Remodelling

The disorganised scar tissue of fats cells, fibroblasts, inflammatory cells and loose connective tissue should be at the stage where it has been coaxed along to become something more functional. My ankle ligaments feel much stronger than they did a week ago. It's now at that stage that defines whether it stays as a mess that holds together, but without most of the elastic qualities a good a ligament has, or it becomes a functional ligament again. So this means training to encourage the remodelling process. There should be plenty of collagen now, and after the week and a bit of basic movement exercises most of it should be aligned in the right direction. The fibres will be type 3 collagen which are significantly thinner than the dense type 1 fibres which make up the majority of a healthy ligament. Into my fourth week post injury and I am running on the assumption the strength of my ligaments is at best 10-20%. It's a dangerous time. Without loading it will stagnate, but load also creates risk.

Time has to be a friend. I need to listen intently to how my body is responding and take into account a lot of the research. I could force myself into running and there is a chance it may work. Unfortunately it is more likely I'll re-tear at least one of the ligaments and be back at square one. My end goal is to be able to run again. Before that I have a few stepping stone goals. Those goals have to be met before I attempt my first 2 minute run.

  • I need to be able to walk at a brisk pace for 60 minutes (including hills) without pain. At the moment I'm getting pain on the downhills within a 30 minute walk.
  • I need to be able to do 30 single leg calf raises plus 30 single leg hops without pain. I'm at 2x15 single leg calf raises today, so still a bit to go.

So far I'd only been doing straight line exercises. No rotation or turning. This weeks sees a very modest introduction of some lateral movement. Unloaded inversion and eversion repeats. Towel drags with the feet and plenty of single leg squats, lunges and other legs exercises. I'm surprised at how much I'm enjoying doing this work at the moment. My focus when training is high. Maybe all the extra meditation and mindfulness training I'm fitting in is carrying over.

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