An ankle sprain (external ankle ligament injury)
"Twisting my foot on a step" or "Twisting my ankle." An ankle sprain is a very common injury, but if it is not treated properly, the pain may persist or the ankle may feel unstable.
Twisting the ankle inward (inward rotation) damages the ligaments on the outside of the ankle. The outside of the ankle has three ligaments, mainly the anterior tibialis ligament, calcaneus fibula ligament, and posterior tibialis ligament. The anterior tibialis ligament is the most susceptible to injury, and it is estimated to account for 60 to 70% of injuries to the external ligaments.
Mild ligament damage that does not involve fractures or dislocations is commonly referred to as a sprain; in reality, the important tissue of the ligament is damaged. Additionally, damage to other ligaments (the anterior tibial tendon, the semitendinosus tendon) and fractures of the bones on the toes of the feet (the fifth metatarsal bone) can also occur. Ligaments have poor blood flow and it is said that it takes about six weeks or more for them to heal completely.
In such cases, seek medical attention.
- The outside of my ankle is swollen and it hurts when I press on it.
- There is sub-cutaneous bleeding (blue bruises)
- It hurts when you put weight on it, and it's difficult to walk on it.
- I keep getting sprains, and my ankle feels like it's wobbling.
Tests performed at our clinic
- Ultrasound examination (echography): To check the condition of the anterior fibular ligament at the spot, primarily the ligament itself.
- X-ray: To check for broken bones (fractures) that have broken off the bone or any abnormalities in the bones.
- Front-drawer test: The ankle instability (mainly damage to the anterior talofibular ligament) is confirmed during the examination
- Additional tests such as MRI: We will recommend them if necessary.
medical treatment
We proceed with treatment in accordance with the “PEACE & LOVE” philosophy, from the immediate aftermath of the injury to the recovery period.
Immediately after the injury (PEACE): If necessary, secure the ankle and use a crutch to prevent weight from being placed on it (protection). Raise the foot to relieve swelling (elevation), and apply pressure as needed to help control the inflammation. Use medications to help control inflammation carefully to prevent hindering tissue repair. We will also explain how to manage it yourself and the outlook for recovery.
Recovery period (LOVE)As the recovery progresses, you can gradually resume your exercise routine. Your physical therapist will instruct you on exercises to expand the range of motion in your ankles, strength training, and balance training.
equipmentWhile the ligament heals (usually about 6 weeks), we will gradually progress the recovery with a medical ankle brace to stabilize the joint. Even after the pain subsides, resuming exercise too soon increases the risk of further injury, so it is important to proceed under the guidance of a doctor or physical therapist.
Doctors who treat this disease
The surgery is performed by a plastic surgeon. Our hospital has a plastic surgery specialist from the Japanese Society of Plastic and Reconstructive Surgery on staff.
Frequently asked questions
Q. Since I can walk, is it okay to leave the sprain untreated?
A. A sprain occurs when the ligament is damaged, and if left untreated, pain and instability may persist. If there is swelling or pain, it is recommended to first check the condition.
Q. I'm worried that I might have broken a bone.
A. With an X-ray, we check to see if there are any broken bones or abnormalities in the bones that could cause the skin to peel off. Fractures of the bones on the toes of the feet can also occur.
Q. How long does it take to get cured?
A. The tendons have little blood flow, and it is said that it takes about 6 weeks or more for them to heal completely. During that time, we use a splint to stabilize the ankle while gradually progressing the recovery.
Q. What should I do immediately after the injury?
A. Immediately after the injury, apply protection and elevate the injured area, and if necessary, apply pressure. After that, it is important to gradually move the injured area as the recovery progresses.