Grade 3 Inversion Ankle Sprain

About 25,000 people experience a sprains in their ankles each day. And do not think that ankle sprains only happen to athletes and basketball players. A sprained ankle is very common with standard activities in non-athletes too. It definitely can and often does happen in most physical activities, but can also happen by walking on uneven ground, misstepping, tripping or stepping on an object and so on... They occur to people of all ages : youngsters, teenagers, adults and the old.
And usually, they are non-contact wounds, which means the ankle just twists because it is not strong enough or flexible enough to withstand the force of your movement on smooth or uneven ground. Why? Out ankles have become extraordinarily week, thanks to the soft cosy shows we wear and the even ground we usually walk on. Our ankles used to be forced to carry us over uneven and natural ground, but not anymore. And the result is a lot of ankle sprains.
I strongly suggest avoiding R.I.C.E. Look, ice is only effective for the 1st 36-48 hours as a rule. What then? If ice is now not effective at containing swelling, then rest alone isn't going to get you better. Yes, rest is crucial to help the healing process, but it is not the healing process itself.

correct healing involves actively doing something to cure the ankle joint. You will see a big difference in mobility once you get back to life and sports. You have to actively rehab ankles and sprains so they heal quickly and properly.

So, what do you have to do? I have counseled a system called H.E.M. For my athletes that I train. For bad sprains, it can take up to two weeks, but keep in mind without H.E.M, those wounds would sometimes take up to 8 weeks for a good recovery. My sportsmen are at all levels, from high school to pro and they need an approach that works efficiently and speedily. And in my experience, the exercises in H.E.M. Are high quality and help protect them from injury. When a person does injure their ankle, I put them on H.E.M. And they're sometimes back to sports within 1-2 weeks.
Now, I shake my head at the folly of this sort of thinking. That just makes the ankles weaker and weaker and puts that in danger for more ankle injuries as well as knee and back injuries. I'm hoping this is beneficial. If you would like to find out more about H.E.M, click the link below :
/">H.E.M. Rehab System for Ankles and Sprains.

Frequently Asked Questions

  1. QUESTION:
    Severely damaged ligaments in ankle. Doctors, do you have an opinion?
    History:
    2 years ago I severely sprained my left ankle, I had a complete tear in my ATFL and a partial tear in my CFL. I am also born with an accessory bone on my Navicular which then fused to the Cuneiform next to it via cartilage. That sprain was treated on my own since I didnt have health insurance. I used crutches for 3 weeks while using RICE. The ankle and its ligaments healed, yet I had developed Posterior Tibial Tendinitis and was experiencing an aching pain on the medial side of my foot (where that fused lump is located) in the mornings, after exercises, and after standing up over 20 minutes.

    After nearly 9 months of that pain, I took 6 weeks off from any physical activity as hand surgery prohibited my participation in any sport. That sore/dull pain went away.

    I now have been able to play basketball, football, and soccer completely pain free for about 14-15 months. Now that is that is the ankles history, lets move on to where it gets tricky.

    1 month ago I incurred another ankle inversion on that same ankle while coming down awkwardly off a rebound in a game of basketball. This time I have insurance and made an appointment with my local Podiatrist. He ordered an MRI and it showed:

    -Bifid os tibiale externum and slight edema at the synchondrosis associated with midfoot pronation and posterior tibial paratendinitis.

    -Peroneal tenosynovitis with slight adhesion's within the peroneal tendon sheath, an os peroneum, and mild peroneus longus tendinosis proximal to and within the cubital tunnel, but no morphologic high grade tear.

    -Anterior Talofibular ligament is torn.

    -Mild Achilles tendinosis without tearing or advanced tendinopathy.

    -Tibiotalar and posterior subtalar joint effusions with synovitis and/or hemorrhage. Mild talonvaicular and naviculocuneiform degenerative changes.

    (Speaking with my podiatrist and doing my own research on these terms I completely understand what is going on with the ankle.)

    The ankle was mildly swollen, no discoloration, and I was able to bear weight on it with a slight limp the very next day; however that old aching dull pain came back. Im thinking tendinitis again. After being in a Cam-walker for 1 month I was ordered for physical therapy and didnt need the boot anymore. My physical therapy was mainly just for the tendinitis so it involved a lot of stretches and electro-stimulation therapy.

    Since I was in the cam-walker for a month, the pain went away. So I decided to tape my ankles up and get back to running and getting back on the basketball court. Well after 2 days of 70% basketball, the ankle felt perfectly fine during and after the game. On the 3rd day of basketball, I inverted my ankle while jumping up off an opponents foot and re-tore my ATFL and possibly my CFL as well.

    This is the 2nd ATFL tear in the last 35 days, and the 3rd in its lifetime. Also, that fused bone on the medial side of my foot is aggravating the tibialis tendon trying to enter into it.

    I am going to see my podiatrist tomorrow morning, but wanted to see if anyone else has an opinion on what I should do from here on out.

    My questions are:

    1. With two grade 3 sprains in the past 35 days, does this diagnose me with Chronic Ankle Instability?

    2. Should surgery be an option to repair the ligaments that have been torn a few times and to shave that accessory bone deformation down to relieve stress on the tibialis tendon?

    3. If healing conservatively, is there a chance to get back to full strength if rested the proper amount of time (several weeks) followed by a more intense physical therapy to help strengthen the muscles and ligaments damaged?

    4.Can the ATFL naturally heal after two severe injuries to it within 35 days, or is surgery a must?

    5. Since I was able to play going about 70% with 0 pain during and after, was this last inversion simply bad luck, or was it because the ligament wasn't fully healed?

    • ANSWER:
      1. Yes, absolutely. Chronic Ankle instability is more of a subjective diagnosis based on your ability to function, but it sounds like your ankle is pretty jacked.

      2. An orthopedic foot or sports med specialist can perform a bronstrom repair to re-attach your ATFL and tighten your CFL. While they were in there, they could probably deal with the accessory navicular. It would be a significant surgery and require some serious PT and rest, but it would eventually get you back on your feet. You're talking about roughly 4 weeks of non weight bearing followed by another 4 in the boot. This would probably help with the posteior tibialis tendonitis eventually.

      3. Typically when an MRI reports that a ligament is torn, that means it's torn all the way through and basically gone. Your ATFL may scar down to a certain degree, but would always be very loose. I think at a bare minimum, you'd be doing regular ankle exercises, like daily, and wearing a quality brace for many years. While it's not an easy decision, I've seen some good results from the Bronstrom repair, including one girl playing Div. I college volleyball.

      4. See the first part of answer 3

      5. Once you have a few good sprains, you're always more likely to sprain again. In addition to having very loose ligaments, your peroneal muscles (which are responsible for protecting against inversion sprains) tend to have reduced reaction time and poor proprioception. A lot of the PT exercises they made you do were to re-train your peroneals.

      One other thing that stands out in your MRI is the "Mild talonvaicular and naviculocuneiform degenerative changes." This basically states that you're starting to develop some arthritis in the ankle. The fact that you're not hurting right now is good, but that's the sort of injury that catches up to you at 55 or 60 years, sometimes earlier.

      I'm assuming you're a younger person so you have to think about the long term health of your ankles. All in all, you might have to transfer your care to an orthopedic foot/ankle surgeon. I don't know what surgical procedures your podiatrist does. You kinda got delt a bad hand, good luck with everything.