When is surgery the right option for your ankle injury?
If you’re suffering from long-term pain and instability after an ankle injury, physiotherapy alone may not be enough.
Ankle injuries are incredibly common, with around 300,000 Britons and 2 million Americans spraining their ankles every year – ankle injuries account for around 20% of all sporting injuries.
I personally suffered an ankle injury during a kickboxing class in 2006 – my ankle has never fully recovered – the tip of my fibula shattered. However, while they can be incredibly painful and inconvenient, the majority of ankle injuries do heal on their own with little medical intervention. However, there are some cases where physiotherapy or surgery is necessary to complete the healing process.
The good news is that many ankle sprains are relatively minor and tend to heal within 6-8 weeks with proper self-care. This means following the RICE injury formula:
- Rest – keep your weight off your ankle for a few days to give the joint time to recover
- Ice – apply an ice pack to the area 3-4 times a day to reduce swelling
- Compression – reduce swelling with a support bandage or strapping
- Elevation – elevate your ankle above your body. In other words: put your feet up!
If your ankle injury is severe, you should of course seek professional medical advice – either by seeing your doctor or visiting your local Accident & Emergency department if the pain prevents you from walking.
In the majority of cases, ankle injuries tend to heal without special treatment. However, if you have a serious injury, you don’t start to see signs of recovery, or you continue to suffer from ankle instability, you may need to see a physiotherapist to help speed things along.
After the initial recovery session, the aim of the physiotherapist is to rehabilitate the ankle and restore normal use and movement. This generally takes the form of various exercises, including getting your ankle used to bearing weight, resistance and strength exercises, balance exercises, massage, and eventually more vigorous exercises such as jogging and running-based drills.
Your physiotherapist will be careful not to push you too far too early, as this could aggravate the injury and slow the healing process.
Most people find that their ankle feels much more stable and comfortable after completing physiotherapy treatment.
The majority of people will not need surgery after experiencing an ankle injury, particularly with effective after-care and physiotherapy. However, some people will continue to experience long-term instability and pain – if you are one of those people, then you might need an operation in order to resolve the problem.
An orthopaedic foot and ankle surgeon, such as ankle specialist Rohit Madhav, can help you to decide if this is the option for you. At this point, it is likely that you will be sent for an MRI scan to assess the ligament damage. This will enable the surgeon to judge whether or not you need surgery and, if so, what type of operation you need. In some cases, you may even need an exploratory operation on your ankle before further surgery is recommended.
The type of operation you need and its associated recovery time will of course depend upon your specific injury or weakness. Generally speaking, you can expect to spend some time in plaster and will usually need to undergo several months of physiotherapy treatment.
Whether you need physiotherapy, surgery or just good old-fashioned R&R depends totally on the type and severity of your injury. You should wear an ankle support while in recovery and also when you start exercising again – if an injury is severe you may well need support for many years to come. You know your body best, so if something doesn’t feel right, don’t be afraid to seek medical advice.