Persistent Ankle Swelling After Injury: Recovery Tips and Insights

Swelling in the ankle after a heavy impact that does not subside?

Hello, six weeks ago I was playing soccer and my left ankle was stepped on by a cleat while trying to kick the ball.
I feel like it was "stomped" on, but the injury is on the inner side of my ankle, which mechanically seems like it shouldn't have been subjected to force, so there might also be ligament and muscle damage.
An ultrasound showed that surgery is not necessary.
The day after the injury, I had an X-ray that indicated no fractures, but there was significant bruising and swelling (the top of my foot and toes are swollen, and there is a larger swollen hematoma at the site of the impact).
During this period, the wound became infected (I took antibiotics for 10 days, and it has since healed).
Currently, I have severe swelling extending from my toes to the lower half of my calf, and after one and a half months, there is still no noticeable reduction in swelling.
How long does it typically take for this condition to improve? Besides foot exercises and elevating my foot while sleeping, are there any more proactive methods I can use for treatment? (Over the past six weeks, I have undergone electrical stimulation therapy 15 times and have been doing daily foot exercises (joint movement is severely limited, with a range of motion of only about 5 degrees, mainly able to move my toes).
The swelling has not subsided, and the skin on my left foot has changed from pale to dark red; is this normal?)

xuesheng, 20~29 year old female. Ask Date: 2015/12/28

Dr. Yin Xinbei reply Rehabilitation

Based on the symptom description, it appears that there is a more severe injury to the soft tissues around the ankle (such as tendons and ligaments), possibly including tears.
It is recommended to arrange for an ultrasound scan to identify the underlying issue.
Electrical therapy primarily serves to relieve pain and has limited effectiveness for reducing swelling and promoting tissue healing.
It is advisable to visit a rehabilitation clinic for further treatment.
The change in the skin color of the left foot from pale to dark red is likely due to edema causing local tissue circulation issues and ongoing inflammation.
Once inflammation and swelling subside, the color should return to normal.
At home, in addition to foot exercises and elevating the foot while sleeping, alternating hot and cold therapy can also help improve swelling.
For more information, please refer to the website: http://stud.adm.ncku.edu.tw/hea/4work/wedu/e2/e231.htm.

Reply Date: 2015/12/28

More Info

It sounds like you’ve been through quite a challenging recovery process after your ankle injury. Persistent swelling after an ankle injury can be frustrating and concerning, especially when it lasts for several weeks. Let’s break down your situation and provide some insights and recommendations for recovery.

Understanding Your Condition
From your description, it seems that you sustained a significant injury to your left ankle, which involved not only soft tissue damage but also possibly some ligament injuries. The fact that you experienced severe bruising and swelling indicates that there was considerable trauma to the area. The swelling you’re experiencing, which extends from your toes to the lower half of your calf, is likely due to a combination of factors, including inflammation from the injury, fluid accumulation, and possibly some residual effects from the infection you mentioned.

Timeline for Recovery
In general, the timeline for swelling to subside can vary significantly based on the severity of the injury, the individual’s healing response, and the effectiveness of the rehabilitation efforts. While some swelling may begin to decrease within a few weeks, it can take several months for full recovery, especially if there was significant soft tissue damage. Given that you are now six weeks post-injury, it is not uncommon for swelling to persist, but it should gradually improve over time.

Recommendations for Recovery
1. Elevation and Compression: You mentioned that you are already elevating your foot while sleeping, which is excellent. Continue to keep your ankle elevated as much as possible throughout the day. Additionally, consider using a compression bandage or sock to help reduce swelling. Compression can assist in preventing fluid accumulation and promote better circulation.

2. Gentle Range of Motion Exercises: Since you have limited movement in your ankle, it’s crucial to continue with gentle range of motion exercises. Focus on moving your toes and ankle within a pain-free range. Gradually increase the range as tolerated. If you haven’t already, consider consulting a physical therapist who can provide tailored exercises and manual therapy techniques to improve mobility and reduce swelling.

3. Cold Therapy: Applying ice to the swollen area can help reduce inflammation and pain. Use ice packs for 15-20 minutes several times a day, especially after any activity that may aggravate the swelling.

4. Hydration and Nutrition: Staying well-hydrated can help your body manage inflammation. Additionally, a balanced diet rich in vitamins and minerals, particularly those that support healing (like vitamin C and zinc), can be beneficial.

5. Gradual Weight Bearing: If you haven’t already, discuss with your healthcare provider about gradually increasing weight-bearing activities. Using crutches or a walking boot can help protect the ankle while allowing you to start putting some weight on it as tolerated.

6. Monitoring Skin Changes: You mentioned that your skin has changed from a pale color to a dark red. While some discoloration can be normal after an injury, it’s essential to monitor for any signs of infection or worsening symptoms, such as increased pain, warmth, or discharge. If you notice these symptoms, seek medical attention promptly.

7. Patience and Consistency: Recovery from an ankle injury can be slow, and it’s essential to be patient with your body. Consistency in your rehabilitation efforts will be key to regaining function and reducing swelling over time.

When to Seek Further Medical Attention
If your swelling does not improve significantly over the next few weeks, or if you experience increased pain, changes in sensation, or any other concerning symptoms, it would be advisable to follow up with your healthcare provider. They may consider further imaging or interventions to assess the healing process and rule out any complications.

In conclusion, while persistent swelling can be frustrating, it is often a part of the healing process after a significant injury. By continuing to follow a structured rehabilitation plan and monitoring your symptoms, you can support your recovery and work towards regaining full function in your ankle.

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