ECO Physiotherapy Center – Health and Wellness

Why does my ankle still hurt?

Ligament injuries (sprains)

I will not only discuss the location of these injuries, but I will also try to classify them by the type of tissue involved, starting with ligaments.

A ligament, which connects bone to bone, provides passive stability to joints, and an injury to this structure is known as a sprain. Let’s start by reviewing the most common ankle injuries.

Lateral ankle sprain

A lateral ankle sprain occurs when you twist or turn your ankle inward at high speed. The ligament usually affected is the anterior talofibular ligament (ATFL) and, sometimes, the calcaneofibular ligament (CFL). Both ligaments attach to the fibula, the bone on the outside of the ankle.

Regardless of the degree of injury, proper rehabilitation is crucial because up to 40% of people develop chronic ankle instability after a first sprain.

Lateral ankle sprains are generally classified on a scale of 1 to 3. Grade 1 is a mild injury with a relatively quick return to activity. Grade 2 is a moderate injury with a slightly longer recovery time. Grade 3 is a severe injury that takes longer to rehabilitate. Generally speaking, a grade 3 injury will also present with more swelling and bruising.

This is where we get to the heart of the problem.

Chronic ankle instability

Chronic ankle instability (CAI) is defined as a “chronic ankle instability condition characterized by repetitive episodes or perceptions of the ankle giving way: ongoing symptoms such as pain, weakness, or reduced range of motion (ROM) of the ankle: Decreased self-reported function; and recurrent ankle sprains that persist for more than 1 year after the initial injury.

An early and persistent approach is essential.

Working conscientiously on the mechanoreceptors and stimulating the ankle proprioceptively is an unavoidable step for successful treatment.

General recommendations:

  1. Proper footwear: That provides support to the ankle.
  2. Orthotics: If instability is severe, it may be helpful to wear a semi-rigid orthotic when engaging in physical activity.
  3. Frequency: 2-3 sessions per week with a physical therapist, combined with daily home exercises.
  4. Follow-up: Periodic reevaluation to adjust the plan according to progress.

If the problem persists despite adequate rehabilitation, it may be necessary to consult an orthopedic surgeon to evaluate surgical options, such as ligament repair or reconstruction in severe cases.

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