Why is the sprained ankle not healing?
However from time to time, the natural course of events is delayed or even arrested. After several weeks, considerable swelling is still present and the ankle is painful to use. When this occurs the question should be asked: what is impairing normal healing? Osteopathic physicians usually recognize that untreated somatic dysfunction is present. In other words, there is a local mechanical dysfunction accompanied by a local autonomic nervous system reaction. The usual culprit is the distal fibula which is displaced slightly anteriorly, posteriorly or inferiorly, relative to the rest of the ankle bones. The displacement corresponds with a restriction of movement in the opposite direction, e.g. a posterior displacement of the distal fibula limits the ability of the fibula to move anteriorly, thus disturbing the mechanics of the whole ankle. Displacement of the distal fibula cannot normally be detected by x-ray. The mobility and position of the fibula must be assessed by palpation, not an e