Chronic Ankle Sprains (Medial Ankle Instability): Treatment Options
Chronic Ankle Sprains (Medial Ankle Instability): Treatment Options
This video provides insight into treatment options for medial ankle sprains, including nonoperative and operative interventions.
View Transcript
Chronic Ankle Sprains (Medial Ankle Instability): Treatment Options
After a medial ankle sprain, some type of treatment is recommended to prevent further injury. Repeated ankle sprains that cause chronic or long-term medial ankle instability change the way the ankle joint moves. This often increases friction within the joint that can cause arthritis to develop, which may lead to increased pain, stiffness, and difficulty walking and bearing weight through the ankle.
When medial ankle instability develops, treatment is needed to stabilize the ankle. Nonsurgical treatment includes rest, ice compression, and elevation to the injured ankle to help manage pain and help the injured ligament heal. Wearing an ankle brace and performing ankle strengthening exercises can also help with stability. Sometimes, an injection into the ankle or even an ankle cast may be used.
Because medial ankle sprains often occur with other injuries to the ankle. Surgery is often needed to restore ankle stability. Surgery for medial ankle instability includes ligament repair or reconstruction. With surgical repair, the deltoid ligament at the inner side of the ankle is either stitched back together or secured back to bone with an anchor. This may be performed arthroscopically through small incisions or through an open procedure.
A repair may also be done with a suture augmentation technique that uses a large, flat suture to provide additional support. If the deltoid ligament cannot be repaired, a reconstruction can be performed to replace the damaged ligament with a tendon graft. If any other ligaments or bones were also damaged, additional surgical procedures may be performed at the same time.
Chronic medial ankle sprains may also require surgical realignment of the foot bones to help prevent further sprains from happening. Following surgery, the ankle will be stabilized in a cast or boot. Rest and limited weight-bearing by staying off the affected ankle is needed for a period of about 6 weeks. Then, a patient will begin physical therapy to start walking and strengthening the ankle.
Most patients can get back to walking and other physical activity by 3-4 months after the surgery, but it may take up to 6-9 months to return to competitive sports.