Initial Injury (May 24, 2023)

While playing tennis, I rolled my left ankle and sustained an ankle injury. I experienced a momentary feeling of dislocation, which resulted in instant pain in my ankle, promptly sending me to the ground. After a few minutes of excruciating pain, it got better, and I tried to walk it off. However, within minutes, the ankle swelled twice its normal size. The joints do this to form a natural splint, per se, to protect the joint. Where’s that water coming from, and what’s the structure of it?

Home and Rehabilitation

I returned home and started the typical rehab protocols, such as rest elevation and compression. I didn’t use ice. I only use ice when the pain is terrible; ice prevents natural processes of healing from occurring. At this point, I was certain my ankle was broken. It was too painful to bear weight, and I promptly started using crutches. I took some painkillers and just rested. Later that day, I went into my hyperbaric oxygen chamber and performed what is called hyperbaric oxygen therapy (HBOT) for about 2 hours. Convinced that the ankle was broken, I’d already made plans with my orthopedic surgeon for possible surgery.

The May 25 Early Diagnosis 

I went for X-rays of my left ankle, and to my amazement, it showed no fractures. With this information, I decided to get more aggressive with the rehabilitation. I started percutaneous hydrotomy in my ankle injecting subcutaneously a solution of saline, lidocaine, magnesium, amino acids, procaine, pentoxifylline, B-vitamins, trace minerals, and a tiny dose of anti-inflammatories. After the percutaneous hydrotomy session, I went into the hyperbaric chamber for another two hours. Then, during the day, I rested the ankle, applied a compression bandage, and kept it elevated. I was still walking on crutches but started doing toe circles to keep the range of motion.

An XRAY of the medial malleolus

May 26 Progressive Rehabilitation

When I woke up that morning, the swelling had gone down slightly. However, the foot had ecchymosis (bruising) all over; it looked bruised and battered. I continued again with the percutaneous hydrotomy and HBOT protocol.

The ankle after a typical percutaneous hydrotomy treatment. Notice the tumescent action of the hydrotomy solution which acts a slow-release reservoir.

I also used a Marc Pro muscle stimulation for many hours. I continued the range-of-motion exercises. I started walking range-of-motion and began more aggressive foot rehab exercises. After all, Nobel Laureate Albert Szent-Györgyi said that healing is the movement of energy.

My rehabilitation protocol:

1. I used resistance bands on my ankle’s medial and lateral sides and began a range of motion. 

2. I also practiced compressing my heel while applying significant toe flexion and holding us for 30 to 60 seconds. 

3. I performed several minutes of balance board exercises with ski poles. 

After the percutaneous hydrotomy with the same solution, I returned to my hyperbaric chamber for two hours.

Spidertech proprioception tape for the ankle. Note Spidertech tape is the same idea as K-Tape.

May 31

I saw Dr. Mike Monroe, an internationally known orthopedic foot and ankle surgeon, tennis player, and good friend. He reviewed the X-rays, which showed no fractures. After a thorough examination, he concluded that I had strained or partially torn the anterior fibular ligament of my left ankle. 

He prescribed an ankle brace and told me to continue my foot rehabilitation protocol and said that I could weight bear as tolerated on the ankle but not to push it.

June 5 Return to Activity

I continued my full rehabilitation program two to three times per day using the ankle resistance bands, the foot platform with calcaneus pressure and great toe flexion exercises, and balance board exercises. I again repeated the percutaneous hydrotomy and 2 hours of HBOT. By this time, the bruising had gone down considerably, and the only place where significant swelling in my ankle had occurred was around the lateral malleolus itself. Now, I could see the veins in my foot again, and the discoloration had resolved. I felt stable standing on my ankle and decided I might try to gently hit some tennis balls the next day.

June 6 – Two weeks post-injury

I started hitting tennis balls with no side-to-side movement. My ankle felt stable, considering what had happened to it. It was apparent all the rehab and interventions I had done thus far had paid off for my ankle injury. Even after the tennis session, my ankle swelling stayed the same and was minimal. I knew my ankle was still injured because while cycling, I tried to stand up and climb on the pedals, I could feel that left-sided pain, so seated cycling felt better. As usual, I performed two hours of HBOT.

June 7 — 9

I hit for an hour with my tennis coach. I did the same thing: hit in place with no side-to-side movement. When I got home, I repeated my hyperbaric chamber session for two hours and the percutaneous hydrotomy treatment. The left malleolus area was slightly swollen, but my ankle felt like it could do anything. So, I decided to start playing tennis without restrictions and signed up for a tournament I had wanted to play in but without expectations. I played in a tennis tournament on a clay court surface, which is easier on the joints overall, and my ankle did very well. At this point, it was only about three weeks post-injury. I played three matches without any problems at all. For rehabilitation, I repeated the hyperbaric chamber and foot rehabilitation exercises. Then 2 weeks later, I played another tennis tournament in Orlando on a hard-court surface. After two matches, my ankle felt fine, although still somewhat sore. Again, I recovered in my hyperbaric oxygen chamber.

July 2 Reflections and Broader Implications

Nearly 6 weeks after injuring my ankle, I played in a tennis tournament in Jacksonville, and again, my ankle felt fine. I came home and did HBOT. My ankle was completely healed. I was discussing my ankle injury with some other tennis players, and they couldn’t believe that my ankle had recovered in only six weeks at my age of 54 years-old. I had a total of four percutaneous hydrotomy treatments, and numerous hours of HBOT.

Around this time, Alexander Zverev, a German professional tennis player, injured his ankle in the semi-finals of the 2023 French Open. He required a wheelchair to get off the court. Undoubtedly, professionals like Zverev use HBOT and other therapeutic modalities. He may have benefited from percutaneous hydrotomy in the long run, but he needed surgery and extensive rehabilitation.

If you want to learn more about modalities like percutaneous hydrotomy, please consider buying the book, Stopping Pain on my website or Amazon. And please leave a review!

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