Knowledge is power

I want to go through some of the major injuries I've had over the past couple years and together we can learn a lot about the body. Let's start with the most recent. High ankle sprains are more rare than your typical sprain. The high ankle sprain is located, as the name suggests, anywhere above the ankle joint. The two major bones above the ankle joint are the tibia and the fibula. When you have a high ankle sprain you partially tear the ligaments that hold those two bones together. There are varying degrees of tearing, which an MRI can show how severe the sprain is.  Ligaments do not heal back together. Scar tissue will form over time and bridge the gap. The build up of scar tissue and how weight falls to the area above the ankle joint  are why high ankle sprains take longer to heal than low ankle sprains.

Your tibia and fibula separate slightly when you put weight on your foot and separate further when you increase dorsiflexion, which is flexing of the foot. Some doctors may recommend surgery where they insert a nail connecting the two bones making certain that the tibia and fibula are stable while the ligament heals (limiting the separation of the tibia and fibula). They remove the nail once the ligaments are stable enough. However, with ballet dancers this surgery is not recommended because it makes the ankle joint too stiff. Ballet dancers need to have more loose ankle joints than the average person because we do much of our dancing on our toes. Therefore, the recommended treatment for a dancer is to put the foot in a boot and use crutches since weight-bearing puts too much pressure on the ligaments if they aren't healthy enough. Crutches and a boot are necessary for about 6-8 weeks. I was on crutches for 3 months (which is longer than usual) because as I was about to get off crutches I slipped in my shower and re-sprained the ligaments and had to start the healing process all over again. That was a low moment for sure.

Now the other injury I'm dealing with is osteoarthritis in the knee.  This is a very common joint disease that most often affects people in their middle age or elderly years. Osteoarthritis is known as "wear-and-tear" where the joint experiences eroded cartilage (shock absorbers) and bone spurs. Even though it is commonly seen in older people it is also very common in most athletes including ballet dancers. I am certain most professional ballet dancers have some degree of osteoarthritis but depending on how severe it is, determines the treatment plan. Most athletes can handle a significant amount of osteoarthritis because of how fit they are. If the muscles surrounding the joint are strong, then the muscles can absorb the force rather then the force solely falling on the joint.

Osteoarthritis is treated with pain management. No matter how much cartilage has deteriorated each person's pain level is different. I for example have a significant loss of cartilage and bone spurs that cause my knee to lock and click. During certain movements the loss of cartilage causes grinding bone on bone. However, I don't feel a tremendous amount of pain and can dance without much limitation. My doctors have informed me that another patient may have the same degree of the disease and be in so much pain they can't walk up a flight of stairs. There are many things that can be done to improve the pain. Non-surgical options include acupuncture, massage, physical therapy, hyaluronic acid injections (help lubricate the knee), or PRP injections (help generate healing). If one wanted to have surgery it would most likely be some form of cartilage transplant.  I chose the hyaluronic acid injection called Monovisc which is a single injection said to last up to 6 months. I received the injection for the first time this Friday 6/7/19. It was not painful and it happened in under 10 minutes. I was able to walk out of the office with minimal soreness.

I hope all of this was informative, when dealing with injuries it is of utmost priority to get as much knowledge about your injury as possible. Seeing multiple doctors and exploring all your options of treatment is very important. Once you have all your information then you can decide, which doctor you feel comfortable with and trust. Ask many questions and do your own research. Talking to others who have had similar injuries also is very helpful. Especially with dancers it is important to see doctors who are familiar with a dancer's body and the requirements of the job.