Twisted my ankle

by Michelle
(Boiling Springs, SC)

I twisted my ankle a little over a week and a half ago getting out of my car stepping on loose gravel . I did not go to the dr die the fact I have been dealing with a passing family member out of town , etc .. I have taken Tylenol , elevating my foot , applying ankle Ace wrap while resting , and adding cold compressss . The ankle is still weak, unusually so . I cannot wear shoes most of the time due to swelling , very bad pain , and they are just too confining . What is my best recourse of action

RESPONSE

Hi Michelle,

Here is what bothers me. It has been ten days since you sprained your ankle and it certainly does not sound like you are making much in the way of improvement.

That is compounded by the fact that your ankle is still very swollen, so much so that you are having difficulty getting a shoe on.

I know nothing about your age, you weight or your overall medical history, but in most cases of rolling over loose gravel, that is not enough to cause a fracture.

Having said that, since it has been ten days and you have been nursing it as best you can and are still having significant pain, then there is the possibility that you may have sustained a fracture.

The only way you will know for sure is with an x-ray.

It is important to rule out a fracture for the obvious reason, that if there is a break in the ankle, one, the pain is going to continue and two, without timely care, you run the risk of having residual problems.

If it turns out that there is no fracture, then the assumption would be that you badly damaged what is known as your lateral ankle ligaments, which are ligaments that attach the ankle bone to the foot bones. This damage could range anywhere from a severe strain, to a tear of the actual ligaments. Again, with the type of injury you sustained I would lean more towards a severe strain rathere than a tear, but as I stated previously, I know nothing about you or your physical make up so I am only guessing.

There are other conditions that could also be causing pain in that area of the foot and ankle. These conditions occur to a lesser degree but certainly could be part of the problem.

These would include a subluxed cuboid bone which is the bone just in front of the heel bone and in this type of "rolling" trauma, can be pushed out of place and begin to hurt.

Also seen in this type of injury is the possibility of what is known as fifth metatarsal fracture, which is the bone that is in front of the cuboid bone and extends to just behind the fifth toe. Fracture of this bone is very common in inversion sprains.

To finish out the list of possible injuries, there is also the possibility that you did damage to the tendon that passes down the outside of the ankle. This is known as the peroneal tendon.

So by this point I hope you realize the reason I cannot give you any real advice is simply because I do not know exactly what is wrong with your foot and ankle.

As I said earlier, the fact that ten days have passed and there is still significant pain tells me that your injury should be looked at by a doctor, first to get an accurate diagnosis and second, to get proper treatment.

Marc Mitnick DPM
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