Ankle Sprain

There are different classifications of an ankle sprain, such as:

• Mild (Grade 1): This classification is mainly characterised by slight stretching and some damage to the ligament fibres. Mild tenderness and swelling in the ankle are felt, walking with minimal pain is still possible.
• Moderate (Grade 2): When a person has a grade 2 ankle sprain, partial ligament tearing has occurred. In this classification, one can experience moderate tenderness and swelling around the ankle. Walking is painful and slight instability is present when examined.
• Severe (Grade 3): A person with a grade 3 ankle sprain has an ankle ligament that is completely torn with severe tenderness, bruising, and swelling around the ankle. Walking is likely not possible because the ankle gives out and there is intense pain.

Symptoms of an ankle sprain vary depending on how severe the injury is. Common ones include:

• pain while carrying out weight-bearing activities or even at rest.
• bruising and swelling of the affected area
• limited movement
• tenderness when touched
• ankle instability
• popping sound or sensation during the injury

An ankle sprain happens when the ankle joint is moved forcefully from its normal position, resulting in one or more ligaments in the ankle stretching, or tearing completely. When this happens, ankle surgery might be needed. Some of the most common causes of ankle sprains include:

• a strong fall
• engaging in sports activities
• landing inappropriately on one’s foot after a jump or turn
• walking on uneven surfaces
• using or wearing inappropriate footwear

People are vulnerable to ankle sprains when they are exposed to risk factors such as:

• Poor conditioning before engaging in extreme or strenuous activities
• Fatigue of the muscles and ligaments that are caused by overexerting oneself
• Bearing excess weight
• Previous ankle injuries or damage

Some people who have sustained ankle sprains previously have a higher likelihood of developing complications. Reasons include failure to receive proper diagnosis and ankle sprain treatments, participating in strenuous activities after spraining the ankle, and having repeated sprains on the same ankle.

When this happens, complications such as the following can occur:

• Instability of the ankle joint
• Chronic ankle pain
• Stiffness
• Swelling
• Arthritis in the ankle joint

While there are a wide range of ankle sprain treatments in Singapore available, prevention is still the best cure. To lower your risk of incurring an ankle sprain, try the following tips:

• Warming up before engaging in any sports activities
• Being extra careful when walking on uneven surfaces
• Wearing appropriate footwear
• Using an ankle support brace on an ankle sprain that is either weak or injured
• Maintaining healthy muscle strength through exercise
• Engaging in stability training
• Stretching regularly
• Resting your muscles and feet when they have been overexerted

The amount of time needed to recover from an ankle sprain depends on how serious the injury is. A minor sprain can take nearly two weeks to heal, while a serious or severe pain can take 6-12 weeks.

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.

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

• We will obtain details on the mechanism of your injury
• We will thoroughly examine the ankle to determine the severity and extent of injury
• X-rays will be performed to exclude fractures
• 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
• We may provide you with recovery aids such as splints and ankle braces
• 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

Call us to evaluate you if you have an ankle sprain!

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:

• 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
• 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

Call us to evaluate if you may need an ankle surgery in Singapore!

Our orthopaedic specialists are well trained and competent in performing surgeries of the ankle with excellent outcomes.

MIS(Minimally invasive surgery) with ankle arthroscopy has the advantage of visualizing the ankle joint via keyhole incisions. During the procedure:

• Scar tissue and loose bodies in the ankle joint can be removed (to relieve locking symptoms and impingement)
• Small osteochondral injuries to the talus can be treated via microfracture with cartilage scaffold to stimulate healing
• In addition, the outer ankle ligaments can be repaired/reinforced during the same procedure to achieve ankle stability

Mini open ankle ligament reconstruction/repair can be performed for revision cases with internal brace

Call us to discuss the optimal surgery for your ankle problem today!