Ankle pain - scar tissue

beltsman

Legend
Been having reoccurring pain on the outside of my ankle under the bone. Left foot this year. Right foot last year. Feels like a sprain but I never remember any acute injury. Finally went to doctor today and diagnosed with chronic pain from scar tissue around my anterior calcaneofibular ligament. He said it is from past repeated sprains - the scar tissue builds up and then gets inflamed during heavy activities like tennis. His only recommendation was two weeks of rest when it hurts and taking anti-inflammatories. Said a brace might help prevent it but that it will undoubtedly keep happening. Said PT and strengthening isn't needed because the ankle isn't weak.

Has anyone experienced something like this before? Not feeling great because I get this pain every few matches...and then I'll have to take two weeks off based on this diagnosis. So basically I won't be able to play much tennis...ever?
 

yossarian

Rookie
Been having reoccurring pain on the outside of my ankle under the bone. Left foot this year. Right foot last year. Feels like a sprain but I never remember any acute injury. Finally went to doctor today and diagnosed with chronic pain from scar tissue around my anterior calcaneofibular ligament. He said it is from past repeated sprains - the scar tissue builds up and then gets inflamed during heavy activities like tennis. His only recommendation was two weeks of rest when it hurts and taking anti-inflammatories. Said a brace might help prevent it but that it will undoubtedly keep happening. Said PT and strengthening isn't needed because the ankle isn't weak.

Has anyone experienced something like this before? Not feeling great because I get this pain every few matches...and then I'll have to take two weeks off based on this diagnosis. So basically I won't be able to play much tennis...ever?
There is no anterior CFL
 
Been having reoccurring pain on the outside of my ankle under the bone. Left foot this year. Right foot last year. Feels like a sprain but I never remember any acute injury. Finally went to doctor today and diagnosed with chronic pain from scar tissue around my anterior calcaneofibular ligament. He said it is from past repeated sprains - the scar tissue builds up and then gets inflamed during heavy activities like tennis. His only recommendation was two weeks of rest when it hurts and taking anti-inflammatories. Said a brace might help prevent it but that it will undoubtedly keep happening. Said PT and strengthening isn't needed because the ankle isn't weak.

Has anyone experienced something like this before? Not feeling great because I get this pain every few matches...and then I'll have to take two weeks off based on this diagnosis. So basically I won't be able to play much tennis...ever?
I'm no doctor nor do I play one on TV but all my experience with injury and rehab is that you'd like to break up the scar tissue. Have you tried deep tissue massage or ultrasound?
 

Addxyz

Semi-Pro
I had a weak right ankle from years of volleyball sprains. I was actually slated to get surgery to stiffen up the outside of the ankle. They were going to reconnect one of the torn ligaments to tighten it up (Brostrom surgery). However, a few months before my surgery, i broke that ankle in a skateboarding accident (similar to Gordon Hayward). I'm now 2 years into recovery and pretty much back to 100% and I just wear an ankle brace. I've pretty much retired from volleyball, so I don't know how it would stand up to jumping. However, for everything else like tennis, it's fine now.
 

socallefty

Semi-Pro
If you keep playing tennis, wear the Aircast A60 brace - that’s the model that Andy Murray wears during his matches. I wear it when I’m coming back from an ankle sprain and it is very good.
 

beltsman

Legend
If you keep playing tennis, wear the Aircast A60 brace - that’s the model that Andy Murray wears during his matches. I wear it when I’m coming back from an ankle sprain and it is very good.
I was actually wearing it when the pain started again! I might need a smaller size.
 

RogueFLIP

Professional
Just bc your ankle isn't weak doesn't mean a physical therapist couldn't help your situation.

Making sure the mobility and range of motion of all the foot/ankle joints is good bc a jammed joint can also cause pain.

Soft tissue work may be able to help break up scar tissue.

Exercises for mobility/proprioception/balance may be able to help break up scar tissue.

Watching you move in a more controlled environment may give the PT clues where other areas of the lower extremities may need addressing (could be weakness, could be lack of flexibility). Bc sometimes where you are having pain doesn't mean that that is the area causing the pain.

I personally am not a fan of some of the other modalities PT's use, but some swear by ultrasound, cold laser, etc to help break up scar tissue. At worst, it does nothing....it's not like it will injure you.


If your brace doesn't fit, by all means purchase something that fits and is snug but comfortable. Sometimes even a good brace can lose it's elasticity over time with a lot of use. If you know that certain movements cause your issue, then try to figure out also if there is a specific tennis shoe that can help support your foot/ankle.

Good luck.
 
I had a weak right ankle from years of volleyball sprains. I was actually slated to get surgery to stiffen up the outside of the ankle. They were going to reconnect one of the torn ligaments to tighten it up (Brostrom surgery). However, a few months before my surgery, i broke that ankle in a skateboarding accident (similar to Gordon Hayward). I'm now 2 years into recovery and pretty much back to 100% and I just wear an ankle brace. I've pretty much retired from volleyball, so I don't know how it would stand up to jumping. However, for everything else like tennis, it's fine now.
I'm right there with you on the VB-related ankle sprains.

One thing that's helped me is a device called a Wobble Board, which is a circular piece of wood with a hemisphere of hard plastic at the bottom with the flat end of the hemisphere attached to the bottom of the board. Very unstable and requires you to engage a whole bunch of body parts beyond just the ankle. to stay balanced.
 

beltsman

Legend
Just bc your ankle isn't weak doesn't mean a physical therapist couldn't help your situation.

Making sure the mobility and range of motion of all the foot/ankle joints is good bc a jammed joint can also cause pain.

Soft tissue work may be able to help break up scar tissue.

Exercises for mobility/proprioception/balance may be able to help break up scar tissue.

Watching you move in a more controlled environment may give the PT clues where other areas of the lower extremities may need addressing (could be weakness, could be lack of flexibility). Bc sometimes where you are having pain doesn't mean that that is the area causing the pain.

I personally am not a fan of some of the other modalities PT's use, but some swear by ultrasound, cold laser, etc to help break up scar tissue. At worst, it does nothing....it's not like it will injure you.


If your brace doesn't fit, by all means purchase something that fits and is snug but comfortable. Sometimes even a good brace can lose it's elasticity over time with a lot of use. If you know that certain movements cause your issue, then try to figure out also if there is a specific tennis shoe that can help support your foot/ankle.

Good luck.
Other doctors (sports medicine) said it could be scar tissue but also could simply be tendon inflammation. Recommended rest and some PT.

Wondering what I can do to prevent this in the future, since it's happened a few times on both feet now. Every single time - no acute injury known. Only pain hours after the match.
 

yossarian

Rookie
I'm right there with you on the VB-related ankle sprains.

One thing that's helped me is a device called a Wobble Board, which is a circular piece of wood with a hemisphere of hard plastic at the bottom with the flat end of the hemisphere attached to the bottom of the board. Very unstable and requires you to engage a whole bunch of body parts beyond just the ankle. to stay balanced.
Other doctors (sports medicine) said it could be scar tissue but also could simply be tendon inflammation. Recommended rest and some PT.

Wondering what I can do to prevent this in the future, since it's happened a few times on both feet now. Every single time - no acute injury known. Only pain hours after the match.
It's thought that the reason for recurrent ankle sprains is due to impaired proprioception of the ankle which stems from damage to the ligament's mechanoreceptors. Because they get used to a 'stretched out' position, they don't send the signal saying "hey, your ankle is in a bad position and needs help" quickly enough for your dynamic stabilizers (muscles) to kick in and assist. The wobble board training is designed to help remedy that

If you don't have a wobble board, any compliant surface will work. Or you can close your eyes too to make it more difficult.

Formal PT will definitely help you reduce the risk of recurrence. Recurrent ankle sprains are common in people who don't get rehab for an acute ankle sprain. Strengthening the ankle musculature is one thing, but you'll also need to really emphasize balance training in order for your body to relearn how to detect the position of your ankle in space and stabilize it to avoid precarious positions
 

beltsman

Legend
It's thought that the reason for recurrent ankle sprains is due to impaired proprioception of the ankle which stems from damage to the ligament's mechanoreceptors. Because they get used to a 'stretched out' position, they don't send the signal saying "hey, your ankle is in a bad position and needs help" quickly enough for your dynamic stabilizers (muscles) to kick in and assist. The wobble board training is designed to help remedy that

If you don't have a wobble board, any compliant surface will work. Or you can close your eyes too to make it more difficult.

Formal PT will definitely help you reduce the risk of recurrence. Recurrent ankle sprains are common in people who don't get rehab for an acute ankle sprain. Strengthening the ankle musculature is one thing, but you'll also need to really emphasize balance training in order for your body to relearn how to detect the position of your ankle in space and stabilize it to avoid precarious positions
I can't recall any serious acute ankle sprain in my life, but I'm sure I've had them. I've played basketball and tennis mostly my whole life.

Can you link me to a wobble board? I searched and some seem to be for kids.
 
It's thought that the reason for recurrent ankle sprains is due to impaired proprioception of the ankle which stems from damage to the ligament's mechanoreceptors. Because they get used to a 'stretched out' position, they don't send the signal saying "hey, your ankle is in a bad position and needs help" quickly enough for your dynamic stabilizers (muscles) to kick in and assist. The wobble board training is designed to help remedy that.
I don't know about @Addxyz but most of the ankle sprains I saw and experienced were due to landing on an opponent's foot, usually the blocker landing on the hitter. Because the center line is neutral, both teams tend to land near or on it. That's ankle-sprain territory.

If you don't have a wobble board, any compliant surface will work. Or you can close your eyes too to make it more difficult.
Formal PT will definitely help you reduce the risk of recurrence. Recurrent ankle sprains are common in people who don't get rehab for an acute ankle sprain. Strengthening the ankle musculature is one thing, but you'll also need to really emphasize balance training in order for your body to relearn how to detect the position of your ankle in space and stabilize it to avoid precarious positions
What I'm not a fan of is using an ankle brace to the exclusion of everything else [ie strengthening and stretching]. Sure, the brace can prevent certain common injuries. It can also immobilize the ankle and transmit the force to the knee. Now the knee takes the full brunt of the force without the shock absorption ability of the ankle. I'd prefer to eschew the ankle brace since I'd rather sprain my ankle than my knee [I've rolled my ankle but I fortunately have pliable ankles].

One part of my pre-match routine is to use an elastic band with handles, step on one end, put my foot through the handle on the other, and do reverse hamstring curls while standing on one leg. That works a lot of muscle groups as well as being great for my hamstrings and ankles.
 
My sister swears by this, and says her ankles are unbreakable (also from volleyball).
I agree with your sister. Give it another try and start with something easier.

I've also seen variations that are more like a cylinder or that have a much bigger base, both of which make the platform more stable.

I would also practice on a rack where people lock their bikes, trying to get into a "surfing" position.
 
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