Sprains and ligament injuries
One of the most commonly injured joints of our body is the ankle. Whether from high-level athletics or simple missteps resulting in a twist or turn, the magnitude of our body weight applied in a forceful manner across the ankle joint can result in a rupture or partial tearing of the important ligaments that stabilize this important weight-bearing joint. Many sprains heal themselves after a few weeks of rest and protection from further injury, but some are severe enough that they leave the ankle with residual laxity or instability which later causes either difficulties with future sports and activities or in some cases progressive damage to the cartilage joint surface.
Some sense that their ankle isn’t quite right and is more prone to repetitive sprains, which further leads to damage to the joint surface. Symptoms can include swelling, discomfort along one side of the joint or another, and occasionally clicking or popping with certain motions. Although initial treatment of a sprain is to immobilize and rest the ankle, this doesn’t always get done since many athletes and others feel they can “walk or play it off”.
This results in incomplete or altered healing of the stretched or torn ligament with a future increase in the vulnerability of the ankle to sprain and strain and often pain associated with further pivoting or twisting on the ankle. Various types of ankle supports or taping can be helpful in the minor cases, but won’t compensate for the more significant pathologies. Occasionally, there are mechanical issues as well, such as loose pieces or damaged cartilage that cause joint pain or increase the sensation of instability.
Treatment for the more minor or moderate problems usually entails physical therapy exercises for motion and strength improvement as well as training to balance the muscle forces about the ankle. Medication can help reduce inflammation but will not correct the underlying problem. In refractory or more severe cases, arthroscopic surgery can treat damaged joint surfaces as well as assist or allow treatment of ligament laxity or insufficiency. In some cases, post-traumatic arthritis resulting from past ankle injuries can also be treated with arthroscopic techniques, though when severe, these types of injuries may require joint altering surgeries like fusions or joint replacement.