Continued ankle swelling post-sprain

[TitoP]

Back in February, I visited my massage therapist for help with the pain I was experiencing through my Achilles. After about a week of discomfort, I could barely walk by the time I got to my appointment. During the session, he pointed out that my ankle was a bit swollen. I hadn't noticed it at all and took a look when I got home. He had eliminated the pain in my Achilles, but then I became aware of some slight discomfort across the top of my foot when I walked and swelling of my inner ankle and arches. I started using an ice compact and wrapping it with an ace bandage at night, not really using elevation, but propping it up on an ottoman in the evenings, and wearing firm arch supports. After a few weeks, I started applying heat with a heating pad. Now it is 6 months later and my foot is still swollen to the point that my normally bony ankle is totally obscured. I have begun propping it up on the back of the couch each night, in case there is excess fluid that could drain, but it's not helping. Should I be using compression to get rid of the swelling? I live in NYC and walk everywhere and this is constantly on my mind. Any help you can offer will be very much appreciated.

[Dr. D]

Six months is a long time to have as much swelling in your ankle as you have described. They key is to find out what is causing the swelling, there is most likely an underlying problem causing the continued edema.

Walking actually helps lower extremity swelling because the muscles in the lower leg contract and compress the vessels and send the blood back to the heart. But, if you have a problem in the ankle and/or foot, continued walking may aggravate this, causing the body to send more blood to the area and prolong the swelling. So, depending on the reason for the swelling, the walking may be helpful or harmful.

Dependency (sitting with your legs down for or standing without walking for extended periods) will worsen any swelling in the feet, ankles or lower legs. Blood flow is also subject to gravity.

Compression and elevation definitely will help control the swelling, but heat may worsen it. Heat causes the the blood vessels to open up, increasing blood flow to the area. Heat is great therapy for certain injuries, especially muscle strains, but probably only contributing to further swelling at your ankle at this point.

It's probably time to make an appointment with your doctor.