Question 1

What is an Ankle Sprain?

Accepted Answer

Ankle sprain is one of the leading causes of ankle pain in the general population and is particularly common in people active in sports and dancing. Most ankle sprains occur after an accidental twisting inversion of the ankle joint. This may injure or tear the outer ankle ligaments (anterior talofibular ligament and posterior talofibular ligament) leading to pain and swelling around the ankle joint.

Question 2

What should you do when you have an ankle sprain?

Accepted Answer

The recommended initial treatment is RICE therapy (Rest, Ice, Compression, Elevation) and is effective in relieving pain and swelling in most cases and preventing further injuries to the ankle in the first 24-48 hours.

Question 3

When should you see an Orthopaedic specialist for your ankle sprain?

Accepted Answer

1. When your pain is severe and you are unable to put weight on the ankle and walk.
2. If your ankle swelling persists and does not improve with RICE therapy
3. If you have repeated/recurrent ankle sprains with features of an unstable ankle such as it is ‘giving way’ frequently (Chronic ankle instability)
4. If a serious ankle sprain is left untreated, it can potentially lead to chronic ankle pain, instability, and arthritis of the ankle

Question 4

How will our doctors evaluate you when you see them for ankle sprain?

Accepted Answer

1. We will obtain details on the mechanism of your injury.
2. We will thoroughly examine the ankle to determine the severity and extent of injury.
3. X-rays will be performed to exclude fractures
4. If your pain has been persistent for 4-6 weeks and you have features of chronic ankle instability such as an ankle that ‘gives way on uneven ground, we may order an MRI (magnetic resonance imaging) scan of the ankle further evaluation.
5. We may provide you with recovery aids such as splints and ankle braces.
6. We may refer you to a physiotherapist in our team, to teach you physical therapy to strengthen the ligaments and muscles around your ankle, restore range of motion, improve balance and proprioception to reduce the risk of further sprains.

Question 5

When is surgery indicated?

Accepted Answer

Fortunately, most patients improve with non-surgical ankle treatment. Only a selected group of patients may require surgery and they usually have already attempted non-surgical treatment without satisfactory improvement.

Patients who may need ankle sprain surgery in Singapore may have:

1. Chronic ankle instability with multiple and recurrent ankle sprains despite physiotherapy and wearing of splints and braces, and with MRI evidence of ligamentous injury/tears
2. Chronic debilitating ankle pain with locking sensation and MRI evidence of osteochondral injury(cartilage defect) of the talus and loose bodies in the ankle joint

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