Physical Therapy in Congress Park, Denver Downtown, Central Park, and Highlands Area for Foot
Welcome to Atlas Physical Therapy'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
“
Atlas Physical Therapy is the best! I came in with a sprained ankle and the staff was super patient and helpful as we worked through the injury. Brett and Will were amazing and I would recommend them... ”
“ Atlas Physical Therapy is the best! I came in with a sprained ankle and the staff was super patient and helpful as we worked through the injury. Brett and Will were amazing and I would recommend them to anyone! The downtown location is super convenient for anyone who works down there too! ”
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By far the best physical therapists I have ever gone to! Alex and Kate have fixed everything that has come up from foot issues, to knee problems to all the tiny little things that happen during... ”
“ By far the best physical therapists I have ever gone to! Alex and Kate have fixed everything that has come up from foot issues, to knee problems to all the tiny little things that happen during training or just life in general. Lexi and Emma are awesome at making sure im doing exercises correctly and making it fun at the same time. With the help of everyone at Atlas Physical Therapy I was able to complete my first ultramarathon and look forward to completing many other ridiculous goals. ”
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I had been referred to Alex at Atlas by several different people, but it ended up being my daughter's plantar fasciitis that finally got us in there. He did absolutely great with her really does well... ”
“ I had been referred to Alex at Atlas by several different people, but it ended up being my daughter's plantar fasciitis that finally got us in there. He did absolutely great with her really does well with kids. I don't have any acute injuries at this point, but while I was in there with her, I asked about various ongoing issues/problem areas I have, and ended up beginning treatment with him as well. He takes a well rounded and very practical approach that for us has included tissue work (both), dry needling (me), ultrasound (her), adjustments (me), and obviously various exercises and stretches. The rest of the staff there is great as well. Highly recommend. ”
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I am a runner and runners sometimes get hurt! Alex has magic hands. The man has helped me get through plantar fasciitis on both feet, hip and knee issues and a pulled hamstring! All while keeping it... ”
“ I am a runner and runners sometimes get hurt! Alex has magic hands. The man has helped me get through plantar fasciitis on both feet, hip and knee issues and a pulled hamstring! All while keeping it fun and just being an amazing coach. If something ails you- go see him! He has magic hands and will get you back on track in no time ”
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I’ve been going to Atlas for a couple of months to work on some issues with my peroneal and Achilles, and I’ve been thoroughly impressed with every single person who works at Atlas. I’ve worked... ”
“ I’ve been going to Atlas for a couple of months to work on some issues with my peroneal and Achilles, and I’ve been thoroughly impressed with every single person who works at Atlas. I’ve worked with at least 5 people here, and they have all been knowledgeable, helpful, friendly, caring and cool. They remember who I am every time I come back, have been great at listening and helping with my recovery, and I quite honestly look forward to each visit. I’ve been getting dry needling done lately, and I was pretty afraid since I hate needles. Both Kate and Amanda have done an excellent job however with minimal discomfort and great results afterwards. I’m happy to have discovered Atlas, and I’ve been recommending it to friends and family. ”
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Heather is great! She took me from barely walking to being able to run again. I broke/dislocated my ankle last year and started seeing Heather once I was weight bearing again. I wouldn’t have... ”
“ Heather is great! She took me from barely walking to being able to run again. I broke/dislocated my ankle last year and started seeing Heather once I was weight bearing again. I wouldn’t have gotten to the point I’m at now without her! ”
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This place is great. I worked with Alex for a little over a month. I visited several PT's prior to meeting with Alex all of whom suggested to remove screws post ankle surgery. With Alex's help, I was... ”
“ This place is great. I worked with Alex for a little over a month. I visited several PT's prior to meeting with Alex all of whom suggested to remove screws post ankle surgery. With Alex's help, I was able to avoid a second surgery, AND am now feeling like I did before the injury. Thanks Alex ”
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Amazing place, awesome team! I broke my ankle in January and had surgery a day later. About 7 weeks after that, I started physical therapy at Atlas and I could not have been happier. I was... ”
“ Amazing place, awesome team! I broke my ankle in January and had surgery a day later. About 7 weeks after that, I started physical therapy at Atlas and I could not have been happier. I was ’assigned’ to work with Kate as my PT and she was fantastic. She worked closely with me on movement, strengthening, massaging and flexibility in order to getting me back to my normal self and activities. At times, I even felt bad for her, because I am very ticklish so working on my foot wasn’t always the easiest thing for her, but she took it like a champ; she even did a great job of distracting me in order for her to work on my ankle issues. The exercises I was instructed to do were super helpful, and I was able to do them both at home and at the facility (along with many more when I was there). I loved how I was able to work with multiple staff members while working out my ankle and everyone pushed me to keep going and never made me feel bad if I wasn’t able to complete something, but rather said it was okay and we would try again the next time I came in. No matter the time of day or how busy they were, everyone said hello to you, by name, when you walked in making you feel very welcomed. Although I have recently graduated, I will sporadically go back so I can have Kate continue to help me recover, get new exercises for strength, and to just say hello to the staff. I could not be more happy with my recovery and the awesome people at Atlas who helped make it happen. ”
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Laura has been a godsend for me and has helped put me back together more than once! I came in when I was pregnant for a hip issues, then post pregnancy for a foot issue. Both situations I was treated... ”
“ Laura has been a godsend for me and has helped put me back together more than once! I came in when I was pregnant for a hip issues, then post pregnancy for a foot issue. Both situations I was treated wonderfully by the administrative staff and the physical therapist. The new location is key, parking is ample. The are communicative, timely and most importantly, work wonders on what ails you! ”
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I’ve been impressed and very satisfied with Atlas Physical Therapy ever since I started seeing them after a foot surgery in 2021. When I returned a year or so later in 2022 I worked closely with... ”
“ I’ve been impressed and very satisfied with Atlas Physical Therapy ever since I started seeing them after a foot surgery in 2021. When I returned a year or so later in 2022 I worked closely with Andrea and Nate. Not only were they fantastic to work with, they were excellent listeners and very effective at finding the best treatment to alleviate my issues. I highly recommend using them for your PT needs! ”
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Am 77 years old and started seeing Lexi at the Stapleton location for strengthening of an achilles tendon injury, core strength training, and flexibility and balance training. Lexi was very sensitive... ”
“ Am 77 years old and started seeing Lexi at the Stapleton location for strengthening of an achilles tendon injury, core strength training, and flexibility and balance training. Lexi was very sensitive to all of my needs and concerns and included all of the areas that I wanted to improve upon in each workout. I have improved significantly in each of those areas and Lexi has given me a series of exercises and stretches to maintain and continue to build on my own. I highly recommend Lexi to anyone seeking to improve themselves in a serious yet fun environment. ”
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I am really grateful to Alex and his crew, they helped me with an ankle injury and my back issues. He helped strengthen and rehabilitate my ankle, while leaving me feeling like he was really... ”
“ I am really grateful to Alex and his crew, they helped me with an ankle injury and my back issues. He helped strengthen and rehabilitate my ankle, while leaving me feeling like he was really invested in my recovery. When we had reached a point where I was still having some pain but he had done all that he could, he didn’t just keep taking my money, he made a suggestion for a doctor that might be able to help me further. I recommend them regularly and will be back with any future injuries. ”
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I’ve struggled for seven years with ankle pain since tearing a ligament, and also developed really bad runner’s knee while training for my first half marathon last year. The only other time... ”
“ I’ve struggled for seven years with ankle pain since tearing a ligament, and also developed really bad runner’s knee while training for my first half marathon last year. The only other time I’d been to physical therapy for a previous injury, the results were temporary. Alex at Atlas PT explained the ’why’ behind my pain, gave me detailed exercises and therapy that were doable, I noticed results immediately... and four years later, I can still run, hike, and ski again without pain. ”
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Hey! I’ve been working with Alex Lanton following two surgeries on my foot. He’s so smart, fun, and effective. I would never go anywhere else for my PT needs. ”
“ Hey! I’ve been working with Alex Lanton following two surgeries on my foot. He’s so smart, fun, and effective. I would never go anywhere else for my PT needs. ”
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My daughter saw Nikhil to address ankle pain due to hypermobility. He was great at quickly identifying the issue, explaining it, and prescribing easy and effective exercises that helped very quickly.... ”
“ My daughter saw Nikhil to address ankle pain due to hypermobility. He was great at quickly identifying the issue, explaining it, and prescribing easy and effective exercises that helped very quickly. Great experience. ”
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 Atlas Physical Therapy, our Physical Therapist 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 Physical Therapists at Atlas Physical Therapy 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 Physical Therapist at Atlas Physical Therapy 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 Physical Therapists 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 Physical Therapy treatments are designed to help control the pain and swelling from the surgery. Our Physical Therapists 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 Physical Therapist 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 Atlas Physical Therapy, 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.
Atlas Physical Therapy provides services for Physical Therapy in Congress Park, Denver Downtown, Central Park, and Highlands Area.
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.
