{"id":726,"date":"2019-10-04T09:18:55","date_gmt":"2019-10-04T07:18:55","guid":{"rendered":"https:\/\/www.barnaclinic.com\/blog\/traumatologia-deportiva\/en\/?p=726"},"modified":"2019-10-04T09:18:55","modified_gmt":"2019-10-04T07:18:55","slug":"sprained-ankle","status":"publish","type":"post","link":"https:\/\/www.barnaclinic.com\/blog\/traumatologia-deportiva\/en\/2019\/10\/04\/sprained-ankle\/","title":{"rendered":"A sprained ankle: what is it and why does it sometimes take a long time to heal or end up requiring surgery?"},"content":{"rendered":"

In professional sport, we see athletes who\u00a0sprain their ankle<\/strong>\u00a0and who are up and playing without and problem just a few weeks later. On the other hand, we also see athletes who have to undergo surgery to\u00a0fix their sprained ankle<\/strong>\u00a0and are inactive for months. We will look at\u00a0what a sprain is<\/strong>, why it sometimes\u00a0takes a long time to heal<\/strong>, why\u00a0ankle\u00a0pain\u00a0<\/strong>persists, what causes the dreaded \u201cpoorly healed sprained ankle<\/strong>\u201d and why an operation may be necessary…<\/p>\n

<\/p>\n

WHAT IS A SPRAINED ANKLE?<\/h2>\n

What we commonly know as a “sprained ankle<\/strong>”\u00a0is an\u00a0injury to the external lateral ligament of this joint<\/strong>. These\u00a0ligaments of the foot<\/strong>\u00a0have 3 fascicules: one anterior, one mid and one posterior. They all originate at the tip of the fibula.<\/p>\n

A\u00a0sprained ankle<\/strong>\u00a0occurs when the joint is \u201ctwisted”. In other words, the foot remains pointing inwards, causing injury to the\u00a0ligaments of the foot and ankle<\/strong>. Depending on the\u00a0severity of the twisted ankle<\/strong>\u00a0and the injury,\u00a0ankle sprains are categorised as grade 1, grade 2 or grade 3<\/strong>.<\/p>\n

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<\/p>\n

DO YOU WANT TO TALK TO DR SERGI SASTRE?<\/span><\/h1>\n

I AM INTERESTED<\/a><\/p>\n<\/div>\n

ANKLE SPRAIN GRADES ACCORDING TO THE SEVERITY OF THE INJURY<\/h2>\n

There are different\u00a0types of ankle sprain<\/strong> depending on how seriously the ankle is twisted:<\/p>\n

Grade 1 ankle sprain<\/strong><\/h5>\n

Grade 1 ankle sprain<\/strong>\u00a0is the result of\u00a0ligament distension<\/strong>. After\u00a0the ankle is twisted<\/strong>, swelling is minimal and\u00a0the patient can start sport activity after two or three weeks<\/strong>.<\/p>\n

Grade 2 ankle sprain<\/strong><\/h5>\n

In this case,\u00a0the\u00a0ankle sprain<\/strong>\u00a0causes a\u00a0partial tear in the ligaments<\/strong>, causing immediate swelling. Generally, this requires\u00a0three to six weeks’ rest\u00a0<\/strong>before resuming normal activity.<\/p>\n

Grade 3 ankle sprain<\/strong><\/h5>\n

A\u00a0grade 3 ankle sprain<\/strong>\u00a0is the most severe and involves the\u00a0complete tear of one or more ankle ligaments<\/strong>. However, surgery is rarely required.\u00a0The\u00a0recovery period\u00a0<\/strong>is usually\u00a0eight weeks or more<\/strong>, until the\u00a0ankle ligaments<\/strong>\u00a0heal.<\/p>\n

*\u00a0Dislocation of the ankle<\/strong><\/a><\/h5>\n

Why are we not always able to heal a sprained ankle?<\/strong><\/h3>\n

In most cases, a\u00a0sprained ankle will heal<\/strong> after a period of immobilisation and physiotherapy rehabilitation. As such, a\u00a0sprained ankle<\/strong> generally heals itself. However, there are times when the discomfort persists, when we cannot\u00a0heal the sprain quickly<\/strong>\u00a0and without discomfort.<\/p>\n

\u201cIn most cases, we manage to heal a\u00a0sprained ankle completely. In fact, they heal\u00a0<\/strong>all by themselves, after an appropriate period of immobilisation and rehabilitation.\u201d<\/p>\n

Due to poor healing of the ankle ligaments<\/h5>\n

In some cases,\u00a0the ligament heals<\/strong>\u00a0in an \u201cexaggerated\u201d fashion. This produces a thicker ligament than normal which \u201crubs\u201d against the\u00a0talus bone<\/strong>\u00a0<\/em>(lower), causing persistent discomfort. In these cases,\u00a0ankle sprain recovery<\/strong>\u00a0will take longer and may cause problems that should be managed.<\/p>\n

Due to associated injuries<\/h5>\n

On other occasions,\u00a0ankle sprains<\/strong> often cause other associated injuries (especially in the\u00a0cartilage of the talus bone<\/strong>). The presence of these associated injuries means that, once the\u00a0ankle ligament<\/strong> has healed, discomfort persists. In fact, this is what happens with most\u00a0\u201cpoorly healed ankle sprains\u201d<\/strong>. Today, almost all of these problems can be solved by\u00a0arthroscopy<\/strong><\/a>. Your\u00a0sports injury specialist doctor<\/strong><\/a>\u00a0<\/strong>will be able to diagnose whether or not you have these associated injuries, and which is the best treatment in each case.<\/p>\n

THE NEW ANKLE LIGAMENT<\/strong><\/h2>\n

It is important to be familiar with the anatomy of the ankle in order to understand what a\u00a0\u201cpoorly healed ankle sprain<\/strong>\u201d is. In this regard, a\u00a0new ankle ligament<\/a> has recently been described, which could explain cases of \u201cpoorly healed ankle sprain<\/strong>\u201d, which up to now were not clear.<\/p>\n

The\u00a0external lateral ligament of the ankle<\/strong>\u00a0(ELL) consists of three parts: The anterior part has recently been described as a\u00a0new ankle ligament<\/strong>, which is no more than the identification of 2 ligaments within the anterior part of the ELL. As occurs in the knee, there is part of the\u00a0external lateral ligament of the ankle<\/strong>\u00a0that is intraarticular (just like the\u00a0anterior cruciate ligament<\/a>, already discussed in other blog entries) and that sometimes does\u00a0not heal after injury<\/strong>. Thus, a\u00a0poorly healed ankle sprain<\/strong>\u00a0could be an injury to the intraarticular part, which does not heal.<\/p>\n

Poorly healed ankle sprain<\/strong><\/h3>\n

As mentioned above, when a\u00a0sprained ankle<\/strong>\u00a0or ELL injury<\/strong> occurs, it usually resolves spontaneously, in line with the grade of injury. If, after 2-3 months, there is still\u00a0pain in the outer part of the ankle<\/strong>\u00a0which, instead of improving, worsens, this tends to be because it is not just a \u201csprained ankle<\/strong>“. As mentioned above, there may be other associated injuries, such as a\u00a0cartilaginous lesion of the talar dome<\/strong> or of the\u00a0subtalar joint<\/strong>, or a \u201cpoorly healed\u201d injury to the joint part of the\u00a0external lateral ligament<\/strong>\u00a0of the ankle may have actually occurred. In this case,\u00a0ankle arthroscopy<\/strong><\/a>\u00a0will be required in order to be able to resume sports activities.<\/p>\n

ANKLE PAIN AFTER \u201cPOORLY HEALED SPRAIN\u201d<\/h2>\n

The main\u00a0cause of persistent\u00a0<\/strong>ankle pain<\/strong>\u00a0tends to be incomplete\u00a0ankle sprain rehabilitation physiotherapy<\/strong>. As with any\u00a0ligament injury<\/strong>, the ligament heals spontaneously (except in the case of the \u201cnew ankle ligament\u201d that we already mentioned). However, as we have also mentioned, this healing may occur in a manner that is too \u201crigid\u201d. Poor healing will cause pain and limited posterior mobility. In these cases, it is always advisable to complete a full physiotherapy programme. Good\u00a0physiotherapy rehabilitation<\/strong>\u00a0will help prevent the dreaded \u201cpoorly healed ankle sprain<\/strong>\u201d.<\/p>\n

AND IF THERE ARE OTHER ASSOCIATED INJURIES?<\/h2>\n

If the\u00a0ankle pain<\/strong>\u00a0<\/strong>is not located in the outer part or is diffuse pain, other types of injury should be ruled out. We have already mentioned that associated injuries can initially go unnoticed but then become apparent once\u00a0the ankle ligament has recovered<\/strong>. One of the most common is\u00a0cartilage injury to the talus bone<\/strong>. When the ankle is twisted, this cartilage is injured by the counterblow…<\/p>\n

WHAT CAN I DO IF I HAVE TALAR CARTILAGE DAMAGE?<\/h2>\n

Magnetic resonance imaging is usually required to confirm talar cartilage damage<\/strong>. If it is detected, it should be repaired by\u00a0ankle arthroscopy<\/strong><\/a>.\u00a0The technique is similar to those mentioned previously for\u00a0knee injuries<\/a>.<\/p>\n

AT WHAT POINT SHOULD I SEE A DOCTOR FOR A POORLY HEALED SPRAIN?<\/strong><\/h2>\n

If\u00a0ankle pain<\/strong>\u00a0persists and does not gradually improve around 2-3 months after the\u00a0ankle sprain<\/strong>\u00a0or\u00a0injury to the<\/strong>\u00a0external lateral ligament of the ankle<\/strong>, you will have to undergo some type of test and have it assessed by an\u00a0orthopaedic specialist<\/a>. In these cases, and depending on the cause,\u00a0surgery to heal the ankle sprain<\/strong> may be required.<\/p>\n

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 <\/p>\n

<\/p>\n

DO YOU WANT TO CONTACT DR SERGI SASTRE?<\/span><\/h1>\n

CONTACT HIM<\/a><\/p>\n<\/div>\n","protected":false},"excerpt":{"rendered":"

In professional sport, we see athletes who\u00a0sprain their ankle\u00a0and who are up and playing without and problem just a few weeks later. On the other hand, we also see athletes who have to undergo surgery to\u00a0fix their sprained ankle\u00a0and are inactive for months. We will look at\u00a0what a sprain is, why it sometimes\u00a0takes a long […]<\/p>\n","protected":false},"author":2,"featured_media":594,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[285,286,121,206,204,109,205],"tags":[287,295,297,298,292,289,288,291,293,296,294,290],"class_list":["post-726","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-ankle-injury","category-basketball","category-futbol","category-handball","category-padel","category-running","category-tennis","tag-adductor","tag-ankle","tag-ankle-injury","tag-ankle-ligament","tag-ankle-sprain","tag-ankle-tear","tag-arthroscopy","tag-grade-sprain","tag-injury","tag-kink","tag-ligament","tag-sprain"],"yoast_head":"\nSprained ankle: what is it and why does it sometimes take a long time to heal?<\/title>\n<meta name=\"description\" content=\"A sprained ankle is an injury to the external lateral ligament of this joint. 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