Ankle Ligament Tears: Symptoms, Recovery, and Surgery Insights

Ankle ligament rupture?

Hello, doctor.
I would like to inquire about my left ankle ligament injury that occurred while playing basketball on August 20th.
Since then, I have noticed that my foot swells in the morning after elevating it, but the swelling becomes more pronounced as the day goes on.
Is this a normal phenomenon? I have been using crutches to walk and have visited the hospital for evaluation.
However, I would like to ask if having swelling for a month is considered normal, and am I at risk of missing the optimal time for surgery? Could there be muscle atrophy or similar issues? Additionally, my ankle's range of motion is very limited; I can only move it slightly back and forth, which feels tight and restricted.
Is this also normal? After surgical treatment, will there be any long-term complications, and how long will it take to recover? Thank you for your assistance, doctor.

Awei, 20~29 year old female. Ask Date: 2020/09/10

Dr. Chen Bochen reply Orthopedics

1.
Performing ankle pump exercises can help reduce swelling (see attached image).

2.
The duration of swelling varies from person to person and depends on the severity of the injury; severe sprains or even ligament tears may require 6-8 weeks for recovery.

3.
Swelling can limit your range of motion.

4.
If surgical intervention is necessary, it indicates that the potential complications of non-surgical treatment are greater.

Reply Date: 2020/09/10

More Info

Ankle ligament tears are a common injury, especially among athletes, and they can significantly impact mobility and quality of life. Understanding the symptoms, recovery process, and potential surgical interventions is crucial for effective management and rehabilitation.

Symptoms of Ankle Ligament Tears
The primary symptoms of an ankle ligament tear include:
1. Pain: This is often immediate and can range from mild to severe, depending on the extent of the injury.

2. Swelling: Swelling typically occurs around the ankle and can increase over time, especially if the foot is not elevated.

3. Bruising: Discoloration may appear around the injury site.

4. Instability: You may feel that your ankle is unstable or gives way when you try to walk or put weight on it.

5. Limited Range of Motion: As you mentioned, you may experience tightness or difficulty moving your ankle in certain directions.

Recovery Process
Recovery from an ankle ligament tear can vary based on the severity of the injury. Here are some general guidelines:
1. Initial Management: The R.I.C.E. method (Rest, Ice, Compression, Elevation) is often recommended in the first few days post-injury to reduce swelling and pain.

2. Physical Therapy: Once the acute phase has passed, physical therapy is crucial for regaining strength and range of motion. Your therapist will guide you through exercises tailored to your recovery stage.

3. Duration of Recovery: Mild to moderate tears may take several weeks to heal, while severe tears could take several months. It’s essential to follow your healthcare provider's recommendations closely.

Surgical Intervention
In some cases, surgery may be necessary, especially if the ligaments are completely torn or if there is significant instability in the ankle. Here are some insights regarding surgery:
1. Timing: It’s crucial to address ligament tears promptly. Delaying surgery can lead to complications, such as chronic instability or arthritis. If you are experiencing persistent swelling and limited range of motion after a month, it’s advisable to consult with an orthopedic specialist to evaluate the need for surgery.

2. Post-Surgery Recovery: After surgical intervention, you will likely undergo a rehabilitation program that includes physical therapy. The timeline for returning to sports or high-impact activities can vary but typically ranges from 4 to 6 months, depending on the severity of the injury and the success of the surgery.

3. Potential Complications: While many patients recover well, there can be risks associated with surgery, including infection, nerve damage, or persistent instability. Discuss these risks with your surgeon to understand your specific situation.

Addressing Your Concerns
Regarding your specific situation, it is not uncommon for swelling to persist for several weeks after an ankle injury, especially if you have been immobilizing the ankle. However, if the swelling is worsening or if you are experiencing significant pain or instability, it is essential to seek further evaluation.
The tightness and limited range of motion you are experiencing are also common after an ankle injury, particularly if you have been using crutches and not putting weight on the ankle. Gradually reintroducing movement, under the guidance of a healthcare professional, is crucial to recovery.

Conclusion
In summary, while some swelling and tightness can be expected after an ankle ligament tear, persistent symptoms warrant further evaluation. It is essential to communicate openly with your healthcare provider about your concerns, as they can provide tailored advice and determine if surgical intervention is necessary. Early and appropriate management can significantly improve your recovery outcomes and help you return to your regular activities, including sports.

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