Ankle joint has locked

by Paul
(Lancashire)

I broke my leg and had compound fractures to both bones in my lower left leg; I've had an external fixator on my leg for 14 months with pins in my leg from knee to ankle 30 pins in all so my ankle had pins in place so it didn't move and now 16 months on everything is off.


I have seen my physiotherapist today she's had a look and said my ankle is locked and is very unlikely it will ever release again.

Is there anything like an operation I can have to change this? Otherwise I will never walk properly again. Please help.





Hello Paul,
This is distressing; it must have been a very bad fracture to have been cast for so long.

I'd start by getting an opinion from the surgeon.

Meantime, start exercise the ankle every hour of the day for five minutes, all not weight bearing; whilst sitting.

Carve out letters in space, make the ankle go through all the ranges of motion. You can also ask a family member to do this passively, mobilizing the ankle in all directions, but without pain.

Stick with your physiotherapist for a month or two; if you feel you're getting no where then you might like to see a chiropractor with a FICS qualification.

I wish I could be more encouraging; the physio could be right, but I would certainly give it a damn good try!

If you're a smoker, stop. Fractures like this never heal well without maximum oxygen.

Dr Barrie Lewis



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Ankle achilles tendon burning pain

by Kamil
(Iran)

Diagram of ankle anatomy

Diagram of ankle anatomy

My right leg ankle achilles hurts like burning, I can't walk in the morning when I get up from my bed,after 10 minutes it becomes ok.
Thank you.





Hello Kamil,
Firstly, is the heel bone swollen and enlarged, and secondly do you have other signs of arthritis in the body? There is a condition known as "enthesiopathy" which is an inflammatory variation of rheumatoid arthritis that may affect the heel and attachment of the achilles tendon. Ask your doctor about it.

More likely, you've strained the achilles tendon and the best treatment is stretching with the knee straight (for the gastrocnemius muscle) and slightly bent (for the sartorius). See ankle exercises ...

Then, using cold hot therapy is the best way to control pain and reduce inflammation.

The underlying cause is often a fixation in one of the small joints in the ankle that has changed the way you walk. Often in the "subtalar" joint after an old sprain that wasn't well managed. See our ankle joint pain page using the Search feature.

I hope this contributes.

Dr Barrie Lewis




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Now what after 14 weeks after "high sprain" of left ankle

Diagram of ankle anatomy

Diagram of ankle anatomy

I am 40 yrs old. Last February, I was kicking around a soccer ball with some kids and ended up on the ground with a sprain. I'm not sure why or how. It did not hurt terribly bad at first. But as I sat there moving my foot around to make sure nothing was broken, the pain slowly increased until it was very painful.

After a few minutes of that, the pain started diminishing and a friend helped me walk over to a picnic table. I stood there talking for about 1/2 an hour and then attempted to hobble to my car- ouch. As I was driving home, my foot felt like it was getting closer and closer to a fireplace. (thankfully, I didn't have to use it to drive- just my right foot for the gas and brake)

Upon getting home (20 min drive) I could not bear to even step on my foot; I hopped to the house and straight to my bed.

Two weeks later I landed flat on my left heel as I lost my footing while trying to hop onto my shower's 5” edge. An unbelievable amount of pain shot from the bottom of my heel, up the back of it and slightly up the back of my leg. I dared not move for a few minutes. Then I went back to my sprained- ankle- life; I laid in bed most of my days with my foot up and only used my right foot and crutches to get around.

Two weeks and 5 days after the initial injury, I went to get an x-ray just to make sure I didn't have a fracture- I thought for sure I should be healing quicker than I was. Whew! Nothing wrong with my bones. But I was amazed at the intense sensations and tingling I experienced when the doc told me to stand on my foot and did different manipulations.

3 ½ weeks later I went to the chiropractor because I felt as though my ankle was jammed. After a couple of weeks, I was able to walk again, but still felt as though something was stuck deep inside. Two weeks ago, my ankle was bumped as I rested it on top of my right knee and was surprised at the shoot of pain that flew through the top of my foot.

It still hurts upon my first steps in the morning and as I'm doing my stretches. I can't properly run because of my lack of full range of motion. And I'm not able to do a full squat. When shaking my foot as I take off my pants, a pain can be felt inside under the top of my foot. I decided to do more searching on the internet for some ideas.

I found your website. It seems, from my reading, that I may have a fixated talus... ? I think my chiropractor has done all that he knows to do, but I know I'm not done. (I'm also doing collagen drinks every morning)

Any comments and/or suggestions?

~Chandra~





Hello Chandra,
Difficult, I agree.

Firstly, is it still swollen? If so, if you find the funds, I'd have a CT. Because of the overlapping bones, it's very easy to miss a fracture in the ankle and foot on plain X-Ray.

The ankle mortice joint controls most of the up down movement of the ankle: dorsi and plantar flexion. Pain in this joint is often felt on the top of the ankle just where foot meets leg, a "hole" slightly on the outer side.

The subtalar joints controls most of the rolling action of the ankle. Pronation and supination. Then the pain is often on the outer side of the heel, but because the subtalar joint is really three joints it can be anywhere in the ankle.

Either could be involved, or other of the many joints in the foot.

I've realised a gap on my site: no exercises for the ankle. I'll get to that, but meantime ask your chiropractor for exercises that you do every day, several times a day.

Perhaps time to see a different chiro, more experienced with the foot and ankle, with a "FICS" qualification, (ask your local chiro association) or an orthopaedic specialist. It's really difficult for me to advise.

Meantime be careful.

I fear this hasn't contributed too much.



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Find a good chiropractor may be your next stop.

I hope this has contributed.

Dr Barrie Lewis



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Grinding ankle

by Jennalin
(U.S.A.)


»
» Ankle Ailments


I jumped in a pool (not knowing how deep it was) about six months ago. And I did something to my ankle. It remained very swollen for about a month and a half. It has been pretty sore ever since then. When ever I rotate it now it grinds and pops.





Hello Jennalin.
It's important to get an X-ray of your ankle and, if you can afford it, a scan. X-rays of the ankle often miss a fracture.

Whether you have fractured a bone in your ankle, or merely displaced a bone, after six months it certainly needs attention.

Some chiropractors treat feet, others not. Ask.

The good news: imagine if you had dived in. You'd probably be in a wheelchair right now. Shallow water is very dangerous.

Dr



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Rolled ankle with broken fibula

by Nicholas Delianedis
(Massachusetts)

3 years ago I badly rolled my ankle. I went to the hospital and they wouldn't do an Xray. They told me I sprained it and sent me home. 2 weeks later I went back and made them do an xray because i was still in pain. The xray showed a broken fibula which already started healing so they said to wait for it to finish healing and see how it feels. I attached a picture of the broken bone. The fibula healed malrotated and since then I have had pain in my ankle, my foot feels like it lands completely different.

I developed pain in my back on both sides that is right below the ribs, along with groin pain and pain around my waist. They looked at my hip and found a torn labrum and arthritis which I believe to have been caused by my broken fibula. I had my hip fixed however my pain has not gone away...

The doctors are not helpful and I this point im conteplating getting a lawyer because no one will help me and they just try to give me medicine instead of addressing the issue...

What should I do?





Difficult Nicholas. You might squeeze some money out of them but at great expense and cost to yourself; and a lot of stress. But it won't fix your ankle.

It's a difficult issue; I too don't x-ray at the drop of a hat. 7 percent of all cancers are caused by medical xrays. So I too wait if there are no definite signs of fracture. The clinical exam was obviously a bit shoddy because a fractured fibula would have been very painful.

When there's enough force to break a bone, almost invariably there been tearing of ligaments and perhaps a hidden fracture within the ankle that hasn't been detected; often hard to see because of overlapping structures.

What's needed is a really thorough and careful clinical exam. Usually in an inversion sprain there's also a subluxation of the talus or subtalar joints. That's where I'd be looking for a start.

And obviously the knock effect on your hip and back; that fracture would have changed your whole gait, and may still be affected.

Look for an experienced and thorough chiropractor who specialises in feet; not just expensive orthotics.

I hope this contributes.

Dr Barrie Lewis



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rolled ankle

Diagram of ankle anatomy

Diagram of ankle anatomy

Stepped on someones foot while running

felt a pop, was able to limp around for a short while, hurt

next day ankle did not swell but could not put any pressure- there was no pain anymore unless it is bumped or pressure is applied

3rd day ankle swelled, still no pain or bruise

i definatley felt a pop towards the top left of my foot left ankle

using crutches to get around

any advice if torn ligament





Hello Elie,
Most likely you have a subluxated talus or calcaneus in your ankle. Typically very sharp pain when weight bearing, with no significant swelling or bruising if there is no damage to the ligaments.

If there was a fracture, you would almost certainly have more swelling and bruising. So an xray may well not be necessary.

Reducing the subluxation is not difficult, but you will have to rehab the ankle as the ligaments and capsule would almost certainly have been stretched, and then it just rolls again.

Many of the foot pain syndromes we treat have their origin in something like this that was neglected. Deal with it now whilst it's acute and save yourself the grief later.

Find a local chiropractor who has works with feet and ankles. Not all chiros do.

Meantime use ice and keep it moving.

Dr Barrie Lewis


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