Trauma to the foot and ankle region is extremely common. You don’t have to be extremely active to experience painful sprains, fractures and tears. Women over the age of 30 and men between 15- to 24-years old are the most susceptible to ankle sprains. Around 50 percent of sprains occur during physical exercise or athletics. Approximately 25,000 people in the United States sprain their ankle every day, leading to over 1 million emergency room visits per year.
Ankle injuries are caused by damage to the bone, ligament or tendon where three structural bones intersect: the tibia and fibula (lower leg) and talus (foot). Ligaments within the ankle joint keep these bones connected with strong elastic bands of tissue that provide a range of motion and support. Meanwhile, tendons attach muscles to the bones to help stabilize the joints and allow your ankle and foot to move on command.
Ankle injuries have many causes, but are often the result of tripping, falling, awkward landings, uneven surfaces, sudden impact, twisting or rolling. Symptoms include sudden and severe pain, swelling, bruising and/or inability to walk or stand.
Common Ankle Traumas
- Fracture: breakage of one or more of the three bones in the ankle
- Sprain: damage or tear to ligaments (connective tissue)
- Strain: damaged muscles and tendons from overstretching or exertion
Most often, the tendons in the ankle strained or inflamed (tendinitis) are the peroneal tendons that defend the ankle. When abrupt trauma occurs, the peroneal tendons tear. Tendons may also suffer smaller, microscopic tears recurrently, but fail to heal due to tendinitis. Tendinitis is a chronic condition that worsens over time, usually initiating intermittent pain, ankle weakness or overarching of the foot. Tendons may also split or slip out of place (subluxation).
At your first appointment, we administer scanning to determine the precise point of trauma for optimal treatment. If a fracture is detected, we’ll discuss both surgical and nonsurgical rehabilitation methods (cast). The need for surgery mostly depends on whether your ankle is stable enough and bones are still in place. If not, we will use surgical methods to place a metal plate and screws to hold the bones together for ideal restoration. After the operation, patients are required to wear a splint and/or a cast. Bones typically heal in about six weeks, but ligament and tendon damage will take longer to recuperate. Keeping weight off the injured ankle is necessary for proper healing and re-positioning. Once mended, a few months of physical therapy helps patients regain normal function.
If you suffer an ankle sprain, surgery is not usually required unless in cases of severe damage.
Grade 1 sprains (mild) are treated with at-home care and strengthening techniques.
Grade 2 sprains (moderate) usually require more healing time and physical therapy.
Grade 3 sprains (severe) are caused by a complete tear or break of the ligament, which is treated by restricting joint movement and possibly reconstructive surgery.
Tendon injuries are treated with casts or splints, activity braces, physical therapy and possibly surgery.
First-aid immediately following ankle injuries follows the R.I.C.E method (rest, ice, compression and elevation). Do not put any weight on your ankle until the area has been properly evaluated by a medical professional. You may use over-the-counter medication to relieve pain, such as acetaminophen (Tylenol) or ibuprofen (Motrin) to help reduce inflammation and reduce discomfort. Overlooking fractures and sprains and letting them heal without a physician’s guidance may lead to repeated injury, arthritis or general weakness.