Ankle Ligament Tears: Causes, Symptoms, Treatment, and Prevention
What is an ankle ligament tear?
The ligaments in the ankle play a crucial role in stabilising the joint by keeping the bones in proper alignment, allowing for movements such as walking, jumping, and running. When an ankle ligament tear occurs, it is often the result of an ankle sprain, which happens when these strong ligaments are overstretched or torn due to excessive force. This type of ankle injury can affect individuals of all ages and activity levels, from athletes to those with a more sedentary lifestyle.
Ankle sprains can vary in severity. In mild cases, the injury may involve small tears in the ligament fibres, causing pain and swelling but allowing for relatively quick recovery. However, in more severe cases, a complete ligament tear can lead to significant instability in the joint, which may result in further damage to the surrounding bones and cartilage if left untreated. This instability increases the risk of chronic issues and re-injury over time.
What causes an ankle ligament tear?
Most ankle ligament tears occur as a result of a sudden twisting or rolling injury to the foot or ankle. This twisting motion overstretches the ligaments, often leading to an ankle ligament tear. In many cases, individuals report hearing a distinctive “pop” sound at the moment of injury, which is usually accompanied by immediate pain and swelling. These injuries are particularly common during sports or exercise, where rapid changes in direction or intense physical strain are involved.
Several specific activities and circumstances can increase the likelihood of suffering an ankle ligament tear. One of the most common causes is participating in sports that involve high-impact movements such as running, pivoting, or jumping, like basketball, soccer, or tennis. These sports place considerable stress on the ankle, making it vulnerable to injury.
However, an ankle ligament tear can also occur in non-athletic settings. Tripping, falling, or simply walking on uneven surfaces can cause the ankle to roll unexpectedly, leading to a sprain. Risk factors that increase the likelihood of this type of injury include wearing improper footwear, particularly shoes without adequate support, or having a history of previous ankle injuries, which can weaken the ligaments over time.
Other risk factors include poor physical conditioning, which can lead to weaker muscles around the ankle joint, and lack of flexibility, both of which make it harder for the body to stabilize the ankle during sudden movements. Additionally, individuals with certain foot structures, such as high arches or flat feet, may be more prone to an ankle ligament tear due to the way their feet distribute weight and pressure during movement.
Understanding these causes and risk factors can help individuals take preventive measures to reduce their risk of experiencing an ankle ligament tear, such as strengthening the muscles around the joint, improving flexibility, and wearing supportive footwear.
What are the symptoms of an ankle ligament tear?
The symptoms you experience can differ according to the severity of your ankle ligament tear. You may feel and see:
- Pain when bearing weight on your ankle or at rest
- Swelling
- Bruising
- Tenderness
- Instability of the ankle
The symptoms of a severe sprain and complete ankle ligament tear can feel similar to a broken bone so it is advisable to seek prompt medical attention to prevent long-term complications.
How is an ankle ligament tear diagnosed?
Your orthopaedic doctor will first perform a physical examination to discuss the symptoms you are experiencing and to carefully check your foot and ankle. The doctor will observe any swelling or bruising, gently press around the ankle to determine which ligaments are injured, move your ankle in different directions to test its range of motion and assess its stability.
Following the physical examination, your orthopaedic doctor may order further imaging tests like x-rays to rule out any fractures and MRI scans for clear images of the ligaments, cartilage and tendons.
Your orthopaedic doctor will then categorise your ankle ligament tear into different grades:
- Grade 1 – Slight stretching and microscopic tears are present
- Grade 2 – Partial tearing of the ligament
- Grade 3 – Complete tear of the ligament
The physical examination and imaging tests aid your doctor in determining the grade of your ankle ligament tear so that the right treatment can be administered.
How is an ankle ligament tear treated?
Your doctor may recommend at-home treatments for milder sprains, such as using the RICE method and taking nonsteroidal anti-inflammatory medications.
For more severe sprains, other non-surgical treatment methods can help too. Immobilisation by wearing a cast or brace, going through physical therapy and doing strengthening exercises may work.
Although surgical treatments for an ankle ligament tear is rare, your doctor may recommend that you undergo arthroscopy or a reconstruction procedure if conservative treatments have been ineffective. Surgery is also usually suggested when the patient suffers ankle sprain with additional injuries such as a tendon rupture.
Arthroscopy involves inserting miniature camera and instruments through small incisions to remove any loose fragments of bone or cartilage, or parts of the ligament.
A reconstruction surgery involves repairing the torn ligament with stitches or sutures. Sometimes, using tissue graft obtained from other ligaments and/or tendons may be needed to reconstruct the damaged ligament.
Can ankle ligament tears be prevented?
Ankle ligament tears can be prevented with the right precautions. Take note to warm up and down thoroughly before and after exercising, pay attention to the surfaces you exercise on (avoid uneven surfaces), choose footwear that has good support, and do strengthening exercises. Most importantly, work towards maintaining good muscle strength, balance and flexibility to reduce the chances of suffering an ankle ligament tear.
