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Old 09-18-2011, 07:51 PM   #1
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Ankles so weak, no sprain and I can't walk

About three years ago I started spraining my ankles every 8 months or so. The sprains were sort of bad, with big swelling, lots of pain and 3-6 months of recovery time, sometimes more. After each sprain, I the next one came easier, was worse, took more time to heal, and didn't heal as well.

Now, three months ago I had a very walk-intensive day. By 6pm I couldn't walk without help, and when I got home my left ankle was swollen and it hurt. It got worse each day, and after 4 or 5 I simply couldn't walk without two crutches (because I had tried using one). I went to the doctor, and after a while I started PT.

Up until 3 weeks ago I still couldn't walk without the crutches, and felft no signs of considerable recovery. Then my right ankle started to swell (after another intense day) and the exact same thing happened, except it hurt (and hurts) more.

Since I didn't actually "sprain" my ankles the doctors think it's nothing serious, but I can't walk! (Because neither ankle can take my full weight.) I can't go to classes, because just moving a little bit makes my right ankle (which used to be the good one) hurt and swell A LOT. It feels very tender (even after 3 weeks), and a few days ago my dad barely touched it and it hurt even more for two days (until returning to its "normal" level of pain).

I'm starting to get desperate! Not walking, not moving... I've gotten two MRIs and they say there are no signs of "serious injury", but the weeks go by, I can't walk and neither ankle shows signs of improvement. And that is with EXTREME CARE (ie. not moving).

The doctors simply don't take seriously the fact that my ankles were SO WEAK that simpy over-walking has brought me here. What can I do? Any comments or experiences will be much appreciated.

(btw I'm 22)

 
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Old 09-18-2011, 08:27 PM   #2
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Re: Ankles so weak, no sprain and I can't walk

Since you talk about repeated sprains, you may have "chronic sprain" or weak ligaments. I would see an orthopedist who is a board-certified foot and ankle surgeon. He may do what's called a stress x-ray to see if your ligaments have gotten too loose due to repeated sprains.

Or, the problem could be something else. Do any specific movements or activities bring on the pain particularly badly? Where exactly is the pain and swelling?

Meanwhile, do you have some sort of support to wear? Maybe a brace in your shoe? I found the lace-up braces from the drugstore to be very helpful.

And of course, ice and elevate. I know how annoying it is to be icing several times a day, but do it!

 
Old 09-18-2011, 08:53 PM   #3
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Re: Ankles so weak, no sprain and I can't walk

Oh no, icing and elevating is no problem at all! No bother compared to not being able to walk. I lie on the couch all day long, so elevating is easy. And it's winter in my country, so my feet are really cold all the time anyway. Actually, heating them releaves the pain.

The pain in the left ankle comes when I move it beyond its -now reduced- range of motion. Also, when I place too much weight on it. I can place place up to 60% of my weight on it without pain.

Now, as I said, my right ankle hurts nonstop. Moving (even if I do my best to not move the ankle at all -or even the leg!-) makes it hurt more, and the swelling gets worse.

Most of the pain and swelling are on the outer side of the foot, near that little pointy bone, because all my sprains have spun my foot inwards, so the outer side stretched too much.

And yes, I've been using braces every since my first ankle sprains. I got ones with magnets (or something), which I don't know if works.

edit: now, I was wondering if there's a chance I might have OCD or something like that?
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Last edited by Flaubert; 09-18-2011 at 09:00 PM.

 
Old 09-18-2011, 09:36 PM   #4
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Re: Ankles so weak, no sprain and I can't walk

The magnets are both useless and harmless, but I looked around, and most of the ankle braces with magnets in them don't look sturdy enough to do much good. I used a device that actually tied on with laces. It looked like half of a high-top sneaker, and it had a solid piece of metal down either side of the ankle.

Now, I am concerned by the amount of pain you are reporting. It could be you have some kind of arthritis, or it could be you have an injury that wasn't detected with the MRI. Feet and ankles are tricky, and sometimes even an MRI can miss something, because there are so many tiny little parts.

 
Old 09-18-2011, 10:27 PM   #5
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Re: Ankles so weak, no sprain and I can't walk

Thanks so much for the quick replies! I'm also worried about the pain, and the swelling, and that it doesn't go away, even after 3 weeks (my right ankle).

But I want to ask: is there anything SERIOUS that could remain unseen in the MRI? Like OCD, RSD, arthritis, gout... (I don't know any more serious conditions, but if someone could enlighten me, I'd be grateful).
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Old 09-18-2011, 11:29 PM   #6
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Re: Ankles so weak, no sprain and I can't walk

Honestly, yes.

I know someone who had a fully torn tendon that was missed on MRI. OCD could go unseen if it's small enough or in a difficult-to-see location. From my personal experience, I had a condition called anterior impingement, and the MRI was initially read as normal. My problem was diagnosed by exam. The key symptom was trouble bending the foot UP and excruciating pain with squatting.

Unfortunately, the negative MRI set back my treatment several months. It didn't occur to me that it could just be flat-out wrong.

And then last winter I fractured my shinbone. First x-ray didn't find the fracture.

Yes, scans miss things. It happens. For the most accurate diagnosis, go to a doctor who has a lot of experience with that part of the body. Give him the ORIGINAL FILMS and the reports from the MRIs. Let him examine you and describe your symptoms. By looking at the films AND examining you AND hearing symptoms, the doctor can come to the most accurate conclusion.

 
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Old 09-19-2011, 01:03 PM   #7
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Re: Ankles so weak, no sprain and I can't walk

I think you for sure need to see a specialist... a podiatrist or a ortho with ankle experience. I'd get some sturdy lace up braces, as well, and wear very supportive shoes.

 
Old 09-19-2011, 04:07 PM   #8
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Re: Ankles so weak, no sprain and I can't walk

I agree with the others. You definitely need to see a foot and ankle specialist who knows the foot/ankle inside and out. I also agree with Jane in that scans can and do miss things. Before I had my ankle surgically repaired, the MRI picked up the ATFL tear, but said that it couldn't tell about the CFL b/c it was "poorly visualized" on MRI. Due to my surgeon's experience and my physical exam and stress xrays, he decided to do an open repair instead of a scope and good thing, b/c when he got in there, he found both ligaments completely torn!

Also 3 years later, I broke my 5th met and badly sprained my ankle. The initial Xray in the ER was negative and they told me my ankle was sprained and that was it, but to follow up with ortho. I did and they did a bone scan and the 5th met was broken. Good thing I didn't walk on it before then! I couldn't anyway from the pain in the foot and from the ankle sprain. But all that goes to show you that scans can miss things!

 
Old 09-19-2011, 11:59 PM   #9
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Re: Ankles so weak, no sprain and I can't walk

That sure is useful, Hollywood48, thanks!

edit: also, I think that my CFL is the most injured ligament. I wonder if it is common for it not to be completely clear in MRIs...
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Last edited by Flaubert; 09-20-2011 at 12:03 AM.

 
Old 09-20-2011, 11:15 AM   #10
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Re: Ankles so weak, no sprain and I can't walk

I don't know if that is common or not. I'm sure it depends on swelling, your personal anatomy, etc. I do know that the CFL isn't the most commonly injured ligament. The ATFL is. *Usually*, if the CFL is injured, the ATFL is too.

 
Old 09-21-2011, 12:31 PM   #11
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Re: Ankles so weak, no sprain and I can't walk

That's very helpful, thanks!
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Old 09-21-2011, 03:36 PM   #12
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Re: Ankles so weak, no sprain and I can't walk

Flaubert,

It sounds like you have received some good advice. If I can add some things as well to maybe help you. The standard of care for most ankle sprains without a fracture is temporary immobilization then physical therapy. If there is continued pain beyond 6 weeks, an MRI is warranted. Not all MRIs are equal and not all radiologists are experts are reading foot and ankle anatomy. A high quality MRI and a trained foot and ankle physician will miss exactly 0% of tendon tears, ligament injuries and OCD lesions. With chronic pain longer than 6 weeks, the main concern of pain is an OCD or impingement lesion. An OCD can remain non-painful, but may detach and cause pain much later than one would think.

Something your physician can do to localized the area of pain is a diagnostic injection. That involves injecting local anesthesia into the ankle joint. If your symptoms resolve, that tells the physician the source of pain is within the ankle joint and not the ligaments, which are located outside the joint. Weakness of an ankle generally does not cause pain. It causes further sprains, but there is a big difference between instability being the main problem and pain. The ATFL is the most commonly sprained/tore ankle ligament and is affected in 100% of ankle sprains. That being said, a torn ankle ligament does not need to be repaired unless the ankle becomes unstable. An arthroscope (scope) can be performed to clean out the ankle joint and see within the joint for things such as detached cartilage, bone chips, impingement lesions and scar tissue.

It is absolutely pertinent to be seen by a physician that specializes in the foot and ankle. You would not see a neurologist for a heart condition so why would you see an internal medicine doctor for your ankle pain.

 
Old 09-22-2011, 10:49 AM   #13
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Re: Ankles so weak, no sprain and I can't walk

Thanks a lot, I'll keep that in mind.
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Old 09-23-2011, 01:28 AM   #14
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Re: Ankles so weak, no sprain and I can't walk

I have been reading this thread as I was diagnosed with bilateral ankle sprains and tendonitis (Aug. 8). In Sept. when it was not resolved, the doctor did an MRI. The MRI did not show any tears but did show a small OCD in my right ankle joint. He is still thinking there is something wrong with my peroneal tendon on the left foot as it is still painful and swollen. He did give me the injection into both my joint and the tendon sheath of my peroneal tendon. The joint responded wonderful and all aches went away. The tendon, while it felt fine that night, is still swollen and hurts. My doctor may scope next month to try to figure out what is going on. Two years ago I had a MRI of my left foot looking for tears in the posterior tibial tendon. The MRI report stated everything looked good. However when the pain persisted my doctor requested the digital pics and these showed a tear. Treatment was delayed for several months and by the time I had surgery, there was also a fractured bone in there. You have to be your own advocate. If it feels as though something is wrong, keep asking questions.

 
Old 09-23-2011, 04:42 AM   #15
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Re: Ankles so weak, no sprain and I can't walk

All I can do is echo what others have said: Keep asking questions.

I sprained my ankle walking (didn't actually roll it) last January. I was diagnosed with tendonitis by a podiatrist and was in and out of a splint most of this year. In July my non-foot doc ordered an MRI since it still wasn't healed, and I scheduled an ortho consult on my own. A month later I found out from the OS, who did new x-rays, that I had bone chips and the calconeal (sp?) tendon & sheath was inflamed (per the MRI). He put me in a brace and ordered PT. I've done 7 weeks of PT so far and probably have another 4 ahead of me. It took about 4 weeks before I could do weight bearing PT.

I don't know if my first doc misread x-rays or if the chips appeared later, but the assumption that the x-rays were clean definitely didn't help out doc #2. I was at a doctor's office about every 4 weeks for 6-7 months asking when this was going to heal/what was going on.

I've got a Donjoy Velocity ES brace. There is no rolling an ankle in this thing. It is pretty light and fits in sneakers pretty well (I did have to get longer laces). It has both laces and velcro straps and conforms to your foot well. It also provides good support even if you don't have shoes on, which was good b/c I never have shoes on at home.

 
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