Dear Ask The Doctor: Im 17 years old, about 2 or 3 years ago i was jumping on my friends trampoline and i came down wrong on my left foot, and my ankle popped out, when i turned to lay on my side, it had popped back in to place, when that happened it chipped of a piece of bone, which i had surgery to get it remove it, they did not put it back in with pins because the chipped bone would grow back. Now i wanted to know if i should get it checked out because i did not go to any physical therapy after surgery, i just let it heal. and some times, not often, i get little sharp pains on the side where my scar is(right side) , and sometimes on the side where the bone popped out(left side). its usually while im in bed
Dear Mohi: Possibly during the episode that you described not only you had a fracture but also an injured ligament of the ankle, which may produce chronic pain and instability. Chronic ankle pain due to a unresolved severe ankle sprain, meaning that by the time when you had the injury, maybe you had lack of appropriate and early immobilization, lack of timely prescribed mobility and strengthening exercises, the development of scar tissue in the ligaments affected, or too much time immobilized. All these mentioned factors are cause of Chronic Ankle pain and instability. Sometimes the use of orthotics that correct the Hyperpronation of the ankle (ankle with tendency to be inwards) is useful in relieving the symptoms (pain and inflammation) in the chronic and unresolved ankle sprains. If this does not work, further evaluation, meaning local exam in terms of checking ankle stability and imaging, MRI, to see integrity of the ligaments are required to determine the right treatment option. If there are no ligamentous tears, you could still use some physical therapy treatment sessions to control pain and swelling that include: ultrasound, whirpool baths, ice and heat and active exercises to strengthening the ankle muscles, it helps also tape the ankle and begin the weight bearing progressively, as long as you do not feel pain or discomfort. But if there are ligamentous tears seen in the MRI and mayor ankle instability, then the surgery may be considered.