Treatment for Ankle Injuries

Phases of Ankle Injury Treatment

Managing ankle injuries effectively involves addressing the problem in three key phases: the acute phase, the rehabilitation phase, and the prevention phase. These stages ensure that immediate needs are met, long-term function is restored, and risks of re-injury are minimised.

Acute Phase: Initial Management

Rest and Protection

Immobilisation: Severe injuries may require braces, casts, or splints. Minor injuries can often be managed with taping or elastic bandages.
Assistive Devices: Crutches or walking aids can help prevent further damage by offloading the injured ankle.

Pain and Inflammation Management

RICE Protocol: Rest, Ice, Compression, and Elevation are standard for reducing swelling and pain.
Medications: NSAIDs like ibuprofen and topical anti-inflammatory creams can provide effective relief.

Specialist Interventions for Severe Injuries

Fractures or dislocations require immediate orthopaedic referral.
Tendon tears may necessitate surgical repair or functional bracing.
High ankle sprains might need stabilisation with surgical techniques.

Monitoring and Follow-Up

Regular assessments are vital to track healing progress and address complications like persistent swelling or pain. Imaging techniques such as X-rays or MRIs may be required for further evaluation.

Rehabilitation Phase: Restoring Function

Physiotherapy

Range of Motion Exercises: Gentle movements like ankle circles and toe stretches restore flexibility.
Strengthening Exercises: Resistance band exercises and calf raises improve muscle support for the joint.
Proprioception and Balance Training: Balance boards and single-leg stands rebuild stability and reduce future injury risks.

Functional Training

Progressive weight-bearing activities, such as walking and light jogging, prepare the ankle for everyday use or athletic performance.

Manual Therapy

Joint mobilisation and soft tissue massage alleviate stiffness, improve range of motion, and enhance circulation for healing.

Advanced Treatment Options

Injection Therapy

Corticosteroid Injections: Effective for persistent inflammation or pain.
Platelet-Rich Plasma (PRP) Therapy: Promotes tissue repair in chronic or severe cases.

Surgical Interventions

Fractures: Procedures like open reduction and internal fixation (ORIF) for complex cases.
Ligament Reconstruction: Addresses chronic instability from repeated sprains.
Cartilage Repair: Arthroscopic surgery resolves osteochondral defects.

Orthotic and Bracing Solutions

Ankle Braces: Provide stability and support during recovery.
Orthotics: Address biomechanical issues to prevent further injuries.
Heel Lifts: Alleviate strain on the Achilles tendon during recovery.

Long-Term Management and Prevention

Patient Education

Patients should understand the importance of completing rehabilitation programs, using supportive devices, and taking precautions during physical activities.

Biomechanical Assessment

Gait analysis and orthotics can address underlying abnormalities, reducing the risk of future injuries.

Regular Conditioning

Incorporating strength and balance exercises into daily routines maintains ankle stability. For athletes, sports-specific training is essential for safe return to activity.

When to Refer

Persistent instability or pain despite conservative treatment.
Severe fractures, ligament injuries, or dislocations requiring surgery.
Chronic conditions like arthritis or nerve-related mobility issues.

Multidisciplinary Approach

Effective treatment often involves collaboration among general practitioners, physiotherapists, orthopaedic surgeons, podiatrists, orthotists, and radiologists. Each specialist plays a vital role in ensuring comprehensive care and optimal recovery.

Case Study Example: A Multidisciplinary Treatment Plan

A 35-year-old athlete presents with a Grade 2 lateral ankle sprain after a football injury. Initial treatment includes the RICE protocol, NSAIDs, and a semi-rigid brace. Physiotherapy begins at two weeks, progressing from range-of-motion exercises to strengthening and proprioception training over six weeks. Gait analysis identifies overpronation, and custom orthotics are prescribed. By 12 weeks, the athlete returns to their sport without residual pain or instability.

Conclusion

Treating ankle injuries requires a patient-centred approach that addresses immediate needs, restores function, and prevents future complications. By following evidence-based protocols and collaborating with a multidisciplinary team, medical practitioners can achieve optimal outcomes. Educating patients on self-management and long-term care ensures they can confidently return to their daily or athletic activities without compromising their recovery. You can view Algeos Fracture Boot products here.