I sprained the ligaments on the outside of my ankle four months ago and still have pain, stiffness, and swelling whenever I use the ankle. Could there be something else going on in the ankle that is keeping me from getting better?

 

Minor ankle sprains usually heal within two to four weeks. If the ligaments were badly strained or actually torn, the healing period may be longer. Persistent problems this long after an injury may signal an underlying problem such as a talar dome fracture. 

The talar dome is made of two two small bones on the top of the talus, or ankle bone. When the ankle turns inward during a sprain, the lower leg bones can squeeze against the talar dome.

In just over 6 percent of ankle sprains, the pressure can chip the talar dome. If the chip loosens, and gets in the way of movement it can cause the joint to "lock up." This kind of fracture is often overlooked during a routine ankle sprain examination. If normal activities continue to cause pain, stiffness, and swelling long after the initial sprain, doctors usually suspect a problem with the talar dome.

The fracture doesn't always show up clearly on X-ray, so a CAT scan or even a bone scan may be required. If the bone scan shows a problem, an MRI will often be recommended because it gives doctors the information they need in order to choose the best type of treatment. You should alert your doctor to the problems you've described.