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Severe Ankle Sprain (Pics) - Input/Opinion?

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I am 27 and am active/competitive in many different athletics. This past Sunday I finished a 400m indoor track event and, probably due to being completely exhausted, I ended up over-rotating my right foot, putting all of my weight on the top of the foot, and I collapsed to the ground from that position.

To me, I destroyed so much (ligaments, muscles, fascia, whatever) in there that my foot is just a mangled mess. I've had ankle sprains on the lateral side, mostly lower, from playing basketball, and they hurt, but they've never been as swollen as this one, which I would figure is from the linear nature of the sprain, instead of lateral movement. I don't know if I popped anything out of socket, or what. The disappointing part of it is if there is ever a moment when I truly know & feel that my body is at it's loosest, most exposed/vulnerable state, it was at that moment of exhaustion, so I'm just upset at the damage that probably happened.

Just to give an idea of my fitness, I generally run about 25mi/wk, a mixture of some longer runs (4-5mi) and some shorter (2.5-3.5mi) with some sprints thrown in at the end, and during the summer I compete in 5k's, 10k's, and some trail races. I'll also mix it up w/some biking, usually 20-25mi, some basketball, snowshoeing, x-c skiing, and other sports - flag football league, kayaking, etc.

As soon as it happened, I had to drive an hr back to home, w/ice taped around the ankle, and did an immediate 20 mnin ice bath, then elevated it. On Day 1, I hit a 20 min ice bath, then stayed in the whole day. I could not put weight on it, only hop on the opposite foot. Later that evening, I managed to get out of the house, but moved around only in extreme pain. This was after 600mg ibuprofen 3x that day.

On Day 2 (yesterday), I could move around slightly better, still in extreme pain, but forced myself to move around on it. I don't want my body expecting "this is it" and shut it down and the area starts to atrophy.

Today I can walk on it, almost normally when I've got shoes on, but it's strangely more painful to touch than it is to put weight on it.

Anyways, I thought it'd be fun/interesting for any input/opinions on what exactly might be damaged, what I can expect over the next couple days, and some ideas on speeding recovery. Even though I over-extended it from the anterior angle, it's weird to me how some of the posterior ligaments have so much swelling.

The pics ain't beautiful, but here they are: http://Flickr.com/photos/jlipin3/sets/7215 7628931778289/
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replied January 19th, 2012
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replied January 19th, 2012
Especially eHealthy
JoshL,

You have done well in managing the acute edema and the injury in general.

Being an athlete, you know that sprains can be mild, moderate, or severe. There is some correlation between the amount of swelling and the amount of damage, but not always. Since you have managed the injury well, the outward appearance may be deceiving.

The blue bruising is doing what it does best, travel in the direction of gravity. It is not uncommon to see blue toes, feet, ankles, and even up the leg after an ankle sprain. If a patient elevates the foot way above the heart, it is not uncommon to see the bruising going up the back of the calf. When the foot is held in a dependent position (hanging down), the bruising goes into the foot and toes.


When you first described your injury, I thought that you may have had a midfoot sprain (across the instep) when you said, "over-rotating my right foot, putting all of my weight on the top of the foot". But, I was a little confused, because most of your swelling is around the ankle. And, not quite sure of what you mean by, "over-extended it from the anterior angle".


Without a thorough examination, it is not really possible to tell what you have torn. But, the lateral ligaments of the ankle, the anterior talofibular (ATF), the calcaneofibular (CF), and the posterior talofibular (PTF) would be the best bet.

It is not uncommon to damage all three in a significant injury. The PTF ligament helps to keep the talus from sliding posterior relative to the tibia. It is often considered the most stout of the three ligaments. It can be injured with an inversion force and also from stopping abruptly.

When examining the ankle, the orthopedic surgeon will palpate each of the ligaments, to see if they are tender. He/she will also test the integrity of the ligaments by doing stress tests, such as the talar tilt and anterior drawer. X-rays are usually obtained, just to make sure there are no osseous injuries. One injury particular to ankle sprains is an osteochondral defect (OCD) of the talar dome.


But, again, the only way to know for sure what you have injured is to have the ankle examined by an orthopedic surgeon.


In your rehab of the ankle, which you are doing well with so far, be sure to stress strengthening of the peroneal muscles on the lateral side of the leg. And, one thing that patients forget to work on, before getting back into activity, is proprioception. Significant injuries can really mess up the delicate unconscious motor control of the extremities. So, if you have access to a physical therapy department or a training room, you might want to work on the balance board for ankle rehab.


Good luck on your recovery and rehabilitation.
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replied March 9th, 2013
JoshL,

Wow, your pictures resemble the swelling and bruising in my foot from my sprain a year ago so much. I was running down the stairs and was skipping steps and when I landed on my right foot, the ankle rolled outwards and I heard a pop. And that swelling started almost immediately. And I remember the bruising was terrible. I was curious...did you hear a pop when it happened? And how is your ankle as far as instability now that it is a year later? Immediately afterwards, and still to this day, I feel like my ankle is very unstable, when I sit with my leg straight out and toes pointed up. And also when I turn to quickly with my foot still planted. I'm waiting to schedule and MRI for next week after seeing the doctor yesterday, but I was just curious about the popping noise and if you have any instability issues over the past year. Thanks! And hope your recovery went smoothly.
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replied March 1st, 2016
Bad ankles is just something I've been living with since I was 13 years old. After rolling my ankle during a camping trip I tore the ligaments in it as well as my knee. The whole right side of my leg was basically destroyed. 2 surgeries later I now realize I waited too long to get the second. If it's not healing properly and you are still in pain, I would get an opinion from an orthopedic. All the physical therapy in the world wasn't helping the fundamental issues with the ankle/leg area. Since my 2nd surgery I can now walk without being in pain. I don't run anymore but am now able to walk 3 miles a day. Another thing to consider is compression. I'm sure you've seen them on Television. Got it from amazon and the swelling is considerably reduced. Don't know if compression is proven medically or it’s a placebo but I notice the difference in my stability and confidence when doing my daily walk. Honestly if everything is repaired properly through surgery the only thing that is left is time (rest) and physical therapy to improve strength and range of motion. You will get better, just takes time and patience.
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replied June 24th, 2016
Ankle Pain
I suffer from Plantar Fasciitis and I have been suggested Grocare products (Nervica and Acidim). It has worked wonders to reduce my pain and has made walking easier for me.
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replied June 13th, 2018
Experienced User
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