Acute inversion or lateral ankle sprains are common injuries that may develop into chronic ankle pain and swelling, even after rehabilitation. An unsupervised exercise program, returning to activities too soon and an undiagnosed injury can lead to injuries such as ankle impingement and synovitis. Immobilization, physical therapy or surgery may help alleviate your symptoms. Consult your physician for a diagnosis and treatment plan.
Chronic Instability
According to a 2006 article in the "Journal of Rehabilitation Research and Development," after an inversion ankle sprain, you experience ankle instability and loss of balance. This is due to the stretching or tearing of ligaments that normally stabilize your ankle joint. If your torn or sprained ligaments do not heal or do not heal properly during rehabilitation, you may develop chronic instability or chronic lateral instability. This instability increases your risk for future ankle injuries, and may lead to ankle degeneration, pain and swelling.
Ankle Synovitis
Ankle synovitis is when the joint capsule becomes inflamed, which can occur after an ankle sprain. If you return to activities like running and jumping too soon, or have chronic instability that impairs normal ankle movements, you could further aggravate your joint capsule, leading to synovitis. Synovitis can lead to pain and swelling during or after physical activities, according to the South Florida Institute of Sports Medicine.
Impingement
The trauma of the ankle sprain, or the swelling and instability following injury may lead to impingement of nerves, ligaments or tendons surrounding your ankle. For example, a 2000 Samsung Medical Centre study found that the instability associated with inversion ankle sprains caused the talus, an anklebone, to rotate during heel-strike and walking, resulting in the impingement of the anteroinferior tibiofibular ligament. Impingement also causes pain and swelling, particularly over the impinged soft-tissue.
Additional Causes
Other possible causes of persistent ankle swelling and pain following rehabilitation include torn cartilage, adhesion or excessive scar-tissue, fractures, a bone bruise, tendinitis and torn or dislocated tendons. These injuries may have occurred at the same time of the initial ankle sprain or developed due to poor healing, lack of recovery time or chronic instability. Along with a physical examine from your physician, an x-ray or MRI may be necessary for a proper diagnosis.
Treatment
Initially, rest, ice, wear an elastic compression wrap and elevate you ankle above your heart to try and reduce the pain and swelling. Non-steroidal anti-inflammatory drugs such as ibuprofen may also help alleviate your symptoms. Your physician may recommend additional physical therapy, especially if your ankle has not healed from your initial ankle sprain. Other treatments to consult you physician about include cortisone injections and wearing a cast or walking boot. If conservative treatment is unsuccessful, arthroscopic surgery is proven to be an excellent treatment option for chronic ankle instability and ankle impingement.
References
- South Florida Institute of Sports Medicine; Complications of Ankle Sprains; Augustine A. Bollo, D.P.M.
- Sydney Orthopaedic; Causes of Persistent Pain Following an Ankle Sprain
- "Journal of Rehabilitation Research and Development"; Balance Problems After Unilateral Lateral Ankle Sprains; Mohammad Akbari, P.h.D, et al.; 2006
- "Journal of Bone and Joint Surgery"; Arthroscopic Treatment for Impingement of The Anterolateral Soft Tissues of The Ankle; S. H. Kim, et al.; 2000
- Bulletin of the NYU Hospital for Joint Diseases; Acute and Chronic Lateral Ankle Instability in the Athlete; Keith W. Chan, M.D., et al.; 2011
