Sprained Ankle Treatment in Singapore

dr gowreeson thevendranWritten by Dr. Gowreeson Thevendran, MBChB (Bristol), MRCS.Ed, Dip. Sports Med.Ed, FRCS.Ed (Trauma & Ortho. ), FAMS (Singapore)

When to Worry About Sprained Ankles?

While most sprained ankles heal with proper home care, certain situations warrant seeking medical treatment. Take a look at some key indicators that it’s time to see a specialist:

Symptoms of a Sprained Ankle

Sprained ankles result from ligament injuries within the ankle. These symptoms vary in intensity but commonly include:

  • Pain: Immediate and ranges from mild to intense, especially when putting weight on the foot..
  • Swelling: Fluid accumulation around the injury, often worsening hours post-injury.
  • Bruising: Discoloration due to broken blood vessels around the ankle.
  • Tenderness: Sensitivity to touch around the injured area.
  • Limited Range of Motion: Difficulty moving the ankle, particularly in certain directions.
  • Instability: A sense of wobbliness in severe cases, impacting standing or walking.
  • Popping Sensation or Sound: May indicate a complete ligament tear.

If you experience intense pain, swelling that doesn’t subside within a few hours, or any other symptom that concerns you, it’s crucial to seek medical treatment.

Diagnosis of Sprained Ankle

Diagnosing a sprained ankle involves a thorough assessment to determine the severity of the injury and rule out any associated complications, and during the diagnostic process, you can expect the following:

  • Physical Examination: Your doctor will carefully examine your ankle, foot, and lower leg. During the process, they will gently touch the area around the injury to assess tenderness and pain levels. They will also move your foot in different directions to check your range of motion and identify any positions that cause discomfort.
  • Imaging Tests: If your doctor suspects a severe sprain, fracture, or other complications, they may recommend imaging tests such as:
    • X-ray: To rule out fractures or dislocations.
    • Magnetic Resonance Imaging (MRI): To visualise soft tissues, such as ligaments and tendons, in detail.
    • CT Scan: To provide a more detailed view of the bones and joints.
    • Ultrasound: To assess the condition of ligaments and tendons in real time.

Based on the findings from the physical examination and imaging tests, your doctor will classify your sprained ankle into grades (Grade 1, 2, or 3) based on the severity of ligament damage. At the same time, this classification helps determine the most appropriate treatment plan.

Immediate Treatments for Ankle Sprains

When you sprain your ankle, taking immediate steps to manage the injury can significantly impact your recovery. Also, it’s crucial to seek an accurate diagnosis from a healthcare professional to ensure there are no associated fractures or other complications. And if you suspect that your ankle is sprained, the RICE protocol (Rest, Ice, Compression, Elevation) is universally advised for initial self-care treatment:

  • Rest: Rest is essential to allow the injured ligaments to heal, so avoid activities that put weight or strain on your ankle. Also, crutches may be necessary if you experience severe pain when bearing weight.
  • Ice: Applying ice packs to the injured area helps reduce pain and inflammation. Additionally, use a thin cloth barrier between the ice pack and your skin to prevent ice burns. Also, remember to apply ice for 15-20 minutes at a time, several times a day.
  • Compression: Compression helps reduce swelling and provide support to the injured ankle. So, use an elastic bandage to wrap the area snugly, but not too tightly, to avoid hindering circulation.
  • Elevation: Elevating your ankle above the level of your heart helps reduce swelling by promoting fluid drainage. When taking this approach, prop your ankle up on pillows or a chair while resting.

Also, balance rest with controlled movement to prevent joint stiffness and muscle atrophy. Be mindful of limitations innate to self-care and consult a doctor for persistent or worsening symptoms.

Grades of Ankle Sprain

Ankle sprains are graded based on severity and ligament damage. At the same time, these grades determine the appropriate treatment plan for the condition.

1. Grade I

A Grade I ankle sprain involves stretching or microscopic tears in the ligaments, typically the anterior talofibular ligament (ATFL) and the calcaneofibular ligament (CFL). This usually results from a low-energy injury with minimal force applied to the ankle, and you may also experience mild pain, swelling, and tenderness around the ankle, but the joint remains stable. At the same time, you should be able to bear weight on the foot and walk with minimal discomfort. Common treatments to alleviate the symptoms include anti-inflammatory medication, ice, and compression.

2. Grade II

A Grade II ankle sprain involves a partial tear of one or more ligaments, most commonly the ATFL. Additionally, this injury is more severe than a Grade I sprain and often causes moderate pain, swelling, and tenderness. You may also notice some bruising around the ankle. While the ankle is still somewhat stable, you’ll likely experience more discomfort when bearing weight or walking, and you may develop a limp if treatment is not sought immediately.

3. Grade III

A Grade III ankle sprain is the most severe type, characterised by a complete tear of one or more ligaments, often including the syndesmotic ligaments that connect the tibia and fibula bones. This typically occurs from a high-energy injury with significant force applied to the ankle. You may also experience severe pain, swelling, tenderness, and bruising. At the same time, the ankle will be unstable, making it difficult or impossible to bear weight or walk. Without immediate treatment, there may also be a noticeable loss of function and range of motion.

Ankle Sprain Treatment

Treatment for a sprained ankle varies based on the sprain’s severity:

Treatment for Mildly Sprained Ankle (Grade I)

For a Grade I ankle sprain, rest and home care are usually sufficient for healing. Your doctor may recommend self-care treatment plans like applying ice packs regularly for the first 48 hours to reduce inflammation and discomfort. Over-the-counter pain relievers can also help manage pain and swelling. Additionally, elevating your ankle while resting is important to minimise swelling and promote healing. With proper care and enough rest, a Grade I sprain typically heals within 1 to 3 weeks.

Treatment for Moderately Sprained Ankle (Grade II)

A Grade II ankle sprain often requires more structured treatment, and your doctor may recommend immobilising your ankle with a brace, splint, or walking boot to protect the injured ligaments and promote healing. This helps stabilise the joint and restrict excessive movement, allowing the torn ligaments to repair.

In addition to immobilisation, your doctor may recommend physical therapy. A physical therapist can design a personalised exercise programme to restore your ankle’s range of motion, strength, and flexibility. Also, these exercises are crucial to prevent stiffness, muscle weakness, and chronic instability. With appropriate treatment and rehabilitation, a Grade II sprain typically heals within 3 to 4 weeks.

Treatment for Severely Sprained Ankle (Grade III)

A Grade III ankle sprain may require more extensive intervention. And while conservative treatments like immobilisation and physical therapy are often tried initially, surgery may be necessary if these measures fail to restore stability and function. Surgical procedures for Grade III sprains aim to repair or reconstruct torn ligaments, ensuring long-term stability and preventing chronic ankle problems.

Following surgery, a structured rehabilitation programme is crucial to regain strength, flexibility, and mobility in the sprained ankle. Also, the complete healing process for a Grade III sprain, especially if surgery is required, can take several months, typically ranging from 3 to 6 months or even longer, depending on individual factors and adherence to rehabilitation protocols.

How Long Will it Take for My Ankle to Recover

The recovery time for a sprained ankle varies, influenced by the injury’s severity and the individual’s treatment response. However, it generally takes 2 to 3 months for a sprained ankle to recover. On the other hand, a fractured ankle can take a longer recovery time, depending on whether it underwent surgery or was treated in a cast. Also, the process involves distinct rehabilitation stages, each critical for a full and safe return to daily activities or sports.

1. Acute Stage (First 1 to 2 Weeks)

The acute stage immediately addresses pain and swelling of the sprained ankle. Treatments include applying external pressure and cryotherapy. This stage also introduces active range-of-motion exercises to manage pain and prevent stiffness, laying the foundation for subsequent recovery phases.

2. Subacute Stage (2 to 6 Weeks, or Longer for Severe Pains)

In the subacute stage, the focus shifts to maintaining the sprained ankle’s range of motion and preventing muscle atrophy. This treatment stage integrates range-of-motion and gentle strength-building exercises, ensuring the ankle retains its flexibility and mobility.

3. Intermediate Stage (6 to 12 Weeks, or Longer for Severe Pains)

The intermediate stage prioritises proprioception, enhancing the sprained ankle’s sense of position. The treatment programme in this stage includes exercises that target balance, coordination, and joint stability, aiming to correct postural imbalances and avert future instability.

4. Advanced Stage (3 to 6 Months or Longer)

The advanced stage marks the transition to more physical and sport-specific activities tailored to the individual’s specific requirements. This stage’s duration can vary, with some individuals returning to full activity relatively quickly, while others, especially those with more extensive damage, may experience a longer recovery with persistent stiffness and discomfort.

Overall healing can extend up to 12 weeks or more, with complete ligament healing and restoration of structural integrity. Throughout the treatment and recovery process, consulting with a healthcare professional ensures the rehabilitation plan is aligned with the unique needs of the individual’s ankle sprain.

When Should I See a Doctor for a Sprained Ankle?

While home care is often enough for sprained ankles, see a doctor if you have severe pain or swelling, can’t bear weight, or notice deformity. Numbness, suspected fractures, or worsening symptoms also warrant medical attention.

With professional help from the orthopaedic specialists at OrthofootMD, you can expect reliable diagnosis, rule out serious injuries, and prevent complications like chronic instability. Schedule a consultation today, and let us provide personalised treatment and optimise your recovery.

Dr Gowreeson Thevendran - Orthopaedic Specialist

Dr. Gowreeson Thevendran

Orthopaedic and Trauma Surgery Specialist in Singapore with 15+ Years Experience

Dr. Gowreeson Thevendran is a fellowship-trained orthopaedic surgeon specialising in minimally invasive treatments for ankle injuries, including sprains. He also focuses on the importance of accurate diagnosis and personalised treatment to achieve optimal recovery and prevent long-term complications. With his training from the UK to Canada, he is experienced in both the operating room and global orthopaedic education.

Frequently Asked Questions about Sprained Ankle Treatment in Singapore

1. What causes an ankle sprain?

Ankle sprains occur when the ligaments that support the joint stretch beyond their limits or tear. This often happens during physical activities when the foot lands awkwardly, twisting the ankle. Common causes include sports injuries, uneven ground, or accidental slips.

Symptoms like pain, swelling, and difficulty walking signal a sprain. Always seek professional treatment to prevent further injury and ensure proper healing.

2. Does insurance and MediSave cover sprained ankle treatment?

In Singapore, sprained ankle treatments are typically covered by insurance and Medisave. Coverage can vary, so it’s important for patients to check with their clinic and insurance provider. OrthofootMD can assist patients in understanding their eligibility for claims and the coverage extent for their treatment.

3. When to worry about sprained ankles? What happens if ankle sprains are left untreated?

Ignoring an ankle sprain can lead to chronic issues such as persistent pain, instability, and repeated injuries. Without proper treatment, the ligaments may not heal correctly, causing ongoing discomfort and an increased risk of re-injury. In some cases, untreated sprains can also lead to joint problems in the future. It’s crucial to treat a sprain promptly and follow medical advice to avoid complications.

4. How are ankle sprains diagnosed?

Doctors diagnose ankle sprains by examining the foot for pain points and swelling and testing the ankle’s range of motion. They may also use X-rays to rule out fractures or MRI scans for a detailed view of the ligaments. These images help determine the sprain’s severity and shape the treatment plan, helping ensure the best approach for recovery.

5. What are the risks and complications of ankle sprain surgery?

Similar to hip replacement, ankle ligament surgery, and flat foot surgery, ankle sprain surgery, though often effective, may carry risks like infection, bleeding, or reactions to anaesthesia. Post-surgery, patients might also experience discomfort from immobilisation, such as itching or sweating under a cast. Medications for pain and inflammation can have side effects as well, including an upset stomach and slight dizziness.

Following a surgeon’s aftercare instructions can minimise these risks. Always discuss the treatment plan and potential complications with your doctor before surgery.

6. Can chronic ankle instability after a severe ankle sprain be prevented?

Yes, chronic ankle instability can often be prevented with proper rehabilitation and treatment. A structured exercise programme focusing on strength, proprioception, and balance is key to recovery. These exercises help retrain the ankle joint, improving stability and preventing future sprains. Consult a doctor for a rehabilitation plan tailored to your specific needs.

Where to Go for Sprained Ankles

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