What is an ankle sprain?

A sprain is an injury to a ligament. Ligaments are important structures that joint bones together. They stabilise joints and also allow you to know what position your limbs are in (proprioception). A sprain can either be a partial injury or stretching of a ligament, all the way up to complete rupture of the ligaments causing a joint to no longer work properly

How does an ankle sprain happen?

Sprains are extremely common around the ankle. They often happen during sports or when someone ‘goes over on the ankle’. Sometimes people can still walk afterwards, this suggests a partial ligament injury. If someone is completely unable to walk afterwards this suggests a more serious injury and possibly a complete rupture of the ligament. You would likely have pain, swelling and bruising in the area with both grades of sprain.

What problems does it cause?

Ligaments are important structures, with a specific role. Mild sprains are likely to settle over a couple of weeks without much input. More serious sprains can cause a joint to become unstable and stop working properly. This can lead to the ankle no longer being trustworthy and patients often describe not being able to run or the ankle giving way regularly. Each time the ankle gives way damage can occur to the joint cartilage and instability can eventually lead to arthritis.

Non-surgical treatment:

Fortunately there are tendons nearby in the ankle that can be trained to do a similar job to the ligaments that have torn with physiotherapy. Once the tendons are doing this job the ankle will often become more stable and many patients can return to full activity. For the physiotherapy to work the patient must stick to a program of regular exercises. The best way to stick to this is to link exercises to something you do every day, such as doing your exercises whilst cleaning your teeth and whilst waiting for the kettle to boil.

Surgery

If an ankle remains unstable or if multiple ligaments are torn surgery may be required. Surgery commonly involves examining the inside of the joint to see the condition of the cartilage and to treat this if it is injured. Then ligaments can either be repaired back, or in some cases reconstruction may be required using a nearby tendon or synthetic material.

Newer methods using synthetic material can be used when the ligaments are too badly damaged or poor quality, when a ligament has re-ruptured or in circumstances where stronger ligaments may be required. They also allow a faster return to activity.

After surgery its likely you will go home on the same day, a period of rest is required for two weeks to allow the wound to heal. Depending on how the ligament has bee repaired or reconstructed a specific set of instructions will be given to get you back on your feet and back to activity in a stepwise manner. A physiotherapist will be involved in your care and help you to get back to your pre-injury level of activity over the following weeks.

It is crucial you don’t smoke (including e-cigarettes) or take anti-inflammatories for at least 8 weeks after the surgery.