‘The most common cause for a persistently painful ankle is incomplete
healing after an ankle sprain. When you sprain your ankle, the
connecting tissue (ligament) between the bones is stretched or torn.
Without thorough and complete rehabilitation, the ligament or
surrounding muscles may remain weak, resulting in recurrent
So says the American Orthopaedic Association, but what would they know?
Fifteen years ago, when I was still in secondary school, I sprained my
ankle badly. In line with NHS standards, I wasn’t given physio, or
even crutches, and eventually I recovered.
Ten years ago, I went to university. I had tutorials and friends
scattered all over the city; I did a _lot_ of walking. In the middle
of walking to lectures, I experienced sudden pain down the back of the same ankle I had injured previously. This persisted for a couple of
weeks before subsiding, but from that point on I started to regularly
experience minor sprains and ankle pain.
I went to my doctor, who examined the joint briefly and told me there
was nothing wrong with it, and that I just needed to lose weight and
the pain would go away.
I didn’t really believe him, but I had a number of issues and didn’t
have the emotional reserves to fight that battle, so I went away and
tried to avoid putting so much strain on the ankle.
It gradually got worse. I went to a different doctor, who again told
me there was nothing wrong with me and that I should just lose weight.
How I was meant to do this when the repeated spraining was preventing me exercising, I don’t know.
The ankle gradually got worse. I saw yet another doctor. This one
accepted that the ankle was damaged, but (without anything but a
cursory examination) told me there was nothing they could do about it
even if it was, and I should just take ibuprofen and try not to limp.
Last year I moved house, and the condition of my ankle substantially
deteriorated, to the point where I had to rest with my foot up for an
hour after walking to the post box two hundred yards down the hill. I
went to my new doctor.
My new doctor asked me what investigation and treatment I had had
previously. He asked me three times, apparently finding it hard to
believe the answer of ‘none’. He sent me to X-ray, just as a
precaution, with the intention of referring me for physiotherapy
Well, I’ve had the X-ray, and I’m not going to physio. I’m going to a surgeon.
Apparently my tibia and fibula are much-chipped about their ends from
all the spraining (it seems that if you really bugger up a tendon, it
breaks off a little bit of the bone it’s attached to) and the surfaces
of the joint itself are, in his own words, ‘manky’ (probably as a
result of the repeated trauma). All of which indicates that the
ligaments that connect the tibia and fibula are damaged, which would
destabilise the entire shebang and cause it to sprain at the drop of a
hat (which is exactly what it’s been doing). And of course, the more
it sprains the more damaged the ligaments get.
My best chance is to have the joint cleaned out and a screw put
through the tibia and fibula to tighten it up again. Sadly, my weight
makes it unlikely that the surgeon will be willing to put me through a
If anyone in the last ten years had sent me for X-rays and physio
rather than telling me to lose weight, I might not now be looking at a
lifetime of pain.