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Ankle Sprain/Ankle Instability

The Condition

Lateral ankle sprains are one of the most common injuries to the lower extremity. They typically result following a twisting injury to the ankle. The injury causes an actual tearing of one or more of the lateral ankle ligaments. This results in swelling, pain and bruising on the outside of the ankle and is usually accompanied by difficulty walking. Repeated injury to the ankle ligaments is commonly referred to as lateral ankle instability. This results in difficulty navigating uneven terrain when walking. Patients often complain of the ankle wanting to ‘give way’ when carrying out activities of daily living. Repeated sprains of the ankle can lead to osteochondral lesions of the ankle and peroneal tendon injuries.

Medial ankle sprains are much less common. They occur when an injury takes place at the deltoid ligament complex on the inside portion of the foot and ankle. These injuries can also lead to chronic pain and instability.

The Treatment

The initial treatment following an ankle sprain involves rest, ice and elevation. Immobilization is often required for a period of time as is medication to help with pain and swelling. Physical therapy is often necessary to regain strength and balance. In cases of chronic ankle instability and severe sprains, surgery may be indicated.

Frequently Asked Questions

Sprains involve the physical tearing of the ligaments that stabilize the ankle joint complex. Fractures are a physical break of the fibula, tibia or talus bones. These three bones make up the ankle joint and its articular surfaces. It is possible to have both an ankle sprain and an ankle fracture occur at the same time. Your podiatrist can help you determine both the nature of the injury and the best method of treatment.

Thorough physical examination can often help in making the appropriate diagnosis. Plain film radiographs (X-rays) and magnetic resonance imaging (MRI) are frequently required to determine the severity and extent of the injury.

Prompt evaluation and treatment are key when trying to avoid healing complications. Physical therapy and ankle bracing can be useful in strengthening and stabilizing the ankle. It is recommended that patients avoid uneven surfaces as these increase the risk for repeat injury. Surgery may be indicated if the injury is severe or if conservative care fails.

Surgical procedures are designed to repair, stabilize and augment the torn tissues.

Yes. Patients who suffer from frequent ankle sprains are more likely to develop osteochondral lesions of the ankle and peroneal tendon injuries. In some cases, a very bad ankle sprain can actually result in the formation of fractures.