Untreated sprains

Consequences from untreated ankle sprains can be multiple and none of them are desirable.

Chronic Ankle Instability (CAI)

Repetition of ankle sprains leads to Chronic Ankle Instability (CAI). This is a diagnosis based on a history of multiple sprains and repeated episodes of an unstable feeling or giving-way, generally associated with pain and swelling.

Ligament laxity or untreated tears can be the cause of CAI, although other factors play a role and these are mainly due to muscle weakness and postural control which are addressed during physiotherapy treatment.

In order to tackle potential modifiable causes, the first course of treatment will be based on physiotherapy. About 1 in 5 patients will not respond to physiotherapy due to severely lax and damaged ligaments in which case ankle ligament repair is the recommended surgery with excellent results.

                        Micro-instability

Ankle microinstability is a novel concept that has emerged after in-depth research of the healing process of ankle sprains and the fact that some patients continued experiencing pain but did not fit in the box of Chronic Ankle Instability. A tear of only part of the ATFL ligament can cause pain and and unstable feeling without a complete ligament tear. However subtle signs during clinical examination or in MRI scans can point to this diagnosis. The arthroscopic visualization of the damaged ligament during keyhole surgery will confirm this suspicion and a classification has been developed by Mr Malagelada and colleagues to describe this injury.

                        Rotational instability

The effects of ongoing ankle instability have shown to be harmful to other ankle ligaments. It is estimated that 40% of patients with Chronic Ankle Instability will also have a tear of the Deltoid ligament. Patients will normally feel pain in both the outer but also the inner side of the ankle. If left untreated it is likely to create further damage to the joint and start the process of arthritis.

Arthritis

Arthritis is the wear and tear of a joint and it can affect any joint in the body. The cause is generally overuse throughout the years in elderly patients, but it can also appear in young patients and this is caused by the lack of proper ligament stability in ankles.