Welcome to Momentum Health's patient resource about Osteochondritis Dissecans of the Talus.
Osteochondritis dissecans (OCD) is a problem that causes pain and stiffness of the ankle joint. It can occur in all age groups. Most cases of OCD usually follow a twisting injury to the ankle and are actually fractures of the joint surface.
This guide will help you understand:
how OCD develops
how the condition causes problems
what can be done for your pain
Hear from some of our Foot Therapy patients
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Sprained my ankle while playing soccer. Got the best treatment from the best physios Mark Taylor and Sofia. They were patient enough to answer all my dumb questions. Also want to mention about the... ”
“ Sprained my ankle while playing soccer. Got the best treatment from the best physios Mark Taylor and Sofia. They were patient enough to answer all my dumb questions. Also want to mention about the lady at the front desk who was really kind. Overall, received the treatment that I was looking for and people are amazing! Highly recommend, would give 6/5 stars. ”
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My wife and I are very selective customers of about everything. If we spend money in today's world, we should get a top and customer-oriented service. The same goes for accessing physiotherapy and... ”
“ My wife and I are very selective customers of about everything. If we spend money in today's world, we should get a top and customer-oriented service. The same goes for accessing physiotherapy and other rehabilitation services after a trauma or a motor vehicle accident. I had never experienced good at other physiotherapists' clinics before. Most clinics are more interested in your insurance money than their patients' complete recovery. I can be biased, but it is my personal opinion. I was very apprehensive in my search for a professional physiotherapy center. I Google-searched for nearly two days and read lots of reviews. I narrowed my search and selected Momentum Health at Deerfoot and 64th Avenue, NE. I can say my hrs. long search was not in vain. The treatment is top-notch and very professional in medical and customer services. I highly recommend this clinic for any massage, physiotherapy, or related service. My physiotherapist, Mark Taylor, Kinesiologist, Safia, and massagist, Meagan, are professional and sincere healthcare professionals. They go beyond and above to help you with your problem. They listen to you and then advise accordingly. I highly recommend this clinic and those individuals I dealt with. It is worth your money, time, and energy to give them a chance and try their positive, effective, and professional service. I will go back to them for sure again if another occasion arises. ”
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I recently saw Joel for an ankle injury. He was professional, empathetic and really helped me understand my limits. I really felt comfortable with his IMS techniques and I felt a lot of relief... ”
“ I recently saw Joel for an ankle injury. He was professional, empathetic and really helped me understand my limits. I really felt comfortable with his IMS techniques and I felt a lot of relief following! One could say he has ‘magic hands’. 5/5 service! ”
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Just had an amazing deep tissue massage from Christina. Walked in with major foot pain. Told her exactly where it hurt. She messaged the area and listened to me if it hurt too much. She then worked on... ”
“ Just had an amazing deep tissue massage from Christina. Walked in with major foot pain. Told her exactly where it hurt. She messaged the area and listened to me if it hurt too much. She then worked on areas she thought would help my foot and it worked. I got up from the table and could walk without pain. The deep tissue massage was perfect. She kept asking if the pressure was good or too much and acted accordingly to my answer. There’s a reason she books so far out. She’s that good. Extremely happy to have found Christina. I would highly recommend her to anyone ”
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Rebecca and Karissa have helped me immensely in recovery from a ruptured achilles tendon. Their guidance and program has helped me heal and strengthen the injury. Top notch quality and care from the... ”
“ Rebecca and Karissa have helped me immensely in recovery from a ruptured achilles tendon. Their guidance and program has helped me heal and strengthen the injury. Top notch quality and care from the best people. Thanks for everything! ”
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I have been a client of Brad Fugimoto for several years and when I developed a sore heel (plantar fasciitis ), I asked him about it. He found that my calf muscle was very tight and said if I could... ”
“ I have been a client of Brad Fugimoto for several years and when I developed a sore heel (plantar fasciitis ), I asked him about it. He found that my calf muscle was very tight and said if I could tolerate deep massage of it, the heel pain would likely resolve. However I didn't think I could tolerate it so decided to try other practitioners, including seeing a podiatrist for new orthotics, another chiropractor for Cold Laser, a Physiotherapist for Ultrasound and Acupuncture , plus doing many prescribed exercises. The pain persisted. So I saw my Homeopath/RN for her opinion. She diagnosed it as a muscle/fascia problem of the lower leg which caused the inflammation in the plantar fascia (heel). Bingo! She recommended a technique called Myofascial Release. This is the same as what Brad had described 3 months ago. So back to Brad I went and after one treatment (which was painful), the heel pain is relieved about 50% and hopefully a few more treatments will bring it back to normal. I very much recommend Brad Fugimoto for his expertise, professionalism and his intuitive ability. ”
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Mark, our physiotherapist was absolutely amazing!! My son sprained his ankle playing sports and months later it was still bothering him to the point he couldn’t play for his competitive soccer team... ”
“ Mark, our physiotherapist was absolutely amazing!! My son sprained his ankle playing sports and months later it was still bothering him to the point he couldn’t play for his competitive soccer team anymore. Mark spent time with him on a weekly basis for a few weeks and drew up a plan for him to also work on his ankle at home and now he is 100% pain free!! Mark made my shy son feel comfortable during his visits and helped him so much! Even on our last visit, my son had strained his neck sleeping awkwardly one night and one visit with Mark fixed him right up! I highly recommend Momentum Health Deerfoot! Thanks so much to Mark and the very friendly reception staff who always made our visits enjoyable! ”
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Good morning i have been having nerve problems and numbness in my left leg hip and ankle, since i have been coming there i have been treated with respect and kindness for my problem, i feel very... ”
“ Good morning i have been having nerve problems and numbness in my left leg hip and ankle, since i have been coming there i have been treated with respect and kindness for my problem, i feel very confident that the team there will help me to get better if possible. Russ is awesum he has done things that no other physio place has tried i believe he accutually cares about my injury and healing process. Hats off to all of you i would recommend treatment here for anyone who has issues with your body. ”
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I have been working with Mark Taylor to help remidy my ankle tendonitis for a couple months now, already seeing massive improvements and very little pain anymore. Would recommend. ”
“ I have been working with Mark Taylor to help remidy my ankle tendonitis for a couple months now, already seeing massive improvements and very little pain anymore. Would recommend. ”
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I've been coming here for a few months. My foot got crushed in forklift incident at the company I was working for and I've been having to learn how to walk on the for again. So far my experience has... ”
“ I've been coming here for a few months. My foot got crushed in forklift incident at the company I was working for and I've been having to learn how to walk on the for again. So far my experience has been positive with Mark being easy to talk to and not overbearing or aggressive. The current negative is that finding the location is hard due to the set up of the mall, but that is the fault of the overseers Shape Properties not knowing how to do competent address designation. ”
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I had an inflamed Achilles’ tendon after rolling my ankle during a winter run. I could barely walk. Amy diagnosed the problem and gave me treatment and exercises that set me right. She focused on... ”
“ I had an inflamed Achilles’ tendon after rolling my ankle during a winter run. I could barely walk. Amy diagnosed the problem and gave me treatment and exercises that set me right. She focused on strengthening my ankle so the problem would not re-occur and stretching to address muscle tightness. The team at Momentum West Springs is my first choice whenever I have an injury. I trust them to get me back fast. Thanks Amy and Nicole! ”
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My first trip to Momentum Health Ogden today had me meeting with Meghan Murphy for physio for my Achilles Tendonitis. She was thorough, knowledgeable and thoughtful of my pain tolerance. I’m... ”
“ My first trip to Momentum Health Ogden today had me meeting with Meghan Murphy for physio for my Achilles Tendonitis. She was thorough, knowledgeable and thoughtful of my pain tolerance. I’m confident in the regimen she’s laid out for my recovery and highly recommend her to help you work through any injuries you may have! ”
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Kaylie and Rachel were absolutely phenomenal in getting me back to life and mobile. I came in with a serious ankle sprain and developed a secondary sprain on my other ankle, too. They worked... ”
“ Kaylie and Rachel were absolutely phenomenal in getting me back to life and mobile. I came in with a serious ankle sprain and developed a secondary sprain on my other ankle, too. They worked diligently with me to make sure I was progressing in my healing process and are both extremely friendly. I would highly recommend Momentum Health and Rachel and Kaylie if you are in need of physiotherapy treatment! ”
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Kaylie and Rachel were an amazing team helping to heal my foot. They were super knowledgeable about the body and friendly to chat with during each session. Thanks so much for the help!!! ”
“ Kaylie and Rachel were an amazing team helping to heal my foot. They were super knowledgeable about the body and friendly to chat with during each session. Thanks so much for the help!!! ”
The cause of most cases of OCD are thought to be actual chip-type fractures. These fractures occur with severe ankle sprains. Which side of the talus the chip is on depends on how the ankle was twisted during the initial injury.
The chip fracture can vary in size and severity. If the bone underneath the cartilage is crushed or cracked and the articular cartilage is intact, the fragment is less likely to move. If the articular cartilage is broken as well, the bone fragment may move out of position, or displace, making healing less likely and later problems more likely.
Because the bone chip is separated from the rest of the talus, the blood vessels traveling to the fragment through the bone of the talus are torn, and the blood supply of the bone fragment is lost. If the fragment displaces, these blood vessels cannot grow back. The fragment loses its blood supply and actually dies. This makes healing less likely.
There is some evidence that the twisting injury may not cause a chip fracture initially. However, it may injure the bone's blood supply, leading to an area of the bone actually dying. This may explain some cases of OCD that appear without a well-defined history of a recent serious twisting injury.
Symptoms
What does OCD feel like?
Initially, OCD behaves like any other ankle sprain injury. You will feel swelling and pain and have difficulty placing weight on the ankle. No special symptoms suggest a chip fracture has occurred inside the joint. X-rays are the best way to determine whether a chip fracture has occurred.
Later, continued problems with the fragment may cause swelling and a generalized ache in the ankle. You may also feel a catching sensation with the ankle in certain positions. This is because the chip can get caught in the ankle joint as it moves, causing pain and the sensation of catching.
Diagnosis
How will my health care provider know it's OCD?
When you first visit Momentum Health, our physiotherapist will examine your foot and speak with you about the history of your problem. Diagnosis of osteochondritis dissecans (OCD) is generally made during the history and physical examination.
Some patients may be referred to a doctor for further diagnosis. Once your diagnostic examination is complete, the physiotherapists at Momentum Health have treatment options that will help speed your recovery, so that you can more quickly return to your active lifestyle.
Our Treatment
Non-surgical Rehabilitation
Treatment for OCD depends on when the problem is discovered. If the problem is discovered immediately after a twisting injury to the ankle, immobilization in a cast or boot for six weeks may be suggested to see if the bone injury heals. You may need to keep weight off the foot and use crutches during this period of immobilization. Your physiotherapist at Momentum Health can instruct you in the proper use of crutches so that you don't put too much weight on your healing foot. We can also provide you with stretches, exercises and other supportive care to help speed your recovery once your cast or boot are removed.
Post-surgical Rehabilitation
Patients normally require crutches to keep from putting weight on the ankle for four to six weeks after surgery. You will probably wear a bandage or dressing for a week following the procedure. The stitches are generally removed in 10 to 14 days. However, if your surgeon used sutures that dissolve, you won't need to have the stitches taken out.
Our physiotherapists usually have OCD patients begin their therapy by doing motion exercises very soon after surgery. Patients wear a splint that can easily be removed to do the exercises throughout the day.
Your first few physiotherapy treatments are designed to help control the pain and swelling from the surgery. Our physiotherapists will also work with you to make sure you are only putting a safe amount of weight on the affected leg.
We will choose exercises to help improve your ankle motion and to get the muscles toned and active again. Our physiotherapist will initially place emphasis on exercising the ankle in positions and movements that don't strain the healing part of the cartilage. As your program evolves, we will choose more challenging exercises to safely advance the strength and function of your ankle.
Some of the exercises we provide are designed to get your leg and ankle working in ways that are similar to the activities you do every day, such as rising on your toes, walking, and going up and down stairs.
At Momentum Health, our goal is to help you keep your pain under control, ensure safe weight bearing, and improve your strength and range of motion. When your recovery is well underway, regular visits to our office will end. Although we will continue to be a resource, you will be in charge of doing your exercises as part of an ongoing home program.
Momentum Health provides services for physiotherapy in Calgary.
Surgery
If the problem is not recognized early, the bone fragment may not heal and may continue to cause problems. Surgery may be required to try to reduce your symptoms at this point.
Surgery usually involves removing the loose fragment of cartilage and bone from the ankle joint and drilling small holes in the injured bone. When the fragment is removed, a defect shaped like a small crater is left in the talar dome. It is this area where the drill holes are made. The drill holes allow new blood vessels to grow into the defect and help to form scar tissue to fill the area. Eventually this new scar tissue smoothes out the defect and allows the ankle to move more easily.
Arthroscopic Method
In some cases the surgery may be done using an arthroscope. An arthroscope is a special miniature TV camera that is inserted into the joint through a very small incision. Special instruments are inserted into the ankle through other small incisions. By watching on the TV screen, the surgeon removes the fragment and drills the defect.
Open Method
The ankle is a small joint, so it is sometimes difficult to get the arthroscope into certain areas. If the defect is in an area of the ankle difficult to reach with the arthroscope, an open incision may be required. This incision is usually made in the front of the ankle to allow the surgeon to see into the joint. Special instruments are used to remove the fragment and drill the injured area.
