Why won't my sprained ankle heal?

January 29, 2009 11:56 AM

Why does my sprained ankle still hurt after over a month of rest?

I tripped while on a run on Dec 19th. Nothing hurt, so I just kept going. I ran the next 2 days, but by the thursday my ankle hurt enough that I decided to stay off it for a while.

There was (and still is) no swelling. I iced, rested, and elevated it for about 2 weeks. I talked to a physiotherapist friend who played around with it and told me it looked like a minor sprain. She lended me a brace that I wore for the week that I was staying with her.

Now it's been over a month and I still can't run. I can feel it slightly when I'm walking or going down stairs, but not enough that it interferes with daily movement.

What should I do? Is there any chance that there's anything more serious going on? Should I just be patient and wait? If so, how much longer? If I go see a doctor, are they going to do anything but prescribe anti-inflammatories and tell me to rest?

I'm not in my home country, so going to the doctor could potentially get expensive, as a sprain doesn't really qualify as an "emergency". A break might...

I just want to start running again!

posted by snoogles to health & fitness (14 comments total)

It can take ages. I hurt my left arm longboarding in mid-August and the green/purple stretching up and down from my elbow didn't fade until mid-October-- and only last week I lifted something heavy and the pain came back, along with some light bruising.

If you can't afford to go to the doctor where you are, I'd say go easy on it for a while yet. As I said, this sort of thing can take ages.
posted by dunkadunc at 12:01 PM on January 29

This is typical from what I understand. Ankle injuries are notoriously slow to heal. I sprained my ankle pretty badly a while back and the random pains didn't go away for almost a year. I even re-sprained it six months after the injury by putting on my shoe (coincidentally, this was the only time a doctor has told me that I should come up with a more exciting story).

The doctor told me recurrent pains are common. It'll take a while, unfortunately.
posted by HonorShadow at 12:08 PM on January 29

The only way for a wound to fully heal is to not stress the area that is injured. Unless you're going to walk on crutches or be in a wheelchair for three weeks, this will take some time to heal - walking puts constant stress on your ankle. So yeah, be patient - and DO NOT start running again until it's healthy, or it never will be. Trust me on this.
posted by pdb at 1:07 PM on January 29

IANAD.

Everyone/every situation is different, but I've been dealing with my ankle-related problem (tendinitis) for years. I've seen orthopedic specialists and all of them tell me it's not serious enough to operate, and I should just stretch, rest it, get an ankle lift, etc. - super frustrating, and I don't know where to go from here. Acupuncture and physical therapy have been of limited help to me thus far.

I would resist any urge to start running again or "push through pain," this can cause chronic injury - micro-tears and scar tissue. I'm convinced that if I'd received better advice and taken care of my injury from the get-go, I might still be running competitively. I love running, and it was heartbreaking to hear one doctor say, "I don't think you should ever run again."

Rest, ice, compress, elevate, and so forth. Eat well. Gradually slide back into a workout routine - I'd suggest cross-training in ways that don't stress your injury. For me, elliptical machine was good, exercise bike/stair stepper were not. Stretch and do isometric exercises. Take NSAIDs to reduce inflammation (be conservative with this). Don't let it get chronic!

- slowly recovering distance runner
posted by xiaolongbao at 1:10 PM on January 29

Don't rush the healing process for the sake of getting back into sports. I sprained my left ankle snowboarding about 12 years ago, then tore it again after a month of rest (I had tickets for Whistler that I wasn't going to miss...) It's still usually a little sore and stiff. Take it easy!
posted by nicwolff at 1:58 PM on January 29

Should I judge what is acceptable cross-training solely on what doesn't cause pain? Is erging (rowing machine) alright?
posted by snoogles at 2:04 PM on January 29

Soft tissue injuries take a fantastically long time to heal properly. I hurt my shoulder pretty badly and it took a year before it was really back to something like normal. It's been two years now and it still gives me twinges.
posted by Chocolate Pickle at 2:59 PM on January 29

When I was a teenage I had lots of sports injuries, especially to the hands. One time the family doc was taping me up (finger sprain) when he pointed to his little finger and said that he didn't take proper care of a sprain there and it still bothered him five years later.

It seems to be that the fastest way to heal is to take the time to heal.
posted by trinity8-director at 3:38 PM on January 29

I had a really horrible ankle sprain misdiagnosed and it took YEARS to heal. It still hurts every now and again, even though I've had surgery to fix it.

My advice would be to take some anti-inflammatories (generic ibruprofen should be fine) *before* you run and to watch for any signs of it getting worse. Also, put ice on it for ~20 min. immediately after running.

You're probably not doing any further damage to it and keeping any swelling (even if you can't *see* it) down should help alleviate the pain. And of course, if you need to see a doctor to get the anti-inflammatories, do it. Certainly this isn't an emergency, but if there's a clinic or something you can go to just to get it checked out, it'd be wise to do so.

Good luck!
posted by grapefruitmoon at 3:39 PM on January 29

I've still got one ankle noticeably bigger than the other from a basketball sprain/ligament tear two or three years ago. (Landed on a foot, my foot went all the way to the side, I could swear I felt the bottom of my leg bones hitting the cement for a second) My cousin, who was not my physical therapist, not yours, but is, really, a physical therapist suggested that I need to build up the weakened tissue. One of the exercises is just moving your foot from the ankle, so that you make circles with your big toe. This can be very, very tiring, so don't overdo it.

After that, when you're healing a bit better, standing with the balls of you feet on a step, and your heel hanging off, vary between standing on your tip-toes, then lowering your heel below the level of the step. Again, this is a strengthening exercise, not something to do right after. If you feel pain, seriously, stop.

And seriously, IANAPT
posted by Ghidorah at 5:08 PM on January 29

Oh, and: my GF, who had a long dancing career, recommends tracing the alphabet in the air with your toe, over and over, as the best of all therapy exercises for a recovering sprained ankle.
posted by nicwolff at 12:25 AM on January 30

"Is erging (rowing machine) alright?"

You are using your legs for stabilization when rowing, so be very careful. Make sure you've taped or wrapped the ankle snugly so it won't suddenly give out when you put pressure on your foot.

I severely sprained my ankle more than 20 years ago, and it still aches every once in a while. A true sprain injures the ligaments holding your ankle bones together, and ligaments have notoriously poor blood supplies, which is why these injuries can take forever and a day to heal.
posted by SuperSquirrel at 10:45 AM on January 30

Should I judge what is acceptable cross-training solely on what doesn't cause pain? Is erging (rowing machine) alright?

The rule l've been taught is that you have done too much for your current stage of healing if it hurts at the time, hurts an hour later, or hurts the next day. Within those parameters, you are fine.

Definitely do keep moving it as much as you can in that pain-free range though. Immobilization is not your ankle's friend.

There are things that could accelerate your healing: supplements like vitamin C, bromelain, bioflavonoids, and proteolytic enzymes have all been proven to help with tissue healing, though I think those are especially for more recent injuries. Physical therapy modalities like ultrasound or laser can help heal sprains too. You might be able to find those services without going to an MD in that country.
posted by olecranon at 12:11 PM on January 31

Thanks for all your help! I guess I'm going to have to be patient. Looks like running is still out of the question, but I should be able to find other activities that won't put too much pressure on my ankle.
While it's not reassuring to know that so many people have had injuries like this stick around for so long, it's good to know I'm not alone!
posted by snoogles at 2:22 AM on February 1