Ankle Sprain Treatment

OVERVIEW

An ankle sprain is a common musculoskeletal injury of all age groups, athletes and people with physically inactive lifestyles. This occurs when there is stretching or tearing of the ligaments in the ankle, causing pain and difficulty walking. Without appropriate physiotherapy or treatment, a severely sprained ankle may not heal properly, possibly resulting in repeated ankle sprains, longer recovery time, and chronic ankle instability. So, it is necessary that you see an orthopedic specialist to assess the severity of injury to find the best solution.

SYMPTOMS AND CAUSES OF ANKLE SPRAIN

If you have a sprained ankle, you may experience some of the following signs and symptoms, depending on the injury severity:

1. Swelling and bruising (most common)
2. Tenderness when touching the ankle
3. Restricted range of motion
4. Pain when putting weight on the affected foot
5. Ankle instability
6. Popping sensation or sound as the sprain occurs (severe level which requires prompt and proper medical evaluation)

Typically, a sprain occurs when your ankle is forced to move out of its normal position (inversion, eversion or high ankle sprain), which can cause one or more of the ankle's ligaments to stretch, partially tear, or tear completely. 

There are many causes of ankle sprain, including: 

1. Planting your foot the wrong way when walking or running
2. Stepping in a hole or on an uneven surface
3. Participating in sports that require cutting movements or twisting of the foot (trail running, basketball, tennis, football, soccer, etc.)
4. Stepping on someone else’s foot while playing sports
5. Falling from the ladder or height
6. Doing strenuous activities, like playing surf skates
7. Having high arches (high-arched feet or cavus feet), or flat arches (flat feet or fallen arches), which is a predisposing factor that increases the chances of ankle sprain and recurrent ankle instability

If you suspect an ankle sprain, see an orthopedic specialist for prompt and proper evaluation of the severity. Your orthopedic specialist should prescribe necessary physical examinations to ensure the highest level of diagnostic precision and accuracy. At WIH International Hospital, Orthopedic and Sports Medicine team provides comprehensive examinations to personalize the best treatment solution possible for you, which typically include: 

  • X-ray

X-rays should be ordered to detect the possibility of a broken bone either in the ankle or foot (a broken bone can cause similar symptoms of pain and swelling), and also examine other bony issues (i.e bony impingement, flat or high arches, cartilage injury and/or other suspicious conditions).

  • MRI (magnetic resonance imaging scan) 

Until after swelling and bruising ease (which should be approximately 6 weeks post injury), an MRI should be ordered if there is any suspicion of a very severe injury to the ligaments, any damage to the bone or cartilage of the joint surface, or other issue. This is to determine the right treatment depending on your conditions or injury severity. 

Since ankle sprain candidates with high or flat arches have a greater likelihood to experience recurrent ankle instability even after self-healing or receiving surgical treatment of ankle sprain, foot reconstructive surgery can be done in the same session with ankle sprain surgery to both repair the ankle sprain and correct the arch.

TREATMENT SOLUTIONS OF ANKLE SPRAIN

Our highly-experienced team of board-certified foot and ankle orthopedic and sports medicine specialists provides 24-hour care so as to deliver a prompt and personalized holistic consultation. We are ready to expertly offer all aspects of services that help restore sprains and strains from non-surgical personalized physiotherapy and rehabilitation to specialized surgical options with arthroscopic-assisted techniques that answer each individual’s conditions with sustainable and satisfactory outcomes.

  • Personalized Physiotherapy and Rehabilitation Program

Normally, most sprains will feel better after 2 - 3 weeks. As there is a risk of recurrent damage, avoid strenuous activity and exercise (such as fast walking, running, etc.) for up to 6 weeks.  Severe sprains and/or strains can take months to return to normal. However, if it takes longer than usual to recover, you should be advised to see an orthopedic specialist and/or physiatrist for appropriate treatment.

In case physiotherapy and rehabilitation are ideal for your conditions following the X-ray and MRI results, our well-trained physiatrists will prescribe you a personalized physiotherapy and rehabilitation program to restore your ankle's range of motion, strength, flexibility and stability, while working multi-dimensionally with expert physiotherapists to clarify the proper method and monitor the progression of exercises, which may involve various degrees of balance improvement tailor-made just for you.

  • Minimally Invasive Surgery (MIS)

In cases that the injury doesn't heal or the ankle remains unstable after a certain period of the physiotherapy and rehabilitation program, surgery should be taken into consideration. To enhance overall life quality and unlock your life as desired, WIH foot and ankle orthopedic and sports medicine specialists successfully utilize pioneering orthopedic MIS techniques, including:

1.    Arthroscopic Brostrom Repair 

Those who continue to have ankle pain or instability may be candidates for the arthroscopic lateral ankle ligament repair (arthroscopic Brostrom repair) to repair the ligament for improvement of functional outcome. 

While traditional surgical methods require large open incisions to expose the ligament to repair it, leaving large-sized wounds, more pain, more stiffness and a long downtime, an arthroscopic Brostrom repair is a gold standard that allows the ligament to be repaired from inside the ankle joint by using a specialized microscope (arthroscopy) and advanced surgical equipment via only 2 - 3  minimal incisions. 

The arthroscopic Brostrom repair offers the advantage of smaller wound size, less pain, more cosmetic outcome, fewer complications, faster recovery, and quicker resumption of work and sports activity.

2.    Arthroscopic All-Inside Reconstruction

The arthroscopic all-Inside reconstruction is a complex specialized alternative technique to reconstruct a ligament arthroscopically. This technique is modified from the arthroscopic Brostrom repair especially for candidates who desire satisfaction on both functional and much more cosmetic outcomes.

The arthroscopic all-inside reconstruction offers the advantage of smaller wound size, less pain, more cosmetic outcome, fewer complications, faster recovery, and quicker resumption of work and sports activity.

Beyond the arthroscopic brostrom repair, the arthroscopic all-inside reconstruction leaves no surgical knot touchable outside the joint, thus causing no irritation when wearing shoes, and giving more flexibility, less stiffness, less scarring as well as more aesthetic outcome.

DETAILS OF ANKLE SPRAIN SURGERY

Type of Anesthesia:  General anesthesia administered by anesthesiologist to ensure safety

Operation Time:        2 hours 

Length of Stay:         3 days 2 nights 

Recovery Time:         4 - 6 weeks depending each person’s healing and post-op rehabilitation

ANKLE SPRAIN SURGERY AFTERCARE

  1. After surgery, post-op immobilization will support and stabilize your ankle and foot for 1 - 2 weeks.
  2. Use a cold compress (cooling gel) and and keep your treated foot elevated for 72 hours after surgery to reduce bruising and swelling.
  3. Pain is well-managed by prescribed medications.
  4. You will be advised to avoid exposing your wound to water, and maintain wound care and hygiene by using the antiseptic solution.
  5. The stitches will be removed 10 - 14 days after surgery.
  6. After 2 weeks, post-op immobilization will be removed and replaced with a removable cast or booth.
  7. A rehabilitation program will be ordered for your motion enhancement of the treated ankle.
  8. You will be advised to put weight on the treated ankle as tolerated.
  9. After all, a holistic physiotherapeutic program will be ordered and personalized to increase your muscle strength and ankle balance.