Mr Troy Keith MBBS (Hons), FRACS (Orth), FAOrthA
Orthopaedic Foot and Ankle Surgeon
What is ankle instability?
Ankle instability occurs when the ankle repeatedly”gives way” or sprains during sporting or daily activities. Some people may experience intermittent or ongoing ankle pain, which occurs with instability episodes.
When left untreated, ankle instability can be a debilitating condition decreasing the level of function and quality of life with the potential to lead to chronic pain and arthritis.
How common are ankle sprains?
Ankle sprains are among the most common musculoskeletal soft tissue injuries.
Sports that involve jumping, pivoting and twisting movements such as football, basketball, and netball as well as sports which require sudden change of direction such as soccer and tennis open participants up to ankle sprains.
Which ligaments are injured?
When patients roll their ankle, usually the first ligament to tear is the anterior talofibular, then the middle calcaneofibular (see Figure 1).
Occasionally a small bone fragment may pull off with the ligaments. This ”fracture” generally does not require surgery.
What are the grades of ankle sprain?
Ankle lateral ligament tears can be either:
Partial (grades I or II) or
Complete rupture (grade III)
The majority of acute ankle sprains can be treated without surgery. Even a complete ligament tear can heal without surgical repair if appropriately managed. Treatment approaches are based on your injury and circumstances and best discussed with your GP and surgeon.
How is an ankle sprain diagnosed?
Diagnosis is mainly by physical examination. However, if your GP has concerns an Xray or ultrasound may be requested to better assess your ankle.
Ultrasound can be very useful to assess which ligaments are involved.
An MRI (Magnetic Reasonance Imaging) maybe requested to assess the cartilage inside the ankle joint and other important ligaments and tendons surrounding the ankle.
Ankle Sprain Treatment Melbourne
Initially RICE > REST – ICE – COMPRESSION – ELEVATION and early weight-bearing are advised.
Protecting your ankle using either bandaging, ankle bracing or an orthotic “moon” boot (dependant on the severity of the injury) can all help with pain relief while the ankle swelling settles. You can discuss pain relief medications with your doctor.
Physiotherapy is useful in regaining range of motion, strength, as well as balance. There is also increasing evidence that ”core strengthening” as well as strengthening muscles surrounding the hip, can be beneficial in the rehabilitation of the sprained ankle. This can be discussed further with a physiotherapist or your doctor.
For patients who fail to make progress with physiotherapy due to pain, a guided corticosteroid injection into the ankle may help relieve inflammation and pain so that physiotherapy can then continue.
How long should a sprained ankle take to recover?
Rehabilitation of your sprained ankle should focus on regaining your balance or “proprioception”, as well as range of motion and strengthening your peroneal muscles.
This usually takes between 6 -12 weeks dependant on severity.
If pain and/or instability is still ongoing after this time, surgical approaches may be considered.
It is estimated up to 10-20% of acute ankle sprains not properly treated may develop chronic instability and require surgery.
Ankle Instability Treatment Melbourne
If you have any questions, please do not hesitate to contact me.
Mr Troy Keith sees patients in relation to ankle instability treatments. Mr Keith may recommend an ankle arthroscopy to help diagnose potential causes of pain. Mr Keith consults in Melbourne from his rooms in Armadale, Malvern, Richmond, Heidelberg and in Shepparton, country Victoria.