Disease · Foot Surgery and Ankle Surgery

Ankle Ligament Tear: Common Ankle Ligament Injuries & Long-Term Effects

Here you will find selected medical experts and specialists in clinics and medical practices for the diagnosis, treatment, surgery and rehabilitation in the medical field Torn Ligament in the Ankle. All listed physicians are specialists in their field and have been carefully selected for you according to strict guidelines.

Medical AuthorDr Wolfram WenzICD-10: M66.27, M66.37, M66.47, M66.57

Brief overview — the essentials first

A torn ligament in the ankle joint occurs when one of the stabilizing ligaments of the ankle joint partially or completely tears. For diagnosis, X-rays are usually taken to rule out bone injuries. Other procedures such as MRI or ultrasound can confirm the suspected diagnosis. Depending on the severity of the injury, surgery is not necessary in most cases—immobilization followed by targeted physical therapy is sufficient. It is important not to put weight on the foot too soon, as this can delay healing or cause the joint to become unstable. A torn ligament usually heals within four to six weeks. Targeted balance training can reduce the risk of the ankle twisting again.

A torn ligament, a sprained ligament, or a ligament injury is an injury that occurs primarily as a result of trauma (sprain). Twisting the foot, which causes the structures to be overstretched, is the most common cause. If the overstretching is too severe, the medial and lateral ligaments, as well as the joint capsule or syndesmosis, can tear. In cases of severe twisting, a bone fracture may even occur. The lateral ligament or ligaments are particularly often affected. Lateral ligament tears account for about 20 percent of all sports injuries.

Below you will find further information as well as a selection of specialists for ankle ligament tears.

Not all ligament tears are the same. If only one ligament is torn, the stability of the ankle is not necessarily compromised. If multiple ligaments are torn, however, ankle stability is no longer guaranteed. In addition, a distinction is made between completely torn ligaments and those that are only partially torn.

For treatment, it is also important to consider the patient’s symptoms and the extent to which they limit the patient’s mobility.

Anatomy of the Ankle Joint
Multiple ligaments provide stability to the ankle joint © bilderzwerg / Fotolia

How is a torn ligament in the ankle diagnosed?

The typical symptoms of a ligament tear are pain, swelling, and a feeling of instability in the ankle joint. Unlike bones, ligaments and tendons cannot be visualized on an X-ray. Nevertheless, an X-ray is usually taken as part of the general diagnosis. This helps rule out bone injuries.

In addition, X-rays can also provide clues to other injuries to the ligamentous apparatus. For example, if the gap between the tibia and fibula is too wide, this suggests a rupture of the syndesmosis (the ligament connecting the tibia and fibula) or injuries to the talus.

The diagnosis also includes

a clinical examination,
an ultrasound,
magnetic resonance imaging (MRI) if necessary—to visualize ligaments, tendons, and cartilage,
if necessary, computed tomography (CT)—in cases of bone involvement.

How is a torn ligament treated?

The severity of the injury is key to choosing the right treatment. After an ankle sprain, standard treatment measures are used first. This is known as the RICE method:

P: Rest,
E: Ice,
C: Compression (pressure bandage)
H: Elevation.

These measures help reduce swelling and severe pain.

Nowadays, surgery is generally no longer necessary for ligament tears. Conservative treatment is usually sufficient.

However, if bony structures are involved, surgical treatment may be necessary. In cases of syndesmotic injury—especially among competitive athletes—surgery is often unavoidable.

With conservative treatment, the joint is immobilized for a few days until the swelling has largely subsided. To prevent the ankle from twisting again immediately, doctors often prescribe a special plastic splint that keeps the foot stable. Treatments such as iontophoresis or ultrasound can also provide relief.

In addition, temporary medication may be helpful in relieving symptoms.

For athletes, this is followed by physical therapy consisting of strength, endurance, and coordination training.

What are the possible complications?

Normally, a torn ligament in the ankle heals without any lasting effects. However, if the patient resumes weight-bearing activities too soon, it may take significantly longer for the pain and swelling to subside.

Of course, it’s also possible for the ligaments to heal back together too loosely. This is referred to as mechanical instability of the ankle joint. If the sprain does not heal completely, chronic instability of the ankle joint may result.

Redness and swelling are signs of a torn ligament © Leop / Fotolia

When can you move normally again?

There is no exact answer to this question. Depending on the severity, a torn ligament usually heals within four to six weeks. However, it also depends on what treatment is required.

Rehabilitation after surgery usually takes longer than after conservative treatment. The patient’s behavior is also important. Are they following the doctor’s instructions? How well are they cooperating with the rehab program? The patient’s behavior plays a major role in the treatment. The goal is to fully restore mobility to the ankle joint. A brace and walking aids support the ankle by stabilizing it and taking the weight off it during the healing phase.

How can you prevent a torn ligament in the ankle?

There is no such thing as 100% certainty. It is one of the most common sports injuries, and an ankle sprain can occur anytime, anywhere. Nevertheless, the patient can minimize the risk. The risk also depends on the sport being played—especially sports involving rapid changes in direction increase the risk.

For example, special coordination exercises can help. This is known as “proprioceptive training.” Balancing on one leg or using wobble boards and wobble cushions can improve the coordination between

muscles,
tendons,
ligaments, and
nervous system

Which doctor treats ligament tears?

Orthopedic surgeons and sports medicine specialists with specialized training are the first point of contact for an ankle ligament tear. They understand the body’s range of motion. If surgery is required, a surgeon will typically be involved as well.

A specialist is also important for follow-up care. A good physical therapy practice can help the injured person get back on their feet more quickly.

FAQ

1. How does a torn ligament in the ankle occur?
A torn ligament is usually caused by the foot suddenly twisting. This causes the ligaments to be overstretched or to tear partially or completely. The lateral ligaments are frequently affected; the syndesmosis or the medial ligament are less commonly involved. The cause is often a twisting injury during sports or on uneven ground.

2. How is a torn ligament in the ankle diagnosed?
To make a diagnosis, X-rays are first taken to rule out bone injuries. MRI, CT, or ultrasound may also be used to more accurately assess the condition of the ligaments and tendons. A clinical examination provides evidence of swelling, pain, and instability.

3. How is a torn ligament treated, and how long does healing take?
Depending on the severity of the injury, conservative treatment—including immobilization, a brace, and physical therapy—is usually sufficient. Surgical treatment is necessary only in cases of severe or bone-related injuries. A torn ligament typically heals within 4 to 6 weeks; recovery takes longer after surgery.

4. Can a torn ligament in the ankle be prevented?
Complete prevention is not possible, as an ankle sprain can occur at any time. However, the risk can be reduced through regular balance and coordination training. The type of sport you play also plays a role—sports involving rapid changes in direction, in particular, increase the risk.

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