Ankle Sprain Follow-up Questions

[Familia]

Hello all, the Dr. said he saw no evidence of break on x-ray he took 2 days after fall.  He stated that there was perhaps a tiny evidence on the outer bone of a tiny tear.  He sent me to get a boot fitted and told me to be sure to do PT as ankles can be trouble if they do not heal properly.

I was so happy to hear ‘not broken’ that I didn’t ask many questions. When he said that it can take weeks or months to get back to normal, I didn’t think to ask what that looked like.

Going home with boot, I spent total of a few hours on it that day, with it up much of the time.  Swelling was at 25% and no pain unless it twisted a little or was whacked (like against something as I walked)  Slept in boot, used crutches & stayed in bed for a few days.

Then, pain began as swelling went down.  I think swelling is at 10% maybe?  Bruising still crazy.  Began therapy on day 9 and am doing exercises every day.  It hurts standing still sometimes, plantar fasciitis flaring up b/c of foot being flexed too often.

I can live with a little pain & soreness, but I just do not know what on earth is normal or what to expect progression-wise.  The ‘it may take awhile’ from the PT & online is vague.  I have never had an orthopedic injury and cannot tell what is normal progression.  Since PT said to stay off of it as much as possible and that my crutches were too short, I had DH rent a scooter instead. It has been much better.  

What I am mainly conflicted about is the general comment from my Dr. that using it will help heal it, then PT says stay off. BTW, the boot hurt the dickens out of me, better to put weight on bare foot, but I can’t talk real steps (too weak, any sideways movement is painful).  And, it hurts when I stand on it next to outer bone when I first get up, but that goes away.

So, my day is warm water bath for it, PT exercises, up with scooter to do a few chores, elevated in bed to work on computer, that routine a few more times with PT exercises at noon and evening.  In evening, I usually use crutches and boot (for protection) to go into yard with dog and just enjoy the beautiful air/sky.

Is this normal for a sprain??  It’ll be two weeks on Saturday  guess I thought I’d be walking by now. Is there any chance the Dr. missed something?  It aches a fair amount, but not all.of.the.time…mostly in evening.  Am I babying it too much?  Am I doing too much?  Completely confused, trying to stay positive that soon enough, I will be able to do my morning walk, play with dog, and be back to driving, but would like to hear other’s experiences.

Sorry so long!  Thank you!!

Edited May 27, 2021 by Familia

[Carrie12345]

I’ve had multiple sprains and one tiny cuboid fracture, all in the same foot, so my brain sometimes melds the experiences together... because they were all almost identical when it came to healing.  And they all started on crutches - no weight bearing allowed until I could do so (In the boot) without pain.

All my recoveries were in months, though they varied in degrees of progression, I assume based on the extents to which I tore myself up to begin with!

[Familia]

Thanks, @Carrie12345, that’s a lot of damage to one foot!  I guess my thinking of weight bearing by now is a little too rushed.

[regentrude]

I am so sorry to tell you what you don't want to hear: ankle sprains can take many months to heal.

I highly recommend you see a specialist and get an MRI to image the soft tissue ( x ray is good for bone, but not soft tissue) to make sure there is no tear to the tendon or injury to the cartilage. 

A family member had an ankle sprain (no fracture) a year ago. Couldn't walk or drive for a couple of weeks. Due to covid, didn't see doctor. It healed some,  could drive and walk a little, but it was still painful after three months. They went to get MRI and discovered that the injury required surgery after all.  5 months of PT 2-3 times a week. Now daily exercises at home. They are can finally go on short hikes; still painful after a few miles. (This person is a young, very athletic rock climber and hiker)

My friend sprained her ankle stepping off her porch. No surgery. 11 months until normal function fully restored.

This may take a long time and absolutely sucks, I am so sorry. Have that MRI.

[Kassia]

I would definitely have it looked at again to confirm there is no fracture.  It might not have shown up on imaging that early.  Unfortunately, even if it is sprained, it could take a very long time to heal.  Just as long or longer than a fracture.

I'm a runner and just injured my ankle badly.  It's going to be a long recovery and I am so upset.  Injuries stink.  😞  

[Pawz4me]

It's probably a good idea to have it looked at again. Like @Carrie12345, I've had many sprains in each ankle over my lifetime. The first occurred in elementary school. So it's been like forever since I've sprained an ankle that didn't already have existing damage, which makes it hard to comment in a meaningful way. But I had a similar experience to the one @regentrude's friend had. I sprained my ankle badly when we were on vacation when the boys were young. We were at least an hour drive from the nearest hospital (no urgent cares anywhere around way back then), so I didn't get it looked at. Finally after a few months, when it was still bothering me, I did get it checked out. At that point I was told there had almost certainly been tendon/ligament damage but that it was too late to do much about it. It did continue to very, very slowly improve but it took about a year before I could really walk anywhere near normally again. A lot of people mistakenly think a sprain is better/easier to heal than a break. But that's not always true.

Edited May 27, 2021 by Pawz4me

[wintermom]

If you can get an MRI done quickly and cheaply, I'd do it.  It may help the PT provide the most appropriate exercises. 

I've 'sprained' or tweaked my ankles too many times to remember them all (volleyball, running, tennis, etc.). Every injury is different.

For you, this being your first sprain, you probably have very little scar tissue and junk from previous injuries. That's a good thing! ;)

[plansrme]

I have sprained an ankle a couple of times but have never been unable to walk on it for two weeks. That is a long time. I have never worn a boot, either. But when you can walk on it, the activity that finally got mine back to normal was walking, IN THE DARK, on uneven ground. I used to drop my daughter at 5:30 AM swim practice, park my car and walk laps along the shoulder of the road the pool was on. It was under construction, sort of, so it was dirt, grass, rocks, weeds, and not smooth, manicured lawn. Each lap was probably a mile, and I walked several while she practiced, mostly before the sun came up. My theory is that it improved proprioception. Or something. I also would brush my teeth standing on one foot, eventually with my eyes closed, for the same reason. But whatever, that is what got me back to normal, and it was much less expensive and time-consuming than PT.

[Familia]

@regentrude @Pawz4me & @wintermom I appreciate your suggestion to get it looked at again, and (in theory) do not mind as much it taking awhile, as not knowing what to expect.  The planner in me wants to know if what I am doing today is appropriate & make a new (even stinky) daily routine.   I am going to call to request an MRI today.  

@plansrme, now that is certainly a different experience!  But, I can imagine that attention to the recovery of proper proprioception (whew, had to look that up=) is really a good thing to consider, too.  Thanks for that tip!

And, @Kassia I am so very sorry to hear about your injury=(  💐

[regentrude]

@Familia are you seeing a podiatrist specialized in ankles? I would not leave the interpretation of the MRI results to a family practitioner.

[Familia]

@regentrudeHe's a sports medicine orthopedic surgeon, but let me check his exact specialty...

His office bio says 'general sports medicine with an professional interest in arthroscopy of the elbow, ankle...."

Would a podiatrist be better?

[regentrude]

11 minutes ago, Familia said:

@regentrudeHe's a sports medicine orthopedic surgeon, but let me check his exact specialty...

His office bio says 'general sports medicine with an professional interest in arthroscopy of the elbow, ankle...."

Would a podiatrist be better?

No, this sounds perfect!!!

[Jean in Newcastle]

Sprains come in different degrees of severity. How long they take to heal will depend on the severity. My last sprain (right at the beginning of the pandemic took a couple of months before I could bear weight. I alternated ice and heat. Especially if there is still swelling you want ice. 

[Katy]

Severe sprains can take 6 months or more to heal. Much longer than a fracture. It sounds like you saw the right kind of doctor, but it never hurts to get a second opinion. 

If you know of a really good chiropractor you might try that. I had a severe sprain when I was training for a marathon in my 20’s.  The doctor said she doubted I’d be able to run for 6 months.  I went to a chiropractor 3 times over 3 days.  Each time the swelling & pain went down.  After 3 days it was gone.  The ankle was still really weak and I had to do a lot of exercises to strengthen it, but less than a week later I was running again.

[Jean in Newcastle]

My chiropractor was able to do laser treatments on my sprained ankle. It really did help. Not a magic bullet but helped to speed up healing. 

[regentrude]

1 hour ago, Jean in Newcastle said:

My chiropractor was able to do laser treatments on my sprained ankle. It really did help. Not a magic bullet but helped to speed up healing. 

My person had good success with ultrasound treatment and manual manipulations by the therapist. Which were reasons to go to in-person PT despite Covid - these couldn't be done via tele-appointment