Ankle sprain/ligament sprain

Technical Name:

Ankle instability

AKA Name:

Ankle sprain

Short Summary:

The ankle joint comprises the bones of the lower leg (tibia and fibula) and the ankle itself (talus).  The joint movement is stabilized by the shape of these bones but more importantly by ligaments that surround these bones to ensure a stable joint when you are weight bearing and moving. 

It is common to suffer an ankle sprain where your foot and ankle twist suddenly, usually where the foot twists inwards (inversion injury).  When this happens the ligaments act to support and stabilize the joint but if the force is too great then these ligaments can be stretched or torn in severe cases.

The main ligament running along the inside aspect of the ankle is called the ‘deltoid ligament’.  The outside aspect of the ankle joint is stabilized by three main ligaments the main one called the ‘anterior talo-fibula ligament’ running from the talus to the distal fibula.  This is the most common ligament to be damaged in simple ankle sprains when the foot twists inwards.  

What are the symptoms?

Most people have experienced an ankle sprain in their life and can happen through relatively minor stumble sometimes. As described above the most common injury pattern is an inward twisting of the foot (inversion) resulting in damage to the ligaments on the outside aspect of the ankle joint (anterior talo-fibular ligament.  Damage to this ligament results in swelling, bruising and tenderness over the outside aspect of the ankle joint.  

If the ligament is sprained then it is possible to weight bear but this can be uncomfortable.

In more serious sprains the ligament can be torn causing more significant swelling and discomfort and weight bearing may be more difficult.  On occasions if the ligament tears it can cause a small break in the end of the fibula on the outside of the ankle.  In these situations the majority of individuals symptoms will settle and improve with rest, elevation and then structured rehabilitation.  However a small number of people may develop ankle instability.

Ankle instability occurs when the ligaments around the ankle are unable to support the ankle joint sufficiently to allow movement without pain or the ankle giving way with any form of loading through it.  This can cause further injury to the ankle joint itself. 

How is it diagnosed?

The majority of ankle sprains will settle with standard rest elevation and then physiotherapy.  If your symptoms fail to settle and you have on-going discomfort or feel your ankle is giving way then you may require further investigation with an x-ray or sometimes and MRI scan.  

How is it treated?

The mainstay of treatment for ankle sprains is physiotherapy exercises focus on reducing the swelling, improving the range of movement and the control and coordination of the ligaments (proprioception).

After several months if the symptoms are not settling and the ankle has not returned to normal then further investigations may be arranged as above.

If these demonstrates any abnormality then surgery can be carried out in the form of ankle arthroscopy or ligament reconstruction.

Important: this information given above is only a guideline as is not complete.  For more information or to book an appointment please contact us.