Understanding Recurrent Ankle Sprains: When Surgery Becomes an Option

Ankle sprains are a common injury that can occur in sports, daily activities, or simply by misstepping on an uneven surface. While many individuals manage to recover from a sprain with rest, ice, compression, and elevation (RICE), some experience recurrent ankle sprains. For these individuals, the solution may go beyond conservative treatments, potentially leading to the need for surgical intervention.

What Are Ankle Sprains?

An ankle sprain occurs when ligaments that support the ankle stretch beyond their limits or tear. The most common type is an inversion sprain, where the foot rolls inward, resulting in damage to the lateral ligaments. These injuries can range in severity from mild (grade I) to complete tears (grade III).

Why Do Some People Experience Recurrent Sprains?

Several factors can contribute to the recurrence of ankle sprains:

1. Insufficient Rehabilitation: After an initial sprain, some individuals may not fully rehabilitate their ankle, leading to persistent weakness and instability.

2. Improper Recovery: Rushing back into sports or activities before the ankle has fully healed can increase the likelihood of additional sprains.

3. Anatomical Factors: Some people may have anatomical abnormalities in the structure of their ankles that predispose them to injuries. For example, a high arch or flat foot can alter the biomechanics of the ankle.

4. Ligamentous Laxity: Some individuals have naturally looser ligaments, making them more prone to sprains.

5. Proprioceptive Deficits: The body’s ability to feel where it is in space (proprioception) can be compromised after a sprain. This loss of proprioception can lead to poor balance and coordination.

Symptoms of Chronic Ankle Instability

Individuals with recurrent ankle sprains may experience symptoms that include:

- Persistent swelling and tenderness around the ankle
- A feeling of the ankle giving way during activities
- Pain or discomfort during physical activities
- Decreased range of motion in the ankle

When Is Surgery Necessary?

In cases where conservative treatments—such as physical therapy, bracing, and activity modification—have failed to provide relief or restore stability, surgical options may be considered. Surgery may also be warranted in the following situations:

- Severe Ligament Damage: If the ligaments are severely torn and cannot heal properly on their own, surgical reconstruction may be necessary.

- Chronic Instability: Patients with chronic ankle instability, characterized by recurrent sprains and a persistent sense of instability, may benefit from surgery to strengthen or repair damaged ligaments.

- Associated Injuries: If the sprain is accompanied by other injuries, such as fractures or cartilage damage, surgical intervention could be required to address these issues.

Types of Surgical Procedures

Several surgical approaches can help stabilize a recurrently sprained ankle:

1. Ligament Reconstruction: This procedure involves repairing or reconstructing torn ligaments, often using tendons from the patient’s body, such as a hamstring tendon, to restore stability.

2. Ankle Arthroscopy: In some cases, doctors may perform arthroscopic surgery to clean out the joint or repair any damaged tissues within the ankle.

3. Brostrom Procedure: This is a common surgical technique used to repair lateral ankle ligaments that may include tightening the ligaments if they are too loose.

Post-Surgery Rehabilitation

Recovery from ankle surgery can be a lengthy and vital process. Physical therapy usually begins soon after surgery to restore range of motion and strength. A tailored rehabilitation program will help ensure proper healing and reduce the risk of future injuries.

Conclusion

Recurrent ankle sprains can be frustrating and may significantly affect one's quality of life. While most sprains can be successfully managed with conservative treatments, surgical options exist for those who continue to suffer from instability and pain. If you find yourself frequently spraining your ankle or if you're experiencing ongoing issues after an initial sprain, schedule an appointment with Dr. Gireesh Reddy or Dr. Sirisha Pokala at Restore Foot & Ankle Specialists by calling (469) 573-3427 or by booking an appointment online.