swollen ankle

I hit the outside of my left ankle very hard on a piece of furniture 18 days ago and it is still swollen. I didn't notice the swelling until the following evening, after working on my feet all day. No bruising, but very tender.

I worked the next day too, and sat down periodically, then was off 1 week. The swelling has gone down, but even though I can walk on it without pain, I can't sit Indian style or lay on my left side in bed.

I have taken ibuprofen intermittently, but have never iced it or elevated it above my heart. I worked 4 days last week, and my ankle was a little painful after a few busy days. I'm a makeup artist, and have a busy schedule this week.

Is it too late to wear a compression bandage, ice the ankle, and elevate it? I'm very clumsy, so I didn't think much of it at the time,(I'm always running into things), so I never went to the doctor and think it's pointless now.

RESPONSE

Hi,

Eighteen days is kind of long for an ankle to still be hurting from nothing more than a bruise secondary to trauma. Yes, working on your feet all day will cause more swelling in the area, but assuming you are relatively young, at this point I would have thought you would be further along in the healing process.
When you suffer an ankle injury from direct trauma as opposed to a twisting of the ankle from a fall, you are more inclined to have possibly suffered a fracture of the lateral malleolus (outside of ankle) then have damaged a ligament.
There is a fair chance you may have chipped the bone and a small chip fracture of this nature might explain why the ankle continues to hurt.
Of course, the only way you are going to know if there is a break is to have an x-ray.
If an x-ray were to show a small crack or mildly displaced chip of bone, then immobilization with a walking cast would be all you need.
I am not sure I can suggest icing and immobilization without at least having an x-ray so you know what you are dealing with.
If for example, it turns out that there is a chip fracture where the chipped bone as pulled away from the main bone then you could wear a cast for the next ten years and you would still have pain. that is why it is important to know what your dealing with.
If after having an x-ray it turns out there is no fracture of a very small "crack" in the bone, then wearing immobilization would be the thing to do.
A compression dressing, applied first thing in the morning would be fine as this would keep the swelling down and in doing so would eliminate much of the pain.
Icing is ok if it makes your ankle feel better, but I am a believer of heat 24 hours after trauma in an effort to increase blood flow to the ankle. Increasing the blood flow bring nutrients to the affected area to help it heal quicker.
But first you should start with an X-ray

Marc Mitnick DPM
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