I want to check in with you to confirm diagnosis and treatment you gave me this week. Again I sincerely thank you for taking your time and listening which is something I normally do not see from health professionals. Also, thank you for actually looking at the MRI which strangely most Doctors (except Dr Loosli) did not attempt.
Diagnosis: Talus stress fracture
Please confirm this diagnosis. This is all makes sense now after researching normal symptoms. Obviously 37 years of USTA competitive tennis and hiking Mt Diablo contributed to overuse. This all started with a major ankle injury in 1963 playing basketball (stepping on top of players foot) in High School. I have injured this ankle many times over the years, most significant 2009, and I only made stress fracture worse by playing on it for the last year or two. I completely stopped playing tennis 6/27/17 and since then have only walked on a flat surface up to 45 min. I have re-injured since 6/27/17 a total of 7 times due to things like gardening, using a ladder to install lights, light hiking, etc. Right now it feels strong and I walk every day 45 min with no pain or discomfort.
1) ice 2x daily for 15 minutes with reusable gel ice pack,
2) alternating heat 4 min and ice 1 min, each evening,
3) wear heel 1/2 inch inserts in shoes,
4) bone stimulator to increase healing twice daily, and
5) continue walking flat surface using wrap around brace.
Please confirm above treatment or add or edit. You told me it will take at least 1 year to heal and to monitor with another MRI in January 2018 and 6 mo later.
Dr Blake's comment: I know Vit D is 32-80 normal range, and calcium is below 10.1 over 40 years old. Which we both are!!
1) Is there a way to speed up significantly the healing process? For example, wear a boot or plaster cast for several weeks, then rehab?
2) What was your source(s) of diagnosis? I believe you based on my symptoms and MRI.
3) Can special heel inserts be made for my shoes? Can you do this? Or perhaps another specialist you can refer? I have seen Dr Jason Hiatt in Walnut Creek and 2 other Podiatrists.
4) Is my walking every day prolonging the healing process? Should I just stop all weight-bearing exercises?
5) After my ankle heals, am I risking injury again by playing tennis?
Thank you for everything and you are the best!