Continued pain and swelling after sprain/presence

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   Our user asked: "Hi, 3 years ago I had a severe ankle sprain (rt ankle) from basketball and xrays showed I had an accessory ossicle on the outside of my ankle near the lateral malleolus. I was on crutches for 2 wks, and a walking cast for 6 wks, and then physical therapy for a month to strengthen my ankle. 4 months ago I sprained my ankle pretty badly (grade 2, lots of bruising/swelling). I went to the orthoped. a month ago since not much had improved despite ice/motrin/rest and he said just to wait and see, and to try pt again if i wanted to. However, my ankle is still stiff, still hurts (like a dull ache with occasionaly shooting pains), and the swelling hasnt improved since 14 weeks ago. I'm on my college's rowing team, and I need to have full use of my ankle to row. I've read that accessory ossicles can impinge tissue around them after a sprain, I was just wondering if that was a possibility or if I should just be more patient with my ankle. My grade 3 sprain healed faster than this one, so right now I'm a little frustrated. I just want to row again. Thanks"

Ask a PT Response: "Just wondering your mechanism of injury/ how you sprained your ankle 14 wks ago? As you mentioned ankle sprains are classified into 3 categories. with inversion ankle sprains being the most common type. You mentioned that you had a grade 2 sprain which I would say on average takes 4-6 wks to recover from. Was there any medical imaging performed on your ankle? For a grade 2 sprain 14 wks should have been sufficient enough time to heal. I guess if I was in your shoes I would try PT again to see if that will help with your condition. If your condition fails to improve with PT, perhaps a MRI may be needed to rule out damage to ligament(s), tendon(s), etc.. You mentioned that you have an accessory ossicle, from what I understand they are often unrelated to a patient's complaint. In regards to your question could the ossicle be impinging tissue? - I would say it could be possible depending on where the ossicle is located and if it is altering the mechanics at the joint ie. os subfibulare. I think the best way to rule this out is to participate in PT and see how PT goes. If your condition doesn't improve get a MRI of the ankle and consult with your ortho again. Best of luck to you."

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Ask a PT Members Profile Send Private Message Find Members Posts Add to Buddy List Senior Member Joined: Jul 07 2008 Status: Offline Points: 954	Post Options Post Reply Quote Ask a PT Report Post Thanks(0) Quote Reply Topic: Continued pain and swelling after sprain/presence Posted: Jan 28 2010 at 8:45am
	Our user asked: "Hi, 3 years ago I had a severe ankle sprain (rt ankle) from basketball and xrays showed I had an accessory ossicle on the outside of my ankle near the lateral malleolus. I was on crutches for 2 wks, and a walking cast for 6 wks, and then physical therapy for a month to strengthen my ankle. 4 months ago I sprained my ankle pretty badly (grade 2, lots of bruising/swelling). I went to the orthoped. a month ago since not much had improved despite ice/motrin/rest and he said just to wait and see, and to try pt again if i wanted to. However, my ankle is still stiff, still hurts (like a dull ache with occasionaly shooting pains), and the swelling hasnt improved since 14 weeks ago. I'm on my college's rowing team, and I need to have full use of my ankle to row. I've read that accessory ossicles can impinge tissue around them after a sprain, I was just wondering if that was a possibility or if I should just be more patient with my ankle. My grade 3 sprain healed faster than this one, so right now I'm a little frustrated. I just want to row again. Thanks" Ask a PT Response: "Just wondering your mechanism of injury/ how you sprained your ankle 14 wks ago? As you mentioned ankle sprains are classified into 3 categories. with inversion ankle sprains being the most common type. You mentioned that you had a grade 2 sprain which I would say on average takes 4-6 wks to recover from. Was there any medical imaging performed on your ankle? For a grade 2 sprain 14 wks should have been sufficient enough time to heal. I guess if I was in your shoes I would try PT again to see if that will help with your condition. If your condition fails to improve with PT, perhaps a MRI may be needed to rule out damage to ligament(s), tendon(s), etc.. You mentioned that you have an accessory ossicle, from what I understand they are often unrelated to a patient's complaint. In regards to your question could the ossicle be impinging tissue? - I would say it could be possible depending on where the ossicle is located and if it is altering the mechanics at the joint ie. os subfibulare. I think the best way to rule this out is to participate in PT and see how PT goes. If your condition doesn't improve get a MRI of the ankle and consult with your ortho again. Best of luck to you."

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