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Ask Our Doctor About: Ankle Pain

The questions on this Website have been answered by Board Certified Foot and Ankle Specialists associated with OurHealthNetwork.com. The foot and ankle physicians and surgeons in this group have a combined 100 years of practice experience. The information and opinions expressed below should not be viewed as diagnoses and treatments, but rather as information to help you understand your foot or ankle related problem. All medical problems should be diagnosed and treated by a foot and ankle specialist in your state, or your family doctor.

Subject: Sprained Ankle

"Hello! I am 22 years old and while playing basketball one night I went up for a lay-up and my ankle rolled under me and went out. I heard a 'pop' and was in a LOT of pain. I went to the emergency room where they took x-rays and said it was a bad sprain. I was so relieved it wasn't broken! But it has been a week now and it's still swollen and bruised badly. I have been keeping it elevated and iced but the swelling will not go down and the pain is still there. What can I do to ease this pain and swelling so I can walk again? I was told to use epson salt with hot water. I was also told acupuncture. I'm not sure what to do. Can you please help me?"

Dr. Kasdan's response: "Unfortunately one cannot always go by the ER's diagnosis. I suggest that you see a foot and ankle specialist for further ankle  x-rays. Stress fractures may not show up on x-rays for up to 2 weeks after the injury.  There are other serious ankle injuries which are can occur, such as talar tilt (a dislocation at the ankle), torn ankle ligamnets, and serious sprains. These types of injuries must be properly treated, or they may cause recurring ankle pain for for many years after the injury."

Subject: Torn Ligaments

"This past winter I felt something gradually tear in my left ankle as I was descending the stairs in my home. This was over a period of a couple weeks. After a while I then noticed swelling in my ankle. After several painful weeks of limping to keep the weight off, the pain finally subsided and I was eventually able to walk as usual, which is rather briskly. However, the swelling is still there. Could I have torn some ligaments (since it was always a struggle to keep my floppy slippers on while going downstairs)? Is swelling natural during and after this type of injury? I have been able to move my ankle in range of motion exercises without pain. Mainly, the swelling is my concern. Thanks for your help."

Dr. Kasdan's response: "Ankle injuries can be a source of life-long pain, even without a fracture being present. Severe tears of the ligaments which hold the ankle joint together, when not treated properly, do not heal properly... thus causing recurring pain and instability. I suggest that you see a foot and ankle specialist as soon as possible. Treatments that may help this condition include orthotics, an ankle brace, or physical therapy; or surgery may be needed. You should see your doctor soon."

Subject: Recurring Ankle Sprains

"I keep twisting my left ankle. Each time it seems like it takes less of an injury to twist it. Am I imagining this? How can I protect it from further injuries?"

Dr. Kasdan's response: "The ankle is supported by ligaments which contain elastic fibers. Each time the ankle is "twisted," some of these elastic fibers are torn. When the tears heal, they heal with connective tissue, which has very little "give" to it; thus, it tears easier then the elastic fibers. Subsequent twists produce more serious injuries because the ligaments cannot stretch and thus tear easier. Other causes are: tight ligaments due to abnormal foot structure, muscle imbalances, and lack of proper "warm-ups" before engaging in exertive exercises. To prevent further ankle injuries the ankle must be stabilizede. This is done most easily with a pair of custom-made orthotics, which will limit the abnormal side-to-side motion that occurs when the ankle is twisted, but allows all normal foot and ankle movements. Click here to learn more about custom-made orthotics."

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