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How to cure pain and swelling due to an ankle injury?

Monday, 12 May 2003
Answered by: Mathew Varghese
Consultant Orthopaedic Surgeon and Director
St. Stephens Hospital
Delhi
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Q. I suffered a severe left ankle injury - soft tissue injury, 3 months back. There was a lot of swelling on the outer side. In the first month I could not walk without support. My ankle was immobilised with plaster for a week. I used crepe bandage for 2 months. Now I continue with my normal routine. It swells up with strain and I feel pain-not severe pain but nagging discomfort. Only an x-ray was taken to confirm there was no bone fracture. How long will it take to heal? Should I get any stress Xray taken? Do I require physiotherapy? Will my ankle regain its original strength? Any exercise required for this? I love jogging. Will I be able to jog again?

A.  Sprains of the ankle are very common injuries. Even after adequate plaster immobilisation, patient may have recurrent pain and swelling. Usually this results from inadequate healing of the sprained ligament. This is more common if it was a severe injury with rupture of large number of fibers of the ligament. Ligaments normally hold bones of the body together. If the ligaments are broken completely the bones become unstable. So, if the ankle ligament does not heal fully the foot tends to get twisted whenever you walk on uneven ground. Such patients with chronic instability and a demonstrable X-ray instability need surgical correction. Having said that the decision for surgery is not as common considering the frequency of the injury. A number of patients do not think the disability is significant enough to get surgery done. Some of these patients are benefited by raising of the outer body of the heel more than the inner border. This, by natural tendency, relaxes the ligaments that are frequently torn and prevents recurrent sprains. Some patients particularly those with partial tear of the ligament do well with what is called a wobble board exercise. This can be made at home with the help of a physiotherapist.

A.  Sprains of the ankle are very common injuries. Even after adequate plaster immobilisation, patient may have recurrent pain and swelling. Usually this results from inadequate healing of the sprained ligament. This is more common if it was a severe injury with rupture of large number of fibers of the ligament. Ligaments normally hold bones of the body together. If the ligaments are broken completely the bones become unstable. So, if the ankle ligament does not heal fully the foot tends to get twisted whenever you walk on uneven ground. Such patients with chronic instability and a demonstrable X-ray instability need surgical correction. Having said that the decision for surgery is not as common considering the frequency of the injury. A number of patients do not think the disability is significant enough to get surgery done. Some of these patients are benefited by raising of the outer body of the heel more than the inner border. This, by natural tendency, relaxes the ligaments that are frequently torn and prevents recurrent sprains. Some patients particularly those with partial tear of the ligament do well with what is called a wobble board exercise. This can be made at home with the help of a physiotherapist.

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