How to Prevent and Treat Common Ankle Injuries

We’ve all rolled an ankle after a lay-up on the basketball court or stepped awkwardly off an icy curb. Strains, sprains, and even breaks are some of the most common ankle injuries, and most of us will experience some form of ankle injury throughout our lives. So it’s no wonder that common ankle injuries cause more than one million trips to emergency rooms annually. 

At the Orthopaedic Hospital of Wisconsin, we know that even a minor ankle injury may result in painful swelling and make it difficult to walk for days or even weeks. Thankfully, our talented specialists are here to help diagnose and treat injuries to any joint, including the ankle. Today, OHOW’s Matthew Mestelle, PT MPT, discusses common ankle injuries, how to prevent them, and how to manage if you find yourself with an injured ankle.

The Anatomy of the Ankle

The ankle contains the two bones that make up the lower leg—the tibia and fibula—and the talus, a dome-shaped bone connecting the lower leg to the foot. The end of the tibia is the prominent bone on the inside of the ankle. The fibula is the bony prominence on the outer portion of the ankle.

These bones fit together tightly in a healthy ankle and allow the foot to move up and down. For proper function, the foot and ankle must also be able to tilt inward and outward. These motions occur mainly through the subtalar joint between the talus and calcaneus, or heel bone. Several ligaments connect and hold these bones in place. Additionally, numerous tendons that connect the bones to muscles controlling the lower leg, foot, and ankle pass through this region.

Injuries can occur to any of these structures in the ankle. The most common ankle injuries are sprains to the ligaments, fractures to one or more bones that make up the ankle, or problems with the tendons that pass through the lower leg and foot.

Preventing Ankle Injuries

A sprain involves the stretching or tearing of the ligaments that stabilize the bones of the ankle. The most commonly injured ligaments are on the outside of the ankle and connect the fibula to the talus. This is the painful ankle injury that occurs when you “roll” your ankle. Severity can range from mild to complete rupture of the ligaments, and recovery time will vary accordingly. 

We often associate ankle problems with athletes or individuals who engage in work or exercise activities requiring high physical demand, but half of all ankle sprains treated in U.S. emergency departments occurred outside of athletics. 

While it is true that accidents do happen and a portion of ankle injuries are often out of our control, there are still several preventative measures we can take to minimize the risk for a potentially debilitating injury and lengthy recovery process. 

Tips for Preventing Most Common Ankle Injuries

• Maintain the flexibility of your lower leg muscles, especially the calf muscles.
• Maintain your lower body strength and ability to balance on a variety of surfaces.
• Choose proper footwear that supports your foot and ankle. 
• Pay attention to your environmental conditions to prevent slips and falls.

Managing Ankle Sprains

Despite following proper precautions, many ankle sprains are unavoidable. Thankfully, these injuries are often mild and can heal relatively quickly. However, without appropriate management, there can be a concern for issues down the road. As many as 70% of individuals who suffer an ankle sprain may develop physical limitations such as lasting pain, swelling, stiffness, or even chronic ankle instability. 

Should you experience an ankle sprain, there are many ways you can try to manage it at home. Of course, if the injury continues to be painful for longer than a few days, it’s always best to visit your doctor. In the meantime, try the following tips.

Tips for Managing a Mild to Moderate Ankle Sprain

• Practice “RICE” or rest, ice, compression, and elevation until the pain and swelling improve.
• Engage in a gentle range of motion and stretching exercises (especially the calf muscles).
• Employ the short-term use of a brace or compression sleeve to decrease pain while walking.
• If the concern persists, physical therapy can help you further manage the swelling, restore normal range of motion, strength, and balance.
• Your Physical Therapist can also help determine if you should see a doctor to evaluate your ankle injury further.

Usually, after an ankle injury, your doctor will take x-rays of your foot and ankle to determine if there are any broken bones. The presence of a fracture will require you to keep your ankle immobilized and to keep weight off the affected leg for some time. It typically takes at least six weeks for bones to heal. A fracture that isn’t stable or a case where the bones are out of alignment will require surgery.

What to Expect After Ankle Surgery

After surgery, you’ll need a period of immobilization, limited weight-bearing, and physical therapy to regain range of motion, strength, and the ability to walk comfortably. Normal daily activities may resume within 3-4 months following ankle surgery, but it may take well over a year to fully recover strength and mobility. It’s crucial that you follow the guidance of your physician, who can help you get back on your feet as quickly as possible.

Injury to the ankle tendons can range from tendinitis (inflammation of the tendon) to tearing the fibers that make up the tendon. These ankle issues occur from either an acute injury or a repetitive activity resulting in overuse. Treatment of tendon injuries will again depend on the severity of your ankle injury (and your doctor will guide you).

For many patients, tendinitis typically requires a period of rest, anti-inflammatory treatments, physical therapy to restore normal flexibility, and body mechanics to minimize abnormal stresses on the irritated muscles and tendons. If your doctor determines that there is a tear or rupture to one of the tendons in your ankle, they may recommend surgical repair. They’ll often use an MRI to evaluate the soft tissue structures in greater detail.

Whether you are interested in preventing injuries from walking outside this winter or are curious about the best way to manage that painful, swollen ankle you suffered playing soccer last weekend, there are some tips to benefit everyone. If you experience one of the common ankle injuries mentioned above, make an appointment with one of our talented specialists to begin your recovery and prevent possible complications. We’re here to help you return to full mobility.