On and off pain from 10-month-old ankle sprain

by Deb

Where exactly does it hurt?

Where exactly does it hurt?

I first sprained my left ankle ten months ago in late January 2017 while playing basketball. It was very painful at first and my ankle became very swollen. I went to get it checked by an orthopaedic doctor and X-rayed right after, and was told that my bones look completely fine, and I just needed to rest, elevate, ice it, and I should be completely fine within a few weeks. I was on crutches for about 2-3 weeks before slowly resuming easy physical activity like walking again, as my orthopaedic doctor had suggested. (he even told me that I could run and exercise like before, but I didn't). My ankle remained slightly swollen for the months thereafter (it never return to its original size), but for the most part, it wasn't painful anymore and I could walk normally again. (though I noticed that when I stand for too long, my left ankle/foot will hurt and I'll have to sit down)

Flash forward to August 2017: I was standing in line at Universal Studios (after a day of lots of walking and standing), and out of no where, I felt a sharp pain in my left ankle again. It hurt to walk/stand, so I ended up renting a wheelchair to use after that for the rest of the day. The next two weeks, I went to a highly-recommended acupuncture specialist in my area, and after the acupuncture sessions with her, my ankle felt better again and I could walk without pain again. She recommended me to buy cooling patches to put on my ankle for 6 hours a day, and buy an ankle sleeve to put on my left foot when I'm out walking. My foot felt fine for about a week after that, until I boarded a flight to Japan in mid-August. After I landed in Japan, my left ankle started hurting again (perhaps due to the summer humidity there, as well as being at such high altitude during the flight for hours).

My first month in Japan, I went to various doctors: acupuncture specialist, orthopedic/sports clinic, etc. I was told to wrap my ankle with a tape to support it while I'm out walking by the acupuncture specialist, and the orthopedic doctor told me to do foot stretching and toe-curling exercises and ice my ankle every night. I did this with little results. Then I tried rubbing a lavender essential oil on my several times a day, and that helped noticeably for about 3-4 weeks. Every time my ankle would hurt, I would rub the essential oil on it, and it would feel better. I was walking and standing normally with no pain for about 3 weeks (perhaps I walked too much), and then starting a few days ago, the pain returned - except this time, it's a different sensation - a kind of tingling feeling when I stand, walk, or even I'm just sitting or lying down in bed. I notice the occasional tingling sensation in my lower leg sometimes too. I'm not sure what is the problem is, and want to get it checked, but going to the doctor here in Japan is very expensive since I don't have insurance. Some internet articles suggested that I get an MRI scan to check what is wrong with my ankle in more detail, while other people have told me that it's not worth it.

Right now the pain is usually in my left foot, but sometimes there will be an occasional tingle in my lower leg or even left thigh. So far I've been trying to not walk as much as possible, but since I don't have a car here, I have to walk at least 2,000-3,000 steps a day to go to the store, buy food, etc.

Any advice would be greatly appreciated! I'm considering going to a doctor, but am at a loss what kind of doctor to try seeing this time. I'm worried they won't be able to truly help like the previous doctors I've seen, and am afraid of the very high consultation price that they won't name until after my check-up. (it's also difficult to understand what the doctors are saying in Japanese, so not sure if going would be very helpful)

Thank you very much!!

Hello Deb,
Obviously it's impossible for me to make a definitive diagnosis, but clearly something more serious happened than anyone anticipated; that MRI would certainly be helpful in your case, but reading the scan is notoriously difficult.

If I was to speculate, dangerous, it sounds like the capsule, or one or more of the ligaments was sprained, and like a spring that has surpassed its elastic limit, no longer is giving the ankle the proper support that it needs; so an awkward, but often tiny movement allows one of the bones, usually in the ankle mortise or subtalar joints to subluxate again, and causes that very sharp pain when weight bearing and trying to walk.

It's changed your gait and so is now having a knock on affect up your leg. No back pain? The muscles on the side of your leg are having to work overtime to stabilise the ankle, something the ligaments should be doing, and so they are beginning to protest.

You've been doing all the right things; only you make no mention of daily exercises to mobilise the joint and strengthen those muscles. Are you doing something like that?

What you need is a doctor who specialises in sports injuries; either a chiropractor with a FICS post graduate qualifaction, or equivalent in the medical world.

Meantime also start doing the ankle exercises at the link below. That's the best I can suggest. Let me know how you get on.

Dr B

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