Ankle Ligament Damage

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 talonavicular ligament, and the talocalcaneal ligament. Working in tandem, these fibrous bands of connective tissue help keep the ankle stable through all of the different activities humans perform daily.

Ankle ligament damage can be caused by traumatic injuries that occur when the foot is planted, falls or missteps, or a direct impact on the ankle. When these ligaments become overstretched, they can begin to fray or even tear completely. Only a specialist can determine the severity of a tear, 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 complete tear of the connective tissue. Individuals will experience a lot of instability in the ankle joint accompanied by 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.

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, you may require immobilization of the ankle for a set period.
• 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.

Conservative treatment aims at reducing pain and swelling and providing rest to the injured ligament. Failure to treat ankle ligament damage may result in chronic ankle instability. Surgery may be required if nonsurgical treatments fail to provide relief and ankle joint instability persists after months of treatment.