Lingering Pain After a Sprain

Restricted motion in the ankle joint could leave you with discomfort, even after rehab.

Kim asks: About a year ago I suffered a serious ankle sprain. I’m back to running, but my ankle doesn’t feel the same as it used to, and I’m wondering if it ever will? I wear a brace, but I’m not sure if it really helps. Is this normal for an ankle to still feel “off” even after time off and rehab? Any suggestions?

Most ankle sprains heal well and enable you to return to activity without a problem if the ligaments are not reinjured during the tissue-repair phase of the rehab protocol. Full ligament healing takes about 12 weeks if there is no reinjury of the tissue.

That said, even with good rehab some people do not regain normal joint motion after a sprain, and you appear to be one. The foot and ankle have many moving parts. If the motion through one of the many joints is inhibited in some way, your ankle will feel “off” when walking or running. While an ankle sprain mainly damages ligaments, the foot and ankle joints are also stressed and may lose normal motion in the process. It only takes restricted motion in one of the many joints to leave you feeling like your ankle is not right.You can evaluate yourself in front of a mirror by comparing the motion through your foot and ankle on the injured and uninjured sides. With your feet about 15cm apart and pointing straight ahead. Raise up and down on your toes and then on your heels. Look for differences in motion. Do the same comparison while rolling your feet in (inversion) and out (eversion). Sometimes you can see and feel the difference in movement between the injured and uninjured side. When there is a difference in motion, there is also restriction in the motion through at least one of your foot joints articulations, and that is likely the cause of your ankle feeling “off”.

A restriction in motion can be more subtle than those detected by the technique described above. A provider with manual therapy skills (podiatrist, physician, physical therapist or chiropractor) and an interest in the foot may be able to find the more subtle restrictions. Once the restriction is isolated, mobilisation may be used to “release” the joint to resolve the problem for you. It may take some detective work to find a provider who can get your foot moving normally again.

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