Ankle Injuries: What you need to know

When should I consult my doctor about my ankle injury?

Some ankle sprain injuries need more careful evaluation by a doctor. Some signs which are suggestive of more serious injury (eg an ankle or foot fracture) include:

  • Inability to bear weight
  • Inability to push-off or tip-toe
  • Tenderness over the bony prominences at the side of the ankle (the medial and lateral and malleoli)
  • Tenderness in the foot

If in doubt, see your doctor for a more thorough assessment.

I have just sprained my ankle. Do I need surgery?

Ankle sprains are common sporting injuries. Although it is often associated with injury to the collateral ligaments of the ankle, surgery is not usually necessary in the majority of cases. The acute treatment should consist of RICE (Rest, Ice, Compression, Elevation) for the first 48 hours or so, followed by one to two weeks of gradual return to activity. An ankle brace or ankle guard may be helpful in this phase of recovery.

I have heard that ankle sprains can cause tears in the ligaments, doesn’t these need to be repaired?

Ankle sprains do cause a tear or stretch of the lateral collateral ligaments in the ankle. However, the majority of patients will improve with RICE treatment and, if necessary, physiotherapy. Surgery is usually reserved for patients with chronic pain, recurrent sprains or sensation of instability, especially with sports.

What kinds of tests are necessary to diagnose and assess my ankle pain/instability?

Usually, a plain x-ray will be done to bony injuries. MRI scans can be helpful especially in helping to diagnose and pinpoint causes of pain in the foot and ankle. This is because the foot has many bones, ligaments, tendons and muscles, all of which need to be carefully assessed.

I am going for ankle ligament reconstruction. What is the rehabilitation protocol like after surgery?

After surgery, the ankle will need to be placed in a walking cast boot which can be removed for dressing changes. Typically, this is kept on for about 6 weeks. Crutches will need to be used and full weight bearing on the operated ankle is allowed. After 6 weeks, the cast boot is removed and physiotherapy can start. The ankle will usually feel quite stiff and weak at this time and physiotherapy is essential to maximize the benefits of surgery. A progressive programme of regaining motion, strength, balance and agility is prescribed. Most patients will take at least 3 months before returning to “normal” sports.

What about arthroscopic surgery? What is the recovery time after this?

The rehabilitation protocol after ankle arthroscopy is more variable, and depends on the diagnosis and treatment. In the most straightforward cases, you will actually be able to bear weight on the leg the same day, and full recovery is expected within a month. In more complex cases, recovery will be similar to that for ankle ligament or cartilage reconstruction.

 

 

Dr Ooi Lai Hock

Consultant Orthopaedic Surgeon and Medical Director

Island Orthopaedic 

 

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