Treating Ankle Sprains
Most ankle sprains can be treated conservatively and won’t require surgery. Even complete ligament tears can heal with proper and early treatment and immobilization. For mild ankle sprains the doctors at City Podiatry may recommend the RICE protocol. Rest the ankle, apply ice to keep the swelling and inflammation down, wear compression bandage and elevate the ankle. Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen and naproxen can also help control pain and swelling.
In addition to the RICE protocol and medications, some cases can require an ankle brace, boot or cast and crutches due to inability to walk properly. Physical therapy may also be prescribed. This involves modalities and exercises are used to prevent stiffness, increase strength, and prevent chronic ankle problems. Rehabilitation after an ankle sprain involves time and attention. The length of recovery time depends upon the extent of injury and may take from weeks to months.
After an ankle sprain, one may continue to re-sprain it if the ligaments do not have enough time to heal completely. If pain continues for more than 4 to 6 weeks, it may now be a chronic ankle sprain. Activities that tend to aggravate a sprained ankle include stepping on uneven surfaces, returning back to work and sports to early. Abnormal proprioception is a common complication of ankle sprains and can also lead to repeat sprains. This is when there is an imbalance and muscle weakness that can lead to a reinjury. Repeat sprains and chronic sprains may persist with instability, a sense of the ankle giving out, and chronic pain.
Surgery is last resort and for patients that fail conservative and nonsurgical treatment. Patients who experience persistent ankle instability after months of rehabilitation and nonsurgical treatment may be good candidates for arthroscopy. During arthroscopy, your doctor uses a small camera, called an arthroscope, to visualize inside the ankle joint. Small instruments are used to remove any loose fragments of bone, cartilage, tendon and ligament that may be free floating within the joint. Reconstruction and repair of chronically torn ligaments with stitches may be necessary in some cases. The damaged ligament is sometimes replaced with a tissue graft obtained from other ligaments and/or tendons found in the foot and around the ankle.
Outcomes for ankle sprains are generally quite good. With proper treatment, most patients are able to resume their normal daily activities after a period of time. Most importantly, successful outcomes are dependent upon patient commitment to rehabilitation exercises. Incomplete rehabilitation is the most common cause of chronic ankle instability after a sprain and can put the patient at risk for continued ankle sprains.