Ankle Ligament Injuries in Teenagers & Adults

By Dr. John Goodner, D.P.M

The ankle is a complex joint consisting of bones, ligaments, cartilage, tendons and joint lining. The primary motion of the ankle is up and down. It has limited sideto-side motion. When excess motion occurs from side to side, ankle ligaments can tear. Ligaments connect bones together. Once the ligaments are torn instability can develop. On the outside of the ankle there are three ligaments. The inside of the ankle has five and connecting the tibia and fibula are three more.

Ankle ligament injuries can occur from stepping off of a step and rolling the ankle, to playing sports and coming down and landing on somebody’s foot. It is also very common in women who wear heels and roll their ankle to the outside, causing damage to the ligament structure of the ankle.

When ligament injuries occur, it is most often associated with a feeling of a crack or a pop, and is associated with pain, swelling, occasionally discoloration and inability to weightbear.

It is always best to evaluate these ankle injuries as soon as possible. A thorough history and physical will allow the doctor to identify the ligaments that have been injured and the extent of the injury. X-rays are taken and occasionally MRIs if the suspected damage is significant.

Treatment is then aimed at reducing the damage to the ligaments and giving the ligaments an opportunity to heal primarily. Treatment for these injuries could be as simple as RICE (rest, ice, compression, elevation). For a very simple stretching injury to the ankle ligaments, an ankle brace is used most often. When the ligaments are torn, then immobilization is absolutely necessary. A boot or a cast is applied for two to six weeks. Patients are allowed to immediately weightbear. Cross training is completely allowed. Avoid any type of anti-inflammatory. This will help to reduce the inflammation but at the cost of allowing those ligaments to heal because inflammation is a critical part of the healing process. Physical therapy may be necessary after cast removal. A return to sports could take four to eight weeks. Chronic instability may develop if treatment has not been initiated immediately. This may be corrected with a ligament tightening procedure. Long-term prognosis is almost always excellent.

■ Dr. John Goodner is a Board Certified Reconstructive Foot and Ankle Surgeon with the Foot, Ankle and Leg Specialists of South Florida and specializes in sports medicine foot and ankle injuries, foot and ankle arthroscopy, lower extremity trauma, and lower extremity deformities in infants, children, teens and adults. The South Florida Institute of Sports Medicine in Plantation is located at 17842 NW 2nd St Pembroke Pines, FL 33029-2806 Tel: (954) 430-9901 The practice website is www. SOUTHFLORIDASPORTSMEDICINE.com. Instagram @SouthFloridaSportsMedicine. Twitter @SFLSportsMed.

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