{"id":27359,"date":"2019-11-05T09:42:07","date_gmt":"2019-11-05T16:42:07","guid":{"rendered":"https:\/\/www.uchealth.org\/today\/?p=27359"},"modified":"2022-09-06T08:06:11","modified_gmt":"2022-09-06T14:06:11","slug":"after-talus-fracture-nonsurgical-treatment-has-figure-skater-back-on-blades","status":"publish","type":"post","link":"https:\/\/www.uchealth.org\/today\/after-talus-fracture-nonsurgical-treatment-has-figure-skater-back-on-blades\/","title":{"rendered":"Nonsurgical treatment has figure skater back on blades"},"content":{"rendered":"<div style=\"margin-top: 0px; margin-bottom: 0px;\" class=\"sharethis-inline-share-buttons\" ><\/div><p>They may look graceful as they leap with apparent effortlessness and land with flair, but figure skaters return to Earth with forces of up to about <a href=\"https:\/\/gizmodo.com\/sensors-show-figure-skaters-absorb-8x-their-own-body-we-1526842854\" target=\"_blank\" rel=\"noopener noreferrer\">eight times<\/a> their body weight on ice not known for its forgiveness.<\/p>\n<figure id=\"attachment_27367\" aria-describedby=\"caption-attachment-27367\" style=\"width: 714px\" class=\"wp-caption aligncenter\"><img loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-27367\" src=\"https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2019\/11\/05090713\/Maggie-Skater-Jump-solo.webp\" alt=\"skater working on a jump after recovering from a talus fracture.\" width=\"714\" height=\"1000\" srcset=\"https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2019\/11\/05090713\/Maggie-Skater-Jump-solo.webp 714w, https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2019\/11\/05090713\/Maggie-Skater-Jump-solo-214x300.webp 214w, https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2019\/11\/05090713\/Maggie-Skater-Jump-solo-107x150.webp 107w, https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2019\/11\/05090713\/Maggie-Skater-Jump-solo-200x280.webp 200w\" sizes=\"auto, (max-width: 714px) 100vw, 714px\" \/><figcaption id=\"caption-attachment-27367\" class=\"wp-caption-text\">Figure skaters like Maggie land jumps with a force of up to eight times their body weight. Photo by Todd Neff, for UCHealth.<\/figcaption><\/figure>\n<p>Maggie Johnson, 17, had been figure skating since she was 6 and was all too familiar with the pounding of proper landings \u2013 not to mention the bumps and bruises her sport imparts. But the injury that would bring her to UCHealth happened a long way from her home ice at Centennial\u2019s Family Sports Center.<\/p>\n<p>Maggie, a junior at Cherokee Trail High School in Aurora, was in the Louvre Museum in Paris on the first full day of a March 2019 school trip to France and Spain. She had just checked out the Mona Lisa and was walking down the stairs when she seriously twisted her right ankle. Being well-versed in dealing with physical pain, Maggie gutted it out. The next stop was the Eiffel Tower. Facing long elevator lines, she and her classmates took the stairs down from the second floor.<\/p>\n<figure id=\"attachment_27368\" aria-describedby=\"caption-attachment-27368\" style=\"width: 450px\" class=\"wp-caption alignright\"><img loading=\"lazy\" decoding=\"async\" class=\"wp-image-27368\" src=\"https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2019\/11\/05090715\/Maggie-Skater-Sacha-Lalonde.webp\" alt=\"coach and skater talk at ice rink\" width=\"450\" height=\"300\" srcset=\"https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2019\/11\/05090715\/Maggie-Skater-Sacha-Lalonde.webp 1200w, https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2019\/11\/05090715\/Maggie-Skater-Sacha-Lalonde-300x200.webp 300w, https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2019\/11\/05090715\/Maggie-Skater-Sacha-Lalonde-1024x683.webp 1024w, https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2019\/11\/05090715\/Maggie-Skater-Sacha-Lalonde-768x512.webp 768w, https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2019\/11\/05090715\/Maggie-Skater-Sacha-Lalonde-150x100.webp 150w, https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2019\/11\/05090715\/Maggie-Skater-Sacha-Lalonde-200x133.webp 200w\" sizes=\"auto, (max-width: 450px) 100vw, 450px\" \/><figcaption id=\"caption-attachment-27368\" class=\"wp-caption-text\">Maggie and Lalonde talk jumping form. Photo by Todd Neff, for UCHealth.<\/figcaption><\/figure>\n<p>The Eiffel Tower\u2019s second floor is 674 stairs and 31 floors above ground level.<\/p>\n<p>Maggie somehow made it down and through the rest of the trip \u2013 even attempting to flamenco dance in Sevilla despite the bruising and swelling. When she got home, her mom Lorena had already booked an appointment at <a href=\"https:\/\/www.uchealth.org\/locations\/uchealth-lone-tree-health-center\/\">UCHealth Lone Tree Medical Center<\/a>. There, <a href=\"https:\/\/www.uchealth.org\/provider\/alexander-ebinger-md\/\">Dr. Alex Ebinger<\/a> examined her ankle, ordered an X-ray and an MRI and referred her to <a href=\"https:\/\/www.uchealth.org\/provider\/kenneth-hunt-md-foot-and-ankle-orthopedic-surgery\/\">Dr. Kenneth Hunt<\/a>, a surgeon specializing in foot and ankle orthopedics and the medical director <a href=\"https:\/\/www.uchealth.org\/locations\/uchealth-foot-and-ankle-center-central-park\/\">UCHealth Foot and Ankle Center<\/a> in Denver\u2019s Stapleton neighborhood.<\/p>\n<h3><strong>Skip the surgery for talus fracture<\/strong><\/h3>\n<p>What Hunt found underscored just how tough Maggie was: there were torn ligaments, there was an avulsion fracture where part of a <a href=\"https:\/\/en.wikipedia.org\/wiki\/Joint_capsule\">joint capsule<\/a> had torn off a bit of bone, and she had a talus fracture.<\/p>\n<figure id=\"attachment_27364\" aria-describedby=\"caption-attachment-27364\" style=\"width: 300px\" class=\"wp-caption alignleft\"><img loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-27364\" src=\"https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2019\/11\/05090703\/Maggie-Skater-talus-getty.webp\" alt=\"image of a foot, showing the talus boan inside where the foot bones meet the ankle.\" width=\"300\" height=\"300\" srcset=\"https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2019\/11\/05090703\/Maggie-Skater-talus-getty.webp 591w, https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2019\/11\/05090703\/Maggie-Skater-talus-getty-300x300.webp 300w, https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2019\/11\/05090703\/Maggie-Skater-talus-getty-150x150.webp 150w, https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2019\/11\/05090703\/Maggie-Skater-talus-getty-200x200.webp 200w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><figcaption id=\"caption-attachment-27364\" class=\"wp-caption-text\">The talus bone. Getty Images.<\/figcaption><\/figure>\n<p>None of it was good news, but the talus fracture was the greatest concern. The talus serves as the ankle\u2019s fulcrum and bears the body\u2019s weight with each step \u2013 or, depending on the jump, each landing. The Fort Collins Invitational, which was coming up the following weekend, wasn\u2019t going to happen for her. The good news was, there would be no surgery.<\/p>\n<p>Hunt has done many surgeries on broken taluses, including one on former University of Denver hockey star <a href=\"https:\/\/www.uchealth.org\/today\/most-bruising-defender-tariq-hammond-back-on-the-ice\/\">Tariq Hammond<\/a>. But what\u2019s right for one bladed athlete may not be right for another. Maggie\u2019s ankle ligaments and the avulsion fracture would repair themselves \u2013 and so would her talus, which had what\u2019s called a nondisplaced fracture. It means the bone broke and then resettled right where it had been before. As long as the bone stayed put and the ankle was rehabilitated properly, the talus, too, would heal on its own, Hunt concluded. He sent Maggie home with an ultrasound stimulation device to speed healing and a referral for physical therapy (PT).<\/p>\n<p>PT would be the key to Maggie\u2019s recovery and return to the ice. And so, following a brief period on crutches, she started her weekly visits to <a href=\"https:\/\/www.uchealth.org\/locations\/uchealth-orthopedics-steadman-hawkins-clinic-denver\/\">UCHealth Steadman Hawkins Clinic Denver<\/a>.<\/p>\n<h3><strong>Call it POLICE<\/strong><\/h3>\n<figure id=\"attachment_27370\" aria-describedby=\"caption-attachment-27370\" style=\"width: 400px\" class=\"wp-caption alignright\"><img loading=\"lazy\" decoding=\"async\" class=\"wp-image-27370\" src=\"https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2019\/11\/05090721\/Maggie-Skater-spin.webp\" alt=\"skater in mid spin on ice after recovering from talus fracture.\" width=\"400\" height=\"286\" srcset=\"https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2019\/11\/05090721\/Maggie-Skater-spin.webp 1200w, https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2019\/11\/05090721\/Maggie-Skater-spin-300x214.webp 300w, https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2019\/11\/05090721\/Maggie-Skater-spin-1024x731.webp 1024w, https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2019\/11\/05090721\/Maggie-Skater-spin-768x548.webp 768w, https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2019\/11\/05090721\/Maggie-Skater-spin-150x107.webp 150w, https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2019\/11\/05090721\/Maggie-Skater-spin-200x143.webp 200w\" sizes=\"auto, (max-width: 400px) 100vw, 400px\" \/><figcaption id=\"caption-attachment-27370\" class=\"wp-caption-text\">Maggie mid-spin. Photo by Todd Neff, for UCHealth.<\/figcaption><\/figure>\n<p>When she started PT soon thereafter, Maggie was still in a walking boot. Not too many years ago, Hunt and other surgeons would have prescribed what\u2019s known as RICE \u2013 rest, ice, compression, and elevation \u2013 for a couple of weeks and perhaps longer. Now, Hunt says, the acronym is POLICE: protect, optimally load, ice, compression, and elevation. You still do the icing, compression and elevation to reduce swelling and inflammation, but these days, doctors know that those who safely work the joint as early as possible do better in the long run.<\/p>\n<p>Steadman Hawkins physical therapists Gillian Brown and Meghan Clusserath took the lead in Maggie\u2019s PT. The first step was to understand Maggie\u2019s goals and motivations. They differ from patient to patient \u2013 not everyone intends to propel themselves skyward and land again on a quarter-inch-wide blade \u2013 and the PT process will vary depending on the patient\u2019s ultimate goal. Universal is the message that doing PT at Steadman Hawkins as well as at home can make an enormous difference in long-term outcomes.<\/p>\n<figure id=\"attachment_27365\" aria-describedby=\"caption-attachment-27365\" style=\"width: 300px\" class=\"wp-caption alignright\"><img loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-27365\" src=\"https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2019\/11\/05090706\/Maggie-Skater-fall.webp\" alt=\"skater on the ice after a fall.\" width=\"300\" height=\"214\" srcset=\"https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2019\/11\/05090706\/Maggie-Skater-fall.webp 1200w, https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2019\/11\/05090706\/Maggie-Skater-fall-300x214.webp 300w, https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2019\/11\/05090706\/Maggie-Skater-fall-1024x731.webp 1024w, https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2019\/11\/05090706\/Maggie-Skater-fall-768x548.webp 768w, https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2019\/11\/05090706\/Maggie-Skater-fall-150x107.webp 150w, https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2019\/11\/05090706\/Maggie-Skater-fall-200x143.webp 200w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><figcaption id=\"caption-attachment-27365\" class=\"wp-caption-text\">What goes up must come down \u2013 a lesson figure skaters know all too well. Photo by Todd Neff, for UCHealth.<\/figcaption><\/figure>\n<p>Brown or Clusserath, depending on the week, started slowly with gentle range-of-motion work to get the joint moving and to relax and enhance the flexibility of the ankle\u2019s muscles. Maggie\u2019s ankle, which had been dysfunctional for weeks, had to be coaxed into regaining proper motor control.<\/p>\n<p>Soon Maggie had graduated to weight-bearing and band exercises focusing on improving strength and stability. That work extended up to the hip and core muscles, all of which play a role in the kinetic chain that Maggie\u2019s damaged ankle had rudely interrupted.<\/p>\n<p>Then came <a href=\"https:\/\/en.wikipedia.org\/wiki\/Plyometrics\" target=\"_blank\" rel=\"noopener noreferrer\">plyometric<\/a> exercises \u2013 jumping and hopping movements \u2013 that strengthened and prepared her body for a return to the ice. By August, she was back in Stapleton to see Hunt, who said she was ready to skate again.<\/p>\n<h3><strong>Returning to the ice<\/strong><\/h3>\n<p>In early October, Maggie stroked around a Family Sports rink with her coach, Sacha Lalonde. She competes as a Novice, a U.S. Figure Skating tier which, considering she and her fellow competitors have skated most of their lives and can do double jumps, seems a misnomer (it\u2019s actually two levels from the very top). She warmed up first, spinning away and doing single jumps.<\/p>\n<figure id=\"attachment_27366\" aria-describedby=\"caption-attachment-27366\" style=\"width: 1200px\" class=\"wp-caption aligncenter\"><img loading=\"lazy\" decoding=\"async\" class=\"wp-image-27366 size-full\" src=\"https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2019\/11\/05090709\/Maggie-Skater-Jump-harness.webp\" alt=\"skater turning in air while coach holds a harness to support her landing.\" width=\"1200\" height=\"857\" srcset=\"https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2019\/11\/05090709\/Maggie-Skater-Jump-harness.webp 1200w, https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2019\/11\/05090709\/Maggie-Skater-Jump-harness-300x214.webp 300w, https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2019\/11\/05090709\/Maggie-Skater-Jump-harness-1024x731.webp 1024w, https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2019\/11\/05090709\/Maggie-Skater-Jump-harness-768x548.webp 768w, https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2019\/11\/05090709\/Maggie-Skater-Jump-harness-150x107.webp 150w, https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2019\/11\/05090709\/Maggie-Skater-Jump-harness-200x143.webp 200w\" sizes=\"auto, (max-width: 1200px) 100vw, 1200px\" \/><figcaption id=\"caption-attachment-27366\" class=\"wp-caption-text\">: Maggie Johnson practices double toe loops as coach Sacha Lalonde spots her with a pole harness at Family Sports Ice Arena in Centennial. Photos by Todd Neff for UCHealth.<\/figcaption><\/figure>\n<p>Lalonde then connected a safety harness to something a sport fisherman would feel comfortable handling. Lalonde followed Maggie round after round as she worked on double toe-loops \u2013 a new jump for her. It involved smashing her right toe pick into the ice to attain greater altitude as she leaped off the left foot, then landing on the right foot with a force equivalent to some multiple of her body weight. Lalonde\u2019s role wasn\u2019t to lift, but to soften the inevitable falls. Maggie then took off the harness and tried the jump perhaps a dozen times or more without Lalonde\u2019s spotting.<\/p>\n<figure id=\"attachment_27369\" aria-describedby=\"caption-attachment-27369\" style=\"width: 450px\" class=\"wp-caption alignright\"><img loading=\"lazy\" decoding=\"async\" class=\"wp-image-27369\" src=\"https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2019\/11\/05090719\/Maggie-Skater-Sacha-Lalonde-2.webp\" alt=\"skater talking to coach at ice rink.\" width=\"450\" height=\"321\" srcset=\"https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2019\/11\/05090719\/Maggie-Skater-Sacha-Lalonde-2.webp 1200w, https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2019\/11\/05090719\/Maggie-Skater-Sacha-Lalonde-2-300x214.webp 300w, https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2019\/11\/05090719\/Maggie-Skater-Sacha-Lalonde-2-1024x731.webp 1024w, https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2019\/11\/05090719\/Maggie-Skater-Sacha-Lalonde-2-768x548.webp 768w, https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2019\/11\/05090719\/Maggie-Skater-Sacha-Lalonde-2-150x107.webp 150w, https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2019\/11\/05090719\/Maggie-Skater-Sacha-Lalonde-2-200x143.webp 200w\" sizes=\"auto, (max-width: 450px) 100vw, 450px\" \/><figcaption id=\"caption-attachment-27369\" class=\"wp-caption-text\">Maggie and Lalonde talk jumping form. Photo by Todd Neff, for UCHealth.<\/figcaption><\/figure>\n<p>\u201cYou\u2019ve got the arms \u2013 you were missing the legs,\u2019 Lalonde called out.<\/p>\n<p>Finally, she landed it \u2013 cheated, as it\u2019s called when the landing skate doesn\u2019t quite do the full rotation \u2013 but a triumph nonetheless.<\/p>\n<p>\u201cShe\u2019s ahead of where she was before the injury,\u201d Lalonde said.<\/p>\n<p>Maggie looked satisfied with the effort. She was planning on competing again early next year \u2013 perhaps at the Denver Invitational in March; perhaps in Fort Collins, which she missed this year because of that ankle. After that, it will depend on where she ends up in college. But clearly, she loved being back on the ice.<\/p>\n<p>\u201cSix months after the injury, I\u2019m in a good place,\u201d she said.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>They may look graceful as they leap with apparent effortlessness and land with flair, but figure skaters return to Earth with forces of up to about eight times their body weight on ice not known for its forgiveness. Maggie Johnson, 17, had been figure skating since she was 6 and was all too familiar with [&hellip;]<\/p>\n","protected":false},"author":23,"featured_media":27370,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"_relevanssi_hide_post":"","_relevanssi_hide_content":"","_relevanssi_pin_for_all":"","_relevanssi_pin_keywords":"","_relevanssi_unpin_keywords":"","_relevanssi_related_keywords":"","_relevanssi_related_include_ids":"","_relevanssi_related_exclude_ids":"","_relevanssi_related_no_append":"","_relevanssi_related_not_related":"","_relevanssi_related_posts":"","_relevanssi_noindex_reason":"","footnotes":""},"categories":[8],"tags":[606,183,110,2748,3681],"class_list":["post-27359","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-news","tag-a-f-williams-family-medicine-clinic","tag-orthopedics","tag-physical-therapy","tag-uchealth-lone-tree-medical-center","tag-uchealth-steadman-hawkins-clinic-denver"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v27.2 (Yoast SEO v27.2) - https:\/\/yoast.com\/product\/yoast-seo-premium-wordpress\/ -->\n<title>Skater back on blades after talus fracture - UCHealth Today<\/title>\n<meta name=\"description\" content=\"There were torn ligaments, an avulsion fracture and a talus fracture. 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