Do You Have Chronic Pain After An Ankle Sprain?

One of my secretaries at work came to me a couple weeks ago and asked me about her ankle.  She had sprained it years ago and was continuing to have pain and wanted to know what she could do to stop it.  The problem here was that she decided she wanted to be a runner and when she tried to increase her mileage, her prior ankle sprain became a problem causing her to have severe pain and muscle spasms around her ankle.

Strangely enough, at the same time, I was seeing a 13 year old girl who had sprained her ankle a year ago and continued to have pain with every day activities like walking and climbing stairs.  This young lady could not participate in any sports.

I thought both of these stories would be relevant here and that you guys could learn something from them.

The Secretary 

My secretary is a 25 year old dancer who just gave up dancing about a year ago.  She actually has had many sprains on this ankle and even one that included a little bone chip.  She had some physical therapy in the past that helped out some.  Up until the time she started trying to run, she could work out at the gym without too much trouble, but she decided she wanted to be able to have another activity to add to her workouts.  Running is going to be that activity, as she really enjoys it and doesn’t want to have to give it up for her ankle.

So, when I had a little down time at work and the phones weren’t ringing off the hook, I took a look at her ankle.  It was a little tender and it was definitely hypermobile, but I would expect a dancer to be hypermobile anyway or she wouldn’t have been any good at dancing.  She was just as hypermobile in the other ankle, so I didn’t worry about it.  Check out my post on hypermobility if you want to know what I mean.

I concluded that she didn’t have the stability in her ankle to tolerate running and that was why the muscles in her ankle were cramping up when she ran.  The ligaments in the ankle were compromised due to all the sprains, so the muscles around the ankle were working overtime to create the stability that was lacking from the damaged ligaments.  This also meant that her larger hip and thigh muscles had to get stronger in order to help out those muscles around the ankles so they didn’t have to work as hard.

The Teenager

On to my 13 year old patient.  As I said, she had sprained her ankle a year ago and just continued to have pain with most of her activities.  After she sprained her ankle, she was given the usual advice to rest it, stay off it, and ice it until she could walk again.  So that’s what she did and that’s all she did.

When I examined her ankle, she was still tender over the area that was sprained and her ankle was also rather hypermobile and weak.  Again, not something all that uncommon with teenage girls.  I decided that her ankle needed to be stronger and that she needed to improve her proprioception.  Proprioception is your brain knowing where your joint is in space without having to look at it.  This can get messed up after an injury and needs to be retrained so that you can function well on one leg.

What They Did To Get Better

Both of these girls needed similar plans to get them back into shape.  As for my secretary, who was already used to working out and had decent core strength, I recommended she work some single leg balance activities into her gym workouts using a BOSU ball or an air filled disc.  I also suggested that she do some single leg strength activities to build her hip and thigh strength such as single leg squats, single leg Romanian dead lifts, and single leg bridges.  Doing this stuff on one leg works great for building the stability that she is missing.  She came back to me a couple weeks after trying out this stuff and told me that she was already starting to feel better.

My teenager, as you may realize, needed a little more guidance and nagging to get things done.  She needed some basic strength work first, like pulling on bands with her ankle and going up and down on her toes.  Once she built a little strength back, she was able to do some lower level single leg balance work.  She also got a healthy dose of lower level hip and core exercise because she was extremely lacking in this area.  I worked with her for about a month and when she finished up she was completely pain free and could return to doing all of the activities she had been avoiding.

So, there are two examples of patients that had ankle pain long after their injuries that went ahead and got better.  I hope this inspires you to look into what you can do for yourself if you’ve been struggling with chronic ankle pain during your exercise or sporting activities.  You don’t always just have to put up with the pain.  It’s possible that with a few added exercises, you could be pain free.  This also goes for those of you who have just been having ankle pain for no apparent reason.  You don’t need to have had a traumatic injury to seek out help.

photo credit: congvo via photopincc

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