The Center for Podiatric Care and Sports Medicine

Can You Locate This Dislocated Ankle?

Posted by on Thursday, March 29th, 2012

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The initial news was grim when it came down late last week: New York Yankees relief pitcher Joba Chamberlain, still in the middle of recovering from Tommy John surgery, had severely injured his ankle while jumping on a trampoline with his son at a play center. At first we heard the ankle was dislocated and broken. Then we heard that he had lost so much blood that his life was in danger while the paramedics were rushing him to the hospital. Talking heads in the media said he was definitely out for the season, maybe another year. Maybe this would be a career-ending injury, especially if he needed his foot amputated, as some suggested.

Okay, now that we’ve got all the hysteria out of the way, Joba came to training camp yesterday and explained what really happened to his ankle, which is of great interest to us because we love everything to do with feet and ankles here.

 

  • The injury was an open dislocation of the subtalar joint in the heel area of the right foot.
  • No bones were broken.
  • There was some bleeding, but never nearly enough to put his life in danger.
  • His foot was never close to being amputated.
  • The main worry now is to watch out for infection since this was an open wound.
  • He’s in a cast for about six weeks; the New York Post said the cast had “a tube-like mechanism sticking out and delivered cold compresses to the area.” (could I be in a cast like that for the summer?)
  • Chamberlain feels confident he’ll be back on the mound this season, but the Yankees seem to be less sure.
  • Quote of the day: when a nurse at the hospital asked Chamberlain what happened, his five year old son said, “My dad got owned by a trampoline.” Thanks for the support, kid.
    [round up of reports from Bronx Baseball Daily]

You don’t have to be a major league pitcher to suffer a dislocated ankle–hey, he didn’t injure it pitching, he injured it playing with the smart aleck kid–so let’s talk a little bit about this injury and what it means to people whose every movement and tweak isn’t covered on the back pages of the tabloids.

What is an ankle dislocation? It’s exactly what it sounds like. You land on your ankle with such force that the ankle joint pushes out of place. There can be fractures of surrounding bones as well, but as seen with Chamberlain, that’s not always the case.

What is an open vs. closed dislocation? An open dislocation means bones have broken through the skin. Yuck!! A closed dislocation means the bones stay neatly tucked away inside.

How do I know I have a dislocated ankle? Well, if you have an open dislocation, you’ll know something’s wrong so there’s little doubt there. If a bone is sticking out of your ankle, chances are good that something has gone wrong. A closed one is trickier–with all the swelling that follows the injury, it’s not uncommon for people to treat it as a sprain. However, if the pain is severe, something visibly looks out of place in your ankle area, the joint feels either locked or too lose, and if the skin feels cool or tingles, those are good signs that something is really wrong. A podiatrist at The Center for Podiatric Care and Sports Medicine (212.996.1900) can give a definitive diagnosis and take x-rays to see if there is a fracture as well as a dislocation.

What is the treatment? If you have an open dislocation, then as described above, surgery will be required to close the open wound, and it will be carefully monitored for infection. If the dislocation if closed, a doctor can usually pop the joint back into place without surgery. Don’t try this at home. Don’t let your friend who saw his high school football coach pop someone’s dislocated shoulder into place on the sideline during a game twenty years ago do it, unless you’re stranded on a mountainside and need to get to a place where the rescue helicopter can see you. Have a professional do it; if possible (like you’re not in a life or death situation), have a podiatrist who’s been trained to work with feet and ankles do it.

So once it’s back in place, I’m okay, right? Wrong! Once the joint is put back into place, you may be required to wear a cast or walking boot for a period of time in order to allow the tissue and any torn ligaments heal. During this time, you may have to start doing some simple exercises in order to keep scar tissue from building up into a knotty, immobilizing mess. Again, don’t make up some exercises or find them on YouTube–see a professional.

Once you’re out of the cast or the boot, the fun part starts: rehab! You’ll need to do strengthening, flexibility, and balancing exercises. Some physical therapists may use hydrotherapy (everybody in the pool!), electrotherapy, massage, or other hands on therapy to improve range of motion. It’s a long process that can take weeks or months, depending on the severity of the injury and the dedication of the patient to the rehab process.

After the ankle is fully healed and rehabbed, some people may be advised to tape their ankle or wear a brace, especially those who do things like cut in different directions, or need to accelerate quickly. Joba Chamberlain noted that he thought he’d be able to back to baseball relatively quickly because he “doesn’t run the bases.” However, pitchers have to land on their feet after each pitch and need to be able to get off the mound quickly to help field slow rollers or bunts. Unless someone develops drones to take over the, you know, athletic part of pitching, it sounds like Mr. Chamberlain is a good candidate for a lengthy rehab and an ankle brace. Well, it will give him some extra time to heal that elbow! There’s always a silver lining.

How can I prevent a dislocated ankle? Well, you could sit forever and not do anything. Your ankle would certainly be safe then, until you died of boredom. It’s a freak accident. Hope for the best, and be ‘ware of trampolines.

A bad ankle injury is something that needs to be treated by a specialist who knows ankles. If you have an ankle injury, or any other foot issue, contact us at The Center for Podiatric Care and Sports Medicine. Dr. Josef J. GeldwertDr. Katherine Lai, and Dr. Ryan Minara have helped thousands of people get back on their feet.

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If you have any foot problems or pain, contact The Center for Podiatric Care and Sports MedicineDr. Josef J. GeldwertDr. Katherine Lai, Dr. Ryan Minara and Dr. Mariola Rivera have helped thousands of people get back on their feet. Unfortunately, we cannot give diagnoses or treatment advice online. Please make an appointment to see us if you live in the NY metropolitan area or seek out a podiatrist in your area.