Effective Orthopaedic Treatments for Ankle Ligament Injuries

Overview of Sprained Ankle

Ankle ligament injuries, such as a torn ligament, are common among people of all ages. These injuries can significantly impact physical activity, often leading to missed opportunities for athletes to participate in tournaments. A sprained ankle occurs when you twist or roll your ankle more awkwardly than its ordinary course of motion, and the ligament that supports the ankle is stretched beyond its limits, resulting in a sprain or tear. The severity of ankle injury will depend on how many ligaments were affected and how much damage they caused.

Ankle Ligament Tear Treatment

Most sprains heal with common remedies like ice packs, elevation, medication, and light-motion exercises. It’s crucial to start these treatments as soon as possible after the injury. Depending on the severity of the pain, it might take a few hours to a few days. However, if the pain is unbearable, or you cannot put weight on your foot despite these remedies, early intervention is key. Consult a physician to evaluate the injury, which could indicate a severe ankle injury or fracture. If non-operative treatment cannot help treat the injury, a surgical procedure might be required to repair or reconstruct the injured ligaments.

If left untreated, a more severe sprain may weaken your ankle and increase its vulnerability to further harm. However, with the proper care and therapy, you can prevent more severe issues like persistent instability, arthritis, and chronic ankle discomfort and get it treated timely.

Let’s look at some methods of ankle ligament injury treatment.

Non-surgical Methods

Surgery is not always necessary to treat isolated low ankle sprains. Most common ankle sprains will heal without surgical repair if immobilised and rehabilitated appropriately.

A three-phase regimen guides all therapy for ankle sprains:

1. Phase one involves immobilisation, rest, and ice to reduce the swelling. Depending on the grade of the injury, the doctor might recommend a cast. Most of the time, discomfort and swelling disappear within two to three days. Walking could be challenging during this period, and your doctor might advise using crutches as needed.
2. Phase two includes functional rehabilitation, focusing on motion exercises, isometric strengthening, and proprioception (balance) retraining exercises. Here, phase one (immobilisation) is paused to avoid stiffness.
3. Phase three includes progressing with proprioception and strengthening exercises and gradually returning to pre-injury activities. Activities that don’t involve twisting or rotating the ankle come first, followed by sports like football, basketball, or tennis that call for quick, abrupt turns. Rest is recommended for the ankle to heal completely; however, an early return to sporting and work activities may require ankle taping or bracing.

Home Treatments for Ankle Ligament Injuries Recommended by Orthopaedics

RICE treatment which includes:

• Rest: Avoid walking on your ankle and get back into sports to rest it. 
• Ice: Applying ice right away will help reduce swelling. It can be used three or four times a day for 20 to 30 minutes. Avoid putting ice right on your skin.
• Compression: Bandages, ace wraps, or compression dressings will support and immobilise your wounded ankle. The compression might also lessen swelling.
• Elevate: Throughout the first 48 hours, raise your ankle as high as possible above your heart. Elevation also helps reduce swelling.

Medications like ibuprofen and naproxen can help control pain and swelling.

Surgical Treatment for Ankle Sprain

An ankle sprain might rarely require surgical treatment; however, it may be needed in cases of severe damage. Surgery is only recommended for injuries that do not improve with conservative measures or for those who continue to have discomfort and instability in their ankles following several months of nonoperative care and rehabilitation.

Surgery may also be necessary for some high ankle sprains accompanied by ankle syndesmosis instability.

Types of Surgery:

1. Arthroscopy: Arthroscopy is a minimally invasive surgical method that allows the surgeon to see within the joint structures. To see the injured tissues, doctors create a tiny skin incision during arthroscopic surgery and insert a small camera, called an arthroscope, connected to a thin, flexible tube. Visualising the injured ligaments helps assess the degree of damage and identify the kind of surgery that will be required. Any loose pieces of cartilage, bone, or ligament that might be lodged in the joint are extracted using tiny tools.
2. Lateral Ankle Ligament Reconstruction: There are two methods for reconstructing lateral ankle ligaments: tendon transfer and the Brostrom-Gould approach. Both methods require tiny ankle incisions and are considered minimally invasive. The Brostrom-Gould method uses sutures to tighten ligaments. Sometimes, they reconstruct the damaged ligament by replacing it with a tissue graft. Tendon transfer entails taking the place of the weakening ligament with a tendon, either from a cadaver or another area of the body, and securing it with sutures and fasteners like screws and pins.

Post-Surgery Recovery

Following surgery, you must attend physical therapy sessions and wear a cast or boot to help protect the newly repaired ligament. Rehabilitation may take weeks to months. Mobility exercises are recommended to regain the lost strength and agility. A healthy diet is always helpful to nourish the body with the proper nutrients.

Everybody recovers differently, which can take a few weeks to several months. Discuss your potential course of recovery with your physician.

Preventing Ankle Ligament Injuries

While treatment is available for ankle ligament injuries, there are ways in which ankle ligament injuries can be prevented, including:

• Warm-up and light stretching before any workout or sport.
• Consider using an ankle support brace or tape on a weak ankle or a recently injured one.
• Practice muscle strengthening, flexibility and balancing exercises.
• Wear proper shoes to support your activity level, and avoid wearing high heels for long durations.
• Be careful when walking, running, or working on an uneven or slippery surface.

Consulting an Orthopaedic

Consult a doctor if you have a swollen ankle, pain when walking, or difficulty putting weight on the foot. As discussed above, most injuries are treatable with self-care methods and remedies; getting your injured ankle evaluated by a professional is recommended to obtain the best treatment for an ankle injury and regain its movement.

This article has been medically reviewed by Dr Praneeth Reddy, Orthopedic Surgeon.