Ankle Inversion Injury- A First Hand Experience. PART TWO

THE NEXT DAY

 

As I woke the following morning and moved around in bed I thought that my ankle wasn’t as sore as I was expecting.  I inspected the ankle and although it was still very swollen...there didn't seem to be much bruising yet.  I started to think maybe I had exaggerated what had actually happened the night before and the ankle was not actually that bad!..... Then came the reality check..... putting my foot to the floor.... very painful.... much more painful than the night before and the ankle felt extremely stiff.  

As I put my weight through the ankle I was surprised to feel that the majority of the pain was actually medially rather than lateral.  As I hobbled to the freezer to get some ice, each step felt a tiny bit easier, but was still very sore.  I spent rest of the day being the perfect patient…. Icing, Compressing and Elevating it….. whilst it was elevated the ankle would feel fine, but the second I started weight-bearing through it, it was very sore and stiff.

As the day went on the more I would weight-bear through it I would feel like there was some kind of "plunger action" taking place within my ankle.  As I would put my weight on it I would get instant pain as if something was being compressed and the second I released the pressure I would get a feeling of a release…. like a plunger.  I imagined this was mainly due to the swelling, but all these things were new to me, having never had a significantly swollen joint before.

My Physio brain continued to tease me for the rest of the day… as I continued to walk on the ankle, only in short stints, I felt like with each step the pressure was building in the joint and with this pressure, the pain would build up until it would click and feel quite a lot better afterwards.  My Physio brain kept telling me that this meant the ankle was unstable and it must be a rupture of the ligaments, but realistically that sensation could easily be explained by the swelling in the joint.

NEXT FEW DAYS

Over the next couple of days it has got easier to walk, I only used the crutches for the first 3 days and then was able to walk without them, still in quite a lot of pain.  The bruising was now in full flow with a rather menacing looking bruise all down the lateral aspect of my foot leading to the base of the 5th metatarsal. (​long bone extending from the little toe) It had also spread down into the area above my metatarsals….  

I’ve tried to have a feel around the ankle to identify any specific areas of pain, but any palpation of the lateral malleolus (​bony prominence on the outer ankle) is incredibly painful and the pain seems to build for the next few seconds and I am left with a substantial ache.  It also felt unusual doing it to myself, I couldn’t bring myself to palpate with any kind of pressure.

The posterior medial side of the ankle still feels weird, and this continues to be the strongest pain of them all, which was quite surprising.  I imagined there must have been an element of compression there as the ankle was forced into inversion, but expected the lateral side to be the worst of the lot.  The posterior medial side feels like there is lots of pressure there, and it continues to feel as though it is building in pressure as I walk and then it clicks.  I am now able to move the ankle into dorsiflexion (Bringing the foot up) and plantar-flexion, (pointing the foot down)  but any movement into inversion (turning in) is very painful, and then again I am left with a residual strong aching pain.

WEEK 1

I am still in quite a lot of pain when I walk, and when I woke up this morning it was the most painful it has been first thing, which eased off a bit over about a 20 minute period.  I have continued to use the tubigrip to maintain some compression and have also managed to get my hands on some K-tape and have taped it for lymphatic drainage.  It may not be as effective now it is a week down the line, (​also tricky to do it on yourself!)  but I will wait and see what happens. 

I still struggle to do any inversion due to pain, which I suppose I can take as a positive sign that is isn’t a complete rupture and there is certainly no evident laxity, although saying that it is quite early to tell.  I will start to try and gently move the ankle into inversion to encourage alignment of the new collagen fibres.  Icing still really helps with the pain, and if I don’t ice the ankle then it does feel like it gets quite hot both laterally and posteriorly. 

I’m going to try and cycle this evening as I want to get back to doing some cardio exercise, it is very frustrating not being able to go for a run or play football, so I am going to try and cycle if it isn’t too painful.  The bruising is still very evident, and the swelling seems to be slowly going down.

Out of interest I tried to stand on one leg today and was surprised by how difficult it was.  The amount of times I must have spoken to clients about the effect on your proprioceptive system (​balance feedback) when you damage a ligament, but it was very bizarre to experience it first-hand.  It was like my ankle was refusing to respond, so that I had to really overwork at my knee and hip.  Obviously at this point not only is it still quite swollen, but there is still going to be some substantial pain inhibition, but it was interesting to see how the ankle reacted to standing on one leg.