How are your talocrural joints?
Apologies if that seems over-familiar! How are your ankles? Have you ever sprained or broken one, or both?
I recall spraining each at least once, and that is a vague recollection. I certainly know that on rough ground, I have gone over on each and carried on walking. Maybe with a little discomfort but able to continue.
Spraining and breaking
The challenge with a sprain, anywhere in the body, is it involves the ligaments tearing or stretching. Push a join beyond its natural boundaries, and the ligaments will have nothing left to give. The pain and recovery time is based on the severity, graded 1 – 3; while it may be excruciating to put weight on the ankle straight away, the good news is that it is likely you'll be back on your feet relatively quickly.
On the other hand, Breaks are likely to be more painful and generally occur when the forces are excessive, think substantial impacts, sports, car crashes. It is unlikely that walking is possible straight after, and the road to recovery can be longer.
Why is this important, Andrew?
I'm glad you ask! Our bodies adapt; primarily, the brain works out the most efficient way to continue moving.
In this instance, the brain has likely started shifting more load on the uninjured side with the ankle joint. It may have figured out that a slight shift in the upper body is required to counterbalance this change; it may have decided a little more rotation through the knee is worth the temporary discomfort. The brain will elegantly fire off different muscles from your (good) foot to your head to save you time thinking about accomplishing this.
I talk about this a lot and will make no excuse for it and while it sounds great in practice, what the brain fails to do is reset back to the original map when the body has healed.
Fully regaining quality movement.
This bit is essential. Now that the ankle has healed and you can weight bear and move, and following a brief spell of physiotherapy, everything is good, right? Wrong!
Ankle mobility, and range-of-motion, is a crucial link in the quality of movement; also, your body has adapted to moving differently, compromising overall movement quality. That brief spell, focusing on the ankle as a part, has not considered the rest of you and any imbalances that will have occurred.
As a result, you may have developed a slight twinge in the knee or the hip has started to tighten up, or you have developed an ache in your lumbar spine. If you have been mobile with the help of crutches, it is almost a certainty.
The cause
The likely one is a lack, or reduction, of dorsiflexion as a result of the injury. When laying on the floor, this is the ability to pull the foot up; think dorsal fin on a shark. The other way is plantarflexion, pointy toes.
While the ankle is an incredibly mobile joint, the stability comes from the ligaments between the bones and tendons crossing over from muscles in the foot and lower leg. Stretched ligaments and tendons go through a healing process that requires the affected joint to be mobilised, hence the physiotherapy. The effectiveness of a short dose and your diligence in keeping this work up by yourself will determine the extent of mobility, and stability, that return.
One of the biggest losses following an ankle injury is likely to be a lack of dorsiflexion, which will impact many life's movements from walking to running, from sitting down to getting back up again (squatting!).
If you are a regular at the gym, it will impact squatting and lunging. If you have hired a Personal Trainer and they haven't checked your range of movement and are having you squat and lunge at pace or under load, and you have a lack of ankle mobility, and you are experiencing difficulty or pain, it would be wise to ask them to check.
Take care,
Andrew