Typical Toehold Injury Diagnosis & Prognosis.

My ankle hurts.

It seems to be recovering well. I'm definitely wearing an ankle brace and not letting partners touch it in rolling, though, and I can't sit Indian style at the moment, etc. It has been 6 days and it is still quite swollen. On the other hand, I have excellent mobility still. This confused me, but I have talked with a friend who tore all three of her major anterior ankle ligaments, and told me she could still hike. Likewise, I have heard stories of people tearing their ACL and continuing to be elite athletes without ever going in for surgery--it seems some people have high enough quality knees that the stability is maintained by the rest of the knee, making that particular ligament redundant for them. It seems that this is likely much more common for the ankle, though.

The most telling symptom is extreme sensitivity to the position it was snapped in (toe hold).

Picture @ day 5:

This is both ankles side by side, you can clearly see the swelling on the right one.

This is the normal left ankle.

This is the swollen right one.

Update:

It seems like the injury is likely either a a Grade II or III of the anterior tibiofibular ligament (ATFL) of the ankle. The loud popping noise heard at the time of injury made me think it was a III, but some have told me that a grade III should be much worse symptom-wise, so I'm not sure what to think.


This is the gist on treatment and prognosis:

Treatment for grade III injuries is more controversial. A comprehensive literature evaluation and meta-analysis showed that early functional treatment provided the fastest recovery of ankle mobility and earliest return to work and physical activity without affecting late mechanical stability. Functional treatment was complication-free, whereas surgery had serious, though infrequent, complications. Functional treatment produced no more sequelae than casting with or without surgical repair. Secondary surgical repair, even years after an injury, has results comparable to those of primary repair, so even competitive athletes can receive initial conservative treatment. Sequelae of lateral ligament injuries are common. After conservative or surgical treatment, 10 to 30% of patients have chronic symptoms, including persistent synovitis or tendinitis, ankle stiffness, swelling, pain, muscle weakness and 'giving-way'. Well-designed physical therapy programmes usually reduce instability. For individuals with chronic instability refractory to conservative measures, surgery may be needed. Subtalar instability should be carefully evaluated when considering surgery.

--http://www.ncbi.nlm.nih.gov/pubmed/10028133

From that same article:

Grade I and II can be treated with functional therapy.
Severe Grade III injuries can be considered for surgical
repair of the ligaments. In cases where the deltoid ligament
 is involved or there is a severe syndesmotic injury, surgery is
the primary course of treatment in athletes.

--http://www.podiatryinstitute.com/pdfs/Update_2011/2011_14.pdf


Wikipedia tells me that an easy to identify symptom of severe syndesmotic injury is the inability to do a single leg heel raise, which I can do with ease. Not sure yet how to evaluate the integrity of the deltoid ligament, but primary assumption is one acute injury, based on the haptic and auditory feedback at the time of injury.

Finding someone to do this test will help me confirm that it is indeed the ATFL that is ruptured: