Ankle Sprain/Instability

An ankle sprain is a very common injury. It accounts for about 40% of athletic injuries. So what exactly happens when we sprain our ankle? There are ligaments that help support our ankles when we walk, jump, run, etc., especially on uneven ground. When we “twist” our ankles these ligaments are stretched beyond their capability to do so. Sometimes they are stretched (mild sprain), partially torn (moderate sprain) or fully torn (severe sprain).

Most ankle sprains (mainly the mild type) heal uneventfully with an initial period of rest, ice, compression, and elevation (RICE.) However there are many that do not fully heal, where the ligaments stay “loose.” Common symptoms are continued feelings of instability, pain and swelling. A common complaint is “my ankle feels weak.”

So how do we treat ankle sprains? In addition to RICE, one may try a brace or even a cast for a few weeks depending on how severe the sprain. After this initial period of immobilization, a physical therapy program is started. The purpose of physical therapy is to prevent recurrence of the injury or chronic instability of the ankle. Therapy helps to strengthen the ankle and “re-train” the ankle to keep itself stable.

Sometimes there are patients who despite physical therapy have continued problems of pain and instability. In these cases surgery may be indicated. Surgery entails taking the torn ligaments and “tightening” them up again. For most patients this is an outpatient procedure. Post-operatively, I treat my patients in a cast for six weeks followed by a 4 to 6-week course of physical therapy. Expect a return to normal activity in four to six months post operatively.