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Is this normal ankle sprain healing or sign of bone issue?

I had a severe inversion ankle sprain about 7.5 weeks ago – still shocked how far it rolled in. I had lots of pain and serious swelling (3-4 times normal ankle/foot size), could barely walk on it for first few days, and there was extensive bruising in foot, toes (turned totally purple!), ankle, and even half-way up calf muscle. When it happened, I seriously thought I broke it, so went to the ER. The ER doc x-rayed and simply gave me an air-cast brace and suggested it was a grade 2 or grade 2.5 sprain – no break.

Fortunately, it seemed to have healed okay for the most part. All the visible/palpable soft tissue swelling resolved after about a month and mobility is now mostly back. However, the ankle is still significantly larger/wider than my other ankle - seriously looks like two different ankles from two different people. It actually still *looks* swollen (mainly the lateral malleolus looks too big), but it’s hard as bone, not soft swelling and not tender at all to touch or pressing. My mobility is mostly normal except that I cannot squat all the way down (feet flat, A2G) like I used to because of a feeling like *something* in the ankle is stuck or preventing it from going beyond a certain degree of flexion/bend. In a way, it almost looks like my tibia and fibula, right at the ankle malleolus bones, are too far apart, yet just above the ankle they seem totally normal width compared to the other side.

And yet, given this weird feeling and appearance of the ankle, I can walk perfectly normal, I can jog, go up/down stairs fine, I can do my double-unders (jump rope), I’ve been back to lifting for 6 weeks including doing my Romanian deadlifts and rack-pulls with 300-350 lbs for reps/sets with no problem/no pain, and to top it off, since the sprain, I’ve hiked a cumulative 24 miles including some very steep climbs/descents - no hindrance/issue at all.

Everything feels completely back to normal except for an occasional pain if I trip/slip/bump/turn in a sudden weird way, and the fact that I simply cannot squat all the way down because of the feeling like something is blocking my ankle mobility at the bottom of the squat when the foot/leg is at a more acute angle.

So, the question is: Is any of this normal healing for a severe sprain, or are these signs that something more serious is wrong and I should visit an orthopedist? Has anyone (patient or medical professional) experienced or observed something like this with a bad ankle sprain healing? I'd hate to go to an orthopedist visit (specialist copay) and get an MRI ($600 copay) if this is just pretty much par-for-the-course on healing of a bad sprain and perhaps I should just be more patient.

Thank you everyone in advance for any advice or perspective you can offer.
1 Responses
Avatar universal
I'm afraid there is no par for the course.  Everyone heals differently and at a different pace.  It's possible that, for you, you returned to vigorous activity too quickly, or that it was such a bad sprain you did so.  But if you follow professional sports, you'll notice some athletes return really fast from sprains and some miss huge chunks of seasons.  We're just different, so no way for anyone to really tell you.  You're probably headed for that expensive visit if it doesn't go back to normal.  
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