Member Case Study: Swollen Ankle

author : AMSSM

comments : 0

In the fall I was running on some trails and rolled my ankle pretty bad. I took a few weeks off from running and let it heal. Every so often, my ankle feels swollen, or off.

Member question from aarondavidson
It's not so much an injury but a nagging issue. In the fall I was running on some trails and rolled my ankle pretty bad. I took a few weeks off from running and let it heal. Every so often my ankle feels swollen, or off. Where if it was your shoulder or knee it would almost feel like it isn't tracking correctly. If I point my toes and draw circles in the air, my ankle will crack. I can run/cycle/swim on it fine. Any idea why my ankle sometimes feel swollen?

Answer from Dena Florczyk, MD
Member AMSSM

Ankle sprains are one of the most common musculoskeletal injuries in athletic or recreational activities. The most common form of ankle sprain involves an inversion injury (rolling of the ankle) while the foot is plantar-flexed, causing damage to the lateral (outside) ligaments of the ankle. The severity of the sprain is graded on a scale of I (mild) to III (severe) based on the degree of the ligament tear, loss of functional ability, swelling, pain, bruising, and difficulty bearing weight.

Over the first four weeks after the injury, pain and swelling tend to decrease, and there is some evidence that using an external support device (semi-rigid ankle support, lace-up ankle support, tape, or bandage) may reduce swelling, time to return to sport, and subjective instability. In general, early treatment recommendations consist of early weight bearing and mobilization in addition to protection, rest, ice, compression and elevation. Six to eight weeks after the sprain the newly formed collagen fibers of the ligament can withstand almost normal stresses, but full maturation and remodeling of the ligament takes six to twelve months.

A large number of patients may continue to have ankle pain, sensation of instability, and swelling up to a year after the injury. Despite the common occurrence of ankle sprains, there is little known about prognostic factors to predict recovery and occurrence of re-sprains. There is emerging evidence that chronic ankle instability and recurrent sprains can precipitate ankle osteoarthritis and joint degeneration.
  
If you are continuing to feel instability, swelling, or cracking, you should see your sports medicine doctor to assess your ankle stability and obtain radiographs. This will help to evaluate for any potential surgical causes for your symptoms such as a high ankle sprain or peroneal tendon dislocation.

If ankle instability is present, you may benefit from rehabilitation with balance training, strengthening, or use of an external support (lace-up ankle brace) to reduce re-injury.

Hope this helps and good luck with your training!
 

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date: May 25, 2009