Torn or stretched ligaments of the ankle joint can affect various ligaments. In the majority of cases, the anterior outer ligament is affected. However, the other two outer ligaments, the inner ligaments or the syndesmosis ligaments (these connect the tibia and fibula) can also be affected.
Regardless of whether the ankle ligament injury is treated surgically or conservatively, physiotherapy is an essential part of the follow-up treatment in both therapeutic procedures. The techniques used in physiotherapy not only help the patient with his pain symptoms, but also make sure that the swelling of the injured joint is reduced more easily and that the mobility of the ankle joint is maintained as a top priority. Particularly in the acute phase, when the patient must not put any weight on the foot and usually has to immobilize it in a splint or cast, experienced physiotherapists ensure that certain passive exercises and movements do not cause the structures in the joint to clog or stiffen, so that the rehabilitation process can run smoothly.
Exercises for mobilization, improving stability and strengthening exercises are also part of every physiotherapy program after a torn or stretched ligament of the ankle joint. The general goal of any therapy after a ligament injury is to get the patient back on his feet as quickly as possible, so that everyday life and sports can be resumed without any problems. However, care is also taken to stabilize and protect the joint in the long term so that no consequential damage or new injuries can occur.
Treatment/Therapy
No matter what kind of ankle ligament injury is involved, the first aid measure is initially the same for everyone. Those affected should first act according to the PECH rule. This means in detail a break, ice, compression, lifting.
This is particularly important because the ankle joint can often bruise severely, causing the joint to swell over a large area. If a torn or stretched ligament in the ankle joint is suspected as a result of careless movement, an accident or a sports injury, the affected person should consult a doctor as soon as possible so that he or she can determine the exact nature of the ligament injury. The subsequent treatment and therapy then depends on the location and extent of the ligament injury.
There are basically three places where a ligament injury in the ankle joint occurs most frequently. This can result in overstretching, partial rupture or complete tearing of the ligament or several ligaments. Injury to one or more outer ligaments: As a rule, an injury to the outer ligament is treated conservatively, i.e. without surgery.
Those affected must immobilize the foot in a so-called Aircast® splint for 6-8 weeks and must not put any weight on it. Physiotherapy is prescribed to support the foot. For competitive athletes or for injured persons in whom all three outer ligaments are completely ruptured, an operation may be necessary and sensible in order to avoid late effects such as ankle joint arthrosis and malpositioning.
Injury to one or more parts of the inner ligament: Although an injury to the inner ligament occurs less frequently, it may need to be treated surgically earlier than another ligament injury. During arthroscopy, the injured part of the inner ligament is usually sutured. If it is possible to treat conservatively, the principle is the same as for an injury to the outer ligament.
Injury to the syndesmosis ligament: An injury to the syndesmosis ligament is usually caused by violent impacts during contact sports such as soccer or basketball. The swelling lies slightly above the ankle joint and is also noticeable through sensitivity to pressure. In most cases, the injury can be treated conservatively.
Only if there is a complete tear or if parts of the bone are damaged is surgery necessary. No matter what kind of ankle ligament injury is involved, the aim of therapy is to get the patient fit again as quickly as possible and to prevent the development of consequential damage or instability of the ankle joint. Through a patient-specific training plan, adapted to the respective injury, various therapeutic techniques are used to combat the pain, reduce the swelling, maintain the mobility of the ankle joint and perform exercises for strengthening, stabilization and mobility.
- Injury to one or more external ligaments: As a rule, injury to the external ligament is treated conservatively, i.e. without surgery. Those affected must immobilize the foot in a so-called Aircast® splint for 6-8 weeks and must not put any weight on it. Physiotherapy is prescribed to support the foot.
For competitive athletes or for injured persons in whom all three outer ligaments are completely ruptured, an operation may be necessary and sensible in order to avoid late effects such as ankle joint arthrosis and malpositioning.
- Injury to one or more parts of the inner band: Although an injury to the inner ligament occurs less frequently, it may require surgical treatment sooner than another ligament injury. During arthroscopy, the injured part of the inner ligament is usually sutured. If it is possible to treat conservatively, the principle is the same as for an injury to the outer ligament.
- Injury of the syndesmosis ligament: An injury of the syndesmosis ligament is usually caused by violent impacts during contact sports such as soccer or basketball.
The swelling lies slightly above the ankle joint and is also noticeable through sensitivity to pressure. In most cases, the injury can be treated conservatively. Only if there is a complete tear or if parts of the bone are damaged is surgery necessary.
All articles in this series:
