Ankle Ligament Injuries: Recovery and Exercise Concerns - Rehabilitation

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Ankle ligament injury?


Hello Doctor, in March 2020, I injured my right ankle ligaments on both the inner and outer sides while playing basketball, which resulted in a significant swelling that required bloodletting treatment.
It has been three to four years since then, and although I do not experience pain, my right ankle still appears slightly larger than my left ankle.
Is this normal? Additionally, I recently started doing aerobic exercises after a long period of inactivity, and I occasionally feel pain in my left calf or thigh that resembles cramping.
Is this due to my lack of exercise, or could there be another reason? Thank you for taking the time to answer my two questions.

Xiao Lin, 10~19 year old female. Ask Date: 2024/02/10

Dr. Wang Zhaomin reply Rehabilitation


Swelling of tissues after an injury may not be completely resolved and can lead to varying degrees of deformity.
If there is no pain or functional impairment, treatment is generally not required.
Exercise may cause muscle tightness and discomfort; therefore, appropriate warm-up exercises should be performed before engaging in physical activity to prevent cramps, strains, and other sports injuries.
If symptoms persist, it is advisable to seek medical attention from an orthopedic or rehabilitation specialist as soon as possible.

Reply Date: 2024/02/10

More Info


Injuries to the ankle ligaments, such as those you experienced during your basketball incident in March 2020, can have long-lasting effects even after the initial pain and swelling have subsided. It's not uncommon for individuals who have suffered from ankle sprains or ligament tears to notice some differences in the appearance or function of the affected ankle compared to the uninjured one.

Ankle Swelling and Appearance
The slight swelling you observe in your right ankle compared to the left is not unusual. After a ligament injury, the body may respond with inflammation, which can lead to changes in the soft tissue and even the joint capsule. This can result in a permanent increase in the size of the ankle, especially if there was significant damage to the ligaments or if the injury was severe enough to require drainage or other interventions.
However, it is essential to monitor this swelling. If it increases, becomes painful, or is accompanied by other symptoms like instability or difficulty bearing weight, it would be prudent to consult a healthcare professional. They may recommend imaging studies, such as an MRI, to assess the condition of the ligaments and surrounding structures.


Exercise and Muscle Pain
Regarding the occasional pain or cramping sensation in your left calf or thigh when you engage in aerobic exercise, this could be attributed to several factors. Since you mentioned that you have not been regularly active, your muscles may not be accustomed to the sudden increase in activity. This can lead to muscle fatigue or cramping, especially if you are pushing yourself harder than your body is used to.
Additionally, if you are compensating for any weakness or instability in your right ankle, it could lead to overuse of the muscles in your left leg, resulting in discomfort. It's also possible that you might be experiencing delayed onset muscle soreness (DOMS), which is common after starting a new exercise regimen or increasing the intensity of your workouts.


Recommendations for Recovery and Exercise
1. Gradual Increase in Activity: If you are just starting to exercise after a long period of inactivity, it's crucial to ease into your routine. Gradually increase the duration and intensity of your workouts to allow your muscles and joints to adapt.

2. Strengthening Exercises: Incorporate exercises that strengthen the muscles around your ankle, as well as your calves and thighs. This can help improve stability and reduce the risk of future injuries. Focus on both the injured and non-injured leg to maintain balance.

3. Flexibility and Stretching: Regular stretching can help alleviate tightness in your muscles and improve overall flexibility. Pay special attention to your calves and thighs, as tight muscles can contribute to cramping.

4. Listen to Your Body: If you experience pain that persists or worsens, it’s essential to listen to your body and take a break. Consider consulting a physical therapist who can provide tailored exercises and rehabilitation strategies.

5. Hydration and Nutrition: Ensure you are well-hydrated and consuming a balanced diet rich in electrolytes, as dehydration and electrolyte imbalances can contribute to muscle cramps.

6. Footwear: Ensure that you are wearing appropriate footwear that provides adequate support for your activities. Poor footwear can exacerbate issues related to ankle stability and muscle strain.


Conclusion
In summary, while the slight swelling in your right ankle may be normal following a ligament injury, it is essential to monitor any changes and consult a healthcare professional if necessary. The discomfort in your left leg could be due to muscle fatigue from increased activity or compensatory patterns from your ankle injury. By gradually increasing your activity level, focusing on strengthening and flexibility, and listening to your body, you can work towards a healthier and more balanced exercise routine.

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