I sprained my ankle over 22 weeks ago and am still experiencing a dull ache after I run (doesn’t matter if its speed work, intervals, long run, recovery, etc.). I have been running for 10 years without serious injury, completed marathons, Ironman, sprint tris and everything in between. I have had sprains in the past, but this one had me on crutches for a week. I had multiple xrays to ensure nothing was broken or splintered, and even went to an orthopaedic doctor who termed it a “severe high-ankle sprain”. I didn’t rush the recovery, worked with a PT for 6 weeks - feel like I did everything right.
Has anyone ever heard of or experienced anything like this? Will this ankle give me aches and pains forever? Any suggestions on what else I could try??? Help!
The ankle joint can actually be “adjusted” by a chiropractor much the same way they do with the spinal joints. I used to look after a lot of soccer players in an industrial league and saw more sprained ankles than I care to remember.
The ankle joint is an unusal joint in as much that it’s like a sort of hinge where the talus bone of the ankle articulates with the distal end of the tibia. This joint is the only one in the human body that has no direct muscle attachment but is a ligamentous joint. Only ligaments support the talus/tibia articulation. The muscles that move the joint all attach to other foot bones but none to the talus. Hence it’s a relatively weak joint which explains why ankle sprains are so common.
It’s my belief that in an ankle sprain the talus get slightly displaced but can be “adjusted” back . I’ve seen some very chronic ankles such as yours that responded very well to this type of chiro therapy. Usually around half a dozen treatments.
Find a sports orientated chiro in your area who is familiar with this treatment.
“High” ankle sprains are actually sprains of the ligaments which hold together the distal portions of the tibia & fibula. Damage to these ligaments can cause instability at the ankle mortise joint - where the tibia and talus meet. If you are experiencing instability, I would guess that your Ortho would have caught it though.
One other thing to consider is called “osteochondritis dessicans”. This condition can result after an inversion ankle sprain (most common type). You will need and MRI to diagnose this though. A portion of the talus bone loses blood supply after the sprain, and will “die”.
I’m a chiro myself, and an adjustment may help, but no guarantees. After 22 weeks, I think you’re beyond adjustments though. See someone (DC, ortho) and get an MRI. Good luck!
I had a similar sprain when I was younger while playing soccer in college. went through the recommended treatments and it was never really the same. After 1 year I still had this dull ache after runs but it did not hurt as much during. then after about 3 years after the main sprain i reinjured it again. After about 3 months recovery and no running it is just like new and I have no pains anymore. the docs say the tendons healed better and are probaly stronger
it is weird how that works and does not make much sense to me, just is what happen
Yup. Before any “adjustments” - get an MRI to rule out an osteochondral lesion or diastasis. I come from the surgeons point of view. “high ankle sprains” are very slow to heal, but 22 weeks is a little long, even if you don’t rehab properly (which it sounds like you did)
"To be annoyingly anal, the scaphoid has no muscular attachment either. "
That’s right. I stand corrected. That’s another articulation that can be “adjusted” for wrist pain, but have to be particularly careful of previous scaphoid fractures, etc.
I sprained my ankle over 22 weeks ago and am still experiencing a dull ache after I run (doesn’t matter if its speed work, intervals, long run, recovery, etc.). I have been running for 10 years without serious injury, completed marathons, Ironman, sprint tris and everything in between. I have had sprains in the past, but this one had me on crutches for a week. I had multiple xrays to ensure nothing was broken or splintered, and even went to an orthopaedic doctor who termed it a “severe high-ankle sprain”. I didn’t rush the recovery, worked with a PT for 6 weeks - feel like I did everything right.
Has anyone ever heard of or experienced anything like this? Will this ankle give me aches and pains forever? Any suggestions on what else I could try??? Help!
Another diagnosis that could explain this is Reflex Sympathetic Dystrophy. If this is the diagnosis all of the other tests you get will be completely normal and all the ordinary treatments will have no effect. However, if that is the diagnosis, your case is extremely mild and the natural history of this (as you have described it) is it will slowly improve with time, even though it may take many more months, sometimes years.
If this is your correct diagnosis (75% chance) and you came to my office, I would give you a 90% chance of cure in less than a week with a short series of 1 to 3 sympathetic blocks to the area. The best way to make the diangosis is to do a sympathetic block and watch the response. You will have to find an anesthesiologist pain specialist to get this done though.
I feel your pain. I sprained my ankle during a trail run last December (almost 28 weeks ago), then a week later tore up whatever was still intact in there during a misguided attempt to preserve my fitness with deep water running. I have had x-rays that show nothing, have been in PT since April, and last week saw a new sports medicine ortho guy and at his suggestion got an MRI. I see him again tomorrow to talk about what (if anything) the MRI shows.
I feel your pain. I sprained my ankle during a trail run last December (almost 28 weeks ago), then a week later tore up whatever was still intact in there during a misguided attempt to preserve my fitness with deep water running. I have had x-rays that show nothing, have been in PT since April, and last week saw a new sports medicine ortho guy and at his suggestion got an MRI. I see him again tomorrow to talk about what (if anything) the MRI shows.
Susan
If it shows “nothing” you also have an RSD and need to see an anesthesiologist pain specialist (my specialty in a former life). RSD starts after trauma, any trauma such as spraining an ankle, stubbing a tow, or gun shot wounds. The two most common words used to describe the “pain” are burning and aching. It is almost always constant but in very mild cases can sometimes be minimal and not noticable if at rest. The area is usually tender to touch, sometimes light touch, without evidence of inflammation. RSD is the most common missed diagnosis causing chronic pain. About 70% of the people who came through my door had this as a missed diagnosis and I have 50% of those pain free in 2 weeks with appropriate block therapy.
Most docs don’t have a clue about this disorder because the typical presentation looks nothing like the text book presentation, which is showing the worst of the worst, and they don’t have any good tests or treatments for it.
i had the surgery described in the “treatment” section the fall of 2001. completely off my ankle for 12 weeks, followed by 6 months of dedicated rehab. i have been back running ever since.
anyway… like an earlier poster said, you might consider getting an mri to rule out the osteochondritis.
i had the surgery described in the “treatment” section the fall of 2001. completely off my ankle for 12 weeks, followed by 6 months of dedicated rehab. i have been back running ever since.
anyway… like an earlier poster said, you might consider getting an mri to rule out the osteochondritis.
The key to a successful treatment is a correct diagnosis.
dull ache? Is it all around the ankle? Hurts to the touch of the skin or is it definitely inside at the attatchment point of connective tissue, bone and muscle?
dull ache? Is it all around the ankle? Hurts to the touch of the skin or is it definitely inside at the attatchment point of connective tissue, bone and muscle?
The ankle does not hurt to the touch of the skin. This is a dull ache that feels like it is deep inside the ankle. Also, it usually does not hurt while I am running - the pain comes a few hours after running, and usually stays for a day or two.
hate to say it, but that is the same type of pain i had. would never hurt while running, then within a couple hours pain inside my ankle, especially when i put all my weight on it. very sore the day after a run. it got to the point where the day after a long run, i couldn’t put hardly any weight directly on my ankle. i had to walk on the outside of my foot, which of course led to lower back issues, hip issues… etc.
when i had xrays, the osteochondritis dessican didn’t show up, but when i had an MRI, it was the clear as a bell. had a big chip on top of my talus bone that had to be taken out.
Thanks, Frank. I am printing your reply to take with me tomorrow when I see this new dr., in case I need to refer to it.
Susan
The key to improvement is always correct diagnosis. Usually doctors look better than they really are because most things get better on their own whether the doctor does anything or not. However, if the doctor does something, he/she will get credit for it.
When things don’t go well, then the correct diagnosis becomes a real problem. That is when doctors earn their money. Not every abnormality can show up on tests and not every abnormality on an xray or whatever is responsible for the pain. I have seen way too many Xray reports where an abnormality is declared “too small” to cause the pain symptoms. How on earth do they know? That splinter is too small to bother you, just ignore it!
You will know when you have received the correct diagnosis when you respond the the appropriate therapy for that diagnosis.