You know how your feet/ankles swell when you fly? I nuked (hyperplantarflexed) my ankle back in May, and I'm mostly over it now. I workout/exercise vigorously without a brace, but still play ultimate with a brace since it's a bit less of a controlled environment. Anyway, I thought progress had been made. Then I was flying around during TG holidays and when I fly, my ankle looks like the day after I nuked it, like someone took out my ankle and stuck an orange in there instead, totally asymmetric with my 'good' ankle (who has good ankles anymore?). So my question is, why the swelling? Wasn't I healed up? It's functional and does not swell much after normal ultimate related wear-and-tear, etc. What are the implications of the swelling for the health of my ankle? Are there exercises/stretches that I still need to do?

Hi,

Your ankle probably is still healing and depending on how bad the injury was may take a very long time to fully heal. My knee still swells up on planes years after my knee surgery. The problem with planes is two-fold. One problem is that you're not moving for a long period of time. Fluid/swelling is moved around your body by arteries and veins. Arteries have a high pressure and pump blood out all the way to the fingers and toes. But veins are wimpy. Veins need the help of muscle contraction to move fluid/swelling back to the heart. So when your muscles aren't pumping, your veins aren't clearing fluid very well. The other problem with planes is that they are a low pressure environment so everything swells a bit (just like your sunscreen bottle that exploded in your bag).

When you have an injury, even an old one, it is more likely to swell than other areas. Part of the reason for this is that the original anatomy is now disrupted from an injury and things don't work quite as well as they used to. The other part is that there may still be some residual inflammation from repetitively re-injuring your ankle. If you didn't complete a really good rehab program, your ankle is probably still messed up even if it doesn't hurt you much any more.

On the plane, you should make sure to do some ankle exercises in your seat and walk around a bit. I highly recommend wrapping your ankle for flights until it's better healed. There are some example exercises posted here.

Jamie Nuwer MD

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