Grade 2 Ankle Sprain - Pain After 12 Weeks

by Jock Turner
(Cornwall, UK)

36 Hours After Injury

I sprained my ankle (grade 2) 12 weeks ago and I still get a dull aching pain (after light jogging) and there is some residual swelling which is making it difficult to get a full range of motion when I try to stretch.

Apart from the usual lateral ligament damage, I gather there was some rupturing to the medial deltoid ligament as the pain I have now is around this area. When I first injured the ankle there was a large amount of swelling on both sides of the ankle extending half way up the lower leg.

I've just started taking NSAIDs again to try and reduce the last bit of swelling. I also started taking Glucosamine Chondroitin and Cod Liver Oil (about 2 weeks ago) which I also read was good for joint injuries.

I never expected the injury to last this long, is this normal. I don't know how to get rid of this last bit of pain, any ideas?

Thanks

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Grade 2 Ankle Sprain - Pain After 12 Weeks

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Aug 17, 2010
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i know how u feel NEW
by:

I atually have the same problem you do. I sprained my ankel 12 weeks ago. It was blackish purple for 2 1/2 weeks. The brusing went away for the most part but it still hurts and missively swollen. The only differance is I haven't been able to get to the doctor for lack of having a ride there counting the fact I don't have a car yet and my parents think I'm faking (even tho if u look at it u can tell somethings wrong). And that I also have nerve damage for my elbow on the same side that I've been gt therapy for 3 months now. I showed my school nurse and she didn't know how I was walking (I have very high pain tollerance) and the therapist didn't know anything about foot injurys. So I know how sketchy it is having the injury last this long.

Mar 21, 2008
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Keep up with the exercises NEW
by: Bart - SII

It sounds like you have had a little mis-information. I wonder why they told you to take off the compression wrap? I haven't heard anything about it being counterproductive.

Other than that it sounds like you have done alright with your rehab. It is important to make sure that you have all of your motion back - make sure that your ankle moves the same amount as the other one.

As far as strength, lunges, step ups, step downs, heel raises, and elastic band exercises are all great ways to improve your strength. Some are more functional than others.

I believe that balance exercises are the most important part about ankle sprain rehab. Balancing on unstable surfaces - like a wobble board - is good but even better than that is balancing and then moving your upper or lower body to challenge your body. This will improve your proprioception.

If you have access to a physical therapist, athletic trainer, or physiotherapist I would try to see them for at least an evaluation and some home care instruction. You could have some joint restrictions that are causing your continued pain, or you could have some laxity in the ligament that may be causing your problems.

A good evaluation will tell you more closely what might be going on. 12 weeks and still having pain is not unheard of, but it isn't necessarily normal. I would recommend a good evaluation and then slowly work through some more exercises - and I would hold off on the jogging until you are pain free all the time with walking.

Hope this helps - comment back with other questions.

Mar 19, 2008
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Futher information about the injury NEW
by: Jock

Hi, Thanks for getting back so quick!

To answer your questions:

After the injury the first ice application was 1 hr later due to me being a couple of miles away from home at the time and having to hobble home.

Raised the foot and applied ice 10 minutes on 20 mins off for a few hours then once an hour for the rest of the day.

Next day I visited hospital (on a Saturday - no X-Ray department). After palpation of the injury the nurse's advice was 'keep foot raised, apply ice and rest. She thought there was no broken bones and told me to remove the compression bandages that I had on when I went to the hospital as the new medical thinking was that they were 'counterproductive in the rehabilitation of this type of injury'. Yes, I too was surprised with that bit of advice but as this was the first injury I had had in about 5 years, I listened to the expert (even though every piece of advice I read subsequently recommended compression!)

I asked for crutches but these weren't available so I hobbled out of the hospital and was told to try and walk as naturally as possible putting full weight on the ankle (again, weird advice but tried anyway).

Since then I have used ice on and off most days. Some days are better than others and I don't feel much, other days the ankle throbs on and off depending on the amount of time I stay standing on it.

I have tried wobble board and balancing exercises which go fairly well but still aggravate the ankle to the point where it starts to ache again. I have also tried to jog on grass for half a mile or so but it still aches usually for hours after I have finished.

I never got an x-ray even though I went to the doctor's after a few weeks worried that I might have an avulsion fracture. Doctor refused saying even if there was any fracture nothing could be done for it at this stage apart form being patient and waiting for the ankle to heal naturally.

So here I am 12 weeks on still with some swelling and pain and feeling very frustrated.

What should I do now?

Mar 19, 2008
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Great Picture! NEW
by: Bart - SII

I know it couldn't have felt good, but that is a great picture of your swelling. It looks like you had a lot, even down into your foot and toes.

Ankle sprains heal differently for everyone. 12 weeks is probably on the long side for most grade II sprains, however, it is highly dependent on the initial care, the rehabilitation you underwent, and how soon you started back to activities.

Just a few follow up questions and then I can give you better advice on where to start from an exercise standpoint -

How long were you off of your ankle - ie. on crutches, resting, etc.

Where you able to apply all of the R.I.C.E. Principles immediately after injury, especially compression?

What kind of exercises have you worked on to improve your strength?

What kind of exercises have you done to improve your balance?

Did you do any type of formal rehabilitation with a physical therapist, physiotherapist, or athletic trainer?

Did you have an X-ray at some point?

I am sure you have probably already read through most of the ankle sprain information on the site, but here is the link just in case...Ankle Rehab These might give you an idea of where you may have overlooked some things.

Use the comment box on your post to reply back and hopefully I can give you a little direction.

Thanks again for the picture!

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