Sprained Ankle (6 months on)

[darkstar]

Hi all, i sprained my ankle 6 month ago by jumping off a roof (i know..... pretty stupid) I'd been to the pub and therefore landed badly. I fell back, my left ankle swelled up and was black and blue. I had x rays the following day which showed no breaks. I kept weight off it for 2 weeks, icing it and applying pressure but had to fly out to China so was walking about on it everyday.

I realise this was not ideal! My ankle is still quite painful, it's fine when walking but i can't run on it. It;s fairly weak and is still quite swollen. Not significantly but there is a solid lump on the inner side.

Any tips to combat this problem, what could this lump be? Is it soft tissue?

Thanks for you time
Tom.

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[ATTIreland]

Hi Darkstar,

I dont know if you've seen anyone (physician, physio, etc) since the x-ray but if not think its time to put the hand in the pocket and go see one. Far too much going on in the ankle to diagnose properly over the internet. Stuff like how exactly you injured it, location of pain, type of pain, amount of swelling, area of swelling, ankle mobility, area of point tenderness, and a hundred other things effect the possible diagnosis.

However to get you started, seeing as you still have swelling 6 months post injury I would probably see about another x-ray as some fractures do not show up well in the first two weeks, plus doctors sometimes miss things, plus the swelling may have made the image difficult to read.

After that, the fact that you seem to have had more of an impact injury than an inversion/eversion injury would make me suspicious of an osteochondral lesion of the talar dome (basically that part of the bone and cartilage of a bone in your ankle is damaged).

Anyway if you give more info we'd have a better idea but still think you should see someone.

[darkstar]

Hi, thank you for your reply.
After the original x-ray i had another one 2 months later, this showed no breaks. I was then referred to a Physio, i went private to save time. After two sessions she gave me a number of exercises and i left it there. The exercises seem to focus on increasing strength in the Ankle, i remain to complete them every now and then but after this amount of time i am unsure if they are making any difference.

May an MRI be the way to go?

Thanks.

[ATTIreland]

Yes I'd look to go down the MRI route alright at this stage seeing as you've seen a physio and its not improving after 6 months. Another physio or doctor may be able to spot something after examining you that could mean not needing one but if your physio has looked at it already and didn't spot something the chances that another physio will are fairly slim.

One of the biggest problems with the sports medicine field is that it is hard enough for a practitioner to know how good another practitioner is in a certain area before getting treated by them, so imagine how hard it is for a lay person!

While the MRI may be costly depending on your situation, it should give you an idea of whats going on and be worth the expense in the long run.

Hope that helps.

[rubberbones]

I have had a lifetime of sprained ankles. They take a long long time to heal. About every 6 month I would sprain my ankle, bad. So ten years ago I sprain my ankle down in central America, NO ICE, no doctor. Basically I totally avoided any aspect of the R.I.C.E. therapy. It was a bad sprain, I limped it out, just kept going. That was ten years ago. I had not injured my ankle for ten years after that. I will not ice an injury, keep it moving and elevate it.

[vam44]

There are some kinds of ankle injuries where the talar dome has microfractures or damage to the cartilage surface. These do not always show up on a normal Xray but will with and MRI.

If this is the case then you will need to be very patient and get some good advice about how much to load your ankle.

If these problems are excluded then often it is a matter of making sure that the ankle joints and foot joints are moving adequately, good muscle strength around the joint and some good balance exercises.

[markmiller]

I do not believe that R.I.C.E. is a viable treatment for an ankle sprain. There are so many different kinds of damage from ankle injury. And rest and ice alone cannot heal any of them. 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.

I am not saying that rest is not important after an ankle injury. I am simply saying that rest alone is not good. And ice is really only effective for about 2 days. You really 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 sprained my ankle numerous times playing basketball and I always used RICE before. It would take me about a month to recover. Eventually, I looked for a better way to rehab as my knowledge of the body grew. I found a very simple at home rehab treatment for sprained ankles called H.E.M.

I have yet to find anything else that is simple to do and works so effectively. I noticed a substantial reduction in swelling in 2 days and was walking normally again in 4. I went for a run on day 6 and had no pain. H.E.M. contains a complete rehab and prehab treatment program with a wide variety of healing techniques, stretches and exercises. I recommend it very highly. Give it a shot and let me know what you think.

Best,
Mark