If you think you have sprained your ankle stop any sport or strenuous activities you were taking part on.

Try to rest the ankle and follow the RICE protocol, with special focus on Elevation

Take a pain killer or anti-inflammatory if required depending on pain levels.

Use crutches only if necessary. Attend A&E or an Urgent Care Centre to rule out any fractures or more severe injuries.

Follow-up with a Foot & Ankle Orthopaedic Specialist for the best treatment and advice.

Crutches are a method of support, but they are not absolutely necessary to help healing an ankle sprain. During the first few days after the injury, it is common to struggle with weight bearing and hence crutches can then be beneficial.

Ultimately the scientific literature supports a functional treatment based on returning to full weight bearing unaided as soon as comfortably possible.

Ankle sprains are classified depending on severity between grade 1 and 3, being 3 the most severe.

From an anatomical point of view, a grade 1 corresponds to a stretch to the ligament; a grade 2 a partial tear; and a grade 3 a complete tear.

Clinically, a grade 1 will show lesser amounts of swelling and bruising than a grade 3 and these also tend to be more painful.

An X-ray may not always be necessary but it will help to rule out other more severe injuries that require urgent treatment. There are guidelines published to assist with the need for X- rays (such as the Ontario Criteria), but as a rule of thumb these would be required when there is tenderness in bony prominences or inability to bear weight. Given the dramatic consequences of missing a fractured ankle, when in doubt it’s sensible to err on the safe side and obtain an X-ray.

Unless a scan is performed a sprain cannot be diagnosed. X-rays are only able to visualize bone structures, and as a soft-tissue (ligament) injury a sprain will not be represented. By obtaining a scan a sprain cannot only be diagnosed but also classified according to the grade to fine tune the treatment. In addition other associated injuries will also be diagnosed when doing a scan, such as tendon injuries, cartilage damage, minor fractures or

Both options will be able to accurately diagnose an ankle sprain and soft-tissue injuries. The decision at times depends on the type of sprain, suspected associated injuries or availability in clinic. The sensibility and specificity of both scans is very similar ranging from …

Some ligaments in the ankle are possibly able to heal naturally and by doing so they tend to create some scar tissue that may or may not be symptomatic in the long term. Other ligaments are unlikely to heal and this discrepancy has to do with the anatomic position of ligaments. Those that are intra-articular (inside the joint) such as the ATFL’s superior fascicle or deep deltoid are bathed in synovial fluid which interferes with ligament healing and therefore are unlikely to heal. Others such as the CFL or superficial deltoid ligament are extra-articular and demonstrate some healing potential. In any case, a non-healed ruptured ligament does not always mean that the ankle will remain symptomatic and can instead enable full function with the right treatment in place.

Physiotherapy is the best and most scientifically proven modality to improve the healing of a sprained ankle.

There are also available innovative nutraceuticals specifically designed to help with the recovery from these injuries and ensure the adequate nutrients are provided for enhanced healing potential. Link to a type of injury-specific nutraceuticals and supplements – www.tengengb.com/

When done arthroscopically driving is generally possible from 2 weeks after surgery. If the repair is done with open surgery, it will be 4 weeks after surgery.

No. There are two main techniques to repair the ligament, being open or arthroscopic surgery. In open surgery a large incision is made over the ligament to stitch it up in addition to doing an arthroscopy first to look at the joint. In arthroscopic surgery the ligament is repaired and stitched internally using only miniature keyholes (of less than 5 millimeters). In addition to the smaller scar, there are more substantial benefits from arthroscopic surgery including less pain, faster recovery and return to sports with fewer complications. As a modern and technically demanding technique, only a handful of surgeons in the UK are prepared and are routinely performing the arthroscopic technique safely.