In April 2011 I injured my ankle playing football (soccer) in what I thought at the time was a fairly routine, minor grade 2 sprain. I received a challenge on the inside of my foot, causing it to roll outwards. I was able to complete the game, playing with a degree of pain, but the next day it was too painful to walk on.

It improved steadily for the first month, until it was very nearly better but then seemed to stall. I slowly returned to playing football and it got to a point where I could feel it aching slightly when I played, but it would not restrict me in any way and would be no worse as a result of having played. Then, in July, 3 months after the initial injury, I played 3 times in a week, with the final occasion being a tournament which took place over several hours. I did not specifically re-injure my ankle again, but it felt much more painful immediately afterwards, and I had trouble walking on it for the next few days.

From then on, the injury seemed to take on a different nature. There was no longer any progress on a day to day basis, on some days it seemed to be worse or better for no apparent reason, and on the whole, it would ache progressively more throughout the days then return to its previous level in the morning. At this point I began seeing a physio, who mobilised the joint and massaged the calf muscles around it and made corrections to my posture as she felt my biomechanics may have been making a low level contribution to the lack of progress, (in that I needed to rely more on my glutes and core muscles rather than my hip flexors and lower back and I had been over-using my toe flexor in that foot, which I had been feeling as a tightness through the bottom of my foot).

These sessions with a physio seemed to get me over a hump and I was able to make progress again, culminating in a return to playing football around the end of October. At this point I still had some low-level aching in my ankle, but believed that exercise may help it to return to normal. I played 10 minutes in my first week back with no pain and while there was some aching later that night, it felt ok again the next day. The following week I intended to up my activity slightly, but due to 2 other players getting injured during the game I had to play the full 40 minutes (this is 5 a side football). Again, there was a bit of aching that night and for the next day or 2, but it basically then felt fine again. The following week however, even though I only played about 15 minutes, I sensed that something wasn’t quite right, and although I didn’t have any pain at the time in my ankle, I started to feel tightness through the bottom of my foot while I played.

Sure enough, the next day, my ankle felt similar to how it had done when I first started seeing the physio, aching persistently, (although not with great intensity), whenever I walked on it for more than a couple of minutes or sat down for longer periods without having it up. This activity/inactivity also seemed to result in it getting slightly more swollen, although not greatly, and it would normally return to a level of swelling where there is a noticeable, but not significant difference in size in relation to the other ankle, the following day.

I immediately began seeing my physio again, but this time I have not felt any signifificant improvement in the subsequent 3 months. The aching I generally experience now is low level and appears to be related to a tightness in the front and back of my calf. I feel that this tightness/aching emanates from the slightly swollen region on the upper, outer side of my ankle, but possibly continues up slightly into the front of my calf. Stretching or massage of the front or back of my calf provides some relief, but only for a matter of minutes (although this is longer when carried out by the physio), and the only other thing that stops the aching is icing it or lying down fully (like when asleep), although I do also get some relief by keeping it up on a chair or something.

In the 3 months since my failed attempt at a return to football, there have been some occasions where I felt like I was making progress for a couple of days (usually after seeing the physio), and I would get less aching during the days but these would never last. In thinking about the reasons why this might have been, as I have not been doing much on it, even keeping walking to a minimum, the only thing I can think of is cycling, as I had been doing this for up to 10 miles a day. I drastically reduced my cycling 3 weeks ago however, and in that time have also taken a week of work, (which was spent at home resting it and occasionally exercising it by standing on my leg to work on my balance) and I am still no better off.

My physio says that she does not really understand what the problem is so I am also completely baffled and would welcome any input from anyone! My physio says that it does not make any sense that it would ache when I am sat down normally as this should not be putting any stress on it, but she does not think that there is something major wrong with it, as there does not appear to be any apparent weakness and it is not massively swollen. I also have good mobility in the ankle, as demonstrated by how far I can get down when bending my legs from a standing position with my heels on the ground, although it further confirms my belief that my calf muscles have something to do with this as I feel tightness in the front and back of them when asked to do this without prior massage or stretching.

I have previously gained great help and comfort from this forum when I injured my MCL in the knee on my other leg a couple of years ago (see baffling 8 month grade 2 MCL sprain if you’re interested or remember me) so I am really hopeful people will be kind enough to share their thoughts with me again. I would really appreciate it as it is having a significant effect on my whole life, and I worry all the time about what I should or shouldn't be doing to make it better. Should I use crutches even though on a scale of 1-10 the pain is never more than a 2-3? Should I do more activity on it? Should I push for getting an MRI scan, or ultra-sound or some other form of treatment?

Thank you for reading this far anyway. Sam

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