Muscle Fibrosis After Ankle Injury: Recovery Insights

Muscle fibrosis

It has been 5 months since the car accident, and I have a fibula fracture (slight crack) and a torn deltoid ligament.
The internal fixation screws have been removed.
I would like to ask about some areas on the muscles of my foot that feel a bit swollen and hard (close to the inner side of the ankle).
When I touch it, it feels itchy and numb, unlike other areas, and sometimes it is accompanied by sharp pain.
I asked my doctor about this, and he said it might be due to previous bruising and that the muscle has become fibrotic.
He recommended that I use a topical treatment, but I can no longer see any bruising on my foot.
Will it still be effective? What should I do to alleviate this? Is physical therapy effective? I haven't done any rehabilitation before and have been resting at home.
Will it heal on its own?
Additional information: Compared to my uninjured foot, the injured foot's ankle has limited flexibility in both upward and downward movements, but I can walk normally and have no issues going up and down stairs.
Do I still need to undergo rehabilitation? Will there be any long-term complications?

Lingling, 20~29 year old female. Ask Date: 2005/04/09

Dr. Xu Zhenrong reply Rehabilitation

Dear Miss Lingling,
Regarding your question, since I cannot ascertain your exact condition, I can only provide a general explanation.
It is normal for certain areas of the skin to feel numb after surgery because some sensory nerves beneath the skin may be severed during the procedure, or peripheral nerves may be damaged due to a fracture, resulting in a sensation of numbness in parts of the skin.
However, this condition typically improves as the nerves regenerate over time.
As for the lump on the dorsum of your foot, it may be due to reduced movement during your recovery period, leading to stiffness in certain muscles.
It has been five months since your fracture occurred, and ideally, you should begin to engage in physical activity.
At home, you can start with heat therapy followed by stretching exercises.
This will help improve the range of motion in your ankle.
Neglecting this may worsen the ankle's mobility, which could affect your ability to navigate stairs.
Generally, a fibula fracture does not significantly impact lower limb function.
However, some individuals may alter their walking posture due to pain after surgery, and if this posture does not return to normal after healing, it may lead to other discomforts later on.
Therefore, I recommend paying attention to your walking posture and monitoring for any stiffness in your muscles.
The best approach is to develop a good exercise routine.
If your issues persist, I suggest visiting a nearby hospital's rehabilitation department for a detailed assessment by a rehabilitation physician or physical therapist.
Wishing you a speedy recovery,
Xu Zhenrong
Rehabilitation Department, Taipei Hospital

Reply Date: 2005/04/09

More Info

After an ankle injury, particularly one involving a fibula fracture and ligament damage, recovery can be a complex process. It’s understandable to have concerns about muscle fibrosis and overall recovery, especially after five months post-injury. Let’s break down your situation and address your questions regarding muscle fibrosis, recovery, and rehabilitation.

Understanding Muscle Fibrosis
Muscle fibrosis refers to the formation of excess fibrous connective tissue in muscles, which can occur after an injury. This condition can lead to stiffness, reduced flexibility, and discomfort. The symptoms you describe—areas of your ankle feeling swollen and hard, along with a tingling sensation and occasional pain—are consistent with muscle fibrosis or scar tissue formation following your injury.
When you experience a significant injury, the body initiates a healing response that includes inflammation and the formation of scar tissue. While this is a natural part of the healing process, excessive scar tissue can lead to complications such as reduced range of motion and chronic pain.

Recovery Insights
1. Physical Therapy: Engaging in physical therapy is highly recommended. Although you have been managing at home, professional guidance can significantly enhance your recovery. A physical therapist can provide targeted exercises to improve flexibility, strength, and range of motion in your ankle. They can also employ techniques such as manual therapy to help break down scar tissue and improve circulation to the affected area.

2. Self-Care and Rehabilitation: While you may have been resting at home, it’s crucial to incorporate gentle movements and stretches into your routine. This can help prevent stiffness and promote healing. Activities like ankle pumps, toe curls, and gentle stretching can be beneficial. However, it’s essential to avoid any movements that cause pain or discomfort.

3. Use of Topical Treatments: Your doctor suggested using a topical treatment like "喜療紽" (likely a form of anti-inflammatory or analgesic cream). Even if you no longer see visible bruising, these treatments can still help alleviate discomfort and reduce inflammation in the underlying tissues. They may not directly address fibrosis but can provide symptomatic relief.

4. Monitoring Symptoms: Keep an eye on your symptoms. If the tingling or pain worsens, or if you notice any new symptoms, it’s crucial to consult your healthcare provider. They may recommend imaging studies to assess the healing process and rule out any complications.

5. Long-term Considerations: As for the concern about long-term effects, it’s possible to experience residual stiffness or discomfort after an injury. However, with appropriate rehabilitation, many individuals can regain full function. The key is to stay proactive in your recovery efforts.

Conclusion
In summary, while it’s encouraging that you can walk and navigate stairs without significant issues, incorporating a structured rehabilitation program is vital for optimal recovery. Muscle fibrosis can be managed effectively with the right interventions, and physical therapy can play a crucial role in restoring function and alleviating symptoms.
If you have not yet started physical therapy, I strongly encourage you to do so. It can make a significant difference in your recovery trajectory and help you return to your previous activity levels, including any sports or physical activities you enjoy. Remember, recovery is a gradual process, and being patient with yourself while actively participating in your rehabilitation will yield the best results.

Similar Q&A

Managing Ankle Fractures: Addressing Numbness, Blisters, and Muscle Atrophy

Hello, Dr. Shi: On June 17, 2017, I suffered a fibula fracture and tibial displacement in my right ankle. I underwent surgery to install a plate and six screws, and I have a splint (which is open from the foot to the calf). I placed four handkerchiefs or tissues between the botto...

Dr. Shi Guozheng reply Orthopedics
Elevating the foot and performing up-and-down movements of the ankle can help improve slight muscle atrophy. After rehabilitation, this condition will improve. Once the fracture has healed, weight-bearing activities can be resumed, and gradual recovery will occur.

Managing Ankle Fractures: Pain, Recovery, and Exercises to Prevent Muscle Atrophy

If someone has a fibula fracture on the outer side of the ankle and has been in a cast for three months without removal, and the ankle is still not completely reduced in swelling, it is normal to experience pain on the left side of the ankle when attempting to walk with a crutch ...

Dr. Shi Guozheng reply Orthopedics
It is normal to perform up and down movements of the ankle joint after the cast is removed, as well as eversion and inversion exercises. You can try putting weight on it; if there is no pain, you can gradually increase the load.

Is Mild Ankle Swelling Normal After Fibula Fracture Recovery?

Dear Doctor: I had a fibula ankle fracture and was in a cast for 6 weeks without surgery. After that, I used a single crutch for 2 weeks, and now I am walking without any assistive devices. It has been 3 months and 2 weeks since the injury. Around the 10th week, I had an X-ray wh...

Dr. Shi Guozheng reply Orthopedics
It is normal for a fracture to take over three months to heal, and you can continue to engage in light activities. Typically, bone healing requires a solid foundation and takes about six months, so gradual improvement is expected. If the muscles are not trained, they may atrophy,...

Chronic Ankle Shortening and Muscle Tension After Old Leg Fracture

Approximately 30 years ago, I sustained an open fracture of the left tibia in a car accident. The steel rod that was placed to support the knee has been removed, but the fixation wires remain in place, and there appears to be a small fragment closely adhered to the bone. The phys...

Dr. Shi Guozheng reply Orthopedics
It may be related to tissue adhesions, so you can try rehabilitation to see if it alleviates the symptoms. If there is no improvement, further evaluation will be needed to determine if surgery is necessary.