UKC

I have managed to completely tear the ATFL and CFL on the outside of my ankle (as in - broken in two). Has anyone else experienced this and can share any views on if you were able to get back to full climbing with/without ligament reconstruction surgery?

I'm lucky enough to have private medical through work, with lots of physio and scans, but interested in views/experience of those who've made or attempted a return to climbing (and trail running / hiking / mountaineering / the other ankle-intensive activities we love)!

I did this while bouldering (classic...) and I'm worried about if it'll ever be stable enough to (e.g.) drop off a boulder problem (as you normally would tens of times per session) or to take a lead fall without excessive risk of re-rolling it. Obviously would be more stable with ligament rebuilt but would rather not if I can avoid, as it's not risk-free and will mean even more time off from everything. 

At the moment I can actually climb ok - tested at the bouldering wall - but massively (and rightly) limited by my mind not wanting me to drop/fall off from any height and needing to downclimb everything.

Thank you!

I torn all the ligaments whilst playing rugby and had the surgery to repair.  I was fine, functional-stability wise, before the surgery, but the excess mobility had cause osteophytes on my shin which were painful so got it all sorted at once.

Before surgery I was able to climb and surf no problem and it was only running which was causing me pain, but possibly not due to the ligaments.  I would often go over on that ankle though... but damage was already done.... I possibly wouldn't have bothered with the surgery if I didn't run/ wasn't as young as I was (28).

Surgery was a breeze - I would highly recommend asking for a nerve block if they will do it, rather than relying on oral pain meds. Overall the pain was minimal, and in hindsight was more to do with the shaving of my bone for the other issue than the ligaments.

I believe the only way to do the surgery is open, meaning that you have an open wound.  This necessitates a back slab and dressing rather than cast which is quite cumbersome.  2 weeks of that and then moon boot for 6 weeks.  I was back to playing rugby well within 3 months but I was pretty religious with my physio. My body was very protective of it or the first few weeks out of the cast and I was still conscious of it for probably a year.  After that its been a couple of years of pushing the mobility back to 'normal'. exercises were initially about strength in the calf, and then increasing stability using dynamic movements on a swiss/ balance beam - it probably showed me how poor my balance was regardless of injury! you could start on a static bike as soon as the boot was off, as well as some gym or even lightly jogging.  anything where you ankle was sure to stay in a neutral orientation (so not cycling in cleats, for example).

My surgeon warned me that it might feel weirdly tight as the ligament will be shorter, which it did.  some people may hate that (yoga?) and I cant sit comfortably cross legged/ on my knees like I used to. Functionally I'm great and its very minimally different to the other side..

Whenever I almost go over on it (while hiking, for example) I get an 'oh fcuk, if messed it up again, feeling. but, its still fine and its just learning to trust your body again.

You don't mention your age, which will obviously affect the recovery time. you could probably carry on without the surgery and see how often you go over on it. Once that exceeds your threshold then have the surgery? but in my opinion, it wasnt that bad!

I did something like that around 15 years ago. I was youngish and assumed I'd heal and bounce back. Not sure which exact ligs I damaged but I ended up with weak lateral support across tibiotalus. Coped ok for 10 years, continued to run and climb but gradually OA set in. Now my talus bone has rotated.... varus with severe OA as the joint isn't lined up and cartilage worn away. 

I think I've discovered the ins n outs, various options, pros cons are complicated and decision making not easy. I'd consider the long game. I wish I had. Maybe from now on see if it's worth keeping an eye on this joint and see if can get it x-rayed yearly say. If it's showing uneven wear, consider that your joint surface maybe on a count down clock and use it wisely. Im now edging closer to ankle fusion or replacement. I suspect if I stopped running earlier on I'd have got a longer life span out of my cartilage.

I'm not sure if ligament repair is successful or not. I went the conservative route and had the talus gradually rotate. If repair can reduce, delay,prevent that, it may be worthwhile.

I suspect you'll get on no matter what you do but may face OA in 10 20 years....

I fully dislocated my ankle 3 years ago - remember sitting on the bouldering mat looking at my foot pointing 90 degrees in the wrong direction. It took a fair amount of physio (6 months) to get me back walking again - I found biking really helped in the rehab due to encouraging ankle movement and building back strength. I still lack the full range of movement in my ankle, but its strong enough for me to have entered my first ultra bike race in 2 weeks, and an ultra marathon in September, so it will get better! I am very aware about dropping off boulders now, even if I know the landing is fine - am sure the confidence will come back with time. Hope the recovery goes well. 

My ankle went between two mats that were poorly stitched together at a bouldering wall and came out rotated 90 degrees, tearing both ligaments you mention. Initially misdiagnosed as a bad sprain, I did eventually get a surgical consult but they reckoned as I was young and reasonably fit physio was a better option. As I understand it the physio basically trains the tendons which happen to run the same course as the ligaments to fire quicker? And partially act as ligaments? Though that might be a reductive way of looking at it.

Was back to climbing about 4 months after the incident, in hindsight I would have left it longer. But it's pretty much back to normal now. Permanently slightly larger than the other ankle due to scar tissue on my tendons. Used to get tired on long slabs and I am paranoid about rolling it, but it hasn't been particularly prone to it so I think that's just my own residual paranoia.

My main worry now is looking ahead and assuming I'm at a much greater risk of arthritis so maybe ask if the surgery impacts on that. I'm 29, the injury happened at 24.

Thanks all so far for sharing your stories... While sprains don't "sound" bad I appreciate these pretty debilitating and incredibly painful so thanks for being open... this is on the whole pretty reassuring about getting back action, although eye-opening about OA and possible complications :/ . A few further questions:

- When it does 'go over' again without the ligaments, have you found that basically fine as the ligaments to damage are already gone, or have you found that means it's much more likely to re-sprain / re-break? (I didn't mention but the tibia and talus are also broken where they join, possibly a near/temporary dislocation causing this, but are expected to head up naturally in another month or two).

- Any residual issues with eg taking lead falls? That, plus having any confidence bouldering and being able to run are my top concerns.

For those that asked I'm 33... so not the youngest but I'd like to think relatively young in the grand scheme of things...

Give it time to heal and build up slowly.  If you do lots of different sports / training then think about prioritising.  Find doctors who specialise in the specific area of your injury. Get second opinions.  Work with physiotherapists beyond basic rehab in conjunction with advice from surgeons.

This is the advice that I wish someone had given me 15 years ago.  Now facing ankle fusion after years of pain reduced mobility.