Dr. Brian Weatherby, MD

The recovery after ankle arthroscopy surgery depends on exactly what is done during the surgery.
If you just have scar tissue removed and a "clean up" type surgery then you will be non-weight bearing (NWB) in a splint (plaster or fiberglass wrapped with an ACE wrap) for 2 weeks. The 2 week period of NWB is necessary to prevent what is called a synovial fistula from forming at the site of the incisions. A synovial fistula is where the ankle joint forms a tract or tunnel up to, and through the skin. This is bad as joint fluid will drain and your joint could get infected. After 2 weeks NWB in a splint then you will be placed in a walking boot which you will usually wear for 2-4 weeks. After the boot then you will wear a brace for 4-6 weeks. Ultimate recovery (back to running or sport) is usually about 8-10 weeks.
If you have a more advanced surgery such as treatment of an osteochondral defect (cartilage problem) or ankle ligament reconstruction then you will likely be NWB for at least 4 weeks, sometimes 6 weeks. After the first 2 weeks usually a boot will be placed so you can start moving your ankle in physical therapy. Once you begin weight bearing you will wear the boot 2-4 weeks, then a brace for 4-6 weeks after the boot. Ultimate recovery will be a bit longer, about 3 to 3.5 months.

This is a bit of a tough question to answer directly.
It depends on what treatment you have had thus far, what your symptoms are and how your symptoms are affecting your activity.

In general most doctors will recommend initial treatment with an ASO brace (easily purchased online).
In addition to the brace you should also pursue physical therapy. This shouldn't require more than a few visits with a physical therapist. They should be able to provide you with the appropriate exercise instructions and equipment (theraband, BAPS board, etc.).
If you have a higher arch foot you may also want to consider a lateralizing heel wedge (again found online) to put in your shoe. This will take some of the tension off of the tendons.
After 8-10 weeks if the pain still persists then your doctor should consider an ultrasound guided steroid injection in to the peroneal tendon sheath. Recent research has shown this can be effective at relieving the pain and is very safe.

With continued symptoms despite all of these treatments that is significantly impacting quality of life, or keeping you from doing necessary or desired activity then your doctor will likely get an MRI to see if you have tendon tearing or other problems with the tendons. If so, reconstructive surgery may be indicated.

The short answer is yes, an ankle brace should help peroneal tendonitis. You want to make sure you get the appropriate type of ankle brace. Most doctors will recommend an ASO brace (easily purchased online).
In addition to the brace you should also pursue physical therapy. This shouldn't require more than a few visits with a physical therapist. They should be able to provide you with the appropriate exercise instructions and equipment (theraband, BAPS board, etc.).
If you have a higher arch foot you may also want to consider a lateralizing heel wedge (again found online) to put in your shoe. This will take some of the tension off of the tendons.
After this, if you were to still have pain significantly impacting quality of life, or keeping you from doing necessary or desired activity then you may need surgery to reconstruct/repair the peroneal tendons.

Ideally you should see either a sports medicine trained doctor (surgeon or non-surgeon), or a orthopedic foot and ankle surgeon.

Great question!

About 10,000 ankle sprains happen in the US every day and are often under treated by other health care providers.
Simple treatments such as rest, elevation, ice and compression are good in the first 12-24 hours, but a few more modalities are needed after this.

Keep in mind a sprain of any joint in the human body by definition is an injury to the stabilizing ligaments of that joint. They are either stretched (Grade 1), partial torn (Grade 2) or completely torn or ruptured (Grade 3). Thus, depending on the severity an ankle sprain can sometimes indeed be as bad as a bone fracture.

With bad sprains (severe swelling, bruising, pain, limp while walking or inability to walk) an orthopedic walking boot (easily purchased online) is recommended for the first 10-14 days. This provides rigid immobilization and support to the ankle, facilitating decreased swelling and pain, and allowing you to walk. If the sprain is not as bad, or after the boot, a medical grade brace that can be worn with a shoe is recommended, such as an ASO brace (again available online). This provides support and compression but is less cumbersome than the boot. This is typically worn for about 6-8 weeks.

In addition, during the first 2-3 weeks of a sprain the body is generating an inflammatory reaction around the ankle joint in response to the injury. To address this one should consider the use of an over the counter anti-inflammatory such as ibuprofen, motrin or aleve. Take an appropriate dose 2-3 times per day. Obviously consult with your primary care doc if there are any concerns about taking this if you have other medical conditions.

Lastly, the #1 reason to have long lasting issues after an ankle sprain is the lack of appropriate rehabilitation. Meaning, physical therapy is important. So, at a minimum one should work with a physical therapist for at least 2-3 visits to be taught an extensive home exercise program and be educated on the equipment needed to do this (theraband & BAPS board, both available online).

If after 10-12 weeks significant pain or instability (ankle rolling frequently even with brace) persist then seek evaluation with a foot and ankle trained orthopedic surgeon.

Leaving an ankle sprain untreated, depending on the severity of the sprain, can result in other problems.
A sprain by definition is an injury to the stabilizing ligaments of the joint. The ligaments are either stretched (Grade 1), partially torn (Grade 2) or completely torn or ruptured (Grade 3).
Thus, if you have a Grade 2 or 3 sprain (evidenced by more severe bruising, swelling, pain and the inability to bear weight) it should cause an appropriate level of concern.
Grade 2 or 3 sprains untreated can lead to two main problems. The first is that you could develop chronic ankle instability. Chronic ankle instability is a condition where the ligaments no longer provide the necessary stability, your muscles/tendons around your ankle have not been rehabed/retrained appropriately and thus you will repeatedly roll your ankle. This will often happen when you step on a small rock, tree root, child's toy, etc., or when walking on uneven ground. If a brace does not control this problem reconstructive ligament surgery is necessary.
The second problem that can develop is call synovial impingement of the ankle. This happens when a large amount of scar tissue forms in the front of your ankle because it hasn't been mobilized adequately. The scar tissue then repeatedly becomes "squeezed" or traumatized, as if you bit your lip every day. The tissue therefore becomes inflamed and swollen all the time. This will cause pain in the front of your ankle, especially when you run, navigate stairs, stoop down or do squats. When this occurs a steroid injection will offer relief much of the time. However, sometimes arthroscopic surgery is necessary in some cases to remove the inflamed scar tissue.

So, as you can see don't take an ankle sprain lightly.
However, you can coordinate appropriate treatment for an ankle sprain on your own if you are comfortable doing such.

With bad sprains (severe swelling, bruising, pain, limp while walking or inability to walk) an orthopedic walking boot (easily purchased online) is recommended for the first 10-14 days. This provides rigid immobilization and support to the ankle, facilitating decreased swelling and pain, and allowing the patient to walk. If the sprain is not as bad, or after the boot, a medical grade brace that can be worn with a shoe is recommended, such as an ASO brace (again available online). This provides support and compression but is less cumbersome than the boot. This is typically worn for about 6-8 weeks.

In addition, during the first 2-3 weeks of a sprain the body is generating an inflammatory reaction around the ankle joint in response to the injury. To address this one should consider the use of an over the counter anti-inflammatory such as ibuprofen, motrin or aleve. Take an appropriate dose 2-3 times per day. Obviously consult with your primary care doc if there are any concerns about taking this if you have other medical conditions.

Lastly, the #1 reason to have long lasting issues after an ankle sprain is the lack of appropriate rehabilitation. Meaning, physical therapy is important. So, at a minimum one should work with a physical therapist for at least 2-3 visits to be taught an extensive home exercise program and be educated on the equipment needed to do this (theraband & BAPS board, both available online).

If after 10-12 weeks significant pain or instability (ankle rolling frequently even with brace) persist then seek evaluation with a foot and ankle trained orthopedic surgeon.

This essentially means you have a condition called ankle instability. Meaning, the ligaments around your ankle that normally provide stability and thus keep it from rolling or suffering a sprain are now not working. This simple treatments for ankle instability are bracing (such as an ASO brace that can be purchased online) and at least a short course of physical therapy to learn exercises that can strengthen the tendons around your ankle to compensate for your ligaments not working. If, despite bracing and PT over 2-3 months, your ankle continues to roll or you suffer frequent sprains, then you would need to see a foot and ankle orthopedic surgeon. Consideration may be given to a surgery to reconstruct your ankle ligaments if the problem is affecting your activities or quality of life.

Unfortunately not. Gout is a problem wear uric acid, the waste product of every living cell in our body, is not cleared by the kidney. Either because there is more uric acid than normal being made or because the kidney is not good at getting rid of it. When the uric acid level is high, it will crystallize in joints (it literally looks like white paste in the joint). Most commonly the big toe joint. This can cause "gout attacks" with a red, hot, swollen, painful joint for several days. This is because the body is reacting to the uric acid accumulation by generating a massive inflammatory reaction in the joint. To treat gout, other than dietary changes, medications are used. There are 2 "maintenance" medications available, Uloric or Allupironol. These are taken every day and work by helping to decrease uric acid levels. A medication by the name of Colchicine is used only for gout attacks but should not be taken regularly. Anti-inflammatory medications like a prescription strength Ibuprofen can be used as well. The only time surgery is considered in the spectrum of a gout condition is when a joint becomes so destroyed by repeated gout attacks. At that point, a "clean up" type surgery may be warranted, or a more aggressive surgery like a replacement or fusion may be needed. Hopefully, in your case, this will never be needed.

Great question, and a very common one.
Sounds as if you sprained your ankle.

About 10,000 ankle sprains happen in the US every day and are often under treated by primary care docs and other health care providers.
Simple treatments such as rest, elevation, ice and compression are good in the first 12-24 hours, but a few more modalities are needed after this.

Keep in mind a sprain of any joint in the human body by definition is an injury to the stabilizing ligaments of that joint. They are either stretched (Grade 1), partial torn (Grade 2) or completely torn or ruptured (Grade 3). Thus, depending on the severity an ankle sprain can sometimes indeed be as bad as a bone fracture.

With bad sprains (severe swelling, bruising, pain, limp while walking or inability to walk) an orthopedic walking boot (easily purchased online) is recommended for the first 10-14 days. This provides rigid immobilization and support to the ankle, facilitating decreased swelling and pain, and allowing the patient to walk. If the sprain is not as bad, or after the boot, a medical grade brace that can be worn with a shoe is recommended, such as an ASO brace (again available online). This provides support and compression but is less cumbersome than the boot. This is typically worn for about 6-8 weeks.

In addition, during the first 2-3 weeks of a sprain the body is generating an inflammatory reaction around the ankle joint in response to the injury. To address this one should consider the use of an over the counter anti-inflammatory such as ibuprofen, motrin or aleve. Take an appropriate dose 2-3 times per day. Obviously consult with your primary care doc if there are any concerns about taking this if you have other medical conditions.

Lastly, the #1 reason to have long lasting issues after an ankle sprain is the lack of appropriate rehabilitation. Meaning, physical therapy is important. So, at a minimum one should work with a physical therapist for at least 2-3 visits to be taught an extensive home exercise program and be educated on the equipment needed to do this (theraband & BAPS board, both available online).

If after 10-12 weeks significant pain or instability (ankle rolling frequently even with brace) persist then seek evaluation with a foot and ankle trained orthopedic surgeon.

You should see: a sports medicine specialist (either surgeon or non-surgeon), a foot and ankle orthopedic surgeon, or a Physician's Assistant or Nurse Practicioner that works with a sports medicine specialist or orthopedic foot and ankle surgeon.

Otherwise here is the typical approach to ankle sprains:

About 10,000 ankle sprains happen in the US every day and are often under treated by primary care docs and other health care providers.
Simple treatments such as rest, elevation, ice and compression are good in the first 12-24 hours, but a few more modalities are needed after this.

Keep in mind a sprain of any joint in the human body by definition is an injury to the stabilizing ligaments of that joint. They are either stretched (Grade 1), partial torn (Grade 2) or completely torn or ruptured (Grade 3). Thus, depending on the severity an ankle sprain can sometimes indeed be as bad as a bone fracture.

With bad sprains (severe swelling, bruising, pain, limp while walking or inability to walk) an orthopedic walking boot (easily purchased online) is recommended for the first 10-14 days. This provides rigid immobilization and support to the ankle, facilitating decreased swelling and pain, and allowing the patient to walk. If the sprain is not as bad, or after the boot, a medical grade brace that can be worn with a shoe is recommended, such as an ASO brace (again available online). This provides support and compression but is less cumbersome than the boot. This is typically worn for about 6-8 weeks.

In addition, during the first 2-3 weeks of a sprain the body is generating an inflammatory reaction around the ankle joint in response to the injury. To address this one should consider the use of an over the counter anti-inflammatory such as ibuprofen, motrin or aleve. Take an appropriate dose 2-3 times per day. Obviously consult with your primary care doc if there are any concerns about taking this if you have other medical conditions.

Lastly, the #1 reason to have long lasting issues after an ankle sprain is the lack of appropriate rehabilitation. Meaning, physical therapy is important. So, at a minimum one should work with a physical therapist for at least 2-3 visits to be taught an extensive home exercise program and be educated on the equipment needed to do this (theraband & BAPS board, both available online).

If after 10-12 weeks significant pain or instability (ankle rolling frequently even with brace) persist then seek evaluation with a foot and ankle trained orthopedic surgeon.

Great question, and a very common one.
About 10,000 ankle sprains happen in the US every day and are often under treated by primary care docs and other health care providers.
Simple treatments such as rest, elevation, ice and compression are good in the first 12-24 hours, but a few more modalities are needed after this.

Keep in mind a sprain of any joint in the human body by definition is an injury to the stabilizing ligaments of that joint. They are either stretched (Grade 1), partial torn (Grade 2) or completely torn or ruptured (Grade 3). Thus, depending on the severity an ankle sprain can sometimes indeed be as bad as a bone fracture.

With bad sprains (severe swelling, bruising, pain, limp while walking or inability to walk) an orthopedic walking boot (easily purchased online) is recommended for the first 10-14 days. This provides rigid immobilization and support to the ankle, facilitating decreased swelling and pain, and allowing the patient to walk. If the sprain is not as bad, or after the boot, a medical grade brace that can be worn with a shoe is recommended, such as an ASO brace (again available online). This provides support and compression but is less cumbersome than the boot. This is typically worn for about 6-8 weeks.

In addition, during the first 2-3 weeks of a sprain the body is generating an inflammatory reaction around the ankle joint in response to the injury. To address this one should consider the use of an over the counter anti-inflammatory such as ibuprofen, motrin or aleve. Take an appropriate dose 2-3 times per day. Obviously consult with your primary care doc if there are any concerns about taking this if you have other medical conditions.

Lastly, the #1 reason to have long lasting issues after an ankle sprain is the lack of appropriate rehabilitation. Meaning, physical therapy is important. So, at a minimum one should work with a physical therapist for at least 2-3 visits to be taught an extensive home exercise program and be educated on the equipment needed to do this (theraband & BAPS board, both available online).

If after 10-12 weeks significant pain or instability (ankle rolling frequently even with brace) persist then seek evaluation with a foot and ankle trained orthopedic surgeon.

Great question, and a very common one.
About 10,000 ankle sprains happen in the US every day and are often under treated by primary care docs and other health care providers.
Simple treatments such as rest, elevation, ice and compression are good in the first 12-24 hours, but a few more modalities are needed after this.

Keep in mind a sprain of any joint in the human body by definition is an injury to the stabilizing ligaments of that joint. They are either stretched (Grade 1), partial torn (Grade 2) or completely torn or ruptured (Grade 3). Thus, depending on the severity an ankle sprain can sometimes indeed be as bad as a bone fracture.

With bad sprains (severe swelling, bruising, pain, limp while walking or inability to walk) an orthopedic walking boot (easily purchased online) is recommended for the first 10-14 days. This provides rigid immobilization and support to the ankle, facilitating decreased swelling and pain, and allowing the patient to walk. If the sprain is not as bad, or after the boot, a medical grade brace that can be worn with a shoe is recommended, such as an ASO brace (again available online). This provides support and compression but is less cumbersome than the boot. This is typically worn for about 6-8 weeks.

In addition, during the first 2-3 weeks of a sprain the body is generating an inflammatory reaction around the ankle joint in response to the injury. To address this one should consider the use of an over the counter anti-inflammatory such as ibuprofen, motrin or aleve. Take an appropriate dose 2-3 times per day. Obviously consult with your primary care doc if there are any concerns about taking this if you have other medical conditions.

Lastly, the #1 reason to have long lasting issues after an ankle sprain is the lack of appropriate rehabilitation. Meaning, physical therapy is important. So, at a minimum one should work with a physical therapist for at least 2-3 visits to be taught an extensive home exercise program and be educated on the equipment needed to do this (theraband & BAPS board, both available online).

If after 10-12 weeks significant pain or instability (ankle rolling frequently even with brace) persist then seek evaluation with a foot and ankle trained orthopedic surgeon.

It is likely your big toe hurts because of some early arthritis. I have this same problem as well because of sports injuries when I was young. The pain usually is at the MTP joint, or knuckle joint of the big toe. A simple solution that works for most people at your age, and that has worked for me is the use of a carbon fiber insert or turf toe plate in your shoe. It is easily interchangeable. Below are links to purchase online:

https://urldefense.proofpoint.com/v2/url?u=https-3A__www.zoro.com_impacto-2Dinsole-2Dmens-2D5-2Dto-2D6-2Dwomens-2D7-2Dto-2D8-2Dpr-2Drhinotuff_i_G0008443_&d=DwIFAg&c=RTeKZtrutbwfr0CyFOEmTYBZxm_B1KJOO0ckfHRv_LY&r=HGAfYKxNkzjBUfldOIkx9jyKhr245IAkiPeCkn3JtGw&m=6oxu7ho_DGkM9um2uJYz7KSXYB6yyeEGFPYjR9R0FJc&s=Swk5vA39LndXXyjHjvwz93IJ7rqTCWYfkM2eJNwTXpU&e=

https://urldefense.proofpoint.com/v2/url?u=https-3A__www.healthyfeetstore.com_turf-2Dtoe-2Dfull-2Dsteel-2Dinsole.html&d=DwICAg&c=RTeKZtrutbwfr0CyFOEmTYBZxm_B1KJOO0ckfHRv_LY&r=HGAfYKxNkzjBUfldOIkx9jyKhr245IAkiPeCkn3JtGw&m=SUH8SAZ_dzE3u1TFmd3saWbkHqbbEO_1-G7gNuJeQvM&s=d5grtLdi8K6CwVhstVXZJX39xuW0Bq50YMbtf3jB13E&e=

Great question, and a bit difficult to answer.
Every person experiences pain different because the pain receptors in our nervous system are all wired differently. Some people will have a lot of pain after a "minor" surgery, and others will have little pain after a "major" surgery like ankle fusion. There is no way to predict this.
Your surgery should be performed with some type of general anesthesia along with what is called a "popliteal nerve block". This is where the anesthesiologist numbs the sciatic nerve behind your knee. In addition, a "catheter" should be placed after the initial injection. A catheter is a small tube, smaller than an IV tube. After your surgery a gravity flow pump will be connected to this tube and drip marcaine (like novacaine at the dentist) on the sciatic nerve to keep your nerve numb for about 2 days.
Sometimes patients will have no pain at all after the 2 days when the nerve block/catheter wear out, sometimes they will. If so, your surgeon should prescribe an opioid type pain medicine, AND other non-opioid medicines like tylenol and ibuprofen (if it is safe for you to take these medications thus ask your surgeon/doctor). The idea is that you take the tylenol and ibuprofen type medicines on a scheduled basis (usually you stagger them meaning you can take each every 6 hours and thus you take one of the 2 every 3 hours. You only take the opioid pain medicine as needed for uncontrolled pain.
In my experience with this type of approach patients' pain is managed well and they rarely require the refill of the opioid pain medication.

There are no exercises or maneuvers to specifically strengthen ligaments. But, our tendons around the ankle, if strengthened will compensate for ligament weakness or laxity. Specifically, you need to focus on strengthening your peroneal tendons group on the outside of your ankle. The link below offers good instruction on how to do this:

https://www.torbayandsouthdevon.nhs.uk/uploads/25300.pdf

Great question, and a bit difficult to answer.
Every person experiences pain different because the pain receptors in our nervous system are all wired differently. Some people will have a lot of pain after a "minor" surgery, and others will have little pain after a "major" surgery like ankle surgery. There is no way to predict this.
Your son's surgery should be performed with some type of general anesthesia along with what is called a "popliteal nerve block". This is where the anesthesiologist numbs the sciatic nerve behind your knee. In addition, a "catheter" should be placed after the initial injection. A catheter is a small tube, smaller than an IV tube. After your son's surgery a gravity flow pump will be connected to this tube and drip marcaine (like novacaine at the dentist) on the sciatic nerve to keep your nerve numb for about 2 days.
Sometimes patients will have no pain at all after the 2 days when the nerve block/catheter wear out, sometimes they will. If so, the surgeon should prescribe an opioid type pain medicine, AND other non-opioid medicines like tylenol and ibuprofen (if it is safe for your son to take these medications thus ask your son's surgeon/doctor). The idea is that he takes the tylenol and ibuprofen type medicines on a scheduled basis (usually you stagger them meaning you can take each every 6 hours and thus you take one of the 2 every 3 hours. He would only take the opioid pain medicine as needed for uncontrolled pain.
In my experience with this type of approach patients' pain is managed well and they rarely require the refill of the opioid pain medication.

The best initial treatment for peroneal tendinits is bracing with a medical grade brace such as the ASO brace (can order online), at least a couple visits with a physical therapist to be taught exercises to do at home on your own for 6-8 weeks, avoidance of activities that make it hurt worse such as running, sports, etc., and a short course of an anti-inflammatory medication such as ibuprofen or aleve for 3-4 weeks (check with your regular doctor if you have questions about whether or not you can take these medications).

If, after about 8 weeks or so your pain persists despite this then you should see a sports medicine trained doctor or orthopedic surgeon for further evaluation like an MRI to look for a tear or other problems.