If you've ever sprained your ankle, it's likely you have experience with ligament injury. These structures hold bones together throughout your body. Ankle injuries most frequently affect the ligaments on the outside of the ankle.
Ankle ligament tear treatment may include a combination of rest, exercise and rehabilitation. Surgery is sometimes needed for severe ankle sprains.
Depending on the severity of your ligament injury, initial treatment may include anti-inflammatory medication and physical therapy modalities such as ultrasound and electrical stimulation to decrease pain and swelling. As healing progresses, range-of-motion and strengthening exercises are added.
Grading Ankle Injuries
Ankle sprains are categorized and treated based on the severity of the ligament injury. Grade 1 sprains involve ligament stretching without obvious tearing. A grade 2 ankle sprain describes a partial ligament tear, and grade 3 sprains involve complete tearing of one or more ankle ligaments.
Ankle Ligament Tear Treatment
Initial ankle ligament tear treatment during the acute phase of healing — the first few days after the injury — focuses on reducing pain and inflammation. Ice packs can be applied for up to 20 minutes every 3 to 4 hours, beginning immediately after injury. Cold application helps decrease pain by making your nerves less sensitive and is most effective for the first few days after injury, according to the Mayo Clinic.
Non-steroidal anti-inflammatory medication, such as ibuprofen (Advil, Motrin), naproxen (Aleve) or aspirin, may alleviate pain and reduce inflammation during this phase. Elevating your leg as much as possible helps limit and reduce swelling. Your doctor may recommend crutches, a supportive boot, elastic bandage and/or a splint to protect your ankle from further injury.
Interventions in the Subacute Phase
The subacute phase of healing begins around day four and continues until 2 weeks after an ankle ligament injury. During this phase, range-of-motion exercises begin to decrease ankle stiffness caused by swelling. You might receive physical therapy, including ultrasound and electrical stimulation, to help promote healing and exercises to improve your mobility.
Exercises often include drawing the alphabet in the air with your toes, ankle circles, gentle stretches and possibly non-weight-bearing activities, such as riding a stationary bike. You might begin to put some weight on your foot as you walk, if approved by your doctor.
Time to Get Moving
The rehabilitation phase of treatment typically begins once you are able to bear full weight on your ankle and no longer need crutches to walk. This phase may begin 2 to 6 weeks after injury, with more severe ligament tears at the later end of that time frame.
The goal of this phase is to regain movement, strength and function in your ankle. Your physical therapist may stretch your ankle to decrease stiffness and improve movement. Strengthening exercises, such as calf raises, towel toe scrunches and toe marble pick-up, may be performed.
Restore Full Function
Six weeks after injury and beyond, treatment for ankle ligament tear treatment focuses on returning to full function. Range-of-motion exercises continue with added resistance from an elastic band. Balance training activities, such as standing on an uneven surface and standing only on your injured leg, are also included in treatment. Functional activities might also include sports and recreational activities, jumping and running.
Surgery for Ankle Sprains
Severe grade 3 sprains may require surgery, particularly if you have ongoing pain or consistently feel like your ankle is going to give out. In these situations, your torn ankle ligaments may be reattached with screws. You may have to wear a cast and use crutches for 6 to 8 weeks while the ligament heals. Once the cast is removed, treatment begins at the subacute phase and progresses through the rehab and functional phases.
Warnings and Precautions
Seek medical attention if you sprain your ankle, even if you think it's just a minor injury. Early treatment can prevent long-term issues with loss of motion and chronic weakness that can develop after this injury.