The occasional ankle issue was a way of life for Addison Klosterbuer but there were never any injuries in all her days as a young basketball player that kept her out of action for a significant length of time.

That was until last season, her first at the University of South Dakota, when she stole the ball at an early season practice then began sorting her way through traffic. She rolled her ankle and went down.

The former star guard at Central Lyon High School thought it was a sprain, maybe worse than normal but still just a temporary setback. Walk around in a boot for a few days, then get back at it, right?

Instead, Klosterbuer sat out her team’s next practice with a sore ankle that was a lot more swollen than had been the case in the past when this kind of injury occurred.

Not just another sprain

Eventually that led to a visit at Sanford Orthopedics and Sports Medicine Sioux Falls with orthopedic surgeon Alan Yan, M.D., who specializes in treating foot and ankle conditions. When an attempt to get past the discomfort without surgery wasn’t working, it was time for another conversation.

“It didn’t feel good at all,” Klosterbuer said. “I’d torn most of my ligaments in my ankle so every time I would do a step back or something like that it felt like it would just give out.”

Klosterbuer’s visit with Dr. Yan included another round of X-rays and an MRI. When she returned to talk with the doctor, she had lots of questions about what was wrong and what would come next.

“Dr. Yan had a whole picture drawn up of my ankle and he explained every single little thing,” said Klosterbuer, a redshirt freshman.  “After the X-rays, I was nervous about surgery, but Dr. Yan knew what he was going to do and after he explained it, I was not as nervous. I knew I was going to come back good from it.”

Dr. Yan told her the surgery would clear up her current injury while also addressing the accumulation of damage suffered from all those previous sprains. In some ways, Klosterbuer’s severe sprain was an accident waiting to happen. Now it was time to fix it.

“This was an acute injury on top of a chronic injury, which is something we see in young athletes quite often,” Dr. Yan said. “It’s an injury, if it’s not dealt with properly, that will prevent athletes from participating in competitive sports.”

Common but complicated

While she had avoided cartilage issues that could have complicated her injuries further, there was pain and swelling that extended from the back of her ankle to her big toe. The overall instability promised to become a long-term problem if not treated.

“Her injury is very common for basketball players, but ankle sprains can be very complicated,” Dr. Yan said. “In the structure of your ankle you have ligaments and tendons. With tendons, you can have preconditioned weaknesses. When you have frequent sprains, a severe ankle sprain will set you back and you cannot get back to the previous status or the desired status without proper management.”

Proper management in this case meant an intricate surgery that included an anterior arthroscope, a posterior arthroscope and a Brostrum procedure – a procedure that tightens and repairs ligaments on the outside of the ankle.

It was a two-hour surgery and Klosterbuer went home the same day. The recovery began with a progression of walking aids – crutches, a boot, a scooter – on the way to what would become an intensive rehab effort.

“I’d never ever taken that much time off from basketball since I started playing,” said Klosterbuer, who had customarily made basketball a year-round part of her life. “I think God made it happen for a reason. The timing and everything all worked out and I’m back to playing now. My ankle feels better than it has ever felt.”

Collaboration in rehab

As an orthopedic surgeon, Dr. Yan is often called on to work with athletes like Klosterbuer. The rehab includes regular conversations with the patient and with physical therapy providers. In this case, communication and collaboration were a vital piece of Klosterbuer’s return to basketball.

“Physiologically, athletes are actually the best patients you can treat,” Dr. Yan said. “You most often have very good results because usually they’re young and they’re very healthy. They have a very good potential to heal. The only caveat is they may have peer pressures or team pressures to return to the sports as soon as they can.”

Klosterbuer took heed. With this injury, short cuts in rehab would not be in her best interest.

“During PT one day I could actually start putting my full weight on it,” Klosterbuer said. “It was like, ‘Man, I can actually walk again without anything hurting.’ That’s when I realized this was working.”

By the time practice at USD began this fall, Klosterbuer was ready to go. Dr. Yan and a Sanford team of providers put her in that spot.

“One of the reasons why I enjoy being an orthopedic surgeon is that we’re taking care of dysfunctions – we get people back to speed, back to their function, especially with athletes,” Dr. Yan said. “The patients are happy. You see them with a smile on their face and they’re back in the spotlight.”

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Orthopedics, Rehabilitation & Therapy, Sports Medicine