Are you suffering from Weak Ankles?

Almost everyone would have experienced their ankle giving way, which usually involves the turning in (inversion) of the ankle. This leads to stretching or tearing of the ligaments over the outside of ankle, often resulting in injury to one of three sections of the ligament.

Many patients would recover quickly over a few days, however if more than one part of the ligament complex is damaged, you may take longer to recover or may even develop weakness of the ankle or continued pain.

Other possibilities are:

• sprain of medial (deltoid) ligament
• the ligaments connecting the two leg bones (syndesmosis)
• other less common injuries to bones or tendons around the ankle

Majority of patients recover well within a few days with ice, rest and elevation. Compression bandage helps to keep the swelling down (RICE).

Physiotherapy is successful in many patients, but a small group of patients may continue to suffer from weak ankles or continued pain and encounter difficulty with sports, exercise and even normal activities. Patients with persisting symptomatic instability may benefit from surgery.

If you suffer any pain or weakness, beyond 3-4 weeks, you may need an assessment by an Orthopaedic foot and ankle specialist. It is important to identify any serious or associated injuries early to guide appropriate treatment. X-rays and a scan (usually an MRI) may be needed to assess the bones and soft tissue of the ankle.

When you sprain your ankle, the connective tissues (ligaments) are stretched or torn and the ability to balance is often affected. Proper rehabilitation is needed to strengthen the muscles around the ankle and retrain the tissues within the ankle that affect balance. The majority of these injuries heal and recover well although some continue to have pain, weakness and instability. Repeated episodes of the ankle rolling over, can lead to further damage to the joint.

A common symptom of ankle instability (weak ankle) is the feeling the ankle ready to give way or roll over. Weak ankles can be the result of a previous ankle injury following a sprain that has not adequately healed or was not rehabilitated completely. In patients with hypermobility, the injury can lead to further stretching and weakness. People with chronically unstable ankles will often complain of sore ankles especially while standing, walking or doing various activities. This mostly affects the outside group of ligaments, which are known as the lateral ligament complex.

Surgery usually consists of repairing or the reconstruction of two sections of:

• lateral ligament complex, namely the ATFL (anterior talo fibular ligament)
• the CFL (calcaneo fibular ligament)

These ligaments are tightened with the help of special bone sutures. Although this procedure is very successful, the ankle has to be kept in support such as a plaster for usually about 6 weeks.

The internal brace is the latest technique available for strengthening weak ankles. This is used in addition to repairing the weak ligaments and can be used to reduce the time in plaster significantly (usually 2 weeks) and aid rehabilitation.

Patients will be able to start weight bearing sooner, commence physiotherapy earlier and return back to activities quicker. Even in patients with increased flexibility (hypermobility), the internal brace provides stronger and lasting support, with reduced chance of recurrence.

OneWelbeck Orthopaedic foot and ankle specialists such as author of this guidance, Mr Pal Ramesh are helping patients with ankle problems and making sure to get the right treatment which can reduce the pain of sprained ankles.

If you have any questions regarding ankle sprain, please visit our contact page. Anyone looking to talk with us directly can phone the clinic on 0203 653 2002.