Question
Dear Dr Tabari,

I injured my right ankle over 2 years ago while hill-running. My ankle turned inwards and although I could not weight bear for weeks and had severe sharp pain in the inner ankle, all x-rays were clear and no treatment was given.

Since then I have intermittent sharp pain in the inner ankle, bad enough to cause limping on several days a week. The pain often comes during rest and even in bed at night. The inner ankle is quite swollen all the time and has a red area in the centre. My ankle feels hot and the pain is intensely sharp and stabbing. My GP has injected it with cortisone and offered NSAIDS, but unfortunately nothing has worked.

I am now extremely frustrated, not only with the daily pain, but more so as I cannot walk far, never mind get back into running. I would be very grateful for any advice.

Regards,
Wendy, UK.
(aged 43, and otherwise fit and healthy)  

Answer
Hi Wendy
Ankle is a joint that is surrounded by many structures such as small and large ligaments, tendons, and nerves.  Is is often said that if you have a severe ankle sprain, you often injure less structures if you have a fracture than if you don't have a fracture.  Some of the ligaments enveloping the ankle joint are very delicate and will tear in the event of a moderate to severe ankle sprain.  Although these small ligaments are not detrimental to the function of your ankle, you can develop chronic ankle pain if the sprain was not treated properly with aggressive physical therapy and other anti-inflammatory modalties.  there are also large ligaments surrounding the ankle without which the ankle cannot function properly.  I think that you should have am mri of your ankle to rule out tendon and ligament injury around your ankle.  furthermore you should see an orthopedist who is a foot and ankle specialist or a podiatrist for a complete biomechanical evaluation.
If you have any further questions please do not hesitate to e-mail me
good luck
isaac tabari DPM
www.footdocnyc..com

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