Podiatrist (Foot and Ankle Specialist) Questions Ankle Injuries and Disorders

Does swelling around the ankle indicate a serious injury?

I twisted my ankle while walking the other day. I was okay with the pain was minimal. However, this morning I noticed slight swelling around my ankle and I am worried if it means a serious injury. Or is it just a reaction? The pain has not changed.

4 Answers

Swelling is a physiologic response to the trauma resulting in injury to small blood vessels promoting the bruising that is seen, but also an escape of fluid from the vascular system into the interstitial or soft tissue. The initial phase of healing following the bodies initial management of local bleeding through clotting is an inflammatory phase with introduction of factors and other transmitters promoting migration of cells necessary to promote healing of the tissue. There are many factors that may contribute to the swelling of the area and not all equate to severity of injury. With that said, it would make sense that the greater the injury, the more likely to have greater tissue involvement and the swelling would be worse. When this occurs in a closed compartment of tissue, a concerning secondary condition known as compartment syndrome may occur. For most injuries beyond swelling we consider pain to the area, local deformity, and associated dysfunction of part to grade severity. If there is no noted deformity, the part functions pain free with no appreciated altered movements and, in the case of an ankle's ability to bear weight on the extremity, understand swelling is a physiologic response that will resolve with rest, elevation, and time. If it fails to do so, this may be a greater indicator of injury.
This is not uncommon after an ankle sprain. Sometimes swelling and bruising can occur in the days following the injury. I would recommend seeing your podiatrist.
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It is likely that you strained, or sprained, one of the ligaments in your ankle. Swelling is your bodies reaction to damage. Pedal and ankle injuries are frustrating due to the difficulty we have in staying off our feel to let injuries heal. If the pain persists past a week or becomes worse with time, rather than better, you should consider having a podiatrist evaluate the injury.
It apprars you suffered a grade 1 ankle sprain which means the ankle ligament was stretched but not torn. Swelling normally does indicate an injury but if your pain has been minimal then I would not let it worry you. Grade 1 sprains heal fine. I recommend a compression device (ace wrap) on your ankle for one to two weeks after a sprain and implementing the RICE protocol. Thanks for your question and goodluck. If you have additional questions please feel free to call the office.