Why Your Ankle Sprain Isn’t Getting Better

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Ankle sprains are remarkably common in the United States, with an estimated 27,000 occurring each day. Although an ankle sprain is commonly considered a minor injury, at least one-third of those experiencing an ankle sprain will have ongoing symptoms.

Ankle sprains vary in severity, ranging from stretched ligaments to partial or complete ligament tears. The majority of ankle sprains can heal well with appropriate treatment. Even severe ankle sprains can be treated with RICE (rest, ice, compression, elevation) followed by physical therapy to regain strength and range of motion. These initial treatments are essential to restore the function of your ankle and prevent complications.

A more complex problem may be present if the pain persists for several weeks or even months after the injury.

Chronic Ankle Instability

Chronic ankle instability occurs when the torn ankle ligaments fail to heal correctly, typically due to improper rehabilitation following an ankle sprain. This results in an unstable ankle with weakened or stretched ligaments. Symptoms include pain, swelling, repeated ankle sprains, and the sensation that the ankle could give out at any time. Without treatment, chronic ankle instability can lead to further ankle problems. Learn more.

Impingement and Synovitis

During activities, soft tissue impingement occurs when damaged ligaments or scar tissue from an ankle injury becomes compressed between the ankle joint bones. This is common in athletes but can be present with any activity level. Soft tissue impingement of the ankle can be painful and lead to worsening synovitis. Synovitis is inflammation of the inner lining of the joint capsule. This can occur in any joint but is common following ankle injuries and leads to increased pain and swelling. Learn more.

Cartilage Damage

Cartilage damage of the ankle joint, also known as an osteochondral defect/lesion or talar dome lesion, can occur after trauma to the ankle joint. A fragment of cartilage (or cartilage and bone) may partially detach or fully detach and float around the ankle joint. Symptoms include deep ankle pain (which is worse with activity), swelling, catching, popping, or clicking of the ankle during activity. Learn more.

Tendon Injury

The two peroneal tendons run outside the ankle joint and attach to the outer midfoot and the foot arch. These tendons are subject to injury from an ankle sprain or from repetitive ankle sprains. This can include tendinitis, tears, or subluxation. Tendinitis is inflammation of the tendon and can occur with or without tearing. Subluxation occurs when there has been damage to the structure that holds the tendons in place, allowing the tendons to pop in and out of place during activity. Learn more.

Nerve Injury

Although a nerve injury is less common, the nerves surrounding the ankle are subject to being stretched during an ankle sprain. This can lead to pain, numbness, or tingling following the injury. If significant swelling is present, this can put additional pressure on the nerves and cause or worsen these symptoms. Further, if scar tissue develops as a result of the injury, nerves can become entrapped in the scar tissue and cause ongoing pain, numbness, or tingling.

If your ankle sprain isn't getting better, schedule an appointment with our foot and ankle specialist.