Ankle injuries how long to heal

The other 20 percent of patients might have initially neglected their injury, and because they did not seek immediate care, what began as a grade one, may have turned into a more severe grade two or three injury, possibly requiring surgery. Sprains not adequately rehabilitated, untreated or repeat injuries can cause chronic ankle instability—a condition marked by persistent discomfort and a giving way of the ankle from stretched or torn ligaments.

Proper rehabilitation and treatment are needed to strengthen the muscles around the ankle and retrain the tissues within the ankle that affect balance to help prevent further sprains or injuries. Surgery is sometimes also needed depending on the degree of instability or the lack of response to nonsurgical approaches.

The best thing a patient can do is to be seen by someone who specializes in foot and ankle care as soon as an injury occurs. For more information on ankle sprains, other foot conditions, or to find a foot and ankle surgeon near you, visit FootHealthFacts. Repeat 30 times. Tie one end of the band to a table or chair leg B.

Loop the other end around your foot. Slowly pull the foot toward you. Ankle eversion. Seated on the floor, with an elasticized band or tubing tied around the injured foot and anchored around your uninjured foot, slowly turn the injured foot outward.

Ankle inversion. Seated on the floor, cross your legs with your injured foot underneath. With an elasticized band or tubing around the injured foot and anchored around your uninjured foot, slowly turn the injured foot inward.

Standing stretch. Stand one arm's length from the wall. Place the injured foot behind the other foot, toes facing forward. Keep your heels down and the back knee straight. Slowly bend the front knee until you feel the calf stretch in the back leg. Hold for 15—20 seconds. Repeat 3—5 times. Seated stretch. Loop an elasticized band or tubing around the ball of the foot.

Keeping the knee straight, slowly pull back on the band until you feel the upper calf stretch. Hold for 15 seconds. Repeat 15—20 times. Stand facing a wall with your hands on the wall for balance. Rise up on your toes. Hold for 1 second, then lower yourself slowly to the starting position. Repeat 20—30 times. As you become stronger, do this exercise keeping your weight on just the injured side as you lower yourself down. Stand with your toes and the ball of the affected foot on a book or the edge of a stair.

Your heel should be off the ground. Use a wall, chair, or rail for balance. Hold your other foot off the ground behind you, with knee slightly bent. Slowly lower the heel. Hold the position for 1 second. When sitting or resting, use pillows or a footrest to keep the foot and ankle elevated. Heat increases blood flow to an injury, which can speed healing. Some people also find that it helps relax tight muscles, easing pain and tension. However, do not use heat while the ankle is still swollen, as this can increase inflammation and slow healing.

Once the swelling goes down, try applying a heat pack for 15—20 minutes at a time. Some people find relief from alternating heat and ice packs. Only try this after the swelling is gone — not immediately after the injury.

An injury to the ankle puts nearby muscles and other structures at risk of damage. This is especially likely if the tissues have become weak from disuse. Stretching keeps the muscles strong and limber. It also helps more blood circulate to the area, which may help the ankle heal faster. Gently stretch the ankle by moving it in all directions at least three times each day.

Try flexing the foot forward, then backward, or rolling it clockwise, then counterclockwise. However, it is important to avoid overextending the ankle or moving it in any direction that hurts. The pain and swelling that immediately follow an ankle sprain may be severe. This can make it impossible for a person to put any weight on the joint.

As the swelling goes down, walking can promote healing. Start by walking short distances within the house. Then, gradually build up to longer distances as the ankle begins to heal.

However, walking may require a person to hold the injured ankle in an unusual position or twist the body to avoid putting excess weight on the joint. If this is the case, wait 1—2 days, then try again. Exercise can restore strength and balance, while preventing the muscles in the area from weakening. This can reduce the risk of another sprain. After the swelling goes down and walking is comfortable, it may be a good idea to start exercising the ankle. A person can try performing the following exercises for 10—15 minutes every other day:.

That's really to focus on proprioception and strengthening of the surrounding musculature to see if that can be adequately Sorry, to see if that can adequately restore their sense of stability and allow them to return to activity.

These patients often need bracing for more strenuous sporting activity to give them the sense of stability that they need.

If those things fail, then surgery to repair the ligament is often very helpful. This is a diagram of the classic Brostrom-type repair. This is the fibula right here. This is the calcaneofibular ligament, which has been cut and shortened and repaired.

You don't always actually have to repair this. The most important part is repairing what's called the anterior talofibular ligament. That ligament is actually underneath here. This is the extensor retinaculum, which holds down the tendons on the front of the ankle. We incorporate that into the repair for some additional stability. Underneath that is the ligament repair. That's very successful surgery. People do very well with that and they're able to return to most sporting activities, but it does take about six months before they can go back to real strenuous activity.

Scenario 4 is an year-old football player who twisted his ankle on the turf about a month ago. They did rest, ice, compression, elevation, and told him he'd be better in a couple weeks because it didn't look like that bad a sprain but he continues to have significant pain, pointing to the anterolateral aspect of the ankle.

The pain travels up the leg from that point. X-rays are negative, but an MRI shows this fluid right here in the recess of the syndesmosis. This, as we talked about earlier, is a syndesmotic injury, or your classic high ankle sprain. This is the injury to the syndesmotic ligaments that connect the fibula to the tibia, and so, when the ankle externally rotates, that's what puts stress on these ligaments.

You can diagnose this with what's called a squeeze test where you squeeze the fibula against the tibia proximally in the leg, just below the knee. That should recreate pain at the ankle. People often complain of pain over the tibia where you put your hand or your thumb. That's not a positive test. It has to be pain that they feel down in the ankle. The X-rays will be negative unless there's severe ligament disruption and instability.

That's a different sort of injury. These take a long time to heal. They need a good bit of bracing for a while and rehab, and mostly time, but they will almost always settle down. Scenario 5 is a year-old female. She sprained her ankle about nine months ago. She got better for a while but has pain in the anterolateral ankle. No instability. She did some therapy, which didn't help, but she did get a cortisone injection in the ankle and that seemed to give her excellent relief for a period of time.

This scenario, this is really a diagnosis of exclusion until you get to this point. This is an arthroscopic image of the ankle. Patients can develop what's called an anterolateral impingement lesion. What that is is essentially hypertrophic scarring of the lateral ankle ligaments or the capsule.

That creates, essentially, an impingement lesion where, when the ankle dorsiflexes and comes up, this excess tissue that you see here in the ankle. Here is the talus and up here is the tibia. When these two bones come together during activities, or even just walking, it pinches all this tissue here and causes pain. These patients respond very well to excision of this tissue, but oftentimes they'll get better with time or with a local cortisone injection.

MRIs are not very helpful. They often don't show this lesion. We're looking at some research to see if ultrasound may be more helpful in finding these lesions, but sometimes it's simply a diagnosis of exclusion. You've ruled out all the other things, their pain is appropriate and clinically appropriate to this sort of diagnosis, and you offer them an arthroscopy. That will often solve the issue for them.

Scenario 6 is a year-old female. She turned her ankle stepping off a curb about six weeks ago. They placed her in an air stirrup in the ED but that didn't really help. Her bruising and swelling has resolved but she continues to have a lot of pain over the lateral foot and ankle. Here are her X-rays.