Ankle sprain with hard lump that won't heal

Hello!

How it happened:
When I was playing football about 2 months ago, I sprained my right ankle.
The next day it was swollen in the right side (of the right ankle)(the typical ankle swelling, where that outward rounded bone lies).

The pain got alright in a couple of days and was able to walk fine.
I didn't play for a month and took no other special care.

I went to play and I twisted the same ankle again (bent it sideways-inwards while stepping).
It again got swollen and pained, and I went to a doctor.

What the doctor said:
He said it is a simple ligament strain and I that I should be fine in a month (we took X-Rays also).

How it is was 10 days ago:
One month passed, but the swelling didn't subside. I could run well though.
But when I bent my right foot towards my leg (like when you press the ground hard with the front part of your foot), it hurt right where the swelling is. The same when I took it in the opposite direction also.
The swelling was hard to touch. I went to the doctor again to ask him.

What the doctor said:
He said I'm not to worry and that it would get alright. He said I could start playing. He said I don't need physiotheraphy.

Now:
It has been 10 days and the situation is the same. The swelling won't go below this level. It is hard.
I'm afraid to go play again.

Is it possible that I may have permanently lost range of motion? And the swelling, why is it hard? Will it go away?

Thanks!

Hi there,

I have seen many ankle sprains and without seeing or palpating I assume that the hard lump is soft tissue from the swelling that has hardened which happens after swelling and as a protective response to try and protect the ankle. Spraining your ankle pulls on the ligament and also strains the muscles on the outside of your leg. What this then does it reduces the strength in the muscle so when you go an play again it is too weak and then re injures. After ankle sprains you need to rehabilitate the ankle back to its normal strength. The following points below are my suggestions:
1. Deep tissue release either yourself or by a physiotherapist on the area of pain, what this does is breaks up the soft tissue and increases blood circulation to improve and accelerate healing. ALso releasing the muscles to improve the length and reduce swelling/ pain this can be loacted on the outside of your shin from the outside of your knee down to the ankle. I do highly recommend seeing a physiotherapist for this or for dry needling if they do that in India.

2. Range of movement exercises for the ankle and gentle stretching such as for the calf

Ankle Sprains- Part 2 Stretching and Range of Motion Exercises - YouTube

3. Strengthening exercise such as balancing in on one leg progress to -> calf raises on 2 legs -> calf raises on one leg -> squats ->squats on injured leg maintaining balance -> unstable surface balancing i.e. on a pillow or softer surface -> sport specfic drills i.e. running side ways, hopping, skipping, jumping, pivots and turns. Generally rehabilitation takes over 4-6 weeks before you would be advised to return back to sport otherwise the risk of re injury is high.

I would highly recommend seeing a sports physiotherapist for instruction and advice though otherwise again you are likely to continue to have problems and reinjury.

Hope this helps.

Thanks kwunfu. I'm working on those.

It would be very nice if you answered these questions:
1. Will the hardened soft tissue condition (swelling) go away by itself? Worst case, if I just don't play for 2 months and just do those exercises, can I expect it to be gone?

2. Has the swelling got anything to do with recovery? The doctor said mine is a basic ankle sprain and that I shouldn't worry about the swelling. But is it really the case?

Thank you.

Hi Soccerer. I agree with Kwunfu's physio management. How is the swelling? Is it getting better? From my experience it will slowly decrease over next few months but you will always have some small to medium swelling over the ankle. You might have to wear an ankle brace when you play soccer in the future. BUT must do your ankle rehab exercises. Good luck! and get well soon!

Hi iphysio, thanks for your reply.
I went to a physio and he asked me to do a bunch of lower body exercises so that my body would be better flexible and ready for unexpected positions while playing. Not really ankle specific, but full lower body muscles.
The swelling has come down quite a bit and is not very far from normal.
But the pain I used to get when I pressed the front of my foot hard against a step( so as to bend my foot closer to myself) (like it is done to stretch calf muscles), has not improved. The pain is the same.

Quote:

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but you will always have some small to medium swelling over the ankle

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do you mean permanently? even after the few months?

I'm doing the ankle rehab exercises, yes.

Hi Soccerer. From my experience, usually there is some swelling. That is why I suggest some sort of ankle brace or compression brace/sock to offer support and decrease swelling when you play sports. Are you doing wobble board exercises from your physio? ~ iphysio.

Hi iphysio, yes I have been doing some wobble board exercises and also some balancing (single-legged) on a trampoline.
Although, I'm not sure how I'll continue these after my physiotherapy sessions are over, since I don't have those equipment.'

I'll wear an ankle brace.

I'm sorry, but I'm just trying to confirm this: can I expect the swellling to go down completely after many months or might a small amount remain permanently.

Thanks!

You can find wobble , wobble board on sites where they sell physio equipement.It develops core strenghtening so that you don't get injuries so easily anymore.Just google. I don't know in India but if you take a look for UK for example, is one called physioroom, to have idea what you are looking for. Then find it in India. You should continue doing it , and also to do stretching of your calf muscles. Usually , an ankle sprain has a good to excellent outcome to majority of people, if treated correctly. Exercises improve the circulation which help decrease swelling. Same thing does the elevation of the food in a position above the heart, the compression of a brace as you were suggested by the physios here.

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You can find wobble , wobble board on sites where they sell physio equipement.It develops core strenghtening so that you don't get injuries so easily anymore.Just google. I don't know in India but if you take a look for UK for example, is one called physioroom, to have idea what you are looking for. Then find it in India. You should continue doing it , and also to do stretching of your calf muscles. Usually , an ankle sprain has a good to excellent outcome to majority of people, if treated correctly. Exercises improve the circulation which help decrease swelling. Same thing does the elevation of the food in a position above the heart, the compression of a brace as you were suggested by the physios here.

Hi Soccerer. From my experience, usually there is a small amount of swelling after many months but its hard to say. You might have no swelling after few months. I hope the best for you. Keep up your physio rehab exercises and wish you speed recovery. (I think its worthwhile getting the wobble board!) ~iphysio.

Thank you for your help! I'll take care and do those exercises well.

I would suggest you to consult a good Orthopedic doctor regarding your problem. He/she can suggest you the best.

Hi, I also sprained my ankle (grade 2 anterior) 5-6 weeks ago and still have a large hard lump under my ankle. The ankle is clicking and it's affecting the ROM. I can jog OK but any twisting and turning hurts. I've had 3 physio appointments but he doesn't seem concerned about it. He gave massage, ultrasound and exercises to strengthen and balance. I've had no x-Ray or MRI scans. I did RICE for the first 3-4 days. What's the best way to try to get the swelling down, is it to keep up the exercises so that circulation is improved and massage? I've heard dry needling might be helpful. Should I continue to ice or heat, maybe both? I've sprained lateral ankle ligaments before (playing soccer again) and there is scar tissue but I'm worried the longer I leave this, the less likely I'll be able to get rid. I guess everyone responds differently to all treatments. I read chiropractors might be able to help reduce scar tissue/swelling or should I see an orthopedic surgeon. I'm not young anymore but want to get it sorted. Thanks!

Ankle pain hurt a lot in alignment. Most occur during while running, while palying or step on uneven surface. It can be identify by pain and swelling, burising trouble walking, Instability.

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