Chronic ankle pain and instability... Anybody know what's going on?

[justspaceycasey]

Hello.

THE STORY: Playing softball 20 months ago, I suffered a severe sprain. I'm not just saying this. Any and every medical professional I've come in contact with says they've never seen a sprain look as ugly as mine. The ankle was literally the size of a softball (and I don't say that just for comparison's sake), and the bruising was hideous. My foot had wedged up against the base while I was baserunning. I was returning to the bag. After the sprain occurred, the second baseman also fell on it... I could hardly breathe because of the pain, and I couldn't walk on it at all. My personal trainer said it was "just a sprain" and told me to use RICE (rest, ice, compression, elevation). I did that. Fast forward a month... The swelling was down, the bruising wasn't quite gone, and the pain was still awful. Under the advisement of my foot and ankle specialist, I was put in a walking boot. I stayed in it for 2-3 months, but the pain wasn't going away. I had many x-rays up to this point... All negative. The doctor was kind of insensitive... But I was glad when he set up an MRI. I got the MRI, kept up with the walking boot, and went about my business, still doing exercises and everything he asked. MRI came back and the result was bone bruising. I also got a bone scan, which showed the same results: bone bruising. He said that "Bone bruises take a long time to heal. There's no way of knowing when you'll get rid of the pain and get your mobility back." Okay, fair enough. He had me do this thing that sent waves (maybe magnetic) to my ankle to promote healing. I can't remember what it was called... Anyhow, I got sick of being told to "wait it out" because the ankle wasn't feeling better and I couldn't do my all-time favorite activity: long distance running. Everyone was sick of me complaining that it hurt, so I walked away after 14 months of various treatment, which included a couple of months of physical therapy, which didn't help. I stopped my complaining and decided to take his advice. "Waiting it out" is exactly what I did.
Now fast forward... 6 months after this, my ankle is still hurting. It aches a lot more after use. The inner part aches more than the outer, though they both hurt. The bone that juts out on the inner part (I think it's the "ankle bone" or something) is noticeably bigger (perhaps swollen). My ankle is still weak and gives out when running without a brace... So I don't run. I am a high school student, but I work 3.5 hours a day as a janitor. During the day, it hurts and is stiff. I can't bend it as far (like when you do a squat). But after use, like during work, it aches a lot. I get home and HAVE to get off of it because it throbs or aches. It's to the point where I'm done waiting. I went to a specialist with higher credentials (he's supposedly 'one of the best') and he is much more aggressive. He's sending me back to physical therapy for 6-8 weeks and said "If it doesn't get better, we'll go ahead and have surgery." He said I'd be getting an ankle arthroscopy to see what we're dealing with. He suspects ligament damage. YAY. I'm glad I finally MIGHT get this resolved...

THE PAIN (DESCRIPTION): The outer pain is toward the center and front. While on my feet, it throbs sometimes. It aches constantly, whether I'm using it or not. It feels "weaker" than my other ankle. It gives out a lot when running or jumping, though I haven't had any repeat sprains. I've been lucky. The inner pain is around that bone that juts out. It kills. It also stretches up sometimes (especially when I'm on my feet) into the inside of my leg (calf area, on inside, about half way up). This specific pain aches, but often 'burns.' I can't jump on one foot without pain in those regions. When I rotate my feet and do those ankle exercises (such as writing the alphabet with my foot), I hear far more cracking in my bad ankle than I do in my good one.

QUESTIONS:
What is wrong with my ankle? (Ligament damage? Tendon damage? Cartilage?)
Has anybody experienced similar? (Any words of advice? Does the surgery help?)

Thanks in advance, and sorry that the post was so long!

[unregistered]

Hi Justspaceycasey,

I had a similar experience as you and it sounds like the outer ligament maybe torn and you might have scar tissue with in the joint. I ended up with a ankle ligament construction and was fine.

[ryanbroad82]

Sounds like your on the right track with the specialist, if the ankle has continually "given way" or felt unstable over the last 2 months it could be ankle instability i.e. torn ligaments, or continual aching could mean there is something also going on in the joint itself. MRI's are good, but they still don't always show the full picture. The "Gold Standard" for determining what exactly is wrong with your ankle is an arthroscope! And if it has been going on for 20 months I think this would be the best option. Good luck with the Physio though, you never know with some good rehab you might get back on track.