Most ankle injuries improve with rest, ice packs, analgesics and physiotherapy without long-term problems. However, in approximately 5-10%, pain and instability may continue beyond the usual healing time of 6 to 12 weeks. The ligaments may not heal properly and may weaken, or there may be damage to the joint or some other nearby structure. Ankle instability is when there is a tendency for the ankle to "give way", often with minor stresses that make a person prone to repeated ankle sprains. This is more commonly due to damage to the proprioceptive nerves than to the actual weakness of the ligaments. These are small nerve endings in the joint and the ligaments that tell the brain where the ankle is and in what position it is. If these nerve endings do not work properly, the brain does not get reliable information and the muscles around the ankle may not work. together properly
How is the problem diagnosed?
It is important for a specialist to examine you for any signs that you have other problems around your ankle, such as damage to the joint surface. The examination of the ankle will reveal if the ligaments are lax. Investigations may be required, such as special X-ray views, magnetic resonance imaging to detect damage to the ligament, and other causes of pain
What can be done about the instability of the ankle?
The first treatment is a physiotherapy program to re-train proprioceptive nerves that do not work properly, performing various exercises and activities. Exercises are also shown to stretch and strengthen the muscles around the ankle. A molded insole can be recommended for your shoe to reduce additional stress on the ankle ligaments. An ankle clamp can help tense or replace the ligaments. Many people will find that their ankle is much more stable and comfortable with physiotherapy.
Will I need an operation?
If problems continue, such as pain and instability despite other measures, an operation may be required. It is possible that a keyhole surgery (arthroscopy) is required to smooth the scar tissue, remove the loose joint pieces and evaluate the condition of the ligament. An operation may be necessary to reconstruct the ligaments of the ankle if the tests show that the ligaments are weak / lax.
Consult an orthopedic / sports surgeon for more information.
Read the full article "Why does my ankle sprain not improve?" Written by Dr.GK Sudhakar Reddy at Practo.com here: https://www.practo.com/healthfeed/why-is-my-ankle-sprain -not- get-better-25298 / post
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