Ankle Discomfort: Causes and Recovery After Injury

Discomfort in the ankle while walking?

Hello doctor, recently when I walk for about 20 to 30 minutes, my right ankle starts to feel uncomfortable.
The area on the outer side of my heel noticeably sinks in, and I feel a dull ache there.
When I move my ankle up and down, I can also hear a cracking sound.
What could be the cause of this? The area connecting to my calf also feels slightly uncomfortable, and the sole of my foot is also bothering me.
I previously sprained my ankle and injured the ligaments, but that was about three months ago.
At that time, I had an inversion injury to my right ankle, resulting in partial ligament tear.
I have been undergoing rehabilitation treatment since then.
Could this be a residual effect, or is it possible that the ligaments have not fully healed?

Xiao Shi, 20~29 year old female. Ask Date: 2017/02/03

Dr. Shi Guozheng reply Orthopedics

The pain in the foot's sole may be due to inflammation of the tendons or ligaments near the ankle, possibly indicating plantar fasciitis.
Treatment options include medication or physical therapy, and it may be related to a ligament sprain.
It is advisable to rest more and temporarily avoid walking long distances or standing for extended periods.

Reply Date: 2017/02/03

More Info

Hello! Thank you for your question regarding your ankle discomfort. Based on your description, it sounds like you may be experiencing residual effects from your previous ankle injury, particularly since you mentioned a history of a sprain with partial ligament tears.
When you sustain an ankle sprain, especially one that involves ligament damage, it can lead to a variety of symptoms that may persist even after the initial injury has healed. The discomfort you are feeling in your ankle, particularly around the outer side of the heel, could be attributed to several factors:
1. Ligament Healing: After a sprain, ligaments can take time to heal completely. Even if you have been undergoing rehabilitation, the healing process can vary from person to person. If the ligaments are still not fully healed, they may not provide adequate stability to the ankle, leading to discomfort during activities like walking.

2. Tendinitis: The repetitive motion and strain on the ankle can lead to tendinitis, which is inflammation of the tendons around the ankle joint. This can cause pain and discomfort, especially during movement.

3. Joint Instability: If the ligaments have not healed properly, you may experience joint instability. This instability can lead to abnormal movements in the ankle joint, which may cause pain and a "cracking" sound (crepitus) when moving the ankle.

4. Scar Tissue Formation: After an injury, scar tissue can form around the damaged ligaments and tendons. This scar tissue can limit mobility and cause discomfort, especially if it restricts normal movement patterns.

5. Muscle Weakness: Following an ankle injury, the muscles surrounding the ankle may weaken due to disuse or protective behaviors (like avoiding putting weight on the injured ankle). Weak muscles can lead to poor support for the joint, resulting in discomfort during activities.

6. Post-Traumatic Arthritis: In some cases, an injury can lead to early onset arthritis in the affected joint. This can cause pain, swelling, and stiffness, particularly after activity.

Given that you have been experiencing discomfort for about three months post-injury, it is essential to continue with your rehabilitation exercises. These exercises should focus on strengthening the muscles around the ankle, improving balance, and restoring range of motion. Additionally, consider the following recommendations:
- Physical Therapy: If you haven't already, consult a physical therapist who can provide a tailored rehabilitation program. They can assess your ankle's stability and strength and guide you through exercises that promote healing.

- Rest and Ice: If you experience pain after walking or standing for extended periods, it may be beneficial to rest the ankle and apply ice to reduce inflammation.

- Supportive Footwear: Ensure that you are wearing supportive shoes that provide adequate cushioning and stability for your ankle. Avoid high heels or shoes that do not support your foot properly.

- Gradual Return to Activity: Gradually increase your activity level. If walking for 30 minutes causes discomfort, try shorter intervals and gradually build up your endurance.

- Consult a Specialist: If your symptoms persist or worsen, it may be wise to consult an orthopedic specialist. They may recommend imaging studies, such as an MRI, to assess the condition of the ligaments and any other structures in the ankle.

In conclusion, while it is possible that you are experiencing residual effects from your previous ankle injury, it is crucial to continue monitoring your symptoms and seek professional guidance if necessary. With appropriate rehabilitation and care, many individuals can recover fully from ankle injuries and return to their normal activities. Take care, and I wish you a speedy recovery!

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