Sprained ankle = knee pain?
November 5, 2023 1:48 PM Subscribe
Almost a month ago, I sprained my ankle. It has then, so far, healed—no visible bruising and swelling has appeared to go fully down. However, I've been experiencing an onset of knee pain. Do you think the incidents are related?
Obligatory YANMD. When I stand, my knee feels stiff/funny, especially on the front part. Kind of feels like the lower and upper parts are misaligned somehow, and it feels somewhat "numb" and yet painful—not sure if that makes sense. When I sit/lay down or walk, the pain/sensation is not there for the most part—it's chiefly when I stand. I wear compression socks almost every time I go out, and occasionally wear ankle boots, but regardless, the issue appears.
I had X-Rays of my knee done, which revealed mild arthritis and patella alta. I doubt the arthritis is new, because it's generational. The X-Ray results also included small tricompartmental osteophytes detected (whatever that means).
I find it extremely odd that I'd, all of a sudden, have onset of this pain, especially arthritis (which seemingly appeared out of nowhere). Based on that, do you think it's caused by the ankle sprain? The pain/sensation started after the ankle sprain—before that, I had absolutely no issues.
The Urgent Care doctor who diagnosed me said it was likely because I was walking "funny" to compensate/protect the sprained ankle, and prescribed me Flexeril to help with the pain. Flexeril is supposed to make you drowsy, yet they prescribed me to take it during the morning and evening, so I am worried about the impacts on work.
I have an upcoming appointment with my PCP and am not sure how to best explain this situation and see what they think. Any helpful input would be wonderful. For context, I'm hitting 40 pretty much right around the corner. My knee physically looks and feels normal—no swelling or deformations of any kind.
Obligatory YANMD. When I stand, my knee feels stiff/funny, especially on the front part. Kind of feels like the lower and upper parts are misaligned somehow, and it feels somewhat "numb" and yet painful—not sure if that makes sense. When I sit/lay down or walk, the pain/sensation is not there for the most part—it's chiefly when I stand. I wear compression socks almost every time I go out, and occasionally wear ankle boots, but regardless, the issue appears.
I had X-Rays of my knee done, which revealed mild arthritis and patella alta. I doubt the arthritis is new, because it's generational. The X-Ray results also included small tricompartmental osteophytes detected (whatever that means).
I find it extremely odd that I'd, all of a sudden, have onset of this pain, especially arthritis (which seemingly appeared out of nowhere). Based on that, do you think it's caused by the ankle sprain? The pain/sensation started after the ankle sprain—before that, I had absolutely no issues.
The Urgent Care doctor who diagnosed me said it was likely because I was walking "funny" to compensate/protect the sprained ankle, and prescribed me Flexeril to help with the pain. Flexeril is supposed to make you drowsy, yet they prescribed me to take it during the morning and evening, so I am worried about the impacts on work.
I have an upcoming appointment with my PCP and am not sure how to best explain this situation and see what they think. Any helpful input would be wonderful. For context, I'm hitting 40 pretty much right around the corner. My knee physically looks and feels normal—no swelling or deformations of any kind.
When I was finishing physical therapy for a broken ankle, my physical therapist cautioned me to look out for compensation injuries in my feet, knees, and hips, because those areas are all part of our legs' systems of compensating for any imbalances or issues.
That said, could it be possible that when you fell, you also inadvertently bruised or twisted your knee when you went down? I've had that happen before, too.
posted by limeonaire at 2:19 PM on November 5, 2023 [5 favorites]
That said, could it be possible that when you fell, you also inadvertently bruised or twisted your knee when you went down? I've had that happen before, too.
posted by limeonaire at 2:19 PM on November 5, 2023 [5 favorites]
Response by poster: In other words, your knee pain is only on the affected side,
That's right — only on the same side/leg as the ankle sprain, not the other side/knee.
That said, could it be possible that when you fell, you also inadvertently bruised or twisted your knee when you went down?
It could be, but I don't recall feeling any twists or anything unusual on my knee when my ankle was sprained, and the knee pain didn't really start hurting until ~2-3 days later. How could I be sure?
posted by thoughtful_analyst at 3:10 PM on November 5, 2023 [1 favorite]
That's right — only on the same side/leg as the ankle sprain, not the other side/knee.
That said, could it be possible that when you fell, you also inadvertently bruised or twisted your knee when you went down?
It could be, but I don't recall feeling any twists or anything unusual on my knee when my ankle was sprained, and the knee pain didn't really start hurting until ~2-3 days later. How could I be sure?
posted by thoughtful_analyst at 3:10 PM on November 5, 2023 [1 favorite]
It could be tight quads pulling your patella slightly out of place. "Patella alta"
In which case you would have the PCP give you a referral to a physio for quad stretches and a handful of exercises.
On top of this you could start doing quad stretches at home. Like, tonight.
> How could I be sure?
If the quad stretches make the pain go away and the physio exercises keep it away.
> The Urgent Care doctor who diagnosed me said it was likely because I was walking "funny" to compensate/protect the sprained ankle, and prescribed me Flexeril to help with the pain.
Urgent care doc probably knows their stuff.
posted by sebastienbailard at 3:29 PM on November 5, 2023 [1 favorite]
In which case you would have the PCP give you a referral to a physio for quad stretches and a handful of exercises.
On top of this you could start doing quad stretches at home. Like, tonight.
> How could I be sure?
If the quad stretches make the pain go away and the physio exercises keep it away.
> The Urgent Care doctor who diagnosed me said it was likely because I was walking "funny" to compensate/protect the sprained ankle, and prescribed me Flexeril to help with the pain.
Urgent care doc probably knows their stuff.
posted by sebastienbailard at 3:29 PM on November 5, 2023 [1 favorite]
Urgent care doc probably knows their stuff.I mostly agree, except for handing out a prescription for Flexeril. Flexeril is unnecessary. Physio + heat/ice + occasional NSAID (such as ibuprofen) will do. Your physio may do supportive taping, which may also help.
If you do not wish to take the Flexeril you can safely skip it.
posted by shock muppet at 4:12 PM on November 5, 2023 [1 favorite]
Osteophytes are a normal part of body/bone ageing and essentially once you reach a certain age you will have osteophytes. So is (osteo)arthritis. While osteophytes will show up imaging (x-ray, MRI, etc) they are generally unrelated to pain or function.
posted by lulu68 at 4:26 PM on November 5, 2023 [1 favorite]
posted by lulu68 at 4:26 PM on November 5, 2023 [1 favorite]
I recently was in physical therapy for a weak knee. After some diagnostic tests, the therapist said that it was, instead that I have weak ankles and hips. And because of that, the joint in the middle (the knee), was unsupported and compensating for the other joints.
It seems classic that you sprained your ankle (probably due to weak ankles), and are now having knee problems. So yes, I think the two are absolutely related and going to a physical therapist can help confirm that.
I am about two months in on exercises and my knee feels completely restored. And a bonus was that the ankle strengthening exercises are also helping with balance.
posted by nanook at 5:23 PM on November 5, 2023 [5 favorites]
It seems classic that you sprained your ankle (probably due to weak ankles), and are now having knee problems. So yes, I think the two are absolutely related and going to a physical therapist can help confirm that.
I am about two months in on exercises and my knee feels completely restored. And a bonus was that the ankle strengthening exercises are also helping with balance.
posted by nanook at 5:23 PM on November 5, 2023 [5 favorites]
the "compensation" that you and limeonaire mention seem (to me) to be very likely the cause of the issue. I had back issues (low back/sacro-iliac stuff) that went away, and then years later (when I stopped doing my stretches religiously) manifested as plantar fasciitis in the foot on the same side.... fixing the foot required fixing the back. Not super-intuitive unless you internalized the gospel according to "Dem Bones" and believe the leg bone's connected to the ankle bone.
posted by adekllny at 6:16 AM on November 6, 2023 [1 favorite]
posted by adekllny at 6:16 AM on November 6, 2023 [1 favorite]
Not only compensation injuries, but the initial ankle injury likely jacked up your knee too, but the more serious injury masked it. It's all the same infrastructure, you know? When I broke one knee, and then a couple years later sprained the everloving shit out of basically my entire lower leg, my back and neck were also trashed from the messed-up way I had to move.
There's PT exercises for all this. You often really only need one session for assessment and initial homework exercises, one follow-up to check your form and introduce some advanced exercises, and then maybe the occasional touch-up over a few months.
posted by Lyn Never at 6:29 AM on November 6, 2023
There's PT exercises for all this. You often really only need one session for assessment and initial homework exercises, one follow-up to check your form and introduce some advanced exercises, and then maybe the occasional touch-up over a few months.
posted by Lyn Never at 6:29 AM on November 6, 2023
Yes, definitely nthing to see a PT. It could be compensation from the ankle injury, or it could be that a weaker ankle is putting more strain on the knee, or tight muscles in your leg, or whatever.
For example, when standing without shoes, my left foot completely flattens - any arch disappears - and that put a lot of strain on my knee/ankle/hips/back, so my PT got me in custom orthotics, which significantly decreased my ankle sprains and other issue with the joints on that side.
Not saying you need custom orthotics, but a PT can help assess what's going on and give you exercises etc to help with that.
posted by litera scripta manet at 6:52 AM on November 6, 2023
For example, when standing without shoes, my left foot completely flattens - any arch disappears - and that put a lot of strain on my knee/ankle/hips/back, so my PT got me in custom orthotics, which significantly decreased my ankle sprains and other issue with the joints on that side.
Not saying you need custom orthotics, but a PT can help assess what's going on and give you exercises etc to help with that.
posted by litera scripta manet at 6:52 AM on November 6, 2023
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posted by ClaireBear at 2:02 PM on November 5, 2023