“I have had repeated sprains in my ankle. Will it keep happening? What can I do?”
I have had repeated sprains in my left ankle over the last decade, and now I feel like it takes less and less effort for it to happen again. Why is this happening? What can I do? I'm only 43 so I am concerned for my long-term joint health.
16 Answers
You may have developed ankle instability which can occur from multiple ankle sprains. The ankle ligaments become stretched or partially torn and cannot function properly to keep the ankle from rolling. An exam and an MRI will help to determine the condition of the ankle ligaments and treatments such as bracing, physical therapy and/or surgical correction are dependent on the findings.
If you have chronic sprains the ligaments become progressively weaker and then can sprain more easily. It's important to see your podiatrist to start treating your recurrent problem, before it gets worse.
It likely will keep occurring. Ligaments are different from tendons in that they are structural and have little give and take in them when compared to say, a tendon. Each time that you roll the ankle the ligaments on the outside of the ankle stretch or even tear a little. They don’t contract back to their anatomical length completely and with each reinjury, become more and more loose causing ankle instability, which makes you more prone to further ankle sprains. The ligament in particular to be concerned of is the anterior talofibular ligament, or ATFL, which attaches the leg bone (fibula) to the ankle bone (talus) and is most susceptible to injury in an ankle sprain. You can wear a stirrup type ankle brace when being active or on uneven ground, to prevent reinjury. But the only way to definitively fix the problem is surgical intervention which would consist of tightening that ligament. This is known as a Brostrom procedure. Thank you for the question!
I would be seen by someone who does surgery on ankles either a podiatrist or a foot and ankle orthopedic. You may have ligaments that are torn or very stretched out from repeated sprains over the years. Or you have had several sprains and you haven't had proper rehab like physical therapy.
You may have damaged the ligaments from multiple injuries. There are steps you can take to reduce the likelihood of additional injuries. Speak to your podiatrist.
Work with a yoga board to improve balance. Get some elastic bands and work on strengthening your leg muscles. If it continues, see your podiatrist.
Recurrent ankle sprains may be the result of weakness or previously injury ligaments of the ankle (e.g Deltoid Complex -inner ligaments and/or injury to the Lateral ligamentous tissue such as the Anterior-Talofibular, anterior calcaneofibular, and posterior calcaneofibular: syndesmosis tear). Recommend podiatrist or orthopedic consult. Also, if you have an high arch deformity foot type, then a pair custom made orthotics may help to prevent recurrent ankle sprains vs surgical intervention for repair of possible ligaments in the affected ankle-foot.
I prefer lace up ankle brace called AFO lace up. Works wonders.
Sometimes with a serious ankle sprain, you can tear the ligaments on the outside of the ankle. This will occasionally need surgical correction, so if it keeps bothering you, seek the advice of a professional, who may consider more advanced testing, such as an MRI.
"Sprain" means the ligaments have stretched. And that weakens the integrity of the ankle and makes you more prone to recurrent sprains. But you may also have "ruptured" or torn the ligaments, and that results in increased ankle instability. There are very well-trained podiatrists that you should attempt to see (try to see someone with either a 3-year surgical residency or someone with a 2 year residency and a fellowship in reconstructive rearfoot and ankle surgery). There is a simple surgery that can be performed called a 'Modified Brostrom' lateral ankle stabilization, and you should be recovered well enough to perform most activities by the end of 2 months after surgery.
Every time you have an ankle sprain it further we can use the ligaments in your ankle resulting in more instability. It is very possible that the muscles around the ankle or weak and you may require a vigorous course of physical therapy and rehabilitation to strengthen the tendons around the ankle. You may also require some bracing especially when you do strenuous activities. I would highly recommend that you see a sports podiatrist or sports orthopedic surgeon with a specialty in foot and ankle. It is also possible that You may benefit from more supportive shoes and or foot orthotic devices to provide additional support and stability for your ankles.
You should have an MRI performed on your ankle to rule out tear of you ankle ligaments. This will determine the course of treatment.
Your problem is a result of the previous ankle sprains that have resulted in complete tears of the three lateral (outside) ankle ligaments. When the tears are complete, the ligaments will not heal. Ultimately, the only way to correct the problem is to reconstruct the torn ankle ligaments surgically. There are a few different procedures and the correct procedure can be determined by an MRI. Conservative treatment can not result in the ligaments repairing themselves.
If you do nothing, ankle sprains will become more frequent. I have had patients who rolled their ankles because the stepped on a stone. Also, if you continue spraining your ankle, arthritis is the outcome and you would be looking at an ankle fusion or an implant. Both of these procedures result in some disability and inconvenience. Conservative treatment can not result in the ligaments repairing themselves.
You should find a surgeon who is Board certified and has performed numerous ankle stabilization procedures. There is little chance of performing a primary repair of the ankle ligaments because they have atrophied. A reconstruction with the peroneus braves tendon. After care involves a cast and 4-6 weeks of non-weightbearing followed by physical therapy.
Rod Tomczak, MD, DPM, EdD
If you do nothing, ankle sprains will become more frequent. I have had patients who rolled their ankles because the stepped on a stone. Also, if you continue spraining your ankle, arthritis is the outcome and you would be looking at an ankle fusion or an implant. Both of these procedures result in some disability and inconvenience. Conservative treatment can not result in the ligaments repairing themselves.
You should find a surgeon who is Board certified and has performed numerous ankle stabilization procedures. There is little chance of performing a primary repair of the ankle ligaments because they have atrophied. A reconstruction with the peroneus braves tendon. After care involves a cast and 4-6 weeks of non-weightbearing followed by physical therapy.
Rod Tomczak, MD, DPM, EdD
There are many factors that need to be addressed when someone suffers multiple ankle sprains and injuries. Oftentimes, a biomechanical abnormality such as a high arched cavus foot type can result in frequent ankle sprains. If this is the case with you, perhaps a custom orthotic (not something purchased over the counter) can help reduce the rate of ankle sprains and make your foot more stable. Additionally, ankle sprains can damage the proprioception nerves (nerves that sense the relative position of one's own parts of the body and strength of effort being employed in movement) around the ankle. Although this damage is oftentimes irreparable, it can be mitigated by performing strengthening exercises of the muscles around the ankle, specifically the peroneus brevis and longus muscles. Perhaps a short course in physical therapy can help you out. Additionally, you may want to try wearing a neoprene ankle compression sleeve or an ankle brace to provide stability and support when exercising.
You could have some damage in the lateral ankle ligaments. Which have never seemed to heel properly. An MRI will be able to help determine how those ligaments healed. During activities you may need an ankle brace to prevent them from happening. Another route would be surgery to reconstruct those ligaments (If they are torn or stretched).
Repeated sprains often occur due to the ankle ligaments losing their strength, tearing, fraying, etc. As it happens more than once, the ankle joint becomes weaker and it develops into chronic lateral ankle instability. This can predispose you to severe sprains, fractures, ankle derangement and arthritic changes. There are conservative approaches to treat this condition with physical therapy and bracing. There are also surgical approaches to correct the underlying problem and tighten the ankle ligaments to prevent future sprains. In a young, healthy, active individual, surgical correction is considered a better approach if you are looking to maintain or increase an active lifestyle.
