Why Isn’t My Ankle Sprain Getting Better? What Your Doctor Might Have Missed.

Ankle sprains and strains as well as cartilage injuries have been widely reported to be due to a direct trauma, twisting, or fall.  I recently saw a man in our Piscataway office in his early forties complaining of ankle pain of a few months duration.  He initially denied trauma but after probing him further, he did recall that his pain started hours after jumping and playing on a trampoline with his kids.  He said he didn’t have any pain while he was on the trampoline so he didn’t think it was an issue.  He also admitted to a history of ankle sprains in the past and a feeling of ankle instability

So, What Do I Have and How Can We Treat It?

An X-ray and MRI revealed a very large defect or “hole” in the ankle joint called an osteochondral defect (OCD).  Cartilage does not heal itself as it has no blood supply.  This will not get better on its own.  Without treatment, he will have chronic ankle pain, discomfort and eventually arthritis in the rest of the ankle joint.  The talus bone could possibly collapse and/or the blood supply could be cut off leading to necrosis and irreparable damage.  This man will get better with the proper surgical treatment.  The fractured cartilage and associated bone will be removed and replaced with a graft from the knee.  This is a very successful procedure but without a proper diagnosis via MRI this condition is often times missed.

So, was this injury a direct cause from the trampoline?  One will never know without comparing an MRI of his ankle before and after the trampoline incident.  This comparison cannot be done as an MRI wasn’t done before the injury.  I can only speculate that he most likely did have an injury or ankle weakness before the trampoline injury as evidenced by his sprains and instability in the past.  The impact of the trampoline on his ankle was probably the “straw that broke the camel’s back” as they say.  The force of the trampoline was the final catalyst to his OCD injury.

Trampolines Can Be Dangerous

So how could this have been prevented?  There are a few lessons to this story.  The most obvious is that trampolines can potentially be dangerous, cause harm and should be used with caution.  Have you heard of the recent study and reports on the dangers of inflatable bounce houses on kids?  The journal of Pediatrics recently reported on the dangers of bouncy houses in December 2012.  The journal reported on an increasing number of children being injured with fractures, strains and sprains while playing in a bouncy house.  This article has sparked nationwide media attention.  It makes you think twice about letting your kids go to these very popular bouncy house birthday parties.  However, bounce houses are not the only culprit.  Nor is it only children who are susceptible to these types of injuries.  Adults as evidenced in the above case can be injured as well and trampolines, which involve the same type of jumping forces, can cause very similar injuries as bounce houses.