Treatment
Ankle sprains will be treated differently depending on the time to injury and severity of the injury. What must be avoided is the untreated ankle sprain. After 4 or 6 weeks from injury, an ankle sprain might become pain free without treatment, but this is what misleads some patients to erroneously think the injury has healed. Pain is not the only indicator of the healing process and other factors such as muscle strengthening, and most importantly balance (proprioception) need to be restored or permanent damage can occur (creep in). A number of lesions can develop when a sprain is not treated from the get-go; we will discuss some of them in the next section “Untreated sprains”
High ankle sprains need careful assessment. Those that completely rupture the high ankle ligament (syndesmosis) aka Grade 3 are severe injuries that create abnormal looseness in the joint, and will require early operation to stabilise the ankle.
NON-SURGICAL TREATMENT
The vast majority of well-diagnosed ankle sprains will not require surgery. Even after a complete rupture of one of the ligaments the ankle can heal fully, bearing in mind that other ligaments and strong muscles can assist in providing ankle stability.
RICE
Leaflet physio exercises + Video – Create
? Foot Model. In tights, barefoot. (Martina al estiu)
SURGICAL TREATMENT
Surgery may be considered early in cases of severe, grade 3 ankle ligament tears. However, it is still debatable whether patients benefit from ligament repair on scientific grounds and there is not a bulk of evidence to support early surgery. Current research has still not found clear benefits of acute repair over non-surgical treatment and although outcomes are good after these surgical repairs, a similarly good outcome can be achieved without surgery.
For these reasons, an surgical repair early after a sprain must be discussed on an individual basis with your surgeon, and the benefits may outweigh the risks in very particular cases, being reserved for professional athletes or highly demanding individuals.
High-volume surgeons experienced in ligament repair tend to have better results and lower complication rates.