Ankle Ligament Injury
Ankle Instability Explained by Dr. Tim O'Carrigan
Ankle ligament injury, also known as ankle sprain, can be caused by a sudden twisting movement of the foot during any athletic event or during daily activities. It is one of the most common orthopaedic injuries and can also be caused by walking down a slope or over any uneven surface. The injury can range from mild to severe, depending on the condition of the injured ligament and the number of ligaments involved.
Ligaments are made up of elastic tissues that interconnect bones to one another. They bind the joint together providing stability and support to the joint. The ligaments protect the ankle joint from abnormal movement and stabilize the joint during movement. When stretched beyond its limit, the ligament may partially or completely tear.
Ankle ligament injury may be caused by a sudden twist, fall, and blow to the joint or any abnormal movement. Use of inappropriate shoes during physical activity, or any forceful movement over an uneven surface may also cause a ligament injury. Previous ankle or foot injury and congenitally weak ankle increase the propensity for ankle sprain.
Pain is the most common symptom of ankle ligament injury and can be associated with swelling and bruising. Sometimes the joint may develop stiffness and the patent may have difficulty walking. The symptoms of ankle ligament injury depend on the severity of the injury which correlates with the extent of damage to the ligaments.
A complete physical examination by the physician will determine the degree and nature of the injury. The doctor may move the ankle in different directions to evaluate the extent of the injury. The examination may be painful. X-rays may be needed to confirm the severity of the injury and rule out the possibility of a fracture. In severe cases, a MRI scan may also be ordered.
Ankle ligament injuries need immediate medical attention as if left untreated they may cause chronic ankle instability. Conservative as well as surgical treatment may be used for the management of ankle ligament injuries.
Conservative treatment may be used for immediate relief and the treatment includes RICE therapy (rest, ice, compression and elevation) and medications. The RICE therapy reduces the pain and swelling and provides rest to the injured ligament. Non-steroidal anti-inflammatory (NASAIDs) medications may be recommended for management of pain and inflammation.
Surgery is not commonly recommended for the management of ankle sprain. However, if the conservative treatment fails to provide any benefit, surgery may be required. Surgery is recommended for ankle joint instability persisting even after months of rehabilitation. Common surgical procedures performed for the management of ankle sprain include ankle reconstruction surgery and ankle arthroscopy.
After the non-surgical or surgical treatment, rehabilitation of the injured ankle is important. Physical therapy is effective for complete rehabilitation. It includes strengthening exercises, mobilization exercises and gait training. PT provides long term benefits to the patient and can help prevent a recurrence of the injury.