Ligament Injuries: Causes, Treatments, and Recovery Options

Q: Ligament Injuries: Causes, Treatments, and Recovery Options

Hello： In response to your question, please consult an orthopedic physician first. <br>Based on your description, I personally believe that surgery may not be necessary; it could be a myofascial issue or a gout flare-up. <br>It is best to seek medical attention as soon as possibl

Ligament?

Hello, I have a question for you.
Two years ago, I accidentally fell down the stairs (about 6-7 stories), and since then, I have experienced swelling and pain in both of my Achilles tendons.
I did not seek medical attention immediately and only went to see an orthopedic doctor about a week later when the pain became so severe that I could not walk.
The doctor informed me that there was a tear in the ligaments, and I took oral medication for a while.
There were no further issues until last year when my left Achilles tendon started to hurt again, becoming red and swollen (without any new injury).
I visited the hospital, and a rehabilitation physician also diagnosed it as a ligament tear and administered a pain relief injection with a medication called Kanacalo.
Why has it not healed after such a long time? Recently, the pain has returned, and I have noticed a difference in the thickness of the ligaments in both Achilles tendons, suggesting some atrophy.
What should I do? I have experienced this pain several times, and each time it has been severe enough to prevent me from walking, which is very distressing.
A doctor mentioned surgery to cut and reattach the ligaments.
Is this a viable option? I work in the service industry; if I undergo surgery, how long would I need to rest? What impact could this have on my future? The frequency of these issues is increasing, and I am concerned about potential walking problems in the future.

1.
What is the best course of action? It is difficult to reduce walking since my job requires it.
2.
Is surgery truly necessary? If so, how long would the recovery period be?
3.
Why has it not healed after such a long time?
4.
What should I do if there is indeed atrophy?

~Wuming~, 20~29 year old female. Ask Date: 2007/03/30

Dr. Li Wenlin reply Orthopedics

Hello: In response to your question, please consult an orthopedic physician first.
Based on your description, I personally believe that surgery may not be necessary; it could be a myofascial issue or a gout flare-up.
It is best to seek medical attention as soon as possible.
Wishing you a speedy recovery!

Reply Date: 2007/03/30

More Info

I'm sorry to hear about your ongoing struggles with your heel ligaments after your fall. Ligament injuries can be quite complex and often require a multifaceted approach to treatment and recovery. Let's break down your concerns and explore the best options for you.

Understanding Ligament Injuries
Ligament injuries, particularly in the ankle and heel area, can occur due to trauma, such as falls or twists, leading to sprains or tears. These injuries can cause pain, swelling, and instability in the affected area. In your case, it seems that you experienced a significant injury that may not have healed properly, leading to recurrent pain and swelling.

Why Healing May Be Delayed
There are several reasons why your ligament injury may not have healed completely:
1. Severity of Injury: If the ligament was partially or completely torn, it may take longer to heal, especially if the injury was not treated immediately.

2. Inadequate Rest: Returning to activity too soon can impede healing. Since you work in a service industry that requires you to be on your feet, this could contribute to ongoing issues.

3. Chronic Inflammation: Repeated stress on the injured area can lead to chronic inflammation, which can prolong recovery.

4. Scar Tissue Formation: After an injury, scar tissue can form, which may not have the same elasticity as the original ligament, leading to stiffness and pain.

5. Underlying Conditions: Conditions such as arthritis or other musculoskeletal disorders can complicate healing.

Treatment Options
1. Conservative Management: Initially, conservative treatments such as rest, ice, compression, and elevation (RICE) are recommended. Physical therapy can also help strengthen the surrounding muscles and improve flexibility.

2. Medications: Non-steroidal anti-inflammatory drugs (NSAIDs) can help reduce pain and swelling. However, if you have allergies to certain NSAIDs, alternatives like acetaminophen or topical analgesics may be considered.

3. Injections: Corticosteroid injections can provide temporary relief from inflammation and pain. The "kanacalo" injection you received may have been a corticosteroid or another type of pain relief.

4. Surgery: If conservative treatments fail and the ligament is severely damaged, surgical intervention may be necessary. This could involve repairing or reconstructing the ligament. The recovery time post-surgery can vary but typically ranges from several weeks to a few months, depending on the extent of the surgery and your overall health.

Recovery and Rehabilitation
1. Physical Therapy: Engaging in a structured rehabilitation program is crucial. A physical therapist can design a program tailored to your needs, focusing on strengthening, flexibility, and functional movements.

2. Gradual Return to Activity: It's essential to gradually return to your normal activities. Listen to your body and avoid pushing through pain.

3. Footwear: Proper footwear can provide support and reduce strain on your ligaments. Consider using orthotics if recommended by a healthcare professional.

4. Monitoring Symptoms: Keep track of your symptoms and communicate with your healthcare provider about any changes. If you notice increased swelling or pain, it may indicate that you need to adjust your activity level or treatment plan.

Long-Term Considerations
1. Potential for Recurrence: Unfortunately, ligament injuries can have a tendency to recur, especially if the initial injury was severe. This is why ongoing care and attention to your foot health are essential.

2. Impact on Daily Life: Chronic pain and instability can affect your quality of life and ability to work. It's important to address these issues proactively to prevent further complications.

3. Surgical Risks and Benefits: If surgery is recommended, weigh the risks and benefits with your surgeon. Understand the recovery timeline and what to expect post-surgery.

Conclusion
In summary, it’s crucial to take your symptoms seriously and seek a comprehensive evaluation from an orthopedic specialist who can assess the extent of your injury and recommend a tailored treatment plan. Surgery may be an option, but it should be considered carefully in conjunction with conservative treatments. Prioritize your recovery, and don’t hesitate to ask for time off work if needed to facilitate healing. Your long-term mobility and quality of life are worth it.

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