Can I Run After Ankle Ligament Surgery?

Question from Mike in Corte Madera:
For years I had unstable ankles and repeated ankle sprains. It seemed like every time I would walk on any sort of uneven ground, my ankle would roll under. Although it wasn't always painful, it was bothersome. My doctor said this unstable ankle (continually giving way) was porbably caused by a bad ankle sprain I had back when I was playing high school basketball. I had surgery about a year ago to repair the torn ankle ligaments. The ankle ligament surgery was called a Brostrum repair. Now the ankle seems fine, but I want to know if I can run in a marathon. Ultimately I would like to participate in a triathlon this year as well. Is this possible?

Answer from My Running Doc:
Ankle sprains are very common. Some estimates show that there are nearly 25,000 ankle injuries in the U.S. every day. The vast majority of these ankle injuries (about 85%) are ankle sprains. Many people try to treat ankle sprains at home with ice, rest, elevation, and maybe an over-the-counter brace or ACE wrap to keep the swelling down. But many more will seek treatment at the Emergency Room or from an ankle expert like a podiatrist.

When doctors try to determine how severe the sprain is, they base it on a grading system from 1 to 3. A grade 1 ankle sprain means that you have sort of stretched the ligaments a little. A grade 2 ankle sprain means that you have partially torn one of the ligaments supporting the ankle. Although this is more severe, the ankle ligaments are still mostly intact. A grade 3 ankle sprain means that you have completely torn at least one of the ankle ligaments.

It is often difficult for a patient to tell the severity of the ankle sprain, but there are some indicators that it might be severe and needs to be treated by an ankle specialist. Bruising and swelling are clues that you have had some level of tissue damage. With severe bruising, your ankle doctor should also be suspicious of a fracture. But even if there is no fracture and the ankle isn't broken, that doesn't mean you don't still need serious treatment.

In your case it sounds like you had one of the classic ankle sprains that resulted in Grade 3 ankle injury. Because the ankle ligaments never healed, you were left with an unstable, wobbly ankle. By performing a Brostrum ankle ligament repair, your ankle surgeon has attempted to rebuild and repair the torn ankle ligaments. If the ankle surgery has been successful, you should gain full mobility and use of the ankle. If I were to have performed your ankle surgery, the goal would be to have a much stronger ankle after the surgery than before. This of course means that you should be better able to run and bike once the ankle surgery is all healed.

In short, anyone who has ankle surgery to repair the torn ligaments should be able to run or ride a bicycle without any trouble. Marathon training and triathlon training are reasonable goals, once you have healed. Having said all of that, you should check with your current treating ankle surgeon and make sure your ankle surgery has healed before you start running, cycling or any new training routine.

Best of luck in your 2010 season!

My Running Doc - Dr. Chistopher Segler is a San Francisco based foot & ankle surgeon with a unique perspective on foot and ankle injuries.  He is a rock climber, skier, marathon runner, and Ironman triathlete.  Because of this, he understands when someone has an injury, they want to get better, just to get back to activity.  He understands that the common doctor's notion of "just stop running" or "find another hobby," or "take up Scrabble" are all unacceptable to the athletically minded.  He believes that any active athlete can suffer an injury yet return to sport stronger than ever.