Foot ligament sprains are common. These injuries most often result from the ankle turning inward, damaging the ligaments on the outside of the foot. Tears in ligaments are known as sprains, while tears in muscle are called strains.
Tears can be partial or complete, and are graded as minimal, first degree; moderate to severe, second degree; or complete, third degree. While first-degree and second-degree tears normally heal by themselves with simple measures, third-degree tears may require more complex medical care and treatment.
Treatment for foot ligament injuries often includes rest, compression, ice and immobilization. Once the ligament is healed, specific stretches and strengthening exercises are prescribed.
Sprained Foot Symptoms
Pain is typically the first symptom you will notice after a foot sprain. This typically occurs immediately after injury. Sprained foot symptoms can also include swelling, bruising and difficulty walking, depending on the severity of your injury.
Read more: How to Care for a Sprained Foot
RICE and Analgesics
The initial foot sprain treatment consists of the RICE: rest, ice, compression and elevation. RICE treatments aim to reduce swelling at the injury site. Staying off and elevating the foot, applying ice to the extremity around the injury and wrapping the foot in elastic bandaging decrease swelling. Analgesics such as anti-inflammatory medications not only help with pain, but also reduce inflammation and swelling. Check with your doctor to be sure these medications are safe for you.
For first-degree injuries, treatment may consist of just RICE and analgesics, with weight bearing resuming after a few days. Elevate the foot above the heart level for 48 hours and apply ice for 20 to 30 minutes at a time three to four times a day, the American Academy of Orthopaedic Surgeons recommends.
Splinting or Casting
While RICE techniques also help second-degree and third-degree foot sprains, immobilization with a splint or cast may be required to prevent re-injury. Casting third-degree or complete tears for two to three weeks allows the torn areas to mend.
Physical Therapy Interventions
Physical therapy helps hasten healing by strengthening the injured ligament gradually. Range of motion without resistance to gently stretch the ligament may be followed by resistance-based exercise to strengthen the ligament. Ultrasound and electrical stimulation can decrease pain and swelling.
Developing proprioception — the ability to sense where the different parts of the body are — helps to prevent further injury, the American Academy of Orthopaedic Surgeons stresses. Balancing exercises are included in physical therapy treatment to help develop proprioception after a torn ligament in the foot.
Surgery for Full Tears
A torn ligament in the foot rarely requires surgery, but lasting instability months after the original injury may require one of two types of surgery: arthroscopy or reconstruction.
Arthroscopy examines the joint for loose pieces of bone or cartilage and to see if part of the ligament is trapped in the joint. Frayed areas can be smoothed during this procedure and small pieces of bone or cartilage can be removed.
Reconstruction repairs the torn ligament by sewing the damaged ends back together or using other ligaments or tendons to repair it. Extensive physical therapy is usually required after ligament reconstruction.