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The ankle is the most commonly injured joint in sports. Ankle sprains represent about 85% of all ankle
injuries in the US. While an inversion ankle injury often involves injury to the lateral collateral ankle
ligaments, other structures in this area may also be injured. These associated injuries may not
be evident until weeks or months after the initial event, and may not present themselves until the patient
attempts to return to full activity but is unable to because of persistent pain. Typical associated injuries
include chronic lateral ankle instability, peroneal tendon damage, nerve injury, syndesmotic sprain or tear,
and intraarticular cartilage damage. Although the injury may initially seem minor, a thorough evaluation and
aggressive, conservative therapy is important in improving the outcome.
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Symptoms
- Patients often complain that the affected ankle feels "unstable" or "gives out" frequently
- Patients typically feel unsteady when walking on uneven ground or sloped surfaces
- Repeated inversion injuries will occur with the slightest provocation
- Patients commonly report twisting or spraining ankles every few months with varying levels of severity
- Persistent swelling to the anterolateral aspect of the ankle
- Bracing or taping may not provide adequate stability
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Treatment
Initial treatment involves managing symptoms and biomechanical control. Non-steroidal anti-inflammatories
or steroid injections, if used alone, usually do not provide long term relief.
- Changes in shoe gear
- Functional orthotics are a vital part of treatment, especially when biomechanical abnormalities are present.
- Taping and bracing, particularly during athletic activity
- Physical therapy
If conservative treatment fails to provide relief or the ankle is too unstable to be controlled with bracing and orthotics, surgical treatment
is warranted. Surgical correction is based upon the presenting condition and varies
from simple repair of ruptured ligaments to complex reconstruction of ligaments
with tendon grafts and osteochondral repair of a damaged articular surface.
more information and photographs
You can also download our Podiatry-at-a-Glance newsletters:
A Guide to Lateral Ankle Instability
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