1st OA and Chronic Low Back Pain Edition

Ryan Rankin

Not sitting still, he finds new challenges to conquer.

The National Institutes of Health (NIH) reports that the average age of someone diagnosed with osteoarthritis is 47. That number increases to age 58 when narrowed down to those who specifically have osteoarthritis in the ankle.

Ryan Rankin was only 28 when he was diagnosed, more than half the average age. “I still try and be as active as I can be,” he says. “It’s not easy, but I can’t let my ankle arthritis get the best of me. Not at this age.”

Growing up in Wisconsin, sports were the center of Ryan’s world. He excelled at basketball and played in college. He sustained multiple injuries along the way, especially to his ankle. “From tricking the trainers into thinking I was OK, to telling my coach that if I sat out the next few practices I would be ready for the game, all I cared about was getting out there doing what I loved, which was to play basketball,” says Ryan. His injuries never fully healed.

Sports-related injuries are one of the most common reasons why people develop osteoarthritis. Over time, the cartilage in Ryan’s ankle began wearing away, causing pain, inflammation, and swelling—and leaving him sidelined.

Treatment

Osteoarthritis is a chronic disease. There is no cure. Analgesics, non-steroidal anti-inflammatories (NSAIDs), and corticosteroids are the first line of defense in treating osteoarthritis. Weight management and regular physical activity are two effective methods to combat further deterioration and manage pain. These are all a regular part of Ryan’s approach to dealing with his osteoarthritis. He also uses a TENS machine, continues exercises he learned through years of physical therapy, monitors his diet, and has found taking cannabidiol (CBD) pills help to alleviate daily pain.

Acupuncture and dry-needling provided short term relief, but Ryan wonders if he had continued either practice more regularly, they would have proved to be more beneficial. “I’m always searching for and trying something new that might be able to help my situation,” he says.

Beyond limitations

Do not let what you cannot do interfere with what you can

is a quote by John Wooden that Ryan Rankin lives by. This quote is also the first thing your eye is drawn to when you open Ryan’s blog, My Life With Osteoarthritis. Through this, he has found purpose in sharing his story, focusing on how he can inspire people living with the same condition.

Ryan’s an avid fisherman and enjoyed planning and taking backpacking trips. In 2014, he had planned an ambitious 20-day, 211-mile hike of the John Muir Trail in Yosemite Park… solo. Considered one of the most beautiful and challenging hikes, the John Muir Trail includes hiking Half Dome, El Capitan, and Glacier Point, and ends near Mt. Whitney, the highest peak in the contiguous United States at 14,505 feet tall.

Ryan researched the best ways to complete the trail, bought the right equipment, and trained so his ankle could sustain the ambitious solo hike.

However, two weeks before he planned to embark on his dream backpacking trip, Ryan required a second major surgery on his ankle. The Brostrom procedure was needed to reconstruct damaged lateral ankle ligaments by reattaching the affected ligaments. And a calcaneal osteotomy, which is a controlled break of the heel bone, was performed to correct deformity in the ankle joint and surrounding areas.

Ryan’s extreme goal of hiking the John Muir Trail began to slip away. In his blog Ryan writes, “It’s hard as hell accepting new limitations when you’re still young and active. I want to keep moving and exploring. But when someone, or something like OA, tells you ‘No, you need to stop now,’ it’s almost second nature to figure out a way to break through that barrier and go the extra mile.”

The ankle surgery did not provide much long-term relief and the next step was an ankle fusion.

Surgery

Prior to the second surgery, the pain in his ankle became so severe that his doctor felt an ankle fusion surgery, also called ankle arthrodesis, was the best treatment option. This entails directly connecting the bones that make up the ankle joint: the tibia (shinbone), fibula, and talus bones in the foot. The goal is to reduce pain caused by joint movement that is already limited due to degenerating cartilage in the ankle.

The ankle joint allows the foot to move in all directions. An ankle fusion severely impacts the ability to move the foot; in many cases, the foot is no longer able to move independently of the lower leg. The surgery changes the way a person moves. Physical therapy, stretching, and orthotics can help someone learn to walk comfortably and potentially avoid a noticeable limp as they walk.

Still in his 30s, Ryan did not expect to be facing a surgery that could potentially limit his mobility. He was determined to not let it define him.

Before the possibility of an ankle fusion became reality, Ryan was determined to complete his dream hike. Ryan is stubborn, a trait that many who live with chronic conditions face in learning to accept what our bodies can handle while still living our best life. Ryan researched alternatives to hiking the John Muir Trail that offered a better chance of success. He would hike the High Sierra Trail, a 75-mile hike that would take eight days. The big payoff at the end still included conquering Mt. Whitney.

A dream realized

In 2016, the feeling of reaching the top of Mt. Whitney at the end of his excursion was triumphant, emotional and empowering. Here’s how Ryan described it on his blog:

“While I was battling my osteoarthritis, other people had their reasons for hiking: the loss of a loved one, a father and son rekindling a long-lost relationship, people just wanting to escape society for a few days. Hearing why they wanted to make the journey was very inspiring. We all had our own reason for taking the hike and our own vision of what would make it a success. But while we were on the same trail, we were having unique journeys and being inspired from other hikers’ motivation was a wonderful feeling.”

Two months after his successful and challenging hike, Ryan realized his ankle actually felt better than he expected. He immediately began to think of new and different challenges to face. However, he checked himself, having learned important lessons about life with osteoarthritis. “After all, learning to live with and properly manage osteoarthritis is a marathon, not a sprint,” Ryan admits.

Moving forward

Ryan’s daily life includes constant soreness and stiffness in his ankle. He believes osteoarthritis in his hip and knee isn’t far behind. He wakes up each day not knowing how severe the pain will be. He says, “It’s always around, letting you know it’s still there.”

For someone so active his entire life, Ryan’s biggest challenge has been learning to transition from high-impact activities to ones that are slower-paced. He’s learned to listen to his body, sometimes begrudgingly realizing he has to make adjustments. His beloved basketball is no longer an option.

Imparting wisdom

Ryan wants people to realize that osteoarthritis doesn’t only affect those over age 60. “There are a lot of individuals in their 20s and 30s suffering from the condition and trying to figure out the best way to manage the condition—and they also need support and guidance.”