The most common injury to the ankle in sports is a sprain. It accounts for between 10 and 15% of all injuries. A sprain is the most common injury to the ankle.
Ankle sprains are caused by the stretching or tearing of the ligaments when the ankle twists or turns. Ligaments are strong fibres that support the ankle. There are many types of strains. They can be categorized as follows:
- Grade I (Mild). – Light stretching of the ligament
- Grade II (Moderate), – Complete tear of the ligament
- Grade III (Severe). – Complete tear of the ligament.
Many people consider ankle sprains minor injuries that don’t require medical attention. People often wait between 2 and 8 weeks for their ankles to heal. Another myth is that the ankle is fully healed after the swelling or pain subsides. But, it is possible to sustain long-term injuries or recurrent pain if you continue with your daily activities after an ankle injury. About 20% of patients who have suffered from ankle sprain develop chronic instability in their ankles.
What is chronic ankle instability?
Chronic ankle instability is the persistent giving way on the outside side of the ankle. This happens when the ankle injury doesn’t heal properly. Chronic ankle instability can be characterized by:
- Permanent discomfort or swelling in the ankle
- Repetitive turning of the ankle while walking on uneven surfaces, or participating in sports
- An unstable or wobbly feeling in the ankle
Chronic ankle instability is more common in patients with a history of recurrent or high-grade sprains, lower limb weakness, postural imbalance, and/or a history of recurrent sprains. People who play sports such as tennis, basketball, tennis and soccer are more likely to experience this condition. It can also affect the community, especially those who have a history of falling or walk on uneven ground. Chronic ankle instability can lead to ankle arthritis if left untreated.
How can chronic ankle instability be treated?
Chronic ankle instability is usually treated with medication and physiotherapy. Non-steroidal anti-inflammatory medications, which reduce inflammation and pain, are the most commonly prescribed.
Physiotherapy includes strengthening exercises, balance improvement, and muscle retraining. Surgery will be recommended if the ankle is still not healing or the patient continues to experience ankle instability after three months of physiotherapy. Surgery is performed to stabilize weak or loose ankle ligaments and improve its mechanical stability.
Is it possible to treat chronic ankle instability with surgery?
Brostrom-Gould Repair Open Surgery, which is the most popular surgical procedure for ankle ligament repair, is also available. The Arthroscopic Brostrom–Gould Repair (MIS) has gained popularity among orthopaedic surgeons in the past decade.
MIS, such as the arthroscopic method, is more popular than open surgery due to the following benefits:
- Lower incidence of wound complications
- Less pain and bleeding with smaller incisions
What are the possible risks associated with this surgery?
Although MIS has a lower chance of complications, as with all surgeries, there are still possible risks. These complications could occur:
- Anaesthesia complications
- Nearby anatomical structures may be damaged
- Scar hypersensitivity
- Stiffness in your ankle joint
What are your options after surgery?
Your ankle will be cast after the procedure. The cast will be removed and you can go home the same day.
For a few days following surgery, you will feel mild pain in the ankle. You will be given pain medication to reduce this discomfort. It will be recommended that you elevate your leg.
After 14 days, your surgeon will ask you to return to him to have the stitches removed. After the cast is removed, a removable walking boot will be placed that you can use for several weeks. To aid your recovery, you will be asked to perform ankle mobilization exercises.
Are you a candidate for surgery?
If your ankle pain is severe and you have tried physiotherapy but it has not worked, you should consult an orthopaedic doctor to assess your condition.