Outside ankle pain no swelling
Female, 29 years old, a researcher. Complains of sharp, rather severe outside ankle pain whith no swelling on the right side, which appeared a day ago after careless movement. As reported by the patient herself "twisted her ankle" in hurry and walking on uneven ground. Painful on active movements, more so when she puts weight on it or when she straightens the foot, but without movement only slight discomfort.
A quick test showed only one positive answer, to the question "Is there a connection with a recent injury, accident, fall, bruise?", which is very good for prognosis. We started right away with a video call, since the complaint is quite limited and quite recent, which increases the chances of a quick resolution. Later the patient went through an additional detailed questionnaire and was found to have limited mobility of the sciatic nerve on the left side, as it turned out limiting some movements during yoga practice, but that's another story.
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Verification tests. That same outer ankle is provoked by flexion and especially with the addition of internal rotation of the foot. Nerve mobility tests of the right leg are negative. Self palpation of the ligaments of the outer ankle causes only minimal pain.
Structural verification and diagnosis. With my suggested automobilization of the distal tibial-calf joint, flexion with rotation becomes completely painless. This allows us to determine a definite anatomical structure and diagnose a functional blockade of the distal tibial-cavicular joint.
Treatment plan. Repetition of the self-mobilization of the fibula with the specified number of repetitions several times a day.
Result. Long-term use of the method was not necessary, because after the first time the painful movement was almost completely gone and there was no swelling on the outer ancle, the next day when walking, there was a minimal residual discomfort, which also quickly disappeared.
Outer ankle pain no swelling. Conclusions.
This case is well suited to illustrate remote work with joint dysfunctions. They are also often the quickest to produce such rapid improvement with adequate methods based on accurate diagnosis. Such a WOW effect.
At the same time, there are no thrusting, pushing methods at all, only smooth, painless (this is important!), clearly directed mobilizations, which the patient can be taught to use on his/her own. This means that we are able to gradually but repeatedly act on the disorder, which increases the effectiveness and stability of the results achieved. And also we exclude the risk of additional tissue traumatization, remember - slowly and without pain.
Osteopath, sports medicine doctor
15 years of experience in osteopathy and manual therapy. Read more...
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