Hi, I had a bad sprain in my ankle after a climbing fall in November 2022 (16 months ago). I am still struggling with ongoing intermittent pain and discomfort in that ankle despite numerous extended periods of physio. An MRI showed that I had an edema in the bone and a 9mm cartilage tear. My physio thinks with rehab and plenty of exercises I should eventually be able to go back to running and climbing, but the orthopaedic surgeon who ordered the MRI said that running is not advisable (ever again!!) because I any further damage the cartilage. So far no one has said it needs surgery although if ongoing physio doesn’t help the surgeon may propose that. What would your advised course of action be, and can I ever expect to return to running and climbing in the future? It seems a bit extreme to say I can’t ever run again and I love running, but obviously I also don’t want to do more damage to my ankle or give myself early arthritis.

This is a great question, and whilst I think some OS need to stay in their lane with regards to rehab and beyond, there are some things that you simply can't rehab your way out of... And whilst I'm not saying that you might that person, but (and it is a big but) an MRI that shows swelling and a 9mm cartilage tear, does raise a few more questions. Primarily, where is the tear and is this an osteochondral defect? It sounds like it could be on your talus and the bruising is result of the OCD. Do let me know more details as this could be an OCD or something else.