How to treat an injured ankle that is swollen and painful?

Question

Hi doctor,

Before seven months, I sprained my ankle due to a track and field injury. I postponed crutches for a week due to a trip the following day but went on crutches the next week. I never went to see a doctor. I just went through PT with my athletic trainer. I spent three weeks without rigorous exercise and was able to return. The pain finally subsided after three months. But, it is still swollen and sometimes, painful to flex. Why?

Answer 1

Hello,

Welcome to icliniq.com.

You have mentioned injury to the ankle region, which has been managed by you and your therapist. Essentially, if one is able to ambulate after an injury, this is usually a ligament injury and not involving the bones. But, in my opinion, X-ray of the involved region should always be done to rule out a bony injury. So, once we can rule out that then depending upon pain and associated swelling, ligaments involved can be ascertained and treatment initiated accordingly. In any case, your swelling appears more visible on the outer side. So, probably lateral ligament complex is involved, which is also the most common ligament injury. Swelling can remain around the ankle region since it is a subcutaneous joint, and unless the ligaments have healed completely, it can recur. Now to understand exactly, we need X-rays initially and if that is fine, then MRI can be done to see the status of the lateral ligament complex. Alternatively, stress X-rays of the ankle can be done to see the joint opening, etc. Lastly, I would like to state that the majority of ankle injuries have to be managed conservatively with physical therapy and supportive management.