Persistent ankle pain? It’s not incomplete healing after a sprain, you’re too fat and need to lose weight.

Sarah writes:

‘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
instability.’
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
afterwards.
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
general anaesthetic.
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.

Leave a comment

6 Comments

  1. KellyK

     /  June 30, 2009

    Oh, my. I’m really sorry to hear that. I know it does limited good, but I’d encourage you to both report the doctors who didn’t provide treatment and to post reviews of them on websites like Yahoo Local (local.yahoo.com) or Rate MD (ratemds.com).

    I hope that know that you know what’s behind the ankle issues, you’re able to get it taken care of, and that you can find a good surgeon to fix it.

    Reply
  2. Erin Erlinger

     /  June 30, 2009

    the same thing happened to my mom with her back…..she was told for years and years that her back problems would evaporate if she lost her weight….no one gave her exersizes, or even actually looked at her back until after she lost the weight…and guess what? Once she went from 24 to a 14 she STILL has back probles…turns out she is missing the cushion between 4 of her vertebrates in her neck and lower back….yea that is caused by being fat…it makes me so mad….busy doctors se a bmi over 25 and shut down…”you are fat, lose weight all will be fine” no it usually wont be.

    Reply
  3. I don’t know what your weight is, or which country you’re in, but I’m in the US, I qualify as morbidly obese, and had to have an ACL replacement, using a graft from my hamstring tendon to become my new ACL. I was certainly put under!!! I wouldn’t have done it any other way.

    Reply
  4. Don’t worry too much about the general anesthesia,I’m quite fat and I’ve been under it several times recently, including six operations in the same month for a severe break with complications last year. A good anesthesiologist will have no problem putting you under.

    Reply
  5. Sarah

     /  June 19, 2012

    Hello, the OP here🙂

    The first thing the surgeon said when I walked into his office was ‘When did you break your ankle?’ It turns out that as well as all the other issues, one of the corners of my anklebone is just plain missing and there’s a big bit of bone broken off on the inside of the joint.

    I did have to fight an anaesthesiologist to get the surgery, but fortunately he wasn’t my anaesthetist on the day; the guy who was was lovely. And since the surgery I have been able to walk without limping!

    These days I swim regularly and walk a mile or two at lunchtime. It may not be much but it’s so much better than what I was able to do before that I don’t know how to describe how happy it makes me. I just wish I’d been properly treated sooner, because then I’d be able to do more.

    Reply
  6. Brita Skinner

     /  January 19, 2013

    I am so sorry you had to go through this. It’s happening more and more these day’s and I wish doctors would stop and really look at the problem that a paitent is trying to tell them about rather then just focusing in on their weight.

    I am not obses but I am a heavy set women and I had the same thing happen to me seven years ago when I sprained my ankle. I had to fight for two years of telling doctor after doctor that there was a problem with my ankle because the pain was getting worse instead of better. Fianally I was diagnosed with Complex Regional Pain Syndrome. It is debilitating and I live in constant level 10 pain on a daily basis. I was eventually cut off of WCB and told to get over it, the pain’s all in your head and just go back to work. If I lose all the extra weight I carry around with me, all the pain would just go away.

    Now seven years later, I am finally getting into see pain specialists who deal with CRPS (Complex Regional Pain Syndrome) and sadly me and my husband already know what’s coming. I am quickly losing my mobility. I can hardly walk two or three minutes without resting. I have to use a cain at all times, there are day’s when I can’t get out of bed and my CRPS has started to move into my back and hands. There are days when my hands are clubbed and I can’t move my fingers. (Thankfully today’s not one of those days.) Sadly for me, a wheel chair is in my near future and there is no cure.

    My point here is this, you have to keep fighting and you need to make your doctor listen to you, and if that means that you are going to a different doctor every day, everyother day, or once a week, then that’s what you have to do. Doctors need to realize that weight is not always the sole reason someone is in pain. They need to do their job and take the time to really examin a patient before saying that it’s all in the patients head or they just need to lose weight.

    All I can say is if you are in pain, and it doesn’t matter where the pain is, you have to fight, no one deserves this. And the hardest part for me is, I could have avoided this if only my docs seven years ago had listened to me in the first six months. CRPS is 100% preventable. And to be forced into living with pain for years is not acceptable. Go after the doctors, go after who ever you have to. They need to pay for their mistakes and realize that they can’t take short cuts when it comes to someone’s health and quality of life.

    Reply

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