Anatomy & Background
The human ankle is a multifaceted joint complex comprised of three separate joints in the region where the foot and leg meet. It is necessary for these joints to possess a certain degree of strength as they support the weight of the entire body. Increased strength translates into increased stability, leading to higher standards of weight bearing, mobility and adaptability for the entire body. The ankle, in conjunction with the foot, allows us to preform basic human functions such as standing, walking, running and jumping while serving as connection to the ground. The ankles physiology allows it to withstand the stress of our body weight as well as the ability to adapt to and quickly react to changes in environment and walking surface.
Ligaments
The ankle and subtalar joint are connected with ligaments, which attach bone to bone. Three major ligaments hold the outside of the ankle and foot bones together: the anterior talofibular ligament, the posterior talofibular ligament, and the calcaneofibular ligament. The inside of the ankle consists of four ligaments. These tend to be much stronger than the ligaments located on the outside of the ankle. They are the anterior and posterior tibiotalar ligaments, the tibionavicular ligament, and the tibiocalcaneal ligament. Working in tandem, these fibrous bands of connective tissue are what help keep the ankle stable through all of the different activities humans perform on a daily basis.
Ankle Ligament Damage
Ankle ligament damage can be caused by traumatic injuries that occur when the foot is planted, falls or missteps, or a direct impact to the ankle. When these ligaments become overstretched, they can begin to fray or even tear completely. The severity of a tear can only be determined by a specialist, and one should always consult a doctor to receive an accurate diagnosis.
Grade I: The ankle ligaments are stretched, causing minor damage and micro-tearing. These injuries may be painful, but can be remedied through pain management and proper exercise protocols.
Grade II: Tears that are considered Grade II involve the partial tearing of one of the ligaments in the ankle that causes more laxity in the ankle joint. Treatment for these types of injuries normally consists of immobilization and strengthening exercises.
Grade III: These ligament tears involve a compete tear of the connective tissue. Individuals will experience a lot of instability in the ankle joint accompanied with swelling. Typically this injury will require surgery combined with extensive therapy to allow for a full recovery and full functionality to return to the ankle joint.
Treating Ankle Ligament Damage
When you suffer from an ankle ligament injury, you should initiate the RICE protocols and schedule an appointment with a specialist to receive an accurate diagnosis.
- Rest to minimize worsening the already injured ankle and ligament.
- Immobilization of the ligament will help decrease the stress, and minimize the swelling caused by any extraneous motion. Depending on the severity of the injury, immobilization of the ankle may be required for a set period of time.
- Ice to help reduce swelling and pain for the first 48 hours. Do not apply ice directly to the skin. Always use ice intermittently and do not apply for more than 20 minutes at a time. While icing, do not apply heat to the affected area.
- Elevate the leg to help reduce the swelling of the affected area.
Managing Your Pain
Following any injury to your ankle, you should seek medical attention from a specialist.
- A clinical evaluation may entail a physical exam, X-rays, or an MRI may be necessary in the cases of Grade III injuries.
- Use of ice and immobilization to stabilize and rest the injured joint.
- Your pain management specialist may prescribe anti-inflammatory medication or pain medication as deemed necessary.
- A brace may be needed.
- Surgery may be required in the case of severe Grade III injuries.
Prognosis
Ankle ligament injuries tend to have positive outcomes when a proper plan of care is established. The time frame for full recovery is dependent upon the severity of the injury. Grade I and II injuries may take anywhere from 4-8 weeks to recover from, while Grade III injuries can take up to four months.
