Knee, hip, back, shoulder pain from ankle sprain

by Jovanni
(Easton, PA)

Diagram of ankle anatomy

Diagram of ankle anatomy

I'm 17 and my right knee, hip, back, and shoulder, are messed up.


I injured my ankle during a high school football game and was diagnosed with a high ankle sprain on my right ankle. I couldn't walk for like 5 days but after that I started hobbling. I used the boot for 2 days and tried to get back to walking as fast as possible. This was a rushed injury because I didn't want to lose my starting spot.

I rushed through therapy and I thought everything was going to be ok; turns out I was wrong. In the last year I have felt really bad hip and back pain on my right side. It started with my right knee and I couldn't stretch the way I used to. It then moved up to the hip, then my shoulder, then my neck. I feel like my center of gravity is messed up. I can't lift heavy weight in the gym because my shoulder gets displaced. I can't squat because my hip and knees hurt.

This has really been irritating me because I can't lift and I feel everything on my right side of my body is messed up. I tried a month of therapy, and it worked a little and I'm still doing some exercises. I just don't feel the same as I did. I'm 17 and I want to lift and get in shape but I can't because my whole right side of my body is messed up. Can someone please help me?

Hello Jovanni,
That altered gait from the ankle injury has had a knock on effect all the way up the kinetic chain, and a fixation in one of the joints in the lower leg is still probably the underlying cause.

Learn one thing from this; get properly better first after an injury, otherwise it may be with you for life. "Rush and hurry are not of the Devil," said Carl Jung, the famous psychologist. "They are the very devil."

I have no easy solution for this; certainly I'd stay away from lifting for the present. Swimming may be the way forward since your ankle won't hold you back.
Start hunting for a chiropractor with a FICS qualification; that's a post graduate sports qualification. Phone your state association.

Good luck; let me know how you get on.

Dr Barrie Lewis



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Muscle imbalances of leg due to long term ankle sprain

by Autumn
(Florida)

How do I rehab an ankle after a long term sprain that has caused years of muscle imbalances? Where do I begin?



Hello Autumn,
Lower down I'll put a link to some ankle exercises. I'd start with the so-called alphabet exercises; carving the letters out in space using your big toe.

If there's pain or clicking in the ankle, you may have a subluxated talus or calcaneus; that will also need to be attended to.

Joint injuries cause what is known as 'arthrogenic inhibition'; the nerve supply to the muscles around the joint are inhibited, worsening the injury.

Sorting out that inner ankle injury and then a daily commitment to perhaps 3-5 minutes of exercise is what's needed.

A wobble board is helpful too.

Dr Barrie Lewis



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

by Deb
(Japan)

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 Barrie Lewis


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Sprained ankle

Three days after being told I had a sprained ankle I was called back and told I needed a brace.

I have a swollen ankle joint and they want me to see a specialist; is this necessary? What would happen if I don't go?

It all depends what's wrong. If they called you after several days, it's probably because someone reviewed your x-rays and is concerned.

It would be best to follow their advice.

Dr B

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Ankle sprain with swelling but no bruising

Swollen ankle

Swollen ankle

Ankle sprain with swelling but no bruising means there is probably no serious rupture or fracture.

Last week while going down stairs I rolled my ankle. I could not walk on it properly for about two days. Then the pain got better and the swelling started to go down. There is no bruising but it is still swollen a week after the incident; although it has gone down a fair bit, it is starting to become painful to walk on, the pain going across the front of the foot. I would really appreciate some advice.

Hello Clair,
All sorts of things may have happened, but it doesn't sound like you have fractured anything. At this stage x-rays are probably not necessary, though that should be reevaluated in ten days.

Clearly, if it's swollen some tearing of ligaments has occurred, but with no bruising, it's not most likely a serious rupture.

Where a tight fitting ankle guard, ice it and do our ankle exercises; stay off it as much as you can; a crutch will help. It needs rest.

Then very often the ankle mortise, or one of the other small joints was subluxated, causing the sharp pain with walking. Generally it's not difficult to reduce, but you need to find a chiropractor with a FICS qualifation in sports injuries.

Good luck, I hope this contributes.

Dr Barrie Lewis


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My ankle sprain no doctor can stop hurting

I rolled over my ankle two weeks ago but I never went to the softer; it always hurt until yesterday and it abruptly stopped hurting me but it's still swollen; what do I do?

I don't understand your title, but never mind. Or what a softer is.

If the pain has gone it will probably heal itself, if you give it time; if it was and is swollen, clearly you've torn something, and that will take a minimum of six weeks to heal. Get back in the deep end too soon and it will just aggravate it, and likely be even worse.

So, give it the six weeks and meantime use ice, do our ankle exercises, don't sport, but if you feel it's not painful start walking, and perhaps in a week or two jogging.

Listen to your ankle; it will warn you if you are doing too much. Don't go by the no pain, no gain, philosophy; with an injury of this nature you'll only worsen it.

If in another week or two it's still swollen, or starts hurting again, get a professional opinion.

Dr Barrie Lewis

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Sprained ankle for 2 months

by Selina
(UK )

Ankle mortise subluxation

Ankle mortise subluxation

Sprained ankle for 2 months.

I went to the doctors and was told it's a sprained ankle and I need to ice, rest etc; by second week the was no improvement and my foot stopped moving downwards and it seemed like it was locked; basically I had no ability to do plantar flexion.

I went back again and they referred me for a X-ray however I had to wait for 10 days to receive my result. I was struggling to walk because my foot felt like it was jammed/locked on the joint area and it's so difficult for me to do anything and the pain was not going away.

I ended up going back to the doctors for the third time but they could not do anything until my result arrives; when the result arrived it showed its clear with no broken bone also there's no fracture on the ankle but I was told to rest my foot and do light exercise. I still can't seem to move my foot so therefore just had my MRI scan done so just waiting for results.

I'm so worried that having my ankle jammed in that position for 8 weeks, will it ever go back to normal again. I only done light exercises at home and normal walking. I feel so paranoid it may be a permanant thing and have I done any further damage to my foot?

What treatment would I need?

Hello Selina,
I'm going to stick my neck out, not having examined you, and state that I would give 100 to 1 odds that you've subluxated the talus bone in the ankle mortise joint.

I can do that because I've had the exact injury you describe myself, and I've treated probably several thousand over the years.

When you turn your ankle four things regularly happen.

1. Ligaments are torn, and it goes all the colours of the rainbow.

2. Tendons and muscles are strained and sometimes also torn.

3. One of the many bones in the ankle are fractured; often it's not easily visualised on a normal xray because of the overlapping bones. The MRI will detect it, if present.

4. And fourthly there a subluxation in the ankle mortise, subtalar or one of the many other joints in the ankle and proximal foot.

The ankle mortise controls dorsi and plantar flexion, so I suspect a displaced talus bone; the deviation is usually so small that it's not seen easily on xray or MRI. Having been there myself, I recall well the severe stabbing pain. Probably the worst pain I've had in my life; that you don't forget easily.

The good news, Selina, is that it's usually easily treated by a sports oriented chiropractor. Look for someone with a FICS qualification. Of course, after two months it's not going to be straight forward, and you will have to be patient. But I can virtually guarantee it will get completely better, assuming the MRI doesn't pick up a latent fracture.

Good luck, and let us know how you get on.

Dr Barrie Lewis


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Ankle sprain healed but pains still after 16 months

by Utsav
(Haldwani, uttrakhand, india)

Diagram of ankle anatomy

Diagram of ankle anatomy

I had an anterio talo fibular sprain grade 1, then I sprained it two more times. Gradually the pain has decreased significantly but there is instability in the right ankle and whenever I rotate my ankle it makes a knocking sound; the pain sometimes when I'm not wearing my ankle support and shoes goes in the whole foot; also it's very disturbing. It also get swollen a little.

Hello Utsav,
Yours is a very familiar tale; whether it's a shoulder, lower back or ankle, folk are not advised to through a proper rehabilitation programme, and not willing to wait until healing is complete before going back to sport; and there is another injury, often worse than the first.

Your ankle is unstable now, with lax ligaments that allow one of the small joints to subluxate; hence the knocking sound. That scrapes the cartilage that lines the bone and keeps the inflammation and swelling active.

Is you weight right? If not you are in for major surgery in a few years time to fuse the ankle.

Do a lot of reading about the anti inflammatory diet; at least in some small way it will help.

Probably most important is that a daily, committed exercise programme must be the story of your life. Start slowly and it shouldn't make any of those knocking sounds. Delhi wasn't built in a day; nor will getting your ankle strong again; be patient and diligent and work hard at rehabilitation.

Accept that many sports are now outside of your league.

I hope this helps.

Dr Barrie Lewis

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