Why Can't I Squat After an Ankle Sprain? Recovery Challenges

Ankle sprain prevents squatting?

Hello doctor, I sprained my left ankle while playing basketball on December 1st last year.
Initially, I went to an orthopedic doctor who took X-rays and said there was no bone injury.
Later, I visited a traditional Chinese medicine practitioner, but developed a skin allergy from the herbal plaster, which led me to focus on my skin condition.
I then returned to an orthopedic doctor who took another set of X-rays, and again confirmed that the bones were fine but that there was a ligament tear.
I started rehabilitation, and the doctor administered a glucose injection to promote healing, which helped reduce the swelling.
Now, four months later, I can rotate my ankle freely from side to side, but I am unable to squat down.
When I try to squat, I feel tightness around the ankle area.
Could this be because the ligaments have not fully healed, preventing me from squatting? Thank you.

Liu, 20~29 year old female. Ask Date: 2016/03/14

Dr. Li Weiqiang reply Rehabilitation

Hello, I have an ankle sprain and cannot squat.
I injured my left ankle while playing basketball on December 1st last year.
I can rotate my ankle freely from side to side, but I am unable to squat down.
It is possible that the injured ligaments have become stiffer, requiring prolonged stretching.
I recommend soaking in warm water (40-45 degrees Celsius) for 20 minutes daily, followed by stretching, and then gradually attempting to squat, using body weight to increase the range of motion in the ankle joint.
Sincerely, Dr.
Li Wei-Chiang, Director of the Rehabilitation Department, Taoyuan General Hospital, Ministry of Health and Welfare.

Reply Date: 2016/03/14

More Info

After an ankle sprain, particularly one that involves ligament damage, it is common to experience challenges in regaining full range of motion and functionality. The inability to squat after four months of recovery, despite having normal X-rays and some improvement in mobility, can be attributed to several factors related to the healing process of the ligaments and surrounding tissues.

Understanding Ankle Sprains and Recovery
An ankle sprain occurs when the ligaments that support the ankle stretch beyond their limits and tear. This can lead to varying degrees of injury, from mild stretching to complete tears. The recovery process for a sprained ankle typically involves several stages:
1. Initial Healing Phase: This phase focuses on reducing swelling and pain. It often includes rest, ice, compression, and elevation (RICE). This phase can last from a few days to a couple of weeks, depending on the severity of the sprain.

2. Rehabilitation Phase: Once the initial pain and swelling have subsided, rehabilitation begins. This phase includes physical therapy exercises aimed at restoring strength, flexibility, and balance. It is crucial to follow a structured rehabilitation program to ensure proper healing.

3. Functional Recovery: This phase involves gradually returning to normal activities, including sports and exercises that require agility and strength. It is essential to listen to your body during this phase and not rush the recovery process.

Why You Can't Squat
1. Ligament Healing: Even if the X-rays show no bone damage, the ligaments may still be healing. Ligaments take longer to heal than muscles or skin, often requiring several weeks to months for complete recovery. If the ligaments are still weak or not fully healed, squatting may cause discomfort or tightness.

2. Scar Tissue Formation: After an injury, scar tissue can form in the affected area. This scar tissue can restrict movement and lead to stiffness. If the scar tissue is not properly addressed through rehabilitation, it can hinder your ability to squat comfortably.

3. Muscle Weakness: The muscles surrounding the ankle may have weakened during the recovery period. Weakness in the calf muscles, for instance, can affect your ability to perform movements like squatting. Strengthening exercises are crucial to regain full functionality.

4. Proprioception and Balance: Ankle sprains can affect proprioception, which is your body’s ability to sense its position in space. This can lead to instability when attempting to squat, as your body may not feel secure in that position.

5. Pain and Discomfort: If you experience tightness or pain when attempting to squat, it may be a sign that your body is not yet ready for that movement. Pain can be a protective mechanism, indicating that the ligaments or surrounding tissues are not fully healed.

Recommendations for Recovery
1. Continue Rehabilitation: Work closely with a physical therapist to develop a tailored rehabilitation program that focuses on strengthening the ankle, improving flexibility, and enhancing proprioception.

2. Gradual Progression: Start with partial squats or modified squats that do not put excessive strain on the ankle. Gradually increase the depth of the squat as your ankle becomes more comfortable.

3. Stretching and Strengthening: Incorporate stretching exercises for the calf and ankle muscles to improve flexibility. Strengthening exercises for the lower leg and foot can also support recovery.

4. Listen to Your Body: Pay attention to any pain or discomfort during exercises. If squatting continues to be painful, it may be beneficial to consult with your healthcare provider for further evaluation.

5. Consider Additional Imaging: If you continue to experience significant limitations, additional imaging studies, such as an MRI, may be warranted to assess the condition of the ligaments and surrounding tissues more thoroughly.

In conclusion, the inability to squat after an ankle sprain can be attributed to several factors related to the healing process of ligaments, muscle strength, and proprioception. It is essential to continue rehabilitation and work closely with healthcare professionals to ensure a full recovery.

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