How Long Does A Sprained Ankle Stay Swollen
The swelling associated with a sprained ankle can last anywhere from 2 weeks up to 2 months, depending on the severity of the injury.

How long should an ankle be swollen after a sprain?

Sprained Ankle | Orthopedics & Sports Medicine Every day, approximately 25,000 people sprain an ankle. Ankle sprains happen when the foot twists, rolls or turns beyond its normal motions. When a ligament is forced to stretch beyond its normal range, a sprain occurs.

Severity Physical Examination Findings Impairment Pathophysiology Common Treatment Protocol
Grade 1 Minimal tenderness and swelling Minimal Microscopic tearing of collagen fibers Weight bearing as tolerated

No splinting / castingIsometric exercisesFull range-of-motion and stretching / strengthening exercises

Grade 2 Moderate tenderness and swelling, along with a decreased range of motion and possible instability Moderate Complete tears of some but not all collagen fibers in the ligament Immobilization with air splint Physical therapy with range-of-motion and stretching / strengthening exercises
Grade 3 Significant swelling, tenderness, and instability Severe Complete tear / rupture of ligament Immobilization Physical therapy similar to grade 2 sprains, but over a longer period Possible surgical reconstruction

Reprinted with permission from Bernstein J (ed): Musculoskeletal Medicine, Rosemont, IL; American Academy of Orthopaedic Surgeons, 2003, p.242. The amount of pain and swelling you experience will depend on the amount of stretching and tearing of the ligament.

  1. Instability occurs when there has been complete tearing of the ligament or a complete dislocation of the ankle joint.
  2. Swelling and pain typically last 2-3 days.
  3. Walking may be difficult and crutches may be needed.
  4. When an ankle sprain is suspected, your doctor will perform a physical exam which may be painful.

The doctor may need to move your ankle in various ways to determine which ligament has been damaged. Your doctor may be able to tell you the grade of your ankle sprain based upon the amount of swelling, pain, and bruising. If there is a complete tear of the ligaments, the ankle may become unstable after the initial injury phase passes.

  1. If this occurs, it is possible that the injury may also have caused damage to the ankle joint surface itself.
  2. Your doctor may order X-rays to make sure you don’t have a broken bone in the ankle or foot.
  3. A broken bone can produce similar symptoms of pain and swelling.
  4. An MRI (magnetic resonance imaging) scan may be ordered if your doctor suspects a very severe injury to the ligaments, injury to the joint surface, a small bone chip, or other problem.

The MRI may be delayed in order to allow any swelling and bruising to resolve itself. Most ankle sprains need only a period of protection to heal. The healing process takes about four weeks to six weeks. The acronym R.I.C.E is a good way to remember what to do:

Rest your ankle by not walking on it. Ice should be immediately applied. It keeps the swelling down. It can be used for 20-30 minutes, 3-4 times per day. Compression dressings, bandages, or ace-wraps immobilize and support the injured ankle. Elevate your ankle above your heart level as much as possible for the first 48 hours.

Depending upon the grade of injury, your doctor may recommend a cast boot, air splint, and/or crutches. Even a complete ligament tear can heal without surgical repair if it is immobilized appropriately. Your doctor may tell you to incorporate motion early in the healing process to prevent stiffness.

Ultrasound Electrical stimulation Active range of motion exercises or controlled movements of the ankle joint without resistance Water exercises if land-based strengthening exercises, such as toe-raising, are too painful. Lower extremity exercises and endurance activities as tolerated. Proprioception training

Non-steroidal anti-inflammatory drugs (NSAIDs) may be used to control pain and inflammation. Surgical treatment for ankle sprains is rare. Surgery is reserved for injuries that fail to respond to non-surgical treatment and for persistent instability after months of rehabilitation and non-surgical treatment. Surgical options include:

Arthroscopy – A surgeon looks inside the joint to see if there are any loose fragments of bone or cartilage, or part of the ligament caught in the joint. Reconstruction – A surgeon repairs the torn ligament with stitches or suture, or uses other ligaments and/or tendons found in the foot and around the ankle to repair the damaged ligaments.

All ankle sprains recover through three phases:

Phase 1 – 1 Week – Resting, protecting the ankle, and reducing swelling. Phase 2 – 1 to 2 Weeks – Restoring range of motion, strength, and flexibility. Phase 3 – Weeks to Months – Gradually returning to activities that do not require turning or twisting the ankle and doing maintenance exercises. Later followed by activities that require sharp, sudden turns (cutting activities) such as tennis, basketball or football.

If an ankle sprain is not recognized and treated, chronic problems of pain and instability may result. : Sprained Ankle | Orthopedics & Sports Medicine

Why is my sprained ankle still swollen after 2 weeks?

Pain – There are several common causes of ankle pain that does not go away: The sinus tarsi syndrome Lingering inflammation, scar tissue, or a partly torn ligament can occur in the hollow place in the side of the anklebone called the sinus tarsi ( sinus in Latin means hollow or sunken and the tarsus is the ankle).

This is the most common cause of the sprained ankle that won’t heal. While it can be difficult to discern this problem on an X-ray or MRI, a physical exam by a dance medicine specialist can pinpoint the diagnosis by locating the exact area that hurts. A tarsal coalition Residual pain in the sinus tarsi after the original sprain heals can also be due to an unrecognized tarsal coalition.

The ankle has two components: the regular ankle joint that moves up and down, and the subtalar (ST) joint beneath it that moves in and out. Together, they make up the ankle joint complex. Some people are born with limited motion in their ST joint because the bones in this area are joined together where they ought to be separate—a coalition,

It can usually be seen on an X-ray or MRI. This condition is present in about five percent of ankles. It usually occurs in one ankle only, rather than both. As with a sprain, it can be mild, moderate, or severe. In dancers, it is usually mild or it would have caused trouble before the sprain. Dancers with mild symptoms can often work around it.

The high ankle sprain This is marked by tenderness in the front of the ankle on the outside. Unlike routine ankle sprains where the main damaged ligaments lie right in the sinus tarsi, this one affects a ligament that is higher up, at the level of the ankle joint itself.

  • This is the so-called “high” ankle sprain, which can be a real bugaboo because it takes two to three times longer to heal than a routine sprain.
  • It may not show up on medical tests, so the diagnosis is usually made on the basis of the physical exam.
  • Secondary problems Lastly, there are several conditions, such as FHL tendonitis (“dancer’s tendonitis”) and the os trigonum syndrome that seem to pop up out of nowhere.

Dancers often think that the residual pain is part of the healing process when it is actually a separate problem. Later the sprain may heal, but these conditions can continue to be painful and may even require surgery if left unaddressed.

Why is my sprained ankle still swollen?

How long does a sprained ankle stay swollen? – In Conclusion – An ankle sprain is one of the most common musculoskeletal injuries. It involves a stretched or torn ligament. Ligaments are thick pieces of connective tissue that connect one bone to another.

The most common ankle sprain involves the ligaments on the outside of the ankle. There are three types of ankle sprains: Grade 1, 2, and 3. The severity of the injury and associated symptoms increases from Grade1 to Grade 3. Ankle swelling, tenderness and difficulty walking on the ankle are all symptoms suggestive of an ankle sprain.

There are specific manual tests to determine the integrity of your ankle ligaments. At the Centeno-Schultz Clinic, ultrasound is used in the evaluation of all ankle injuries. A stress ultrasound is an important tool in assessing the health of a ligament.

How long a sprained ankle stays swollen is dependent upon the severity of the injury. Persistent swelling is a warning sign that there is an underlying problem. The most common cause of persistent swelling is instability of the ankle joint due to laxity or injury to the supporting ligaments. If left untreated patients are at risk for developing ankle arthritis and additional injury to tendons, muscles, and ligaments.

If you or a loved one continues to have swelling after an ankle sprain know that the swelling is a warning sign! If left untreated things can be much worse leaving you with fewer treatment options. Schedule a Telemedicine consult with a board-certified physician who can review your history, studies, and provide you the best nonsurgical treatment option.

Why is my sprained ankle still swollen after 3 weeks?

How long will a sprained ankle stay swollen? – Like with a knee replacement, the ankle joint swells after a sprain. This often causes worry and concern for peopl e who see a swollen foot, persistent swelling, or a blue ankle for a long time. However, swelling after an ankle sprain is usually a common occurrence,

The edema can persist for several weeks or even months, but the hematoma gradually fades away. Generally, the swelling is at its maximum in the first few days after the injury, But it can still be relatively large even 2 or 3 months after an ankle sprain, even at stage 1, This isolated sign should not be a cause for concern.

The ankle will gradually return to its normal size over months or years, even after a severe sprain. And if it takes a while to recover, you should look on the bright side: in the vast majority of cases, you can still resume all physical and sports activities you want. Ankle sprain: swelling of the external malleolus, in the days following the sprain.

Is it OK to walk on a sprained ankle?

Should I Walk On a Sprained Ankle? – While it is possible to walk on a sprained ankle, it isn’t recommended. Walking on a sprained ankle can delay the healing process and increase your risk for complications. Ankle pain, instability, and arthritis are common complications of a sprained ankle.

  1. These chronic conditions often require long-term treatment and can prevent you from engaging in your favorite sports and activities.
  2. After you sprain your ankle, you will need to stay off it as much as possible to allow it to heal fully.
  3. This may be frustrating at first, but it will benefit you more in the long run.

Trying to push through the pain and resuming your activities can worsen the injury and delay its healing.

Can I walk on sprained ankle if its still swollen?

Healing a sprained ankle – Ankle sprains usually heal well, if given a chance to rest. For most people, the healing process takes 4-6 weeks. We here at Maryland Orthopedic Specialists recommend the RICE protocol, which involves:

Resting your ankle (meaning you shouldn’t walk on it) Icing your ankle immediately and throughout healing to minimize swelling Wearing a compression device like bandages or athletic tape Elevating your ankle above your heart for the first 48 hours

The length of time you should rest your ankle depends on the grade of your sprain. Understandably, a Grade 1 sprain recovers more quickly than a Grade 3 sprain. Regardless of the grade of your sprain, though, your healing goes through several phases. For the first week or so following your injury, the goal of treatment is to rest, protect the ankle, and reduce swelling and pain.

Is it OK to walk on a sprained ankle after 2 weeks?

Is it OK to walk on a sprained ankle? – February 1st, 2023 If you’ve just sprained your ankle, you might be wondering if it’s OK to walk on it. The answer that most medical professionals may give you is no. In fact, most experts suggest that immobilizing the foot and limiting weight-bearing activities for up to two weeks is the best course of action for a newly sprained ankle.

  1. A sprained ankle occurs when one or more of the ligaments in your ankle are overstretched or torn.
  2. A medical study reports that more than 23,000 U.S.
  3. Adults per day require treatment for an ankle sprain.
  4. With so many ankle sprains happening on a daily basis, it can be important to learn the dos and don’ts behind them.

Physical therapists can be a major resource for those with ankle sprains, These specialists can help you build you an effective recovery plan for your sprained ankle.

How long is too long for ankle swelling?

May is National Physical Fitness & Sports Month, a time to celebrate and promote healthy living. Regular physical activity reduces the risk of a variety of medical conditions and improves quality of live, but it can also lead to the occasional injury.

a period of rest while avoiding sports or impact activitiesa short period of immobilization in a surgical boot, brace, or bandagetaking anti-inflammatory medications for a few days, if the pain is particularly severe

An important part of recovery is early weight bearing following the sprain. In fact, walking on the sprained ankle can actually improve recovery and stimulate stronger healing of the injured ligaments and tendons. One important thing to keep in mind is that ankle swelling can last 2-3 months after the injury, even if the pain has completely gone away.

Compression socks can alleviate the swelling, but time is the best medicine. More severe ankle sprains may require additional treatment. Some patients may benefit from physical therapy to help rebuild strength and speed up recovery. If the pain hasn’t improved after about six weeks of non-operative treatment, an MRI is usually ordered to check for tendon, ligament, bone, or cartilage lesions that might require more specific treatments, including surgery.

MRIs are very rarely needed shortly after the injury, as they don’t usually change the treatment plan during the first six weeks. While ankle sprains don’t usually cause long-term problems, they are painful and inconvenient, and prevention is the best medicine.

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How do I know if I tore a ligament in my ankle?

Sprain: Ligament injury – Have you ever been running through the grass then all of a sudden your foot lands on uneven ground, and you feel your ankle wrench followed by a jolt of pain? It is likely that your ankle is sprained, or twisted. A sprain involves the overstretching or tearing of the ligaments, which are the fibrous connective tissues that connect bones to each other and stabilize them.

  • Sprains occur when the joint is forced into an unnatural position,” Mufich said.
  • They happen most often in the ankle but can occur at any joint, such as the wrist or knee.” Ligament injuries on the outside ankle occur when the ankle turns outward and the foot twists inward.
  • On the other hand, inner-ankle sprains, which are less common than those on the outside of the ankle, result from the ankle rocking inward and the foot turning outward.

Joint or muscle pain, inflammation, hampered movement, tenderness and bruising are symptoms of a sprain. The severity of the sprain can range from mild to serious. A tweak of the ankle could result in an overstretched ligament that becomes tender, swollen and stiff, but the ankle should still be stable enough to support the weight of walking.

How long can an injury stay swollen?

2. How long does swelling last after an injury? – Depending on the severity and type of injury, swelling can last from a couple of days to a few weeks.

Why is my sprained ankle not getting better?

An error occurred. – Try watching this video on www.youtube.com, or enable JavaScript if it is disabled in your browser. Dr. Farber’s patient profiles include: Snowboard Injuries: “Snowboarder’s Fracture” Snowboarding-related ankle injuries are more common than skiing injuries due to the increased range of motion that the snowboarding boot allows compared to a downhill ski boot.

This patient suffered a less common ankle injury that is seen specifically in snowboarding and sometimes in soccer players called a “snowboarder’s fracture.” This is a discrete break in the talus bone at the subtalar joint of the foot. Best treatment often involves early surgery to avoid lasting pain and disability.

(For an alternative sprain originating in bone injury, also see patient profile #5.) Cartilage Fractures: Post-recovery pain with strenuous activity This patient, who recovered quickly from the initial injury, but who continued to feel deep pain with strenuous activity well after the normal healing period, is suffering from a virtually invisible impact or shear fracture of the osteochondral surface on the talus bone.

According to Dr. Farber, the best treatment is often arthroscopic debridement and cartilage stimulation procedures. Ankle Ligament Injuries: Transient pain and post-recovery instability With a history of ankle sprain, this patient presented with pain and ankle instability months after a precipitating injury as a result of tearing of the ligaments near the ankle bone at the outside aspect of the foot/ankle.

If the injury does not improve with bracing and therapy over time, the best treatment is surgical ligament repair. (For an alternative ankle sprain scenario, also see this patient, whose high ankle sprain was treated with long-term bracing). Scar Tissue: Persistent pain that responds to steroid therapy Since this patient’s persistent pain at the outside of the ankle responds to local anesthetic and steroid therapy with minimal diagnostic imaging studies, it is likely the result of scar tissue resulting from an injury and now causing impingent in the ankle with bone movement.

  • If the pain does not resolve with steroid therapy and time, the best treatment is surgical excision of the scar tissue via arthroscopy.
  • Tendon Injury: The patient with post-inversion sprain pain This patient has nagging pain at the side and back of the ankle months after an inversion ankle sprain.
  • This pain is caused by torn tendons.

If bracing and physical therapy does not resolve the ankle injury with time, the best treatment is surgery to repair the damaged tendons. (For an alternative ankle sprain originating in tendon injury, also see the this patient, whose damaged peroneal tendons at the rear of the foot were surgically repaired).

Peroneal Nerve Injury: The patient with pins and needle sensation months after ankle sprain This patient’s ankle sprain involved a stretch injury to the superficial peroneal nerve due to severe inversion and plantarflexion position of the ankle resulting in damage to the peroneal nerve at the front of the ankle.

Best treatment, involving medications, expectations, and time, is based on accurate diagnosis. 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”.

  • 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.
  • And the longer an ankle injury persists without proper treatment, the greater the likelihood that permanent disability will result.” In other words, Dr.

Farber concludes: Once it’s clear that ankle sprain is complicated and not resolving with the usual treatments, the best recourse is a referral to a qualified orthopaedic foot and ankle surgeon. My name is Daniel Farber. I’m assistant professor of clinical orthopedics at the University of Pennsylvania Perelman School of Medicine, director of the foot and ankle fellowship there, as well as the foot and ankle research.

Today, however, we’ll be talking about a more clinical topic. We’ll be talking about the ankle sprain that doesn’t heal. First of all, we’re going to review some of the ankle anatomy and talk about ankle sprain mechanisms, grading and treatment of ankle sprains, and, finally, we’re going to really focus on going through some case scenarios on ankle sprains that don’t heal and what the pathology behind that is.

Then, we’ll briefly review what we’ve gone over. The way I put this together was to have a couple of different scenarios that go over some of these potential injuries. Scenario #1 is a 20-year-old female. She injured her ankle snowboarding about six weeks ago.

  • She was seen by the ski patrol on the hill, told that she just had a sprain.
  • 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.

Here’s a potential scenario where the snowboarder gets injured. You can see her coming down the hill in her best form, coming off a little jump, and, boom, she hits the ground. The foot tends to dorsiflex and evert and creates this injury that you see here.

  • What you can see subtly on the X-ray is this little abnormality here along the lateral aspect of the talus.
  • This is commonly referred to as a snowboarder’s fracture.
  • On a CT scan, it becomes much more clear that, as the calcaneus comes up, it kind of hits against the fibula, it nutcrackers this little fragment here and breaks it off.

This is part of the joint, of the subtalar joint, so it’s an important fragment. It’s a dorsiflexion eversion mechanism. That nutcracker effect happens on the talus. This can be very easily missed because, on regular ankle films, it’s not always as clear as the X-ray that I showed you.

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. The importance of this injury is that it’s much better to treat this early surgically. If it’s a really small fragment, you can sometimes treat this with nonoperative care, but a lot of times, especially with athletic patients who are very active, if this is a small fragment or it’s broken into a lot of little pieces, they do much better with early excision.

If it’s a significant fragment, they’ll do better with fixing this. This is a patient of mine from a couple of years ago. You can see this is a pretty large articular surface fragment that’s fractured. Then, you’ll see in this image here, the peroneal tendons, running right in this area.

  1. This is the lateral ankle here, so this is the front of the ankle.
  2. You can see the two little screws here that we used to fix this into place.
  3. Scenario #2 is a 22-year-old male basketball player.
  4. Sprained his ankle about six months ago.
  5. He recovered fairly quickly but the ankle has never quite felt right, never 100%, and it bothers him a lot with strenuous activity.

The pain is sort of deep in the ankle. 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. Here’s a potential injury of the ankle. You’ll get a little close-up. Look at #50 there as he comes down and rolls his ankle.

If you watch a little linger, you get this close-up view. As his foot comes down, you see that rolling mechanism of the ankle. That’s a classic eversion ankle sprain injury while playing basketball that we see quite commonly. His X-rays are pretty normal. You don’t see any fractures or any clear abnormalities but, because he’s now gone a number of weeks with persistent pain, he got an MRI scan.

Here, you see this edema within the bone along the medial talus. This is consistent with an osteochondral injury of the talus. What’s happened is basically a shear sort of fracture of the cartilage. Then, you get this fluid that gets pushed down into the bone.

This can be a significant source of pain. This is often a delayed presentation because, usually, we expect these to get better. I think a lot of minor osteochondral injuries do happen with these injuries but they get better on their own and don’t need any additional treatment other than the standard treatment for an ankle sprain.

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 pain is often poorly localized. They kind of just feel it deep in the ankle, and it doesn’t always correlate.

If they feel the pain on the inside part of the ankle, they can still have the lesion on the outside part of the ankle. It’s pretty classic that they’re very bad at localizing where the injury is. X-rays are often negative. Sometimes, you can see some lucency in the talus that suggests there’s an injury there but, in more acute injuries, it’s often very hard to see, so MRI or CT scan can be very helpful.

In younger patients, a period of casting can be helpful to get this to heal. In older patients, and I’m not talking that old, but really past adolescence, oftentimes surgery is necessary to clean out the area of cartilage injury. We’ll often drill into the bone in that area to try to stimulate the body to form some scar cartilage over that region.

This is an arthroscopy. What you can see here is this is a flap of cartilage that’s coming up from the normal cartilage surface here. That’s part of that cartilage injury. What we’ve done now is we’ve basically cleaned out that loose cartilage. Now, we have a stable edge of cartilage. Here is exposed bone.

This is a significant injury, where you lose cartilage. We then drill into the bone and what we want to see is this little bit of bleeding here. That’s those good marrow elements that have a lot of stem cells and multi-potential healing cells that can form some scar cartilage over this whole area so that at least that joint has a better gliding surface.

That seems to help very well in most patients. Scenario #3, a 32-year-old female with multiple prior ankle sprains. Her last sprain was about eight months ago. She has persistent pain and swelling, doesn’t trust her ankle. She avoids sports. She has several episodes of giving way over the past six months.

You examine her in the office, and this is just the textbook image that we saw earlier. Again, you see this sort of dimple sign. There’s clear anterior instability. 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.

That’s really to focus on proprioception and strengthening of the surrounding musculature to see if that can be adequately, Sorry, to see if that can adequately restore their sense of stability and allow them to return to activity. These patients often need bracing for more strenuous sporting activity to give them the sense of stability that they need.

If those things fail, then surgery to repair the ligament is often very helpful. This is a diagram of the classic Brostrom-type repair. This is the fibula right here. This is the calcaneofibular ligament, which has been cut and shortened and repaired. You don’t always actually have to repair this.

  • The most important part is repairing what’s called the anterior talofibular ligament.
  • That ligament is actually underneath here.
  • This is the extensor retinaculum, which holds down the tendons on the front of the ankle.
  • We incorporate that into the repair for some additional stability.
  • Underneath that is the ligament repair.

That’s very successful surgery. People do very well with that and they’re able to return to most sporting activities, but it does take about six months before they can go back to real strenuous activity. Scenario #4 is an 18-year-old football player who twisted his ankle on the turf about a month ago.

  1. They did rest, ice, compression, elevation, and told him he’d be better in a couple weeks because it didn’t look like that bad a sprain but he continues to have significant pain, pointing to the anterolateral aspect of the ankle.
  2. The pain travels up the leg from that point.
  3. X-rays are negative, but an MRI shows this fluid right here in the recess of the syndesmosis.
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This, as we talked about earlier, is a syndesmotic injury, or your classic high ankle sprain. This is the injury to the syndesmotic ligaments that connect the fibula to the tibia, and so, when the ankle externally rotates, that’s what puts stress on these ligaments.

You can diagnose this with what’s called a squeeze test where you squeeze the fibula against the tibia proximally in the leg, just below the knee. That should recreate pain at the ankle. People often complain of pain over the tibia where you put your hand or your thumb. That’s not a positive test. It has to be pain that they feel down in the ankle.

The X-rays will be negative unless there’s severe ligament disruption and instability. That’s a different sort of injury. These take a long time to heal. They need a good bit of bracing for a while and rehab, and mostly time, but they will almost always settle down.

Scenario #5 is a 38-year-old female. She sprained her ankle about nine months ago. She got better for a while but has pain in the anterolateral ankle. No instability. She did some therapy, which didn’t help, but she did get a cortisone injection in the ankle and that seemed to give her excellent relief for a period of time.

This scenario, this is really a diagnosis of exclusion until you get to this point. This is an arthroscopic image of the ankle. Patients can develop what’s called an anterolateral impingement lesion. What that is is essentially hypertrophic scarring of the lateral ankle ligaments or the capsule.

That creates, essentially, an impingement lesion where, when the ankle dorsiflexes and comes up, this excess tissue that you see here in the ankle. Here is the talus and up here is the tibia. When these two bones come together during activities, or even just walking, it pinches all this tissue here and causes pain.

These patients respond very well to excision of this tissue, but oftentimes they’ll get better with time or with a local cortisone injection. MRIs are not very helpful. They often don’t show this lesion. We’re looking at some research to see if ultrasound may be more helpful in finding these lesions, but sometimes it’s simply a diagnosis of exclusion.

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 will often solve the issue for them. Scenario #6 is a 42-year-old female. She turned her ankle stepping off a curb about six weeks ago. They placed her in an air stirrup in the ED but that didn’t really help.

Her bruising and swelling has resolved but she continues to have a lot of pain over the lateral foot and ankle. Here are her X-rays. What you’ll notice here is some abnormality at the base of the fifth metatarsal. 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.

  1. 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.
  2. Treatment is often casting or a CAM boot.
  3. Most avulsion-type fractures will heal very readily.

The Jones fracture, like we see in this image here, often gives us trouble healing, and so, especially in athletic patients, we’ll consider putting a screw down the pike here to get this to heal more quickly. Here is an example of that where you see the screw crossing the fracture line.

  1. This, again, helps to get this to heal much more quickly.
  2. Scenario #7 is a 36-year-old female.
  3. She suffered an inversion ankle sprain about six months ago.
  4. She’s done well except she has this nagging posteriolateral ankle pain and swelling and sometimes popping.
  5. Worse with activity.
  6. She uses a lace-up brace, which makes her feel better for activity, but this is still a significant problem for her.

This is a scenario where we can have some injury to the peroneal tendons. This is an MRI image, axial image. This is the fibula here, tibia is here, and these are the peroneal tendons running behind there. You can see these tendons should be restricted back here.

  • They should be back behind the fibula.
  • This one is subluxating out to the side.
  • In that setting, that instability can cause pain.
  • It can also cause a tear to that tendon.
  • This is an injury to the superior peroneal retinaculum.
  • It can be simply a shift of the tendons.
  • It can also be a tear in the tendons.
  • Exam is very helpful to look for subluxation.

If you have their foot in a plantar flex position and a little bit eversion and you ask them to push against the side of their foot, you’ll sometimes feel those tendons shift out of position. MRI or ultrasound can be very helpful for diagnosis. For a tear, sometimes therapy and bracing is adequate to take care of this.

  1. If it doesn’t resolve, then surgery to clean out and repair the tendon is helpful.
  2. If it’s subluxation of the tendons and they really pop out next to the fibula, therapies are often not successful because it doesn’t help to restrain the tendon where it needs to be, and surgery to repair that retinaculum is quite helpful.

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. He now complains of pins and needles sensation in the dorsum in the foot, hypersensitivity over the top of the foot, and sometimes the pain will radiate up the anterolateral leg.

In this setting, this is what we often see, is an injury to the superficial peroneal nerve. You can see the branches of the superficial peroneal nerve. They cover the sensation over the entire top of the foot. You can see in this diagram, this whole area is covered by this single nerve. When you turn the ankle, this nerve gets put on tension and you can have a traction injury.

If you look closely at a lot of ankle sprains that you see, in the first few days, and sometimes even a few weeks, they’ll have irritation of this nerve, but it often quiets down. It’s a little bit more rare that this pain persists for a longer period of time.

You can see this on a regular patient just by surface anatomy. You can see the course of that superficial peroneal nerve right in this area. It’s a very superficial nerve, very susceptible to injury. This will get better with time. The most important thing that you can do is to diagnose this properly so you can let patients know that they will get better, it’s just going to take time.

Why Ankle Sprains Take A Long Time To Heal

Most of the time, the nerve recovers, but it can take a number of months. 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.

In summary, an ankle sprain is usually an ankle sprain, but sometimes it’s not. If it doesn’t get better, you want to further investigate this, both by physical exam, as well as diagnostic tests. It can be any of these diagnoses that we’ve talked about today, and there’s even more, but I won’t torture you with all the additional information there.

I want to thank you very much for your attention. It’s been an honor to have the opportunity to speak with you. Thank you.

Why has my ankle never healed after a sprain?

Dealing with Persistent Pain – Damage to the interior bones, ligaments, and cartilage can cause the ankle to not heal properly. Scar tissue or trapped fluid can also cause persistent pain. A visit to your foot specialist to undergo physical imaging and diagnostics is needed to find the proper treatment plan as every injury is different.

Do ankle sprains ever fully heal?

Why Won’t My Ankle Sprain Heal? Ankle sprains are some of the most common injuries that affect our patients. A simple misstep can cause significant pain and limit a patient’s ability to walk. People often ignore the severity of a sprained ankle and continue to perform everyday tasks while not fully healed, leading to even more ankle pain.

  1. Dr. Jeffrey Muroff, our podiatrist near Centereach, can treat your ankle sprains and give you the care you need.
  2. Symptoms Symptoms of an ankle sprain vary on the severity of the injury.
  3. Most patients will experience pain and soreness in the injured ligaments, as well as swelling, soreness, and stiffness throughout the entire ankle.

It does not take much to cause an ankle sprain. Even a minor ankle roll can lead to a sprain. Our podiatrist near Centereach can determine the severity of the sprain by listening to your symptoms and conducting X-rays and image studies. Why is My Ankle Not Healing? Your ankle isn’t healing because you need to give it more time.

While you might be able to walk on your sprained ankle, it will never completely heal if keep putting pressure on your ligaments. In addition to the usual symptoms, there may also be a bone bruise of a bone chip. Bone damage could take six to twelve weeks to heal, while ligament damage could take three to six months.

That is why it is so important to visit our podiatrist in Centereach to correctly diagnose your sprain.

Ways to Heal Your Ankle Include:– Keeping weight off your feet and icing your ankle will reduce swelling and heal your ankle at home.– Compression will control swelling and support your injured ankle.

– Elevate your foot and recline back. Having your ankle above your waist will improve the blood flow to your ankle. -A walking boot or short cast might be recommended based on the grade of the ankle sprain. – Physical therapy is a useful healing technique depending on the level of pain and grade of the sprain.

Ankle sprains require time to heal. While nobody wants to miss out on activities because of a sprained ankle, your pain and discomfort will intensify until you address it. Our podiatrist near Centereach, Dr. Muroff, will provide you with several options that will treat your ankle sprain and help your ankle to return to normal.

Feel free to contact us with any questions about ankle sprains. : Why Won’t My Ankle Sprain Heal?

Why is my sprained ankle not better after 4 weeks?

When is an ankle sprain more serious? – When you notice an absence of progress after 3-4 weeks this could indicate a further problem with your ankle. If, for example, you notice widespread bruising all around the ankle or see the bruise going down the foot, then it can suggest there is something more serious going on.

How do I know if my ankle sprain is Grade 1 or 2?

Varying Degrees of Ankle Sprains A sprained ankle is a very common injury. A sprained ankle can happen to athletes and non-athletes, children and adults. It can happen when you take part in sports or even by stepping on an uneven surface. Ankle sprains occur when the foot twists, turns or rolls beyond its normal motions.

  • A sprain can also occur if the foot is planted unevenly on a surface, beyond the normal force of stepping.
  • This causes the ligaments to stretch beyond their normal range in an abnormal position.
  • A ligament is an elastic structure.
  • Ligaments usually stretch within their limits, and then go back to their normal positions.

When a ligament is forced to stretch beyond its normal range, a sprain occurs. A severe sprain causes actual tearing of the elastic fibers. There are three grades for ankle sprains determined by the amount of force.

Grade 1: Stretching or slight tearing of the ligament with mild tenderness, swelling and stiffness. The ankle feels stable and it is usually possible to walk with minimal pain. Grade 2: A more severe sprain, but incomplete tear with moderate pain, swelling and bruising. Although it feels somewhat stable, the damaged areas are tender to the touch and walking is painful. Grade 3: This is a complete tear of the affected ligament(s) with severe swelling and bruising. The ankle is unstable and walking is likely not possible because the ankle gives out and there is intense pain.

A physician can diagnose a sprained ankle. X-rays are sometimes needed to rule out a broken bone in the ankle or foot. Broken bones can have similar symptoms of pain and swelling. If there is no broken bone, your physician will be able to tell you the grade of the ankle sprain based upon the amount of swelling, pain and bruising.

Grade 1: Use R.I.C.E. (rest, ice, compression and elevation). Ice should be applied immediately to help keep swelling down for 20-30 minutes up to four times daily. The ankle should be elevated above the chest for 48 hours. Rest your ankle and try not to walk on it. Use compression dressings and wraps to immobilize and support the ankle. Grade 2: Utilize the R.I.C.E. guidelines and allow more time for healing to occur. An immobilization device or splint is also recommended. Grade 3: Permanent instability can occur with a grade three sprain. A cast or a brace may be required for a couple weeks. Anti-inflammatory drugs like ibuprofen can be used to control pain and inflammation with a sprain. Surgery may be considered in younger, athletically active patients.

If an ankle sprain isn’t treated with the necessary attention and care, chronic problems of pain and instability can result. The best way to prevent ankle sprains is to maintain good strength, muscle balance and flexibility. Here are some additional prevention steps:

Wear good shoes Warm up before doing exercises and vigorous activities Pay attention to surfaces on which you run and walk Reinforce the foot and ankle’s stability with a brace if needed Pay attention to the body’s warning signs to slow down when you feel fatigue or pain.

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: Varying Degrees of Ankle Sprains

How do I know if my ankle sprain is serious?

How to Treat a Sprained Ankle? – RICE – Rest, Ice, Compression, Elevation is always the initial treatment for an ankle sprain whether severe or mild. A period of immobilization in a short leg cast, walking boot, or supportive brace is often prescribed.

Physical therapy will help to decrease swelling, increase range of motion and strength, and restore you to your prior level of function. Your therapist will also work on proprioception and balance exercises to improve the ankles/lower kinetic chains’ ability to adapt to changes in terrain and position sense when playing sports or walking down a crowded sidewalk.

Minor sprains often heal on their own. Initially RICE: Rest, Ice, Compression, Elevation is all that is needed. Your doctor may recommend a brace or splint for a few weeks and then slowly wean off as pain and swelling reduce. Minor ankle sprains can take anywhere from 2-4 weeks for recovery before returning to sports.

  1. Severe sprains will take longer to heal, anywhere from 6 -16 weeks.
  2. Prolonged pain, swelling, bruising, and weakness will often characterize a severe sprain.
  3. Patients are put in a walking boot to keep the ankle joint immobilized and to allow healing to occur.
  4. Physical therapy will be prescribed.
  5. Without proper treatment, you may wind up with chronic instability and are at risk for repeated ankle sprains.

Getting proper care for your ankle injury is key for a full recovery and getting back to sports. If you have suspected that you sprained your ankle, contact Paspa Physical Therapy to have one of our experienced physical therapists evaluate your ankle and recommend treatment.

Should you wrap a sprained ankle overnight?

How to Recover From a Sprain Quickly – If you think you’ve sprained your ankle, remember the acronym POLICE to help guide your treatment immediately after the injury and maximize your recovery time. Many people can recover from an ankle sprain within a few weeks of injury by following these guidelines.

Protection – Minimizing and modifying activity shortly after injury can go a long way after spraining an ankle. Some people may need assistive devices such as crutches or the use of a walking boot to help protect the ankle as it begins to heal. Optimal Loading – Progressive loading and activity after injury can help with gradually introducing motion to the foot and ankle.

In general, let your symptoms be your guide to increasing activity after an ankle sprain. Recent research suggests that early, gentle range of motion exercises help with healing. Try to gently “pump” your ankle up and down, make circles with your feet, and wiggle your toes often.

Ice – Intermittent use of ice throughout the day may help with lessening pain in the early phase of healing. The u sual recommendation is 15 to 20 minutes of ice to help with decreasing pain. Do not apply ice directly to the skin. Ice is best, especially for the first 48 hours after injury. Compression – Wrapping a stretchable elastic bandage around your foot and ankle can help minimize swelling after injury.

If you’re going to wrap your ankle, it is best to put the bandage on first thing in the morning, and then take it off at bedtime. You may need to adjust the amount of compression based on your symptoms. Start the wrap down by your toes and work your way up the ankle and then above the joint.

You should be able to slip two fingers under the elastic bandage and still have good feeling and circulation in your toes. Elevation – Propping the ankle up when sitting or lying down can also help with minimizing swelling after injury. Try to elevate your foot, if possible, above the level of your heart.

When your foot is down, the blood rushes down and gets trapped, leading to more swelling and bruising. We especially encourage elevation when icing the ankle to help with pain and swelling.

Can I wear shoes with a sprained ankle?

Which Shoes Should You Wear With a Sprained Ankle? –

Shoes can cause or worsen ankle pain, but they can also improve ankle pain and ankle sprains. Interestingly, changing into supportive shoes as soon as possible speeds up recovery after an ankle sprain. They do this by influencing the biomechanical alignment of the foot, providing support and cushioning, and aiding efficient energy transfer during motion. Shoes with sturdy soles and cushioning are best after sprains.

Will a sprained ankle heal on its own?

Letting your ankle heal – In many cases, your ankle sprain will heal on its own if you give it enough time. Minor sprains generally heal, while more serious ones can take six weeks or longer. The key here is staying off the affected ankle. Trying to walk — or even hobble — on it is only going to exacerbate the injury and slow the healing process.

R est, as we just explained

I ce for 15 minutes every few hours

C ompress the ankle using something like an ACE bandage

E levate it to minimize inflammation

If you do all of these things, you’re setting yourself up for the best chance of success. In the first few days after your sprain, staying off the ankle, keeping it elevated and compressed, and periodically icing it can go a long way.

When should I worry about a swollen sprained ankle?

Should I go to the doctor for an ankle injury? – Dr. Waryasz suggests medical attention for any of the following symptoms, especially if they last more than 24–48 hours:

Bruising or swelling in the area

Deformity, meaning your ankle looks misshapen

Popping or cracking noise, specifically when it’s associated with pain

Sudden, sharp pain

Tenderness when you touch the injured spot

Trouble moving your ankle, walking, weightbearing, or lifting your foot

An ankle sprain and a broken ankle can feel similar, and both can be serious. “Many people may think, ‘It’s just an ankle sprain,'” Dr. Waryasz says. “But sprains aren’t a ‘nothing’ injury. Many sprains can lead to chronic instability and problems down the road. A fair number of sprains lead to chronic instability of the ankle that can require surgery.”

How do I know if my ankle sprain is Grade 1 or 2?

Varying Degrees of Ankle Sprains A sprained ankle is a very common injury. A sprained ankle can happen to athletes and non-athletes, children and adults. It can happen when you take part in sports or even by stepping on an uneven surface. Ankle sprains occur when the foot twists, turns or rolls beyond its normal motions.

  • A sprain can also occur if the foot is planted unevenly on a surface, beyond the normal force of stepping.
  • This causes the ligaments to stretch beyond their normal range in an abnormal position.
  • A ligament is an elastic structure.
  • Ligaments usually stretch within their limits, and then go back to their normal positions.

When a ligament is forced to stretch beyond its normal range, a sprain occurs. A severe sprain causes actual tearing of the elastic fibers. There are three grades for ankle sprains determined by the amount of force.

Grade 1: Stretching or slight tearing of the ligament with mild tenderness, swelling and stiffness. The ankle feels stable and it is usually possible to walk with minimal pain. Grade 2: A more severe sprain, but incomplete tear with moderate pain, swelling and bruising. Although it feels somewhat stable, the damaged areas are tender to the touch and walking is painful. Grade 3: This is a complete tear of the affected ligament(s) with severe swelling and bruising. The ankle is unstable and walking is likely not possible because the ankle gives out and there is intense pain.

A physician can diagnose a sprained ankle. X-rays are sometimes needed to rule out a broken bone in the ankle or foot. Broken bones can have similar symptoms of pain and swelling. If there is no broken bone, your physician will be able to tell you the grade of the ankle sprain based upon the amount of swelling, pain and bruising.

Grade 1: Use R.I.C.E. (rest, ice, compression and elevation). Ice should be applied immediately to help keep swelling down for 20-30 minutes up to four times daily. The ankle should be elevated above the chest for 48 hours. Rest your ankle and try not to walk on it. Use compression dressings and wraps to immobilize and support the ankle. Grade 2: Utilize the R.I.C.E. guidelines and allow more time for healing to occur. An immobilization device or splint is also recommended. Grade 3: Permanent instability can occur with a grade three sprain. A cast or a brace may be required for a couple weeks. Anti-inflammatory drugs like ibuprofen can be used to control pain and inflammation with a sprain. Surgery may be considered in younger, athletically active patients.

If an ankle sprain isn’t treated with the necessary attention and care, chronic problems of pain and instability can result. The best way to prevent ankle sprains is to maintain good strength, muscle balance and flexibility. Here are some additional prevention steps:

Wear good shoes Warm up before doing exercises and vigorous activities Pay attention to surfaces on which you run and walk Reinforce the foot and ankle’s stability with a brace if needed Pay attention to the body’s warning signs to slow down when you feel fatigue or pain.

: Varying Degrees of Ankle Sprains

Should a sprained ankle still hurt after 3 weeks?

How Long Does Ankle Pain Last After Sprain? – Additional studies, such as MRI or CT scan, are usually not necessary immediately after an ankle sprain, as the results of these expensive and time-consuming studies rarely affect the initial management of the sprain.

We have found that a sprained ankle still hurts after 2 weeks, however, if pain persists for 6 to 8 weeks or more, and does not seem to be improving, these additional studies may be required to make a proper diagnosis. One problem that may lead to long-term dysfunction and pain after an ankle sprain is instability.

Patients may feel loose or say that their ankle is giving way without the ligaments actually being stretched. If laxity of the ligaments cannot be determined on the physical exam, the orthopedist may do a “stress x-ray”, where he or she manipulates the ankle while an x-ray is being taken.

This is a quick and usually painless procedure that may give even more information than an MRI. Patients, who are found to be unstable, and remain functionally unstable, despite bracing and therapy, may be candidates for surgical reconstruction of their ligaments. If the stress x-rays are normal, an MRI may be ordered to look for other sources of pain.

These sources could include residual scar tissue from the sprain, subtle injuries to bone or cartilage, at the joint surface, as well as tears or instability of the tendons that surround the joint. If these issues remain symptomatic, despite conservative treatment, many can be treated with minimally invasive surgery using arthroscopy.

When should I stop icing my sprained ankle?

Frequently Asked Questions: When Do You Ice And When Do You Heat? – Determining when to use ice or heat therapy can be complicated. To assist, we’ve answered below some of the most frequently asked questions about when to ice and when to heat acute injuries and chronic conditions.

  • Should I use ice or heat for back pain? Heat therapy is particularly helpful with chronic conditions, especially muscle stiffness and soreness.
  • Localized stiffness may benefit from heating packs while regional stiffness and denser tissues may respond better to a warm bath.
  • If the lower back pain is the result of a recent injury, such as a muscle strain, it’s best to follow the R.I.C.E.

method for the first few days then, after about 72 hours, transition to heat therapy. Should I use ice or heat for pulled muscles? A pulled muscle should first be treated using the R.I.C.E. method. During the first 72 hours, heat should be avoided to prevent increased swelling and inflammation.

After about 72 hours, heat can be incorporated into treatment to increase blood flow and aid the overall healing process. Should I use ice or heat for swelling? After an acute injury, ice should be used to minimize swelling for the first two to three days. After this period, heat can be used to increase blood flow and assist the natural healing process.

Applying heat too early may cause additional swelling by increasing blood flow to the injury. Should I treat a sprained ankle with ice or heat? A sprained ankle will require both ice and heat at different points in the recovery. Initially, treatment will focus on rest, ice, compression, and elevation.

After about 48 to 72 hours – or once the swelling has satisfactorily decreased – heat can then be used to increase blood flow to the injury and aid your recovery. Should I use heat or ice for muscle spasms? Heat therapy increases blood flow and this improved circulation may help with muscular spasms throughout the body.

Massage and stretching may also alleviate pain and discomfort associated with a spasmodic muscle. Should I use ice or heat for neck pain? Many patients ask whether or not to use heat or ice for stiff neck muscles. Neck pain associated with chronic pain, general muscle soreness, or stiffness should be treated with heat therapy.

However, a new injury usually calls for the RICE method to be used for the first two to three days, and then individuals may transition to heat therapy. Should I use ice or heat for shoulder pain? For new or acute injuries, the RICE technique is recommended for the first 24-72 hours. Once swelling has subsided, heat therapy can be used to help increase blood flow to the area and aid recovery.

Heat therapy can also be used to help with the stiffness, aching, and general pain associated with a chronic condition, as needed. Should I use ice or heat for knee pain? The type of knee injury will help determine the proper ice or heat regimen moving forward.

  • For new acute injuries, the RICE method should be used immediately following an injury, and then heat can be applied after two to three days to increase blood flow.
  • For chronic injuries, pain, stiffness, and soreness without swelling, heat may be more appropriate.
  • Heat therapy may help with arthritis, knee pain, and stiff joints by using heat packs, pads, and submerging the affected area in warm water.

In some cases, gel packs may be more effective than traditional heat packs, due to their ability to form around the joint and penetrate tissues.