Ankle exercises for mobility over year after severe sprain

Jan. 2020 started off in the most 2020 way and I fell bouldering and landed badly on my ankle. I ended up chipping the inside of my talus (the chip is still just hanging out) and severely spraining my ankle. Pretty much all the ligament/tendons on the outside of my ankle/foot and some on the inside. I was in a boot for about 6 weeks (after ~3 weeks of non-weight bearing). By April, I was cleared for high-impact stuff and I had done recovery exercises to gain enough mobility to avoid PT. Because Covid, my gym was closed so I didn't start bouldering/falling on it again until June.  

A year+ later, I feel like my ankle mobility has completely plateaued and I'm worried I'll never get it back. There is a visible difference still between my injured and non-injured ankles even when doing something as simple as squatting. I just hit a point when it just doesn't bend any further and becomes painful. It doesn't bother me when hiking but I can definitely feel the differences when I fall/land at the gym since my non-injured side bends further even on very short falls. 

I stretch almost every night before bed hoping it will help but it doesn't seem to be getting any further along. Anyone out there who has been in the same boat and had ankle exercises that work to increase the mobility? Or does anyone think that the chip that is still hanging out in my ankle is the cause? The doctor did mention that if it is giving me issues that they would be able to remove it but I'd obviously like to avoid surgery if possible.

Hey Skylar, sorry to hear about your injury. I had an injury 3-4 years ago that sounds almost identical to what you describe, although it was from hitting a tree on my snowboard. I had complete tears of 2 ligaments, partial tear on the 3rd, and thin bone chip floating around from my talus. I must have been age 24-25 at the time I suppose.

Today it is a bit tight and sometimes makes some odd sounds and sensations, but little to no pain most days and has good range of motion. I seem to have equal range of motion as my other ankle, but it gets sore more easily. I've actually started climbing since then and while I'm at a beginner level it feels good and may be getting stronger from the climbing.

The biggest difference here is I did get the surgery to remove the bone chip. Not fun to spend the money but I was able to get arthroscopic surgery from a different surgeon, after the first I saw had recommended an open surgery. I was impressed with the arthroscopic, can barely see the scars today, it was just two maybe half inch long little cuts anyway.

My understanding is that there is no need to get surgery to repair the ligaments (and I didn't), but what you describe in my non medical opinion sounds like it could be the chip hanging up, or could just be a time thing and have some stiffness to bust through still, although 1.5+ years seems like long enough to me and it seems like you have been active and stretching for most of that. I would consider setting up the surgery if you don't see improvement soon.

In terms of exercises, other than basic calf stretches and such, the one I remember doing is trying to write the alphabet with your big toe, trying to do it mostly with ankle ROM. This was pretty tough/painful at first but got easier somewhat quickly. Other than that I didn't do anything special, I did get back into hiking as soon as I was able, at first wearing an ankle brace, then just boots, then trail runners. I was also trying to learn to skateboard at the time which has some ankle stuff going on, maybe a balance board or something would be good to try also.

Best of luck getting the ROM back, James

Hi Skylar, I'm surprised to hear you say you had enough mobility "to avoid PT".  That may be part of the issue.  Every surgery and serious injury (shoulders, knee, ankle) I have had, the PT was important for mobility because they do things to you that are too painful for you to do yourself.  Maybe a PT person will chime in but is it possible that by not having that PT you developed adhesions and scar tissue that have now frozen you where you find yourself?

I can only speak for myself, but post serious injury, I've had adhesions that needed to be broken or scar tissue that needed to be remodelled.   At least that's what the deep tissue/ sports massage people told me they were doing in there.  It's often quite painful but always ends up with a better result.  Maybe you could look into that.