Why Does My Ankle Hurt After ACL Surgery?

Pain is the most common symptom experienced in people who have undergone ACL reconstruction surgery. An uncommon presentation after ACL surgery is the development of ankle pain. Ankle pain usually develops after an ankle sprain, bursitis, Achilles tendon rupture, osteoarthritis, etc., and surgery may be required to provide relief in some cases, but when pain develops after an ACL surgery, it is mostly temporary and can heal by home remedies or physical therapy. The bottom line is that if you develop ankle pain after your ACL surgery- do not ignore it, because, if not treated, it may lead to complications. Read on to understand the causes and the remedies to treat ankle pain post-ACL surgery. 

Why Does Your Ankle Hurt After ACL Surgery?

ACL reconstruction surgery is a common orthopedic procedure with a success rate of 97%. Certain signs such as pain, swelling, and redness in and around the joint are common after the procedure and these subside within a 2 to 3 weeks of the surgery.. Ankle pain is an uncommon symptom that may be seen in some individuals after ACL surgery and can develop due to the following:

1. Fluid Buildup in Your Ankles

After ACL surgery, fluid from your knee joint (synovial fluid) may move down your shin and ankle, causing pain and swelling. Small blood vessels near your surgical site may also leak blood fluid, which can move down to your ankle and cause pain in your ankle. This is a natural reaction of your body to an injury or surgery.

2. Redistribution of Load

ACL rupture can cause a reduced range of motion in your knees. After surgery, it takes time to regain strength and range of motion. During rehabilitation, when your knees start bearing weight, your body adapts by distributing the load from your knees to the adjacent joints, especially the ankle. This can cause extreme pressure on your ankles, resulting in pain.

3. Your Ankles and Knees are Connected

Your hip, knee, and ankle are all functionally connected and coordinate most of your body movements. Most of the muscles that cross the knee also cross the hip or the ankle. These connections allow an injury or instability in your knees to travel down the kinetic chain and impact your ankles. Hence, during the recovery phase after an ACL surgery, the pain if present in the knee also can lead to pain in the ankle.

 

4. Wearing a Poor-fitting Brace

Compression is one of the first-line treatments for ACL injuries or a rehab protocol post-ACL surgery. Wearing a suitable knee brace compresses the affected region and speeds up your recovery. However, excessive compression might cut off circulation to your leg or compress the nerves in your leg. This may result in discoloration, swelling, and pain in your knees and ankles.

5. Wearing Poor-fitting Shoes

Wearing poor-fitting shoes can cause pain in your ankles and delay your healing. ACL recovery requires a strong foundation, which begins with your foot and ankle. Wearing customized shoes based on your gait analysis (walking pattern) will reduce your ankle discomfort and stabilize your knee and speed up your recovery. 

6. Heel Bone Becomes Stiffer After Surgery

Any load that falls on the knee is distributed to the adjacent joints, such as the ankles. This change in biomechanics (body movements) may cause the ankle to become stiffer. This, in turn, causes pain in your ankles. 

Ankle pain after anterior cruciate ligament repair is temporary and can be managed by physical therapy or at-home treatments. However, if the pain persists for a long time, it indicates an underlying condition. Some of the reasons for your prolonged pain may include:

1. Infection in the surgical area.
2. Formation of blood clots (Deep vein thrombosis) in the leg due to immobility of the joint.
3. Nerve compression due to compression by a brace, excess pressure, etc.
4. Failure of the graft response (graft rejection).
5. Prolonged stiffness of the ankle due to immobility of the knee joint.

What Can You Do to Reduce the Pain?

It is essential to address ankle discomfort after your surgery to avoid any complications and enhance your recovery 

There are several things you may do at home to relieve the pain. The following are some of the ways to reduce your ankle pain.

1. RICE Therapy (Rest, Ice, Compress, Elevate)

It is the most effective treatment for any joint and muscle pain. This also helps in decreasing the risk of further damage to the joint.

• Rest: Avoid using your ankle for a few days to ensure a speedy recovery. The longer you strain your ankles, the longer it takes to recover.
• Ice: It reduces blood flow from the blood vessels surrounding the injured area. Apply an ice pack on the affected region for 10 to 20 minutes several times a day. Do not apply ice directly on the area as it may cause ice burns. Keep the ice cubes on a towel or a cloth and then apply it.
• Compress: It reduces swelling and provides stability to your ankle. Wrap a compression bandage over the affected area until the pain and swelling subside. 
• Elevate: Elevating your leg can help drain the excess fluid away from the wounded area, thereby preventing further swelling.

2. Use Over-the-counter Medications

Ankle pain can be relieved by medication prescribed by your surgeon’s doctor. Do not self-medicate.

3. Practice Ankle Strengthening Exercises

Move your ankles up and down for 10 minutes several times a day. It improves blood circulation and enhances your range of motion. Your physical therapist will guide you about the exercises to be done for your knees, like ankle pumps, calf stretch, hamstring stretch, heel slide, prone hip extension, etc. These exercises will also cause your ankle pain to decrease and provide relief. 

4. Avoid Applying Too Much Pressure On Your Leg

Activities with a high impact tend to exert stress on the knees and ankles, leading to greater discomfort. Switch to low-impact activities such as slow walking, swimming or using a stationary bike until you have fully recovered from your surgery.

5. Put On Supportive Footwear

Wear shoes that provide your feet with adequate arch support. Avoid wearing flip-flops or high heels during this period, as they provide minimal support and may aggravate ankle pain.

6. Consult Your Surgeon or Physical therapist

Pain after surgery is common and will subside with time. However, if the pain persists for a longer period after the surgery, then you should consult your surgeon to rule out any underlying conditions that may be causing the discomfort.

Takeaway

An ACL injury can cause knee pain, but it also has the potential to impact other joints, such as the ankles. However, pain is a common symptom after surgery that will eventually subside with time. Ankle pain can be treated at home by medications, exercises, and home remedies that may help to reduce pain and restore knee stability. However, if the pain persists for a long time, it is advisable to visit your specialist. Consult the best doctors in Bangalore at Medfin for further guidance. 

 

Also Read: Cost of ACL repair surgery in Bangalore

                    What to expect after ACL surgery

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