Let's hear what the collective has to say about this.

My wife twisted her ankle a couple of years ago while on vacation.
We have seen doctors, chiropractors, sports doctors and all sorts of specialists, had tests of every kind, x rays and whatnot.

A voice ventured that her Achile's Talon was the origin of the problem.

Wore a boot that made it worse...

No joy fixing this.

Now she's wearing special socks and that seems to keep the swelling under control just for a while. A temporary solution.

The people we've seen all contradict each other on the path to follow. No advise seem to have been a step on the right direction.

Maybe one of you has been there and found a solution.

We've been stuck at home for over a year and being unable to take a stroll outside make's things a lot worse. She can only handle 3 or 4 blocks before feeling uncomfortable.

Thanks


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I’m not an expert but speak from experience. It could be a stress fracture. They are very difficult to diagnose. I had one in a bone in the top of my foot. Not what you want to hear, but it took a long time to get over.

All my best to your wife.

Get quality imaging. I had multiple pieces of bone fragments in my ankle causing severe pain and swelling. These pieces apparently couldn't be seen in x-ray. A combination of CT and MRI eventually (immediately after imaging) led to surgery.

My injury, was originally diagnosed as a severe sprain or bone spur by the orthopedist quack I first went to. It took 6 months to get him to do imaging and I was on work comp. I had to be careful in choosing where to go with only one second opinion on their dime. I found a highly recommended ankle specialist at UW-Health in Madison for my second opinion and surgery.

By no means an expert but it seems that if our medical system hasn't figured it out then they are unable to think in first principles and determine the root cause. My guess is inflammation, locally, and probably systematic. The body is perfectly able to heal itself if we allow it. Unfortunately our medical system is more prone to prescribing pills for a pebble in the shoe rather than just removing the pebble. Not really enough information to go off of but chronic long-term issues are the body's way of whispering. Don't wait until it's screaming.

quote:

Originally posted by SigSentry:

if our medical system hasn't figured it out

I'm not sure what you meant by "our medical system." Did you mean modern medicine in general? Or did you mean the U.S.A. medical system?

I ask, because the problem is in Argentina, not the U.S.

She sprained her ankle climbing a cascade in Ocho Rios, Jamaica. That might have been effect and not cause.

She's had all sorts of imaging done already before and while in lockdown and the doctors and sports physiologists in the mix are among the best available locally, seriously.
Yet not a single one was categoric or provided some effective treatment.

Recently tried lymphatic drainage with some temporary relief yet in lickdown it is very difficult to obtain a session.

Will look into the hairline fracture thesis. She wore a walker boot an that seemed to make things worse.

Thank you for the ideas. Will explore these alternatives.

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quote:

Originally posted by V-Tail:

quote:

Originally posted by SigSentry:

if our medical system hasn't figured it out

I'm not sure what you meant by "our medical system." Did you mean modern medicine in general? Or did you mean the U.S.A. medical system?

I ask, because the problem is in Argentina, not the U.S.

*western medicine. A generalization of course.

An interesting problem. 4 days before Christmas in 2019 I sprained my ankle getting out of bed. It still hurts and I've pretty much resigned myself to just suffering with it. At least until mercifully I die. Yeah, I went to the ER to be sure I hadn't broken it. They sent me to my PCP, who looked at it and sent me to PT. She was reasonably cute and nice. And she didn't try to make matters worse. Good on her.

I've tried a variety of ankle braces and only one works OK. Its the one sewn into a figure 8. You can only wear it for so long. It hasn't gotten loose and is still OK when I wear it with good heavy socks.

My wife is a nurse. That only means she is indifferent to my pain. I've had to mostly solve my own problems. I sit with my foot elevated when I'm not sleeping. It really helps, staying off my feet. And I've pretty much resigned myself to being a cripple for whatever life I still have. Giving up everything I used to enjoy was difficult, but necessary. I'm at the point where "cure" isn't going to happen. I only want it to not hurt. Keeping it elevated so far is the best treatment. That and keeping my weight off it.

I'm reading this thread on the off-chance something of value will come of it. I have low expectations for that, but at this point anything is worth looking for. I'm at 16 months with no "cure" in sight, and I'm not getting my hopes up too much.

How's her other ankle?

Need more info to nail down a potential cause... while not an orthopod, some additional questions might assist such:

1. How did she specifically sprain her ankle? Describe the mechanics, if possible.
2. Is there pain in a specific region of the ankle? Is there pain under specific types of exercise or better yet, when the ankle is in a given position? Is the pain sharp or throbbing?
3. Any bruising and where?
4. Does whatnot (a real helpful term BTW) include MRI scans? If so, do the radiographic images show any joint capsular involvement?
5. Has she had any previous injuries to the area?
6. How is her walking mechanics as it relates to the injury? Does she start out walking abnormally b/c of it?
7. Is she post-menopausal?

I sprained my ankle when I was about 20 years old to tough to ever go see anyone about it had a few times where I could easily roll it over if I stepped on something wrong. 35 years later going down some steps I rolled it over and ended up with a plate and 8 screws. I think it's possible that it is fractured and just keeps irritating itself. we have a sports doctor clinic near university or Oregon that specializes in these thing for the athletes, this is who repaired mine maybe you could call them. https://www.slocumcenter.com/d...cholas-l-strasser-md

quote:

Originally posted by Dakor:
Need more info to nail down a potential cause... while not an orthopod, some additional questions might assist such:

1. How did she specifically sprain her ankle? Describe the mechanics, if possible.
2. Is there pain in a specific region of the ankle? Is there pain under specific types of exercise or better yet, when the ankle is in a given position? Is the pain sharp or throbbing?
3. Any bruising and where?
4. Does whatnot (a real helpful term BTW) include MRI scans? If so, do the radiographic images show any joint capsular involvement?
5. Has she had any previous injuries to the area?
6. How is her walking mechanics as it relates to the injury? Does she start out walking abnormally b/c of it?
7. Is she post-menopausal?

Interesting and helpful question, thank you for aski g them.
1. No specifics since we were climbing a river fall, meaning following a herd of tourists and trying to find footholds on a very slippery and eroded riverbed full of small holes where your feet barely fit. Will try to add a picture later.
2. AFAIK, the pain and swelling is on the L shaped area behind the ankle. She can no longer walk long distances without discomfort or swelling.
She naturally elevates her leg when she can.
3. Never noticed any bruise or maybe at the begining but we had a tan at the time.
4. Not familiar with the lingo but she had radio and MRI. Joint capsules not mentioned until now.
5. The area had never had an issue until then.
6. She hasn't modified the way she walks.
7. No menopause.

Lucky for her, she had for clients the guys who ran the physical fitness and trsining of one of our top two soccer teams. She couldn't be in better hands or advised if she tried. She's in very good terms with them and consultation goes regularly both ways. She's a very smart CPA
These guys will point her in the direction of the right specialists. Yet, she has seen several specialist and no joy

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Dunns River Falls?

Yah, mon!

One love

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Two things we were asked. Want to see Bob Marley's grave and how bout some ganga mon

This is a longshot, but you might want to check if she has a heart problem. Swelling in lower extremities is common as there's insufficient pumping of fluid back to the heart (ask me how I know this). You might consider getting her an echocardiogram to determine if her EF (Ejection Fraction) is within range.

(I should also ask if your wife has diabetes, which can prolong swelling after a trauma as the tissue heals so slowly.)

While not a physician, I don't think cardiovascular issues are at play given the acute onset can be tied to a specific event. Diabetes can cause edema to the ankle but foot bed and toes are typically first to show such. Spot on that diabetes often delays one's recovery and can contribute to arthritis.

She might have inflammation of the tendon sheath which ultrasound should be able to pick up, perhaps a result of a slight tear to one or more ligaments when the ankle was twisted. NSAID or Corticosteroid therapy would benefit this condition.

You might be able to rule out a joint-capsule injury if upon stretching her foot away from her body (say towards the floor like a ballerina) there is no pain. I would think the sports med guys would have considered this possibility however, as it's a common athletic injury in soccer.

Nerve entrapment could originate from a severe sprain and cause pain but not necessarily the swelling.

quote:

I don't think cardiovascular issues are at play given the acute onset can be tied to a specific event.

Probably true but the OP mentioned that the sprain may have been a result of the edema, and not the other way around. Just wanted to cover all the bases.

She says that her foot has been twisted, turned and extended in every possible direction without causing any pain by those who repeatedly examined her.

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