Dealing With Ankle Pain

Professor Snugglesworth

In 2001, I injured my left ankle while playing volleyball out in the yard. I fell through a small hole that sprained my foot something fierce, causing tremendous pain that made it virtually impossible to walk. A hospital examination showed that nothing was fractured, so they just gave me some crutches and pain killers for a week or two.

Ever since that time, my left foot has never been 100%. I will frequently and constantly feel pain shooting up from the left side of my left ankle, mainly when I'm standing or walking for 3 hours or more.



The circle is where the majority of the pain is centered, and the arrows pointing up indicate that it shoots upward halfway toward the knee, like a geyser. There is never any pain on the right side of the foot.

I've seen specialists and taken therapy, but both offer temporary solutions at best: One doctor described it as my tendons becoming untangled partway, like a shoelace that's barely hanging on. Another gave me a doomsday scenario about how the pain will only get worse as I get older.

Lately I've been taking up jogging, which has become physically and mentally beneficial except for, naturally, my foot. I don't want to quit it since I feel it's improved me where previous stationary exercises have failed, so I wanted to ask your advice on any possible tips or techniques to dull the pain. About the only tip I've been able to gather is to strengthen it with more ankle-related exercises (mainly standing on the tips of my toes), but again, it's all temporary.

This is something that's plagued me for too long, so any help at all would be appreciated.

VisionOfClarity

Did you wrap your ankle when it was sprained and do you wrap it when jogging now?

Professor Snugglesworth

I have wrapped it for a time, but ultimately stopped as it cut the pain down by maybe half. I have been considering wrapping it again while jogging.

By wrapping do you mean a laced-brace, or wrapping straps like what boxers use? I have the former, haven't tried the latter.

mts

i kno wyou have been tot he doctor but did you go to an orthopedist?

is the pain a progressive thing since you first injured it , like has it gotten worse with time? or is a regular thing?

Sounds to me like you tore something initially. it wouldn't show up on an xray, unless you had an mri you didn't mention. For the most part you can get by with a torn ligament or tendon in normal day to day stuff, but once you try and be active it flares up.

therapy probably helped but eventually it will just breakdown and you need to go in and repair it. happened to my shoulder. tore some cartilage in it, did therapy and was fine, but got old and needed to get it repaired


i personally would try and minimize the support you use as much as possible, you want to build strength in your ankle. if you use the heavy duty braces (like the lace up ones) you are not letting your ankle do its job so it gets weak, and you need them strong to support you.

Professor Snugglesworth

I have gotten MRI's and been to Orthopedists. Nothing shows up.

The pain hasn't gotten worse, but some days it will hurt more than others due to strenuous activity (like jogging). There have been occasions where it hurts at maximum even if I spent the prior day just sitting on my ass.

mts

Did you ever get a contrast MRI done?

Did the physical therapy help with pain at all?

Honestly it sounds like something was missed in the diagnosis. its possible to have a break not show on an xray or a tear not show on an MRI.

Professor Snugglesworth

What is a contrast MRI, and what makes it different from a regular MRI?

The physical therapy, as I mentioned, helped a little, but it was temporary at best.

mts

a contrast MRI is where you inject a reagent, such as this

basically the dye will show up really strong on teh scan and will basically fill the space of the joint and expand it a little. So a couple things happen:

As the joint space is expanded you can get a better picture on what is going on since everythign is basically not crammed in on itself.

Since the dye shows up, you can see if it is going somewhere it shouldn't be which would be indicative of a tear.

it basically allows for a more accurate MRI to pick up on small things.

So did the pain come back when you stopped therapy/doing exercises?

If I were you, what i would do is try and find a different doctor. Insurance aside, and not knowing where you are located i would try to find a doctor who works with a professional sports team or olympic athletes. Maybe a basketball team since they have lots of ankle injuries. You want someone who sees ankles all the time.

Professor Snugglesworth

That contrast MRI sounds interesting, and I'm willing to give it a shot. What would be the easiest way to locate a doctor who has that procedure but is also covered by my insurance?

mts

well it is something they need to prescribe. i would start by finding a new doctor in general and see if he thinks its a good idea

Namrok

You know sadly, most recovery is based on timely treatments. You said this happened in 2001 so I wouldn't get my hopes up if I were you.

Still, if anything were going to help, I'd recommend trying physical therapy. They'll show you a lot of exercises targeting your ankle, making it more stable and stronger. Sometimes they'll even massage it to try to help things work themselves out.

On thing about wrapping a joint is that it will make it weaker. Absolutely wrap it if its too weak to exercise straight away, but the goal should be to transition away from a wrap or to use it as little as possible.

I tore my ankle in 2009 doing martial arts and have made probably as much recovery as I'm going to. The ankle is still not as stable as the other ankle, but there is no pain and its highly functional. Takes constant vigilance and exercise though, otherwise it backslides.

Professor Snugglesworth

Any sites with physical therapy exercises and tips for ankles?

Namrok

From my time there (and we may easily have had very different ankle injuries) anything that challenges your balance is good. They had me stand on a form board that wobbled and maintain my balance. They had me use one of these things:

http://www.amazon.com/gp/product/B001FB5ZEO/ref=oss_product

Which I highly recommend BTW. Maybe not that one, its far more unstable that I the ones I used at physical therapy, but a thing like that is good.

Sometimes they would even put me on those things and use resistence bands attached to the wall. Or close my eyes on them. Seriously, stand on one foot and close yours eyes. Next thing you know you are falling over, its nuts.

But yeah, stuff like that. Nothing too complicated.

Auntie Shibby

I actually broke that part of my ankle back in 1999 or 2000. Casted up, big black boot, and then an air cast. It acts up from time to time on me still, I throw on the air cast and get going.

This

Professor Snugglesworth

That looks pretty durable, and easier to wear with a shoe. Know where I can get that online (or in stores)?

Technicus Rex

A couple of years ago I fractured my calcaneus and ended up getting this surgery:


Don't look if your squeamish

Anyway since then I've had chronic ankle pain which comes and goes. I too like to jog but it made the pain pretty bad until I got fitted for a good pair of running shoes (I'd recommend ASICS or New Balance) don't scrimp on the cost. Go to a store like The Athletes Foot where they are trained to fit shoes to the individual. Also your Orthopaedist should be able to prescribe you and orthotic insole which should help.

Another thing that helps is rubbing a heat cream on it or even better having someone massage the ankle with warming oils. I seriously cannot overstate how good this is for pain releif, lucky for me my gf at the time was a masseuse so I was getting taken care of quite well.