Question
In Dec 2004 i fell down a man hole,my right leg went completly down the manhole my left ankle stayed at gronnd level and buckled outover,and i landed on my buttock.I attended hospital and was told that i had damaged ligements in my left ankle,it swelled badly and was painfull i also developed lower back pain and pain down my buttocks and mainly into my left leg (no further than my knee).I returned to work after three months, i continued working for about six months but found the back pain to be getting worse and when walking on uneven ground my left ankle would give way.I stopped work and went for physio therapy for my back and ankle,this just worsened the pain and i stopped but the physiotherapist did confirm a disc problem and laxity in the ligaments in my left ankle.I have recently had MRI scans on my back and left ankle the results are  
Description
There is satisfactory vertebral body alignment and signal with dehydration of the L5/S1 disc. there is no significant marrow oedema, vertebral compression, paraspinal mass or deformaty. There is mid and lower lumbar facet arthrosis. The conus is normal. At the L4/5 level there is mild impingement of the L5 nerve root by a broad based disc bulge, there is no significant neural compression.
At the L5/S1 level there is a broad based disc bulge lateralising to the left with posteriordisplacement of the S1 nerve root
Comment
L5/S1 disc degeneration with posterior displacement of the S1 nerve root. This may accont for an S1 radiculopathy. No specifically traumatic vertebral abnormality demonstrated.

One problem i have now is that i had no medical history of back problems before my accident could the above have been worsened or caused by me landing on my buttocks when i fell down the man hole?

the second problem is that my MRI scans on my ankle have come back saying Normal examination. No cause identified for left ankle pain.Yet my phsiotherapist found laxity, i get severe pain in my left ankle when i push my ankles onto their outside edge, also it still gives way when i step on something uneven

Could you give me your opinion

Thank you  

Answer
Alex,

The muscular reaction to injury is universal:  muscular contractions.  That alone can account for the pain in your back and buttocks -- with or without nerve damage (radiculopathy).

As to your ankle, a phyiotherapist's examination is via movement, whereas a radiologist's examination is via static photograph.  I would more readily believe the physiotherapist.  In any case, ligament damage takes a long time to heal, but the ankle may be destabilized by muscular contractions and stabilized by correction of muscular control via clinical somatic education -- my field.

I would take on a client in your condition with expectation of major improvement, but not complete recovery of ankle function for some months.  The ministrations of a rolfer would help.

Please see the article on recovery from an injury at somatics.com/page4.htm, for more.

with regard,
Lawrence Gold