Wednesday, January 30, 2013

The Seeming Death Of An Ankle

 NOTE: This is about Noodles and his ankle and there are some horrible images of sprained ankles, if you don't like the sight of this stuff or self pity turn a way now!

So I guess this story starts with me and what happened prior to my ankle getting blown out... I have a trainer and he's part of the CHR family and I'd spent about 4 months training my ass off for this years Tour De Bloc. That's me on the left there are the first comp of the year at Joe Rockheads in Toronto cranking down to a 5th place finish in my field. I'd had a good comp and training was fitting into my daily life and around the comps so I was happy.

Then what happened was something of a freak accident :( During a rest period I was at the gym and I was showing someone how I did a move and I fluffed it, my hand slipped and I fell... about 4ft, yup 4 bloody feet. I landed a little lopsided (the mats are angled) and as soon as I hit I knew my ankle was done. Now, I've never had an ankle problem but when you do something like this you just know. I crawled off of the mat with Bobby laughing at me as he thought I was just messing around. This is the image about 10 minutes after I did it... looks a little broken; a few beers later I went to hospital.

Yes man logic, I iced it when I got home and I'm pretty damn good with pain but even after a while it started to get to me. If the beer isn't going to help then I'll go see a professional :)

 Thankfully the hospital was empty and I was seen straight away; FYI: there is always something bad happening when the triage nurse asks why you're there and you say "I have a little boo boo" you show them your ankle and they make noises... and then calls the doctor who then makes noises and then they send you for an x-ray. I don't find Doctor humor very funny, I know full well that I've fucked myself up... also asking if you're in pain when you have a softball sized lump on your ankle is pointless lol. Thankfully they gave me pain killers right away and I started to mellow out.
The x-ray showed nothing, no broken bones (yes really) but a couple of sprains; they told me to stay off of it for a few days and referred me to McGill Sports Medicine because they're the best people in town. I was told it would probably take a few weeks before they saw me. So stay off of the foot as much as possible and here's something to make you look like a Storm Trooper. It's an Air-Cast and they're amazing, between the noninflammatory pills the pain medication and this I was able to hobble about a little after a few days, not much mind you but I could hop about and go for a poop when needed.

Now here's a thing, if it's not broken then the hospital isn't going to do anything for you; sadly it's a fact but hospitals aren't going to do much for you... but they can tell you if you've broken it and that there's tendon damage but that's about it. It's the referral that's what you want because some hospitals will have departments for this kind of injury and they can treat it for you but it will take a long time to get referred. What you need (like I had) was a referral to somewhere where they have specialized sports doctors and therapists (note that I said therapists not physios)

Now I was refferred to McGill University because they have their own department for this kind of thing because they have a massive number of sports teams and there's a CFL team right next door. So I'm lucky to have an option like that and that's what i'd advise is even if you do get refereed to someone seek out out the best you can find. The health service is free and takes a long time and here's something that I'd really like to make clear:
Climbing is what I do and  is very much part of my lifestyle, I'm not the best at it but I'm by no means the worst. Part of my (Ha) income and business is reviewing holds so it's important that i get back on the wall as soon as possible. Now I'm not sponsored but I do represent companies in Canada and a gimped rep is OK, but I've climbed for 27 years and I train for the Tour and I enjoy it. People have seen me since I've done this and I'm not happy (it shows)... so I'm doing every-thing-I-can to get back to my vertical lifestyle asap

So I get refereed and I'm in a waiting pattern, it's late on the day I've done this so I'm in a weird frame of mind. My season at this point isn't fully done at this point as far as I know it's a bad sprain, that's what I've been told by the doctors.. it's a bad sprain, here's a boot, here's some anti inflammatory and pain killers... stay off of it. As i can't walk I take the rest of the week off; even with the boot I cannot walk so I start looking for a walking stick; I live 15 minutes from work and I plan on getting back to work as soon as I can. Thankfully Phil the owner of Shakti had a pair of crutches that I ended up borrowing. With the crutches and the boot I can move around the house a little more freely and I start venturing out of the house a little; normally my walk to work is 15 minutes door to door, with the boot and the crutches and a barrel of grim determination I manage to get to work in 1hr 45mins. Now call me stubborn because I could have gone to the corner and jumped the bus but I didn't want to do that at all; I wanted to do what I normally did and that was get to work as I normally did... thankfully the snow was late so it ended up being a long walk and tiring but I did it.

I'm also lucky with my team at Ubisoft, they knew I was off and they know I train hard for climbing and that I'd done myself a little boo boo. I began icing at work, thankfully the month before they'd put in an ice machine so I made sure that four times a day I iced the swelling to try to keep it in check as much as possible. I also kept it raised as much as possible... even when I slept, which is uncomfortable to say the least. I get a call to go see a doctor at McGill on Thursday. That's faster than I was expecting by weeks and just a day after I sprained my ankle I'm seeing a Doc; not bad going!!

As soon as I'm in the office I'm told to ditch all of the walking aids and to walk on it why? Because in the Doctors words "You can't do any more damage to it" So that's that then, the X-ray again shows that it's sprained but not how badly and they tell me to get into rehab (physio) asap, there's a slot two hours away so I sit and wait.

I'm scheduled to see MC Dion, shes an athletic trainer not a physio but as she looks after the varsity volley ball team and a whole host of other athletes so it seems like a great fit; hell I'm in pain and on painkillers so I'll so anything to get back on the wall as fast as possible... On the left is MC, it was a little weird at the start because there was lots of foot hugging, but what shes doing is feeling the movement of the tendons in my foot to see what's really going on in there; this went on for a while :) Because my ankle is so swollen we start making efforts over the first few weeks to get the swelling down, this is done in a variety of ways, mainly icing the hell out of it with buckets of ice and then dumping your foot into warm water (contrast baths) and then keeping it raised as much as possible throughout the day.

Now like I keep saying I'm keen to do as much as I can to get my ankle fixed so I ice my foot as much as possible at work and I was sitting with it raised a lot, I was even sleeping with it raised to try to help the swelling as much as possible and I guess here's the rub. Walking around on something like this will cause it to swell, so what you're doing it keeping the swelling down whilst you're at work and at home and as soon as you put too much strain on it walking around it just gets blown up again (it's still swollen now); but it does help in the main and means it's easier to get around on.

So not only am I getting ultrasound on the ankle I'm icing it and hooking it up and electrocuting it to help the blood flow I'm given easy band exercises to start trying to strengthen it... I have to say the service at McGill is superb and they'll answer all of my stupid questions a million times so I know what's going on.

Over time we see improvements in many things and MC determines that there's something really wrong :) The X-Ray says sprained but not how bad so when I'm scheduled to see the doc again she suggests we go and ask for an MRI and get the full answer, my follow up with the Doc is a few weeks away at this point. I couldn't have been happier because I hate pain killers and the ankle is OK but it's always a dull pain. Thankfully MC is a champ and pretty good at what she does and shes starting to suspect that the sprain is a tear in the outer of my foots tendons, she can't tell how bad but we know from when shes massaging that area I'm pretty well in tears from it just being touched :( Mind you the bruising kind of shows the details.. yup that's a few weeks in and it's still a couple of wonderful colors :P

So we're a month in and I have a bunch of exercises to do (which I do diligently btw) and we're starting to test out whats working and whats not. For a while there my tibular was displaced slightly in my foot and we start working to get that bugger back into place; here's a funny thing trying to get a bone back into place when the person (me) you're working on knows what you're doing it doesn't make this easy, it's like trying to pick a lock apparently because you need to find the way it'll go back into the right place... we try this for weeks (yes I was walking on it) but nothing works, it seems to be locked up tight in there somewhere so she goes for a different treatment and it's one I love... enjoy the photos:

I call it the Red Neck Water Bath, other people call it hydrotherapy and it's the shit!! Think a huge metal tub of hot water and a water pump that blasts water at your foot... this will take down swelling in an ankle in no time and it'll give a great massage at the same time. Through doing this a bunch of times we managed to get the bones back into place and the swelling down somewhat; my ankle is feeling great (apart from the dull ache) and it's getting stronger. The RKWB and icing means I'm feeling better and better and it's a week before I see the doc again...

There is one thing that is plaguing us and that's the inflection in my ankle (its when you pick your foot up from the toes) some days it's good, I can put my toes to a wall and touch my knee to it, other days it's completely crap and I cannot. We know the bones back in place but there is obviously something else wrong somewhere... countdown to seeing the doctor is ticking. Thankfully the band exercises I'm doing at home means I'm having less trouble walking around but there are instances where it's not so great... but thankfully as I'm rehab minded I can ride my bike a bunch to train so my Niner gets a cycle remake into a trainer for a while. Honestly it's a shame to see such a sweet machine with a road tyre on it

I start trying compression socks at this point, I contacted a company called 110% Play Harder and told them what I'd done, about CHR and how as I'm in recovery I'd like to see how their product works and would like to do a review; they agree and they send me some socks (and talk about fast service, they arrived in 3 days) and I start using their system to ice on the go and to compress my ankle so what's left of the swelling is being dealt with; there's a review on these coming soon, but I'm super impressed at the quality of the product and how it helped my injury for sure. Compression socks on sprains are so good I'm surprised that the C in RICE isn't used more!! RICE BTW is an acronym for Rest, Ice, Compression and Elevation.

And then we go to see the doc; she looks at it and we talk for a bit. I like her because she's straight forward and she doesn't muck around at all, my favorite line was "I can act all cool and read your file or you can tell me what the hells up" well that was simple and to the point, I tell her about the daily progress and what MC and I have been doing and mention that the inflection is on and off all of the time, she says it's MRI time and she'll put in a request for one, it'll take between 6-8 weeks :( but she also gives me paperwork so I can have it done privately. I decide that if I've not heard by Jan 6th (two months after I did it) I'd go private and just foot (HA) the bill myself.... back to rehab and waiting :(

Then there was another stroke of luck that only a picture can describe:
On the morning of December 27th I received a call at 9am from the hospital asking if I could make it there at 7pm for my MRI, that was less than two weeks after the request was put in... why? Because there's a snow storm and people are cancelling! I say yes and head to the shop to shape some holds and to see what Chris is up to; this is by my work, there's horizontal snow blowing and it's mental outside, a 15min walk takes 30mins... and it's bloody freezing!! Now I know how long it takes me to get to McGill and the hospital is in the same spot (about 10 to the bus and then 10 of walking) but it's a snow storm, I leave for the hospital at 2.30from the shop and get there by 4.30. Yup that on a normal day would have taken about 45 to walk took that long, sure I have a crapped out ankle but the buses were stuck, the roads were a mess and there's 2-3ft of snow on the ground and it's getting worse as we speak... like I said it was MENTAL!!

I go up to the MRI clinic and expect to be told to come back when I was due to be seen... nope, no one was turning up for their appointments so I walked right in :) MRI's are a new thing on me, my foot is locked into a boot so I can't move it, I'm given a panic ball and some ear plugs because the noise is a little loud. I wasn't sure what to expect but as this for me was a step (ha) in the right direction I was going to grin a bear it; needless to say I was so stressed I fell asleep :P The people running the machine woke me up when it was done and said that the results should take about 6 weeks because of the holidays, they thanked me for turning up (they did seem bored) and off I went. The walk home was just as bad as the walk there as public transport was pooched in Montreal because of the storm

A week later my results were in and it's an interesting read!! Yes a week later, how many times can I luck out with the ankle??

One grade one sprain, one grade two sprain and two grade one sprains... let me actually explain that in English for you; a grade one sprain is a torn (as in two pieces that aren't attached anymore) a grade two sprain is "it's there, but it's hanging by a thread" and a grade one is a normal sprain. Drastic times for sure :( But not anything after rehab I can't live with, but here's the kicker and it's a doozy for sure. Where your leg goes into your ankle there is a piece of cartilage that's basically a buffer from the bones rubbing on each other, well that's dented. Yes, that little fall has basically been a car crash on my ankle....

So here we are around about today, I'm still in rehab and waiting for a surgical consult (currently scheduled mid Feb) and maybe it'll get operated upon, maybe it won't. The current state of affairs is this; if you grade an injury's pain on a 1-10 scale, 1 being the lowest and 10 being agony then my ankle runs at a constant level of 1 to 2 on a daily basis; it's getting stronger, hell with a brace I'm system training on the Boulder Board a few times a week and remember I was walking around on it a few days after I did it but the fact is it's o.k, not OK. It needs to get fixed and I'm out of the climbing game for a while longer.
This is depressing news when (as you're on this site) you know that I'm a complete hold whore and a bunch of my time is spent running this site and reviewing holds (don't worry we have more reviews coming) so I've had to slow down a little. I do my physio exercises, I ride my bike and I walk to work... I just can't climb. It may actually come to a point where I actually have to stop bouldering and this means I'll go back to leading much more and I'll set more lead routes like I used to do. But it does beg a big question in my mind and please remember this is me still in the middle of an injury and I'm just pointing out a few things for you, dear reader, to think about:  

Climbing is a progressive sport, as you get better at it you generally push harder and further. You go outdoors and even though you feel safe you're probably pushing a boundary on some level, especially with bouldering; hell even indoors you take some pretty hard hits from time to time... do YOU land properly? Do YOU just drop from the top of the wall rather than down climbing to half way and then dropping? Do YOU have enough pads and spotters when you're outside? 

The answer to this is probably no most of the time and please take it from me who hasn't had a break from climbing in 27 years, who is a base jumper, a trained sky diver and someone that revels in generally going fast, hard and pushing my limits; that if you don't know how to fall, or you're about to try a boulder and you don't have a spot but there are other climbers there, ask for one, ask for help. Karma people karma!! Climbing is a friendly community, you won't be judged for asking for an extra spot, or taking a class at the gym on how to fall properly; hell when I go outside I have huge pads and lots of them because I've always weighed the risks of what I'm doing! Help yourself out in the long run, if your gyms pads are shitty go talk to the desk staff or the manager and get them fixed; you pay to be there and it's their job to make sure you're safe. I guess what I'm trying to say is be safe out there, or in there :) This injury happened when my feet where around 4ft from the pads and they're big ass pads and look at the sorry state that I'm in; it was going to happen sooner or later... to be honest I'd have settled for never but shit happens sometimes!

I'm down but sure as hell not out... I'll be back later this year, until then if you've read this far you'll know why I'm not in the videos we make :) Trust me there are some hang board reviews coming, yeah even I can get on a hang board :)

Climb safe people, I'll run updates on this post from time to time as I get more news as to whats happening and when.

Thanks for reading, if you have any questions our email address is up the top on the left or you can just leave a reply in the comments box, we read everything



wbgenetic said...

How's the Ankle update coming along bro?

ntmb said...

its getting better, waiting for a CT scan

Ryan said...

Hey Noodles,
Have you reached the point where they can do cortisol injections yet? That was a huge help when my ankle was recovering. It knocked the inflammation straight out and got me back to leading...