What Causes Ankle Injuries
An ankle injury occurs when the ankle joint is twisted too far out of its normal position. Most ankle injuries occur either during sports activities or while walking on an uneven surface that forces the foot and ankle into an unnatural position. The unnatural position of the ankle in high-heeled shoes or walking in unstable, loose-fitting clogs or sandals is also a factor that may contribute to ankle injuries. In addition to wearing faulty footwear, an ankle injury can happen as a result of:
- Tripping or falling
- Landing awkwardly after a jump
- Walking or running on uneven surfaces
- A sudden impact such as a car crash
- Twisting or rotating the ankle
- Rolling the ankle
Interventions In The Subacute Phase
The subacute phase of healing begins around day four and continues until 2 weeks after an ankle ligament injury. During this phase, range-of-motion exercises begin to decrease ankle stiffness caused by swelling. You might receive physical therapy, including ultrasound and electrical stimulation, to help promote healing and exercises to improve your mobility.
Exercises often include drawing the alphabet in the air with your toes, ankle circles, gentle stretches and possibly non-weight-bearing activities, such as riding a stationary bike 1. You might begin to put some weight on your foot as you walk, if approved by your doctor.
- The subacute phase of healing begins around day four and continues until 2 weeks after an ankle ligament injury.
How Capital Orthopaedics Can Help Treat Your Torn Ankle Ligament Injury
A careful history and examination of your ankle is performed by one of our consultants.Scans are used to confirm the level of damage to the ligaments and also to exclude other injuries such as cartilage damage or tendon injury.
After an expert interpretation of your scans by our radiologists and surgeons, treatment is initiated.
If you have completely torn your ankle ligaments , we will need to immobilise your ankle in a walking boot for three weeks this will then be followed up by a further assessment and physiotherapy
If you have only partially torn your ligaments, then you can go straight to physiotherapy to mobilise and strengthen your ankle. Our team of physiotherapists will help strengthen your ankle and get you back to day-to-day activities and sport as quickly as possible.
If you fail to respond to nonoperative management, you may require surgical reconstruction of your ligaments and repair of any other damage structures in your ankle joint. This will be carried out by one of our highly experienced surgeons led by Simon Moyes.
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What Are The Ligaments Of The Ankle
The ankle is a hinge joint between the leg and the foot, and allows up and down movement. The bones of the leg form a slot, and the talus bone of the foot fits between them. The talus is held to the tibia and fibula by strong bands of tissue called ligaments. Each ligament is made of many strands or fibres of a material called collagen, which is extremely strong.
The ligament on the inside of the ankle has two layers the deepest one is most important. This ligament is mainly torn in association with severe fractures of the ankle bones. Sporting injuries of this ligament are rare.
The ligament on the outside of the ankle is made up of three separate bands: one at the front , one in the middle and one at the back . The front and middle bands are the ligaments injured in a sprain.
The tibia and fibula form a joint between themselves just above the ankle. This also has strong ligaments, one at the front and one at the back . The ligament at the front is involved in 10-20% of ankle sprains this injury is important, as it takes a long time to heal, although it usually heals without the need for surgical treatment.
Reduce Pain And Swelling
- Initial management of an acute lateral ligament injury is to reduce pain and swelling by following the RICE regimen Rest, Ice, Compression and Elevation.
- If weight bearing is too painful, the patient can be given elbow crutches and be non-weight bearing for 24 hours. However, it’s important that at least partial weight bearing is initiated relatively soon, together with a normal heel-toe gait pattern, as this will help to reduce pain and swelling.
- Gentle soft tissue massage can be performed to assist with the removal of oedema and gentle stretches, as long as this is pain free.
- Figure of 8 running
Before returning to full functional activity the patient should have full range of pain f-ee movement in the ankle, normal strength and normal proprioception. If returning to sports, the athlete should be encouraged to wear an ankle brace or to tape the ankle for a further 6 months to provide external support. Types of taping include a heel lock and figure of 6.
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Access Fast Ankle Ligament Damage Treatment With Our Top London Foot & Ankle Experts
With some of the UK’s leading Consultants for foot and ankle conditions at Schoen Clinic London, you can rest assured that you’ll be in the best possible hands. Our multidisciplinary team approach combines the expertise of surgeons, physiotherapists and nurses to provide you with the optimum result, no matter what your condition may be.
Well get you back to doing the things that you love.
Start your treatment journey today. For fast access to exceptional private healthcare at Schoen Clinic London, you can use your health insurance or simply fund your own treatment. Call the team direct on +44 20 4571 6508 or today.
How Do I Get Ready For A Lateral Ankle Ligament Reconstruction
Talk with your healthcare provider about how to prepare for your surgery. Ask if you should stop taking any medicines ahead of time, like blood thinners. If you smoke, try to stop smoking before your procedure. Tell your healthcare provider about all the medicines you take. This included over-the-counter medicines like aspirin. Also, tell him or her about any changes in your overall health, like a recent fever.
Before your procedure, you may need imaging tests, such as X-rays or an MRI. You should not eat or drink anything after midnight the night before your procedure.
You may need to plan some changes to your home and activities before surgery. You wont be able to walk on your foot normally for a while.
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Can I Injure An Ankle Ligament
An ankle ligament can be injured when it moves in the wrong direction, stretches too far or tears. A ligament injury is called a sprain.
A sprained ankle is a very common injury. It happens to people of all ages and levels of health. An ankle sprain usually occurs when someone twists the ankle. For example:
- Falling or almost falling.
- Having someone step on your foot, forcing it into an unnatural position.
- Playing sports that require rolling the foot or cutting back and forth in different directions quickly .
- Walking or running on uneven surfaces .
The three main types of ankle sprains include:
- Inversion ankle sprain: This happens when the ankle rolls inward, injuring the lateral ligaments. This is the most common type of ankle sprain, as the lateral ligaments are weaker than the other ankle ligaments.
- Eversion ankle sprain: This occurs when the ankle rolls outward and injures the medial ligaments. This type of ankle sprain is not common, but it can occur during running or jumping, especially on uneven surfaces.
- High ankle sprain: This type of sprain affects the syndesmotic ligaments. It typically occurs in competitive athletes who experience a forceful blow to the ankle or extreme twisting motion. Its particularly common in people who participate in American football, basketball, hockey, soccer and snow skiing.
At Home Torn Ligament Treatment
You want to help your ligament heal as well as possible. That can mean staying off of your foot for a while, depending on the severity of the injury. But when youre cleared to move around, exercise is a good choice. It not only helps you retain flexibility, but it can also help your ligaments get stronger.
That way, you can reduce the chances of an injury in the future. The treatment for torn foot ligament issues can actually involve using the ligament, as long as its done the right way.
Some of the best exercises to do at home include light cardio options such as:
- Cat and cow stretches
- Butterfly stretches
Physical therapy and a proper diet can also play roles in how well your foot ligament heals, so be sure to talk to your doctor about all the ways you can heal safely and get back to all the things you enjoy in life.
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How Can A Healthcare Provider Tell If Ive Injured An Ankle Ligament
If you think you have a sprained ankle, a healthcare provider may:
- Ask you about your symptoms and when they started.
- Conduct a physical exam by looking at the injured ankle, assessing how it moves and comparing it to the other ankle.
- Take X-rays to rule out a broken bone or other problems.
- If your pain isnt improving, your provider may order other imaging tests, such as MRI, to take pictures of the ankle ligaments.
Complete Nonretracted Tendon And Ligament Tears
When patients find out their radiology report has revealed a complete tendon or ligament tear, this certainly seems quite alarming, as if the structure has completely snapped in half, like a rubber band might. And while this can be true , the majority of the time, a complete tear is actually nonretracted.
While a complete nonretracted tear does mean that the tendon or ligament has been torn through, some of the injured fibers actually remain intact . In other words, the tendon or ligament is still holding together even though it has been torn through. A complete nonretracted tear of a tendon or ligament can usually be helped with a precise injection of high-dose stem cells. The blue area in the GIF image below represents a tendon or ligament, and you can watch as a complete nonretracted tear forms in the structure but doesnt pull completely back.
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Ankle Joint Ligament Injury Caused Due To Domestic Falls
Domestic injury causing ankle joint ligament injury or tear is observed mostly in elderly patients. Elderly patients are also often suffering with osteoporosis and ligament injury is associated with fracture of ankle bone, tibia or fibula. Causes of domestic fall such as fall on slippery surface, tripping on carpet, or fall over staircase can cause ankle joint ligament injury.
Diagnosing Deltoid Ligament Ankle Injuries
Deltoid ligament injuries can be easily diagnosed due to their immediate effects. If the symptoms have been allowed to heal and a person senses something is still amiss, the clinical evaluation may be a little more difficult.
A typical evaluation will begin by examining the patients medical history. Past injury to the ankle or abnormal bone structures within the foot will provide valuable insight into the condition of the deltoid ligament.
A physical examination is soon to follow. The doctor will ask their patient to relax the foot as they begin lightly applying pressure to the inside of the ankle. The doctor will start to rotate the ankle to flex the deltoid ligament and as they do, theyll record the patients reactions.
Based on the physical examination, the doctor will have a better idea of whether or not the deltoid ligament is the issue. To resolve any doubt, they will likely use medical imaging technology to get a view of the tissues within the ankle.
CAT scans and MRIs will give doctors a detailed view of the condition of the deltoid ligament. Localizing tears or abnormalities will help doctors create a treatment plan which specifically targets the injured portions of the deltoid ligament.
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When Should I Seek Treatment For An Ankle Ligament Tear
If any of these symptoms occur, you should seek treatment from a specialist. Also, if you have suffered a sprained ankle in the past, and persistently go over on your ankle, its likely that you have chronic ligament damage.
It is really important to get treated sooner rather than later, as chronic instability and weakened ankles can lead to other more serious conditions, such as ankle arthritis.
How To Prevent Ankle Ligament Damage
To reduce your risk of an ankle injury and torn ligament in ankle, you should always keep the following tips in mind:
- Do not exercise or play when you are tired.
- Maintain a well-balanced diet to keep muscles strong.
- Take steps to maintain a healthy body weight.
- Avoid falling accidents.
- Avoid ill-fitting shoes and select the right pair for right sporting activity.
- Never wear shoes with worn-out heels.
- Be active and exercise regularly.
- Be sure to warm up your body before playing a sport.
- Always run on flat surfaces.
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How Does The Doctor Diagnose An Ankle Injury
The first thing a doctor will do is ask questions about how the injury occurred. Then the doctor will examine the ankle, noting the amount of swelling and bruising. The physical examination of the ankle may be painful because the doctor needs to move the ankle to evaluate the pain and swelling in order to make a proper diagnosis.
The doctor may order an ankle X-ray to determine whether there are any broken bones. In addition to an ankle X-ray, your doctor may ask for X-rays of the leg and foot to determine whether there may be other related injuries. If the doctor suspects a stress fracture, the doctor will ask for other imaging scans such as an MRI, which will show more detail about the injury. If there is a fracture, the doctor may also ask for a stress test, which is a special X-ray taken with pressure applied to the joint. This will help the doctor determine whether surgery is needed.
For most ankle injuries, pain is controlled by using an over-the-counter medication such as acetaminophen or other nonsteroidal anti-inflammatory drug such as ibuprofen. The specific treatment of the injury depends on the type of injury.
Anatomy Of An Ankle Sprain
The most common type of ankle sprain is an inversion injury, or lateral ankle sprain. The foot rolls inward, damaging the ligaments of the outer ankle the anterior talofibular ligament, the calcaneofibular ligament, and the posterior talofibular ligament.
Less common are sprains affecting the ligaments of the inner ankle and syndesmotic sprains, which injure the tibiofibular ligaments the ligaments that join the two leg bones just above the ankle. Syndesmotic sprains, which occur most often in contact sports, are especially likely to cause chronic ankle instability and subsequent sprains.
The severity of an ankle sprain depends on how much damage it does and how unstable the joint becomes as a result. The more severe the sprain, the longer the recovery .
Grades of ankle sprain severity
Mild pain, swelling, and tenderness. Usually no bruising. No joint instability. No difficulty bearing weight.
Moderate pain, swelling, and tenderness. Possible bruising. Mild to moderate joint instability. Some loss of range of motion and function. Pain with weight bearing and walking.
Full tear or rupture
Severe pain, swelling, tenderness, and bruising. Considerable instability, loss of function and range of motion. Unable to bear weight or walk.
Up to several months
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Nonsurgical Treatments For Ankle Sprains
Most ankle sprains dont need surgery.
You should be able to recover from a minor, first-time sprain relatively quickly with home care. This includes treatments known as RICE therapy:
- Rest: Stay off your ankle until it doesnt hurt. Exercising before a sprain has fully healed may make it worse or increase your risk of re-injury.
- Ice: Place a wet towel on your ankle, then cover it with a plastic bag full of ice . Apply the ice for 10-20 minutes, then remove it for 40 minutes. Repeat this as often as you can during the first 48-72 hours after your injury.
- Compression: Wrap your ankle with an elastic bandage. This will help control swelling.
- Elevation: Recline on a bed, sofa, or chair and use a pillow to raise your ankle slightly higher than your hips.
If you have a moderate to severe sprainor home care doesnt helpyou may need additional nonsurgical treatment. These therapies include:
- Orthopedic devices: While you heal, certain medical equipment can help take pressure off your ankle or keep it stable. These include ankle braces, walking boots, and crutches.
- Rehabilitation: Our physical therapists can teach you exercises to improve your ankle strength, ankle flexibility, and balance.
Investigations To Diagnose Ankle Joint Ligament Injury
Investigation is aimed to find the tissue injury and also to rule out fracture and dislocation of ankle joint.
- X-Ray: X-ray examination is useful to diagnose if there is any fracture and dislocation of ankle joint in addition to the ankle joint ligament injury.
- MRI: MRI is useful to evaluate fracture, dislocation and hematoma.
- Ultrasound: Ultrasound is a specific investigation to evaluate hematoma.
- Arthroscopy: An orthopedic surgeon performs arthroscopy. Arthroscopy examination is a specific test to diagnose and treat ankle joint ligament injury and tear.
- Blood Examination: White Blood Cell Count is increased in infection and septic arthritis. WBC is normal in ankle joint sprain without any infection.
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