Ankle Sprains and Ligament Injuries
How do I know if my ankle sprain or injury is serious?
A sprained ankle occurs when you twist or roll your ankle awkwardly. This injury causes the ligaments which hold the ankle bones together to stretch or even tear. This may lead to ankle pain, swelling or even instability.
Ankle sprains should not be underestimated. Treatment for it depends on its severity. In mild cases, self-care with Rest, Ice, Compression and Elevation (RICE) may be all that you need. However, in more severe cases, persistent pain and instability should be formally addressed by an orthopaedic surgeon.
If you experience the following, we urge you to seek medical attention as soon as possible:
• Ankle pain
• Swelling
• Ankle instability or recurrent (repeated) sprains
• Ankle weakness
• Difficulty walking on uneven ground
Symptoms and severity will vary from person to person.
The ankle is a weight-bearing joint. Minor injuries which are neglected can escalate into more serious problems. Timely and appropriate treatment are crucial to treat these injuries and get you back to your active lifestyles.
How can I prevent ankle sprains?
• Warm up before exercise or sports
• Avoid sports which you are not trained or conditioned in
• Wear shoes that fit well and are appropriate for your activity
• Use an ankle brace or guard to a previously weak ankle
• Maintain good muscle strength and conditioning
• Be aware when exercising on uneven ground
How would my ankle be examined, diagnosed, and treated?
Examination and assessment
• Your orthopaedic surgeon will assess how you sustained the injury. You have landed awkwardly during basketball or simply rolled your ankle while stepping off a kerb.
• A thorough examination of your ankle will be performed. Any bruising or swelling around the ankle will be gently palpated to assess for pain. Your ankle will be moved gently to look for any instability. Both your ankles will be compared for completeness.
Diagnosis
• A simple x-ray of your ankle may be performed in serious cases to exclude any possible fractures.
• In cases of recurrent (repeated) ankle sprains with severe pain and swelling, an MRI scan of your ankle may be performed to look for partial or complete tears of your ankle ligaments.
Treatment
• Initial self-care is crucial for all forms of ankle sprains. Timely application of ice-packs, compression and elevation will help reduce ankle swelling.
• Medication such as anti-inflammatories are important to reduce the swelling and pain in your ankle joint.
• Devices such as ankle braces and ankle guards provide compression and stability to your ankle while you recover. In more severe cases, crutches may be required to off-load your ankle.
• After an initial period of rest, physiotherapy and rehabilitation are important in restoring the flexibility and stability of your ankle.
• In cases of persistent ankle pain with instability despite physiotherapy and rest, surgery may be warranted to repair or reconstruct a ligament that won’t heal. This will help restore the function of your ankle and return you to your active lifestyle.
Ankle Surgery
• If patients with known ligament tears experience persistent ankle pain and instability despite appropriate treatment, surgery may be required to restore their function.
• Arthroscopic or keyhole surgery is performed to repair or reconstruct the torn ligament(s). This minimally invasive surgical technique accelerates recovery and reduces the risk of infection.
• Anchor sutures are implants routinely used to reattach torn ligaments to their respective bones
• Patients undergo surgery under general anaesthetic and typically spend a night in the hospital. They are discharged with crutches and a cast which they usually keep on for a month or so.
• Rehabilitation and physiotherapy after surgery may continue for about 6 weeks or so. This varies from person to person.
How Are Ankle Treatments Performed?
Treatment 1
Ankle compression, icing and bracing
Treatment 2
Physiotherapy and rehabilitation
Treatment 3
Surgery to repair or reconstruct a torn ligament
Treatment 1
After the initial ankle sprain, there is significant pain and swelling as the ankle ligaments are traumatized. Ankle compression and icing are crucial to prevent further swelling and worsening of the injury. Bracing provides additional support to the ankle where it is vulnerable and prevents recurrent ankle sprains. All these measures must be instituted timely to allow the ankle to heal and recover faster.
Treatment 2
As the swelling around the ankle improves, physiotherapy and rehabilitation are required to restore the strength, flexibility, and stability of the muscles and ligaments around the ankle. Our trained physiotherapists will institute a rehabilitation program that is characterized by customized and progressive training for you. Muscles that have weakened due to the injury will be strengthened through exercise, stretching, and training. Stability and proprioception of your ankle will be restored using balancing exercises and specialized equipment. This will help you navigate uneven ground and stair climbing after your rehabilitation. These training exercises are crucial in preventing further injuries in the future.
Treatment 3
In severe ankle sprains, one or more ligaments that hold the ankle joint together may be partially or completely torn. Despite initial treatment with compression, icing and physiotherapy, patients may still experience pain, instability and loss of function. In these instances, surgery may be the appropriate treatment to repair or reconstruct the torn ligaments and restore the stability of your ankle. A stable ankle will accelerate your recovery process as it helps prevent recurrent ankle injury and swelling. It allows you to embark on your rehabilitation with confidence and assurance.
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