The Guru explains about sprained ankles and ligments over-stretching

December 23, 2015


I sprained my ankle badly in late October: I stepped awkwardly off a curb in heels and it rolled outwards. It was immensely painful and I couldn’t bear weight for a day. I never saw a doctor as I could tell it wasn’t broken. It was very swollen and purple for several days but then ‘healed’ pretty quickly, which is to say I could bear weight, walk normally etc.

However, I’m concerned that after a month it is not fully back to normal. If I turn my ankle in outward circles it hurts, also if I step or stand in a certain way. I get stiffness in the joint in the mornings and cold weather. I’m still tentative in going down steps and putting my full weight on it. This is frustrating as I want to get back to running etc.

Does this sound normal after a month, to not be fully healed from a sprained ankle? Should I see a doctor or physio?

Am I better building up with running slowly, yoga etc or waiting until the pain/weakness has gone to exercise? T

hank you for your help!

Best, Helen

December 23, 2015

Hi Helen

Seems pretty much like where you should be, considering what you did and what you haven’t done since.

I think you are most probably right that you haven’t broken a bone, but there are a few other things that need to be considered.

When you sprain an ankle, it’s your ligaments that over stretch – either a little bit or rupture or somewhere in the middle. Ligaments are designed to check joint play, and if they are too stretched then bone bashes into bone and the bones bruises which becomes pretty painful for a while after. This may be your scenario.

As the ligaments check movement, the more they are stretched, the more they bleed, the more pain they give. As long your ligament/s (commonly your ATFL) is intact and A is still connected to B, then your joint will wobble a bit and remain painful until the ligament/s heal and tighten up around the joint, usually in a few weeks. If A is not longer connected to B (total rupture) it may need some form of invasive treatment, however you don’t sound like this.

If the sprain is severe (but not ruptured) you need to allow the ligaments to heal but either resting in a boot for the first few weeks (upto 6) and/or making the muscles around the ankle work harder to protect the healing ligaments and joint. You’ve most likely got really poor proprioception (knowing where your joint is in space) around your ankle, which is common post sprain. You need to improve this but learning how to balance on 1 leg – little and often, then when you’ve got the control start to increase the strength of you invertor and evertor muscles around the ankle. If you don’t do this simple rehab, you ankle keeps moving too much and the ligaments can’t ever heal, staying painful for longer.

Try some balance work, try some strength work and maintain ankle range over the next few weeks and see what gives.

Guru Responded

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