Ankle Pain

[The Sax]

Evening all,

1 year ago i was playing football/soccer when i felt a slight pull on the inside of my right ankle, I hadn't twisted it and it wasn't too painful so i continued the game and iced it at the end. The following morning it was quite swollen around the inside of the rigt ankle bone and slightly painful to walk on.

The next 3 weeks of trying to play the pain got worse, mainly when i kicked the football with my laces, it didn't hurt to run though. But again the following morning it hurt to walk on and was quite swollen in the same area.

I decided to rest up for a few weeks before attempting to play again, a trip to my doctor was unhelpful as he diagnosed a sprain (even though i hadn't twisted it) and told me it would get better after 3 weeks. It didn't, but after 2 months i tried to play again, i could run on it but still it was very painful when kicking the ball.

It's painful when i point my foot forward and rotate it both ways. I have also started to get a slight numbness/pain in my knee too.

Any diagnosis would be very much appreciated

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[The Sax]

Is there anyone who could advise me here?

The following few days after playing football it's also painful on the left side of my shin bone just above the inside ankle too.

Thanks

[The Sax]

I'd like to add that i did visit a General Physio about 8 months after the initial injury. He diagnosed an over pronation of my foot and prescribed me some orthotics. These did help at first, but after the 2nd time i played the pain came back in the same area, this time when i ran too.

I am now unable to play any football or run without the ankle becoming sore and painful, again around the inside of my right ankle.

If you are unable to give me an E-Diagnosis can you advise me what specialist i ought to be seeing? Should i stick with physiotherapy or try anotner form of tratment (i.e. Podiatrist, chiropractor, etc, etc).

Your advise would be greatly appreciated as i love playing football/soccer and it's becoming increasingly frustrating not being able to play

Many Thanks

[karen.hankey]

Did you wear the orthotics whilst you played football? Is the pain on the bone, or underneath?

[The Sax]

Thanks for the reply Karen.

Yes, i wore the orthotics. I wore them to 2 practice sessions and they seemed to be stopping the pain. I played one 45 minute half of a game one week and was OK. I then played 90 mins the following week, half way through this 90 minute game the pain suddenly came back. I was just running in a straight line and didn't do anything to set it off.

The pain seems to come from the outside. It's very tender if i tap the inside ankle bone.

The shin bone directly above (on the left side) becomes tender too and even appears to show slight bruising. I sometimes get an ache in my knee too, but not while i play.

Hope this helps.

[karen.hankey]

The anatomy of the inside of your ankle is your tibia (which is the prominent bit of bone), you have a ligament called the deltod ligament (which resists eversion) and then the tendons that invert the foot.

To strain your deltoid ligament is actually quite hard and you would have twisted your ankle into eversion to do this. This is unlikely then as there was no incident.

What would be interesting to check out is your tibialis posterior muscle. This cups around the posterior and inferior aspects of the medial malleolus (the prominent bit of bone) and its job is to maintain the medial arch of the foot. If there is an injury too it you get a gradual collapsing of the arch which also then puts it on stretch.

As you look at your feet, stood normally, is one arch different to the other? Then sit down with you legs out straight and the insides of your feet together. Push them against each other - any pain? Were the orthotics you were given custom made or just off the shelf?

What I would try is ice to the tendon to decrease any inflammation. Then what I do is use a low-dye taping technique, which basically holds the arch in the foot. If that decreases the pain it confirms my diagnosis for me. From there I would either stregthen the muscle to amintain the arch itself or have custom made orthotics for the patient. Which one of these I do depends on the severity of the arch collapse.

Hope this explains things a bit. Look forward to the answers to the questions

[The Sax]

Thanks again for the reply Karen, it's really appreciated.

To be honest there doesn't appear to be any difference between the two arches of my feet. When i sit and push my feet together there isn't any pain - out of interest, where should the pain be coming from?

The pain on my inside shin bone (above the ankle) and when pointing my toes subsides after a few day of no exercise. I only always feel pain when i rotate my foot or tap the inside ankle bone - the front of this bone rather than back (back meaning nearer the achillies tendon).

The orthotics were an off the shelf model, but made of hard plastic rather than soft. They were a 3/4 length model and have 2 wedges inserted into the sole to slightly tip my foot outwards.

Your advice is really helping Karen so if you require any further info from me please ask.

Many thanks

[karen.hankey]

out of interest, where should the pain be coming from if this was a positive test you would get pain behind the inside ankle bone. But this is not always positive in a problematic ankle, it depends on the stage of the injury.

Because of the length of time since the injury occurred any tear/strain should have healed and your now left with a probable change in biomechanics of the ankle.

My advice would be to see a podiatrist to check this out. I am not a big fan of off the shelf orthotics, if you get some custom made then you should get a better outcome because they are specific to you

[The Sax]

Hey Karen,

Thanks loads for the replies. I really appreciate the advice and will definitely take it up.

I'll book an appointment with a local podiatrist ASAP (or when my account balance allows) and post the outcome.

Keep up the good work and thanks again for taking the time out to answer.

Cheerio
Sax

[physiobob33]

hi friend !
I am playing cricket and during the practice mine ankle has
injured and so i want to know that what is the matter way to improve it very soon

[awestphal]

Hi Sax- -

I started running about 7 weeks ago. About a week ago I started having pain on the inside of my ankle just above the bone and it radiates up my leg. It got better after a day of rest but then returned after my next run. Now I have rested for 5 days due to the pain and my ankle/leg has only gotten worse.

Did you ever find out what was wrong with your ankle?

Thanks,
Amy

[Vanc_WA_PT]

awestphal - i'd suggest getting an xray to rule out stress fracture; good luck