What to Do If Your Ankle Sprain Isn't Healing After a Month?

What should I do if my ankle sprain hasn't healed after a month?

Hello Doctor, last month during a physical education class, I accidentally sprained my ankle while playing basketball.
I had an X-ray done, and fortunately, there were no fractures.
I then visited a traditional Chinese medicine practitioner three or four times but stopped after that.
I thought it would heal in a week or two, but it has now been over a month, and I am still experiencing pain.
Last week, I also noticed some bruising on my ankle.
It hurts whenever I press on a specific point or walk for an extended period.
I'm wondering if there are any ways to speed up the healing process.
What should I do for rehabilitation, or how should I proceed?

Niming, 10~19 year old female. Ask Date: 2016/04/08

Dr. Wu Fangcan reply Family Medicine

According to your description, after the foot injury, the X-ray shows no bone damage, but there is bruising a few days later.
It is highly likely that there is a ligament tear or rupture.
Please consult an orthopedic physician for examination and treatment.
Thank you.

Reply Date: 2016/04/08

More Info

When dealing with an ankle sprain that hasn't healed after a month, it's important to take a systematic approach to recovery. Ankle sprains are common injuries, especially in sports like basketball, and while many heal within a few weeks, some can take longer, particularly if there are underlying issues or complications.

Understanding Your Injury
Firstly, it's crucial to understand the nature of your injury. Ankle sprains can vary in severity, classified into three grades:
1. Grade I: Mild stretching of the ligaments with minimal swelling and pain.

2. Grade II: Moderate sprain with partial tearing of the ligaments, resulting in more significant swelling, bruising, and pain.

3. Grade III: Severe sprain involving a complete tear of the ligament, often accompanied by severe pain, swelling, and instability.

Since you mentioned that your X-ray showed no fractures, it suggests that you likely have a sprain rather than a fracture. However, the presence of bruising and persistent pain indicates that the injury may be more severe than initially thought.

Steps to Take for Recovery
1. Rest and Protection: It's essential to avoid putting weight on the injured ankle. Use crutches if necessary to prevent further strain. Continuing to walk on it can exacerbate the injury and prolong healing.

2. Ice Therapy: Applying ice to the injured area can help reduce swelling and pain. Ice should be applied for 15-20 minutes every couple of hours, especially in the first few days after the injury.

3. Compression: Using an elastic bandage or a compression wrap can help minimize swelling. Ensure it's snug but not so tight that it restricts blood flow.

4. Elevation: Keeping your ankle elevated above the level of your heart can help reduce swelling. Use pillows to prop your foot up while resting.

5. Gentle Range of Motion Exercises: Once the acute pain and swelling decrease, gentle range-of-motion exercises can help maintain flexibility. Start with movements that do not cause pain, such as moving your toes and ankle in circles.

6. Physical Therapy: If your symptoms persist, consider consulting a physical therapist. They can provide a tailored rehabilitation program that includes strengthening exercises, balance training, and manual therapy techniques to promote healing.

7. Gradual Return to Activity: As your ankle starts to feel better, gradually reintroduce activities. Start with low-impact exercises, such as swimming or cycling, before returning to high-impact sports like basketball.

When to Seek Further Medical Attention
If your ankle sprain continues to cause significant pain, swelling, or instability after a month, it may be time to revisit a healthcare professional. They may recommend further imaging, such as an MRI, to assess for any soft tissue injuries, such as ligament tears or cartilage damage, which may not be visible on an X-ray.

Potential Long-Term Effects
It's also worth noting that untreated or improperly managed ankle sprains can lead to chronic instability or recurrent sprains. Therefore, it's crucial to follow a comprehensive rehabilitation program and address any lingering issues before returning to high-impact sports.

Conclusion
In summary, if your ankle sprain isn't healing after a month, prioritize rest, ice, compression, and elevation. Engage in gentle exercises as tolerated and consider seeking physical therapy for a structured rehabilitation program. If symptoms persist, follow up with a healthcare provider for further evaluation. Taking these steps can help ensure a full recovery and minimize the risk of future injuries.

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