Sprained ankles that won't heal often indicate a misdiagnosed or overlooked underlying problem. Thinkstock

Why Won't My Sprained Ankle Heal?

It's been a year since I sprained my ankle and it continues to hurt, even with physical therapy. I've had to skip class, and I worry that my injury could ruin any chance of landing a job when I start auditioning. It hurts the most when I do grand pliés. Is there something wrong with me?

—Lame Broadway Dancer, New York, NY

Foot and ankle specialists tell me that when sprained ankles don't heal, there's often an underlying problem that may have been missed or misdiagnosed. Weak peroneal tendons (which run down the side of your ankle) or torn ligaments could account for your pain. However, these are easily diagnosed. The most common reason for residual pain after a sprained ankle is sinus tarsi syndrome. Due to inflammation in the sinus tarsi, you may experience pain in this hollow area on the outside of the ankle, especially when you do grand pliés.

Your situation requires a dance medicine orthopedist with in-depth knowledge of how the foot and ankle function. Diagnosis and treatment for sinus tarsi syndrome typically involve an ultrasound-guided therapeutic injection to find the injury and reduce inflammation. Afterward, you should rest for a week and avoid vigorous ankle movements—the less you do, the more effective the injection will be, although swimming and Pilates can be done to maintain conditioning. You may then resume physical therapy. Later, strengthening activities, such as ankle exercises on a wobble board, can help enhance any lost proprioception and coordination. Stretching your calf muscles will also help the biomechanics of the ankle since an overly tight Achilles tendon can place extra stress on the joints below it. All of this will make reinjury less likely as you return to class and start auditioning.

Send your questions to Dr. Linda Hamilton at advicefordancers@dancemedia.com.

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