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pophead66 03-06-2010 10:08 PM

Inner ankle pain...scar tiisue??
Hi -- I injured my ankle back in September. I turned to my left while loading cargo at work and everything turned except my left foot (which remained "planted"). I felt a pop and it immediately swelled up. I have had X-rays taken (twice), MRI, CT Scan, and a bone scan as well as a month of PT and a cortisone injection. I am still having pain in my inner ankle after being on it for 2-3 hours cumulatively throughout the day. I am wondering if anyone has had this problem. I can feel a "knot" just in front of the left ankle bone which isn't present on the right. Could this be scar tissue from a tendon or ligament which has healed/is healing?? My scans showed no bone damage and since it has been over 5 mos. post injury, I (and the doctor--the third one I've seen) are racking our brains trying to figure it out. The doctor says I have a slight PTTD but I am not having any pain in the arch so I don't know what is going on. I am rambling here but if anyone has any thoughts, I would appreciate it.


pophead66 03-06-2010 10:11 PM

Re: Inner ankle pain...scar tissue??
Sorry for misspelling TISSUE in my subject line!!

K_Lana 03-07-2010 04:50 AM

Re: Inner ankle pain...scar tiisue??
I'd see if they could do another MRI, although I trust them about as far as I can throw them.

I"ve never had an MRI (I've had lots of them on my ankle) that didn''t miss something major.

I've had it miss peroneal tendon tears (as in plural), PTT tear, and ocd lesions. But, how to convince your dr. to keep looking, I don't know.

My PTT tear was not in the arch. That's where the PTT attaches, I believe, but mine was under and behind my medial malleolus (the inside ankle bone) and that is where the tear was. My dr. went in for surgery for "tendonitis" but actually, my PTT and peroneal tendons were stuck down with scar tissue and my PTT was torn. So it was a good thing he decided to go in there to clean things up. Nothing showed up on films. I think scar tissue won't show up on MRI and as far as I'm concerned, very few tears show up on MRI.

Can you get up on your tip toes while standing only on your left foot? That will give you a clue if something is going on with your PTT. If it is hard, painful, or impossible, to get on your tip toes, then you know something is probably going on there.

LisaBdot 03-07-2010 03:25 PM

Re: Inner ankle pain...scar tiisue??
"Can you get up on your tip toes while standing only on your left foot? That will give you a clue if something is going on with your PTT. If it is hard, painful, or impossible, to get on your tip toes, then you know something is probably going on there."

Excellent suggestion! Do try to do it with only the affected foot.

I had 4 shredded tears of the posterior tibial tendon--it hurt just under the bump of the ankle bone, not in the arch. Kind of a burning pain. Ask to see a physical therapist who deals with these kinds of injuries. Man, in my personal experience, they diagnose it in a heartbeat.

Please be cautious about cortisone shots until you know if it's tendon related--they can sometimes precipitate tendon tears.

Have they put you in a brace or a boot to support your ankle? Kind of annoying, but helps with pain.

The advice I got from my sister-in-law PT when I started having symptoms: "Posterior Tibial Tendon. Wear only your athletic shoes, take ibuprophen daily (as an anti-inflamatory agent, never mind pain-relief), ice and elevate daily. If it doesn't get SIGNIFICANTLY better within 3 weeks, see an orthopod." I'll add--make sure the orthopod has a fellowship in foot and ankle.

All the very best,

LisaBdot 03-07-2010 03:26 PM

Re: Inner ankle pain...scar tiisue??
Forgot to mention--the tears didn't show up on the MRI.


pophead66 03-08-2010 09:57 AM

Re: Inner ankle pain...scar tiisue??
Thanks for the feedback everyone. Believe me, this isn't the first time I have heard of MRIs not being totally reliable at catching soft tissue injuries. I can get up on my tiptoes though it is a bit harder when I have been on my feet for a few hours. Feels pretty stiff but not excruciating pain. I am seeing my ortho on the 16th and am going to ask him to feel my ankles and notice the knot on the inside of my injured ankle. Very frustrating as it has been 5 1/2 months since the injury and I am back in the boot until my next visit. I am very lucky to have workers' comp paying for this because there is no restricted duty at my job so either I have to be 100% released for work or I stay home. My ortho had mentioned raising the arch in my foot to fix the slight PTTD/flatfoot but I am not convinced that is related to the soreness in the area near my ankle bone. Anyone had this surgery done?? and is it a necessity for a mild case of flatfoot or is it something I could live with for the forseeable future with the aid of orthotics??

Thanks again for all of your help!!

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