About Chronic Ankle Sprain
The causes of chronic ankle sprain are related to improper healing of ligaments after an acute sprain, breakdown of ligament tissues upon repeated sprains, or loose joints. Muscle weakness and problems with balance or body awareness can also contribute to the development of chronic ankle sprain.
The non-modifiable risk factors, which are uncontrollable disease factors, for chronic ankle sprain include:
- Age
- Sex assigned at birth
- Shape and built of the foot and ankle
- Underlying joint issues
These factors are usually already present at the time of the initial sprain and cannot be changed through rehabilitation programs.
On the other hand, modifiable risk factors, which are disease factors that can be controlled, for chronic ankle sprain include neuromuscular factors such as muscle strength and body awareness.
It's important to note that while some risk factors can be modified through rehabilitation, others are inherent and cannot be changed. It is advisable to consult with a healthcare professional for personalized advice on managing chronic ankle sprain.
The most common early symptoms of chronic ankle sprain include:
- Long term ankle pain
- Swelling and tenderness in the ankle
- Feeling of instability or giving away of the ankle
As chronic ankle sprain progresses or becomes more severe, additional symptoms may occur:
- Recurrent ankle sprains
- Limited range of motion in the ankle joint
- Muscle weakness in the ankle
- Difficulty walking or putting weight on the affected ankle
It's important to note that these symptoms can vary from person to person and may depend on the specific severity and progression of the condition. If you're experiencing any of these symptoms, it's recommended to consult with a healthcare professional for an accurate diagnosis and appropriate treatment.
To diagnose chronic ankle sprain, the following examinations, tests, and procedures are commonly performed:
- Physical exam: A doctor will perform a physical exam to assess the range of motion in your ankle and determine if ligaments have been torn.
- Imaging tests: A magnetic resonance imaging (MRI) may be done if there is suspicion of a fracture, serious ligament injury, or damage to the ankle joint surface.
To determine the severity of chronic ankle sprain, additional examinations, tests, and procedures may be performed:
- Ultrasound examination: This looks at different parts of the ankle, such as the midtarsal joint, syndesmotic ligament, anterior talofibular ligament (ATFL), and calcaneofibular ligament (CFL) to help with an accurate diagnosis. A stress ultrasound involves applying force to the ankle during an ultrasound examination to check for ankle instability. The ATFL ratio in this test can provide useful information for diagnosing chronic ankle sprain.
- Stress X-ray test: This test measures the level of ankle instability but is less commonly performed due to inconvenience and radiation exposure.
- Manual anterior drawer test (ADT): This is a manual test commonly used in clinical practice to evaluate ankle instability.
Remember, it is important to consult with your healthcare professional for a proper diagnosis and appropriate management.
The goals of treatment for chronic ankle sprain include:
- Controlling inflammation and relieving pain
- Restoring full range of motion
- Improving muscle strength and power
- Enhancing proprioception (body awareness) and balance
- Promoting functional activities
- Preventing recurrence of injury
Here are the recommended treatments and how they work to achieve these goals:
- Medications:
- Nonsteroidal anti-inflammatory drugs (NSAIDs) can help reduce inflammation and manage pain associated with chronic ankle sprains. These medications work by inhibiting the production of certain chemicals in the body that cause inflammation and pain.
- Therapies:
- Physical therapy: Exercises and stretching can help restore the normal range of motion in the ankle joint. These exercises focus on improving flexibility and strengthening the muscles around the ankle, which can enhance stability and prevent further injury.
- Strength training exercises: These target the muscles surrounding the ankle to improve their strength and power. This helps provide better support to the joint, reducing the risk of recurrent sprains.
- Balance training exercises: Standing on one leg or using balance boards can improve body awareness and stability in the ankle joint.
- Rehabilitation programs: These aim to restore normal function and performance in daily activities, sports, or work-related tasks. Programs may include specific exercises that mimic real-life movements to help patients regain confidence in using their ankle without fear of re-injury.
- Self-care and healthy behavior changes:
- Wear proper footwear
- Learn bracing or taping techniques
- Modify activities to prevent future ankle sprains.
- Procedures:
- Surgery: Surgery is usually considered when all non-surgical options for treatments have been exhausted. Surgery focuses on repairing or rebuilding the damaged ligaments on the outside of the ankle, to restore ankle stability and function while preserving movement and avoiding surgical complications. The most common procedure for ankle instability is lateral ankle ligament reconstruction and arthroscopic repair.
Medication type and dosing are affected by many factors and may vary by individual, and side effects may occur. Consult your healthcare provider for personalized advice and read the information provided with your medication.