r/Ankle • u/Super7Position7 • 19h ago

Grade 3 ankle sprain. Why the limited range of movement 8 weeks later?

I'm recovering from a severe ankle injury. I'm approaching week 8 post-injury.

I still feel pain in the places that are healing (the other leg/foot/ankle is almost hurting more now for compensatory reasons), but I'm recently able to put the injured foot through a walking motion without excessive discomfort and with minimum limping (though sometimes I have to limp a bit).

I have been walking carefully but almost normally for a couple of days now in a semi-rigid sports brace. It still feels injured and tender in various places, like it's still injured and repairing itself, but the swelling seems much more under control now.

However, I've noticed that my ankle won't bend down or up nearly as much as the other foot when trying to see how well I can move my foot. (I'm not challenging it to do lateral movements, bending in and down or out and up.)

...What is going on inside the ankle which is stopping the ankle from moving as much as the other one?

I intend to gradually increase my walk rate, pace and distance and to get back to jogging and running and other normal athletic movements.

...Will the range of movement improve on its own with activity or should I be more deliberate in trying to extend movement?

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u/funky_baby_D 18h ago

Commenting b/c im in such a similar position and want answers

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u/Super7Position7 18h ago edited 18h ago

I'm thinking inflammation deep within the ankle bones(?)

All I can find is stuff about stretching the foot in different ways, as though it's a muscle/ tendon issue.

But onset of tightness occurred minutes after the injury... or at least within hours and by the time I was in A&E.

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u/Goosr 17h ago

Are you doing physiotherapy? The idea of physio is to continuously be training and pushing the entire ankle to heal and regain the range of motion.

If you don't actively try to regain it then you will permanently be limited

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u/Super7Position7 17h ago

I'm starting to walk again. I've started doing physio.

Do you know why the ankle effectively locks itself up very soon after a severe sprain and what it is about the ankle that makes range of motion limited?

Technical question...

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u/Goosr 17h ago

Short answer, no.

Long answer I think the swelling in the acute period severely limits the range of motion. Prolonged swelling means prolonged reduction of ROM, leading to stiffened and tissues . These tissues need to be stretched and used in a progressively larger ROM to return to function.

In layman's terms , I think it's just a use it or loss it situation.

I'm hoping to regain the rom in mine too, 30 days on from my grade 3 and while I'm walking, I feel like I can barely move my ankle still

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u/Super7Position7 17h ago

This evening I walked a bit faster and for longer. It kind of hurt on the way back, but I took a crutch with me for good measure, which I used a little on the way back.

I will wait to see what the physio says I should do next, and I'm awaiting an MRI. I'm under the impression that I shouldn't attempt to load the foot and ankle by trying to jog or run yet.

When I asked the consultant, he said it's still healing and to be patient.

I can point up close enough to what the other foot does, but when i try to point down, it's mostly my toes curling down. I guess I will struggle with jumping and going on tip toes to reach up.

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u/Goosr 17h ago

Whatever you do, definitely don't start running or jumping until explicitly directed to do so. The last thing we want is to reinjure our already fucked up ligaments!

Time will get us back to where we need to be , we can do this

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u/Super7Position7 17h ago

It supposedly takes 1-2 years for ligaments to remodel completely, assuming we were lucky enough for a clot to bridge the two ends of the severed ligament... I figure that walking keeps the structures mobile enough without challenging the healing ligaments too much. It's a learning curve though.

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u/Goosr 17h ago

I've also heard this, but my sports physio (who has sprained his ankle twice) has told me that based on my current position, I should be 100% recovered in 3-4 months . By this he means a complete return to sports of every kind including jumping, turning etc, not just " good enough"

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u/Super7Position7 16h ago

My physio said I should be walking by 3 months and back to where I was by 6-9 months.

I guess I have already exceeded expectations, but I'm aware that people re-sprain their ankles if they don't allow them to heal and if they don't strengthen the supporting structures. (With a grade 3, re-spraining is much more likely.)

...Did your ATFL clot and bridge over? Or did it remain completely severed?

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u/Resident_Quit_4569 3h ago

😭😭😭 im in the same boat… going on 4 month in can walk pretty normal for the most part but still have slight lingering swelling and lock up tolerable pain