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Hey guys, hoping you can help me out here. I was playing a game of pickup touch football yesterday, and a dude landed on my foot after we both jumped to make a play for the ball. My right foot completely rolled to the side, and long story short, I'm on crutches and a boot as of now.



The guy landed from a jump on the inside of my right foot, resulting in an inversion sprain. I (fortunately) didn't hear any popping sounds and didn't have any functionality issues with my toes. The pain itself was probably the worst that I've ever experienced in my life, and different from routine injuries because it plateaued for an hour instead of gradually decreasing - had to be helped off, couldn't put any weight on it at all. Ibuprofen was/is a godsend lol.

The swelling is greatest in that calconeofibular ligament area, with medium swelling under the medial ligament, and light swelling at the anterior tibiofibular ligament. There was also a sensation of swelling and slight pain along the lower fibula area (muscular pain, not bone). The doctor (a regular M.D., not a orthopedic specialist), diagnosed it as a grade 2 or 3 high ankle sprain. She took x-rays to check for any sign of fractures, and the results came back negative. She said I'll be in a boot for a week, and it'll take about 4 weeks for full recovery.

My main question is: Isn't this a low ankle sprain? High ankle sprains are supposed to be caused by eversion/twisting forces, usually when the knee is subject to an inward force...right? I'd be much happier if it is a low ankle sprain, especially from what I've read in terms of the long-term effects of high ankle sprains...which brings me to my second question. Is this going to turn into a nagging thing like Stephen Curry had a few years ago? If there's any way to prevent re-injury, I'd appreciate the suggestions lol.

Thanks brittlebros

Appreciate it man..had a followup today and they're saying it's a hybrid sprain, majority is lower but some higher damage as well. Nice bruises developing too haha. I can't even imagine rubbing it as of now tho

doesn't reeeally matter whether it's high or low. treatment is the same, and pacing for come back is determined by stability/functionality as you go. whether it takes someone else longer or shorter for a high or low ankle sprain to heal doesn't matter to you right now. good that you're seeing a doc. strongly recommend a session or two of PT once you can bear weight on it, just to have a professional put you through the rehab exercise paces. lmk when you're out of the boot and off crutches, i've got a ton of ankle sprains behind me and lots of rehab, happy to talk through some more shit once you can use the thing at all.

sucks though, sorry man. 

Appreciate it man, it's been 10 full days since I sprained it now but there's still significant swelling on those partially torn ligaments. Part of it might have been my fault, it was getting better, then I went to my college's bowl game in just a boot. Lots of walking + jackass friends that think its funny walking fast = bad idea lol.

For now, still on that RICE protocol...need Advil sometimes for pain but other than that can't really do much. Elevation seems to have a huge impact on swelling - in the morning there's only light swelling, but within two hours it's bad again. Feels like I'm chained to the ground/house, frustrating!

If anyone has input of how proper recovery would be planned in this scenario, I'd like to hear it. I have a followup evaluation on the 13th, where I'll get fitted for a brace.

listen to your doctor/PT.

I want to start hang cleaning and squatting, how long will it take to get back to speed?

longer than you want it to. do not do these if there is any pain.

Are unilateral exercises for only one leg useful for strength training until then?

yes. also, there's some evidence that stretching can also help maintain strength in the absence of any other work, so you can/should keep doing that as well on the injured leg.

rule #1 is don't do anything that aggravates the injury. rule #2 is let it heal, you're not a professional athlete whose livelihood depends on being able to play.

couple of recommendations, which i'll preface by saying AREG is important. don't do anything that feels very painful. the idea is basically to both strengthen the muscles around there that have been weakened by inactivity but also to restore your sense of how to stand and balance on the foot, first statically and then dynamically.

right away:

- balancing on one leg. get to where you can do it for a minute straight and then start adding variations, like standing on a thick pillow, doing it with your eyes closed, doing it while throwing a ball against the wall, doing it while reaching down and touching your toe with the opposite hand, standing on a thick pillow and throwing the ball, etc.
- standing on the edge of a towel in your bare feet and rolling it up under your foot with your toes
- picking up and moving marbles around with your toes.

and one that's a bit more advanced:

- half ice-skaters. stand on the good foot with the bad foot in the air. jump sideways toward the bad foot and balance on it. repeat.

Sent a note to my podiatrist (from back home) early this week; here's the gist of it -

It's been about 7.5 weeks since I sprained my ankle, and although progress is evident, I'm concerned with some aspects of the injury. As of now, I still have moderate swelling along the anterior tibiofibular ligament that was torn during the inversion. I have also developed moderate swelling along the posterior tibial tendon over the last 4 weeks. I can perform daily activities without an issue, but after long walking or moderate basketball activity, the posterior tibial tendon starts to throb with a dull pain (running from the navicular tuberosity all the way up to upper medial malleolus), ultimately leading to soreness. The ankle's fine for moderate cutting and light jogging, but prolonged activity & walking barefoot/in sandals continues to cause this pain. I can induce  a "stretching" pain in the tendon with over-dorsiflexion of the foot (esp along lower medial leg). I know the problem is related to my arches...what would you recommend?

Long story short, he suggested trying pre-fabricated orthodics. It would've been a good idea if I hadn't already been wearing custom orthodics for the past 4-5 years...originally prescribed from the same doctor that was now telling me to try them. The pain actually started after wearing the walking boot for 2-3 weeks after the injury - it was absolutely flat and my ankle now lacked any strength to hold up it's arch as well. I wasn't wearing my orthodics during the actual sprain either (lost them, got remolded BY THE SAME DOCTOR after boot was off). Within the last few days, I've also started to encounter 'pulsing' bursts of sharp pain along the anterior tibiofibular ligament (original tear). The magnitude of pain is low/tolerable, but it's like a combination of a pulsing vein and the stingy pain from a mosquito bite.

Probably going to get a followup with a podiatrist near campus or something...smh. Another thing - been getting lots of random aches and soreness and cramping through body, not sure why. My fluid levels are fine, and salt/nutrients are fine too (usually). Cramping is in calves, upper traps/neck, soreness in back, chest, neck, ankle, forearms, shoulders.

Pics for reference:
   

yeah, def get an opinion from another podiatrist or orthopedist or PT.

suggestion: when you do, describe everything to date as you did in that email, but don't go as far as the self-diagnosis. that is, don't say, "i know it's a problem with my arches." might prejudice what that person tells you, and you might be wrong. say something like, "i have an idea about what the problem is but wanted to get an expert opinion."

if what they tell you is unhelpful, it'd have been unhelpful anyway.

Hm, that's a good point, I didn't catch that. When I finally isolated the pain to the exact tendon, I looked up my symptoms and it's heavily related with flatfootedness. Pain also decreased significantly after getting the new pair of orthodics.

this thing is just getting so frustrating...never experienced this type of long-term injury before. Given me a very new appreciation for professional athletes during their injuries

How is the ankle? Able to jump yet? Sorry that you had to go through this.