University Foot & Ankle Institute
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  • University Foot & Ankle, a Preferred Provider to:
  • UCLA Health System - UCLA Medical Group
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  • And consulting physicians for:
  • C&S - Cedars-Sinai
  • Saint John's Health Center

Ankle Sprains and Chronic Ankle Instability

What is an Ankle Sprain?

Torn Ankle Ligament, Sprained Ankle

 

An Ankle Sprain is the most common foot and ankle injury for children and adults alike. A sprain is usually caused by the twisting of your ankle and can happen during high impact activities like running or basketball or by simply stepping off a curb. Regardless of how it happens, great force is exerted on the ankle ligaments.

 

Should you see a doctor for an Ankle Sprain?

 

In many case, yes you should! Because ankle sprains are so common, they are too often neglected or under-treated, which has led to alarming increase in people needlessly suffering long term pain, instability, and what could have been totally avoidable surgeries.

 

University Foot and Ankle Institute has taken a special interest in treating and rehabilitating ankle sprains and chronic ankle instability. Our physicians evaluate the ankle during your initial visit, looking for stability and abnormal rotation. This helps identify if any ligaments are injured and to what extent. Muscle testing is also performed to assess weakness or injury.

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What are the Symptoms of an Ankle Sprain?

 

A typical result of a sprained ankle is pain and swelling on the outside of the ankle and foot. Pain is often located over the outside of the anklebone and over the ankle’s ligaments and tendons. Some patients cannot place their foot on the ground without pain. The injured area becomes bruised and discolored. There can be a feeling of imbalance as well; it may feel as though the ankle can roll again at any time. You may also experience a locking or clicking of the ankle when it is moved.  

Ankle Sprain - Torn Ankle Ligaments

How do we Diagnose the Severity of a Sprained Ankle?

 

University Foot and Ankle Institute has taken a special interest in treating and rehabilitating ankle sprains and chronic ankle instability. Our physicians evaluate the ankle during your initial visit, looking for stability and abnormal rotation. This helps identify if any ligaments are injured and to what extent. Muscle testing is also performed to assess weakness or injury.

 

It is likely that your doctor will take X-rays in the office to determine if there are any fractures or bone chips from the ligament tear, which are not uncommon. In some, usually chronic cases, special stress x-rays are taken to determine the amount of dislocation. Occasionally, an MRI is needed to provide an enhanced image of the ligaments, tendons, and the cartilage of the joint to determine the true extent of your injury. 

 

University Foot and Ankle Institute offers a dedicated foot and ankle MRI with multi plane imaging specifically designed to meet the requirements of the most common foot and ankle injuries.  In certain cases, a CT scan may be done to check for loose pieces of bone or bone damage. University Foot and Ankle Institute is proud to offer a revolutionary weight bearing CT that allows proper imaging of the foot and ankle in an anatomic position.

 

Treatments for acute Ankle Sprains and Torn Ankle Ligaments

 

Your doctor will explain that a properly supported and treated ankle sprain heals relatively quickly and without much need for further surgery or bracing. However, it can take several months before you feel confident in the strength of the ankle and returning to activity prematurely can lead to additional sprains.

 

It is important to remember that proper protection of the ligament after a sprain and active physical therapy during a sprain will result in a better long-term outcome.  Even with proper protection and bracing, 30% of ankle sprains can have secondary factors leading to pain.  These include chronic ankle instability from loose ligaments, tendon tears, cartilage damage and scar tissue in the ankle joint.  These problems can cause ankle instability, pain and swelling that often need to be corrected surgically.

 

After assessing the severity of your sprain, doctors at the University Foot and Ankle Institute will prescribe the proper therapies, which can include:

 

Cold Therapy

Good old fashioned ice can be used or the newer (and more comfortable) cold gel products are an essential part of any sprain. This helps decrease the inflammation cause by the injury and only when the inflammation is slowed can healing begin.

 

Compression.

An elastic compression wrap, such as an ACE bandage is often used to help reduce swelling.

 

Elevation

Raise your ankle above the level of your heart for two or three hours a day. This helps reduce swelling and bruising.

 

Anti-inflammatory medications

Products such as aspirin, ibuprofen (Advil) and Naprosyn (Aleve) decrease the swelling and pain and increase the healing. Always read the warning labels on this medications and have food in your stomach if you choose to use them as they can have serious side effects.

 

Ankle brace

If there is minimal damage, a simple lace up ankle brace will be used with weight-bearing. In moderate to severe cases, a removable boot will be used to lock down the ankle and foot. In cases with a fracture, a cast will most likely be used to immobilize the ankle and foot.

 

Physical Therapy

Last but not least is Physical Therapy (also known as "PT."  Physical Therapy is usually an essential part of the treatment protocol for ankle sprains.

 

 

Advanced treatment options for a severe and chronic Ankle Ligament Tear or Sprain

 

Although ankle ligaments are strong, ankle rolls can cause serious damage. Ankle ligaments often stretch, partially tear, tear completely, pull off the bone, or pull off a piece of bone. Depending on the severity of the injury and rotation of the foot during the injury, one or more ligaments may be injured. If you experience several sprains over a short period of time, there may be a weakening of the ligaments, which can also cause an unstable ankle.  

 

Some important things you should know about more aggressive treatment options are:

 

Acute ankle sprains do not ALWAYS require surgery

However, 30% of ankle sprains may have continued pain and swelling. This is caused by ligament tears and instability, associated cartilage damage, loose bone, tendon tears or scar tissue in the joint.  These problems are often considered to be in need of more aggressive treatment if the pain and swelling persist for more than three months after an injury. In these circumstances, something the ankle may require surgery.

 

Ankle stabilization surgery

This surgical procedure is usually performed via a small incision and using micro-sized instruments (including a camera), allowing direct repair and tightening of the torn or loose ligaments. Scar tissue in the joint is removed and the joint is “cleaned-up.”

 

Ankle Ligament repair surgery

The ligaments can then be repaired by placing them back onto the bone in their natural position. In some cases a small anchor will be used to anchor the ligaments to the bone. This repair tightens and strengthens the ligaments. If the ligaments are too weak or destroyed to repair, cadaver tendon is used to create new ankle ligaments. This tendon is routed through the bones of the ankle to reinforce the ankle

 

In cases of severe instability, or failed previous surgery, a stronger ankle stabilization repair can be performed by weaving a tendon through the loose ankle bones to tighten the ankle and limit chronic injury.

 

An MRI and possible CT prior to surgery are used to check the ankle ligaments and surrounding bone and tendon structures. If there is an injury to the cartilage, bone, tendon or joint, the associated ankle problems are treated at the same time as the ligament repair.

 

 

Why Partner with UFAI for the Treatment of your Ankle Sprain?

 

University Foot and Ankle Institute is one of the largest and most technologically advanced providers of foot and ankle care in the country. The team of doctors at the Institute offers expert knowledge in the evaluation and treatment of all conditions of the foot and ankle for children and adults.  

 

From the warm initial meeting and care of your acute ankle injury to any surgical care, our team is dedicated to getting you back on your feet, and your life, in a timely and cost effective manner.

 

Our on-site physical therapy services, comprehensive imaging and bracing facilities allow for a team approach and one-stop care of your ankle injury.  

 

University Foot and Ankle Institute was founded and staffed by physicians who are also passionate educators.  As a result, UFAI has become a leader in better educating hospitals, emergency rooms, internists, family practitioners and physical therapists about the critical importance of timely and comprehensive ankle injury care.  Because ankle sprains are so common, they are too often neglected or under-treated, which has led to far too many people needlessly suffering long term pain, instability, and what could have been totally avoidable surgeries.

 

University Foot and Ankle Institute has documented the largest ever study on a triad injury of the ankle.  This triad consists of chronic scar tissue, ankle instability and tendon tear that can occur together due to ankle sprains.  Our revolutionary surgical treatment of these cases has resulted in over a 97% return to full and unrestricted activity in our study group of more than 700 cases.  

 

UFAI  has also helped many orthopedic product companies build or improve their products related to chronic ankle instability and pain.  From bone and ligament anchors to tendon repair equipment and techniques, we are at the forefront of these revolutionary technology and techniques for foot and ankle care.