Treatment Options for Ankle Sprains from Alameda Orthopedic Surgeon
Anterior Talo-Fibular Ligament
The ligament most commonly torn by ankle sprains is called the anterior talo-fibular ligament, or ATFL for short, and usually results in difficulty in walking due to pain and swelling. Thus, patients may often need crutches to get around. The pain and swelling can last for as long as three days. If the injury is serious enough, your Alameda area orthopedic surgeon may recommend that you wear a temporary air splint or cast-boot.
The majority of ankle sprains will heal over time if they are protected. The complete process of healing could take up to six weeks. Your doctor might recommend that you start exercising light movements early in the healing process to keep the ankle from getting stiff. These movements can help you with identifying proper position, location, and orientation of the joint, also known as proprioception. It is not impossible for a total tear of the ligament to repair itself without the need for surgery as long as it is properly immobilized. Even a chronic tear within the ankle joint can eventually return to normal functionality if the overlying tendons are capable of providing support.
If you are suffering from a minor grade sprain, remember to use the R.I.C.E method:
- Rest the ankle. Do not walk on it.
- Ice the joint immediately after the injury occurs. This will help to minimize the swelling and should be applies in 20 minute intervals, three to four times each day. Applying ice in conjunction with a lightly pressurized wrap will additionally quell swelling.
- Compress the joint lightly using bandages or wraps that support and immobilize the injury.
- Elevate the ankle joint for 48 hours at a level above your heart.
The RICE method should be used for medium grade sprains also. You will just need to allow for more healing time. Your physician might employ a device for immobilizing the ankle such as a splint.
The most serious sprains can lead to permanent instability and in rare cases surgery may be required. A small cast or brace for the leg may be needed for up to three weeks.
Proper rehabilitation is necessary alleviate pain and swelling as well as to avoid chronic ankle problems. Electrical stimulation and ultrasound can be administered to help with these issues, too. Initially, your rehabilitation exercises might include limited movements over the range of the joint with no resistance applied. Light exercises in the pool can also be beneficial in cases where exercises like as toe-raising are too uncomfortable. As a patient’s tolerance increases, exercises of the lower extremities can be incorporated. It is important to integrate proprioception training since poor propriception can often lead to another sprain and chronic instability in the ankle joint. As soon as the pain is gone, exercises like agility drills can be performed. The objective is to improve the strength and the range of motion over time as you gain stability.
There are three main phases of recovery that all ankle sprains pass through:
- Phase 1 – Rest. Protect your ankle. Reduce the swelling over the course of one week.
- Phase 2 – Restore your range of motion, strength and flexibility over the course of the next two weeks.
- Phase 3 – Gradually return to those activities that don’t necessitate turning or twisting of the ankle. Do your maintenance exercises. Eventually you will be able to participate in activities that demand sharp, abrupt turns and cuts like tennis, basketball or football.
Pain and inflammation can be controlled by nonsteroidal anti-inflammatory drugs (NSAIDs) depending on your doctor’s evaluation.
Failure to recognize and properly treat an ankle sprain may result in issues of chronic pain and instability.
In rare cases, surgical treatment for ankle sprains may be required. Only those injuries that fail to respond to nonsurgical treatment first should be considered for surgery. Orthopedic surgery may also be reserved for patients experiencing persistent instability after months of rehabilitation and non-surgical treatment.
Surgical options include arthroscopy and reconstruction. In arthroscopy, the orthopedic surgeon will look into the interior of the joint to determine whether or not there are any loose bone fragments, dislodged cartilage, or part of the ligament caught in the joint. Reconstruction will require the surgeon to repair the torn ligament with stitches or a suture. Other ligaments and/or tendons found in the foot and around the ankle can be used to repair the damaged ligaments. Be sure to contact my office for more specific information regarding the limitations of physical activity after recovering fully from an ankle sprain.
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