Chronic sprained ankle develops usually after a single severe episode or multiple sprains to the same ankle. Ankle joint is stabilised by a set of ligaments (static stabilisers) and Muscle tendons (Dynamic stabiliser). In cases of ankle sprain, the ligaments stretch out or tear and leads to weak neuromuscular control(balance). It manifests as pain with increased activity or the feeling of instability especially on uneven surfaces or side way motions. Sometimes it may manifest as recurrent swelling of the ankle joint especially in case of an osteochondral (cartilage) injury.
An orthopaedic assessment is warranted in such cases of sprained ankle to establish an accurate diagnosis. Your doctor may prescribe an Xray and an MRI after clinical examination. An ankle training program to strengthen the the muscles and the joint with balance training provides good clinical outcomes. Sometimes surgery may be required to reconstruct the ATF ligament or treat a cartilage injury.
Arthroscopic surgery has excellent role in treatment of chronic ankle sprain or instability. Ligament reconstruction is usually done in as an open surgery in sprained ankle (Brostrom technique). Every patient should understand the value of a dedicated rehabilitation following conservative or surgical treatment. Ankle strengthening exercises mainly includes the invertors, evertors, Planter and dorsi-flexors of the foot. The ankle is spanned with muscle tendons and joint capsule in addition to the ligament complexes on both the sides.
It is essential in cases of chronic (>6 weeks) ankle instability that the patient does exercises for a prolonged period (~3 months). Balancing/Proprioceptive exercises form the second phase of rehabilitation after adequate strength is achieved. Chronic instability may also lead to arthritic changes at a young age. It is thus imperative to take these injuries seriously and taking essential precautions after the injury. Here are a few exercises which are recommended once the patients become pain free and can start rehabilitation. Please consult our orthopaedic for more information.