If you have suffered a sprained ankle that just doesn’t seem to be getting better, watch this video to learn two common reasons people still have ankle pain weeks after an ankle sprain and what you could do in each scenario. Many people don’t even see a doctor for the injury. The next few days it became incredibly swollen and became bruised around the entire foot. The severity of the injury depends on the extent of damage and the number of injured ligaments. We'll often drill into the bone in that area to try to stimulate the body to form some scar cartilage over that region. Doesn't have any instability, doesn't really have any pain day to day, but, when he's trying to play sports, this is still limiting him. There's clear anterior instability. This one is subluxating out to the side. The X-rays will be negative unless there's severe ligament disruption and instability. If Your Ankle Still Hurts After 3 Months If pain or discomfort persists however, further treatment may be required. Scenario #5 is a 38-year-old female. This video will also equip physicians with ways to identify the most common causes of persistent ankle instability, and provides guidance to identify the point at which further evaluation by an orthopaedic surgeon could be needed. Scenario #2 is a 22-year-old male basketball player. Decide if you should see one, find one suited for you and get the most from your visit. Sprain ankle will take time to heal. We incorporate that into the repair for some additional stability. This can be a significant source of pain. That's not a positive test. Sprained Ankle Still Swollen After Nearly 2 Months. Should you try to play through a sprained ankle? He recovered fairly quickly but the ankle has never quite felt right, never 100%, and it bothers him a lot with strenuous activity. Dr. Jeffrey Kass answered 27 years experience Podiatry Recommended Products and Resources It's a little bit more rare that this pain persists for a longer period of time. It's normal for it to still hurt a mild sprain takes from 2-4 weeks to heal a moderate sprain takes 4-6 and a severe sprain takes 6-12 weeks or longer it other problems too it sounds like u have a moderate sprain so I would say sit out of basketball for a few weeks till it dosent hurt . Your sprained ankle usually will swell and hurt following the injury. Should I be doing PT? I iced/elevated it immediately after, but the next few days I unfortunately did not take care of it like I was supposed to. In the following video, through six patient profiles, Dr. Farber explains the physical and imaging diagnostics for each variant of ankle injury, the likely cause of injury, and the medical (or surgical) therapy for its resolution. You can see the branches of the superficial peroneal nerve. A CT scan will show it but you have to have the suspicion and the knowledge that this might be an injury in order to even pursue a CT scan. Prolonged pain without inflammation occurs primarily with nerve injury. Due to a large number of questions I have received over the years asking about products for health, injuries, performance, and other areas of sports, exercise, work and life, I have created an Amazon Influencer page. This is often a delayed presentation because, usually, we expect these to get better. You can see these tendons should be restricted back here. I want to help you! They cover the sensation over the entire top of the foot. Find a physical therapist that is right for you and your injury as well as who and what to watch out for! Scenario #8 is a 46-year-old male who sprained his ankle falling on the stairs and has a hyper-plantar flexion injury, as well as inversion. That seems to help very well in most patients. This is the lateral ankle here, so this is the front of the ankle. Again, these patients, usually day to day living, this is not a big deal, but it's when they try to ramp up to more strenuous activities that they can't get back there. THE CONTENT DOES NOT AND IS NOT INTENDED TO CONVEY MEDICAL ADVICE AND DOES NOT CONSTITUTE THE PRACTICE OF MEDICINE. display: none; Most ankle sprains will heal with standard RICE therapy (rest, ice, compression and elevation) within two to 12 weeks. Are dog walkers really more likely to get COVID-19. Sorry, to see if that can adequately restore their sense of stability and allow them to return to activity. It can also cause a tear to that tendon. A patient who continues to be unstable at this stage, with giving-way episodes, they will often benefit at first from a course of physical therapy if they haven't had that already. Here, you see this edema within the bone along the medial talus. The pain is often poorly localized. Dr. Farber's counsel to primary care physicians confronting protracted pain after an ankle sprain is to remember that an ankle sprain is still usually an ankle sprain "until it's not". This program offers a comprehensive Q&A collection on injuries such as peroneal tendon subluxation, navicular fractures, Lisfranc injuries and more. I still have ankle pain a month after my ankle sprain. It's a very superficial nerve, very susceptible to injury. You've ruled out all the other things, their pain is appropriate and clinically appropriate to this sort of diagnosis, and you offer them an arthroscopy. That should recreate pain at the ankle. According to Dr. Farber, "Non-healing ankle sprains are typically caused by discreet damage to the interior bones, cartilage and ligaments of the foot or at its junction with the tibia and fibula." If those things fail, then surgery to repair the ligament is often very helpful. For a tear, sometimes therapy and bracing is adequate to take care of this. Sprained Ankle Still Swollen After 2 Weeks. This is a scenario where we can have some injury to the peroneal tendons. That's a classic eversion ankle sprain injury while playing basketball that we see quite commonly. X-rays are negative, but an MRI shows this fluid right here in the recess of the syndesmosis. Flexor pronator strain: Signs, symptoms and treatment of this elbow injury, Tips For Choosing the Perfect Physical Therapist For You. I sprained my ankle over three months ago, I was told that it’s a grade 2 ankle sprain and walked with boot for 4 weeks. Or did you just not rehab the ankle enough, and you need physical therapy? What you'll notice here is some abnormality at the base of the fifth metatarsal. I was running and fell down the stairs and I twisted my ankle. We'll be talking about the ankle sprain that doesn't heal. The pain is sort of deep in the ankle. This is indeed a Jones fracture, and it is an area of the bone that sometimes doesn't heal very well, my point being here is that you just need to make sure you examine this as a possible source of their injury. I went over my ankle when someone pushed me while I was running just under two weeks ago. These patients respond very well to excision of this tissue, but oftentimes they'll get better with time or with a local cortisone injection. YOU SHOULD NOT RELY ON THIS INFORMATION AS A SUBSTITUTE FOR, NOR DOES IT REPLACE, PROFESSIONAL MEDICAL ADVICE, DIAGNOSIS, OR TREATMENT. "And the longer an ankle injury persists without proper treatment, the greater the likelihood that permanent disability will result.". It is still swollen and can only move two of my toes. Here's a potential scenario where the snowboarder gets injured. When these two bones come together during activities, or even just walking, it pinches all this tissue here and causes pain. "An ankle sprain that lingers beyond 3 months is often an injury to a bone, tendon or ligament that is unlikely to heal without intervention," he says. When should you be concerned that something is wrong? If they're really having a tough time, using some neuroactive-type medications, whether that be Nortriptyline or Gabapentin or Cymbalta or similar things like that to help attenuate the nerve pain, can be helpful. Scenario #1 is a 20-year-old female. Tore muscle in tigh a week ago still swollen. The point here is you always need to check the foot when people have an ankle sprain and turn it because you can sometimes end up with a fracture of the fifth metatarsal. She uses a lace-up brace, which makes her feel better for activity, but this is still a significant problem for her. If you need more information about your particular injury and options to treat it and recover quickly and safely, talk to me one-on-one! This is the fibula right here. The way I put this together was to have a couple of different scenarios that go over some of these potential injuries. Her bruising and swelling has resolved but she continues to have a lot of pain over the lateral foot and ankle. When you turn the ankle, this nerve gets put on tension and you can have a traction injury. Is it possible that you have a worse injury? This is an arthroscopic image of the ankle. She has several episodes of giving way over the past six months. Copyright 2020 Dr. David Geier Enterprises, LLC, Sprained ankle: Mechanism of injury, diagnosis and initial treatment of an ankle sprain. You can see this on a regular patient just by surface anatomy. She used a lace-up ankle brace for a couple of weeks but really continues to have a lot of pain, especially along the anterolateral aspect of the ankle, and especially when the ankle is really everted and rolled out to the side. Even severe sprains should be healed and pain-free after 8 weeks, so if pain persists (with inflammation) there is likelihood of an undiagnosed fracture, cartilage tear, or ruptured tendon. They need a good bit of bracing for a while and rehab, and mostly time, but they will almost always settle down. That's very successful surgery. However I still have pain in it sometimes when I put pressure on it. Scenario #4 is an 18-year-old football player who twisted his ankle on the turf about a month ago.