Ankle Sprain Still Hurts After 2 Months

[microkid]

About 2 months ago I think I sprained my ankle - well I say think because I don't remember doing it. I had been doing some fairly physical work, jumping around in woodland etc... The next day the top of my ankle was a bit painful, I thought it was a cramp so I tried to walk it off, but I woke up the following day and I couldn't stand on it. The whole ankle hurt. It was swollen on the outside just above the 'lump' over the top and on the inside just above the lump'

I rested it for a few days with ice and stuff and after a few days I was able to put weight on it, but it was still painful to walk on.

I saw my GP who said yes its a sprain 'I think you have sprained all the muscles an ligaments' he referred me to a physio who I went to see, I also paid for a private physio. Both physios and my doctor have told me it just needs time, rest and ice . But after two months it still hurts when I walk on it for any length of time (particularly downhill) although sometimes it's fine.

When pain occurs it is different to how it was to start with, it is a sharp pain on the inside of the ankle just behind the 'bony bit', it occurs while walking as I 'roll the foot up' whilst bringing my other leg forward.

Can anyone give me some advise? What's going on? Surely it should be healed by now? Is the physio giving me good advise, I have been told to stand on my toes, and to do rotation resistance exercises inwards and outwards - but when I do these exercise the pain flares up again! Is there anything I can do to heal it faster? I have been told when it starts hurting to rest and ice. I have been put my whole foot in a bucket of ice and water for 20 mins twice a day. But it doesnt seem to make much difference. The ankle is still swollen but not as severely.

many many thanks!


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[gcoe]

Hi microkid

I really think you need to get the diagnosis confirmed. Sprains can go on for quite a while but given the history I think there are some doubts about the diagnosis of a sprain. By the way: a sprain is a torn ligament (holding bones together), not muscle and it almost always involves the lateral ligament - that is the ligament on the outer side of your ankle. You can tear the muscles (muscle strain) and have a muscle strai. combinations of ligaments and muscle damage is possible but this is less likely - more likely is the involvement of one tissue whether it be joint, ligament or muscele/tendons.

It is very hard to tell what is going on and I think you can only get a proper diagnosis from a good clinician. You need a thorough history and examination at this stage and that means fronting up for some face to face care.

Having said this there seems to me to be some concerns:

• you don't remember going over on the ankle. You would remember it if you did unless you were drunk or drugged. It hurts like hell when you do it or atleast shortly after.
• The top of the ankle is not the usual site for a sprained ankle
• You are having persistent symptoms. If you have had a lot of swelling and inflammation it is possible to have adhesions forming in and around the ankle - scar tissue which obstructs the normal movement of the anikle - that could give you sharp pain.
• It sounds a bit irritable - that is you do some exercises and it flares it up. Does the flare-up last for some time?

There are other possibilities of what it is. You may not have traumatised it. there could be many things going on. One such possibility is the start of an inflammatory arthritis so I would get it checked out again. It could be the activity might have triggered it or it was just coincidence. Checking this out involves blood tests for arthritis and have you had xrays of the ankle? These should have been done to rule out a fracture.


I think you are right to be a bit concerned about it all. Certainly if it is still giving you significant grief in a month there is something wrong.It could be just an ankle sprain but If you are not happy with your current care then get a second opinion.

[Clawsywp]

hi im not a health person but i have a ankle foot problem thats gone on for like 7-8 weeks now and i must say the doctors i see are driving me nuts.

[markmiller]

It is amazing to me that many people out there still recommend rest and ice as a good sprained ankle treatment. In my experience, it does very little tor educe swelling and absolutely nothing to improve range of motion and strength in the ankle joint as well as break up scar tissue.

Don't get me wrong. rest is important after an ankle injury. And ice is okay for about 2 days afterward. But clinically, ice doesn't reduce swelling after 48 hours, so what's the point after that?

In order to heal correctly, you also have to do some proactive rehab as well or else it will never regain it's natural flexibility and strength. This can keep you in pain and susceptible to more injuries in the ankle down the line. I have found an excellent at home rehab program that I recommend to all my clients. It is called the H.E.M. Ankle Rehab Treatment System

I have yet to find anything else that is simple to do and can be done at home without any equipment. It contains a complete rehab and prehab treatment program with a wide variety of healing techniques, stretches and exercises. Give it a shot and let me know what you think.

Best,
Mark