: Put that camera down and sing! -
Air Force captain’s shocks family with scuba homecoming -
Big dog VERY unsure about tiny kitten -
Some Red Neck Heaven skin at ‘Anything But Clothes’ party -
LISTEN: Queen is hoping for a grandchild before her… -
Nancy Grace’s Zimmerman ‘churros’ jibe -
WARNING GRAPHIC: Three gored in Pamplona’s Running of the… -
Surprise! Sons reunite dad with his first car
-
Florida’s ‘First Lady’ of tax refund fraud gets 21 years in… -
Tragedy as heavily pregnant former Olympian suddenly… -
‘I’m his girlfriend’: Rev. Al Sharpton dating 35-year-old… -
Mother of late billionaire Bruce Wasserstein’s love child in… -
How to undress for your husband: LIFE publishes step-by-step… -
Revealed: The blonde New York Times journalist who is suing… -
David Letterman’s audience hurls BOOS at liberal comedian… -
Texas town changing nudity laws to make body paint… -
Pedophile who ‘stabbed mother to death while her daughter,… -
Man with severed genitalia found naked on Washington road in… -
‘I had sex with my cat and everyone knows’: Crazed woman,… -
Trayvoning, the latest disturbing social media trend…
The comments below have not been moderated.
-
Newest -
Oldest -
Best rated -
Worst rated
I cannot by empathise with Imogen and all she went through. Herbal approach in healing nasty sprains is well documented and used by Central European doctors notably the Swiss, German and others in the region.
St John’s Worth was used for the last few millennia to heal scars and wounds. There is one snag; if you take St John’s Worth tea do not sunbathe, otherwise your skin could break and open a bit. That is because the herbs softens tissue in and on the surface of the body. Marigold is also included in the tea because it it heals any wounds.
On a fresh wound or in this case a nasty sprain they apply poultices such as comfrey root which acts as repair for either bones or tissue. All these operations!
dagmar
,
london,
17/7/2013 15:55
Report abuse
In all seriousness, if it takes you that/too/abnormally long to heal from injuries, you have an allergy(s). Your body is sending all of their fighters to attack the allergen, leaving them in the blood stream, and away from your injury.
Leia
,
Dallas TX USA,
17/7/2013 06:05
Report abuse
Following a fall on hospital ward when my foot was injured in Jauary 2013 I was told Nothing wrong you havent broken bone. The pain was ignored as no bone broken, at times had to plead for chair to bathroom due to great pain most of time. The gp not told on discharge about fall and I was house bound and in pain for months. About time more was done for ankle/foot injury. Now on pain capsules and having to use walker, due to foot not right trying to walk put great strain on other muscles etc., IF ONLY HAD BONE BROKEN may have had correct care. Once was even told to hop on good foot…as elderly I had been very active…not now…but who cares.
osborne
,
manchester,
17/7/2013 00:56
Report abuse
I had this op done 7 years ago (although I think it was experimental back then) after having caused bone damage after severely spraining my ankle. It worked very well the pain disappeared almost over night!
seriously….
,
North Norfolkshire,
16/7/2013 20:39
Report abuse
I hate when I see someone with a bandage on their ankle walking about who has ‘sprained’ their ankle. Having actually sprained my ankle last year and sustaining abrasion fracture (where flecks of bone are stuck to the torn ligaments) I can honestly say it was the most painful thing I had experienced. the size, bruising and shape of my twisted foot had me convinced it was broken so I was quite shocked to find it wasn’t! that was only one ankle so I can’t imagine how bad it must be to have two! sounds like a good procedure, still haven’t got my full use back after a year
Charlotte
,
Wiltshire, UK,
16/7/2013 19:26
Report abuse
The views expressed in the contents above are those of our users and do not necessarily reflect the views of MailOnline.
We are no longer accepting comments on this article.