When An Ankle Sprain Won’t Heal

Ankle sprains are one of the most common injuries seen by EmergeOrtho foot and ankle specialists and by our orthopaedic urgent care providers. Often, these injuries heal with conservative treatment. But occasionally, pain, swelling, or instability persists.

How Do Ankle Sprains Happen?

Any unexpected movement might cause an ankle sprain.  As Dr. Nicholas Viens, Board Certified Orthopaedic Surgeon in Durham and Chapel Hill, explains, “It’s not just a sports injury.  It can happen anywhere, anytime.”  Dr. Viens is fellowship-trained in foot and ankle surgery and sees patients every week with mild to severe ankle sprains.  “People can sprain their ankles walking down the sidewalk, running on a trail, stepping out of a car, carrying a child and not noticing a toy on the ground.  Patients can get injured at work, whether at a construction site or in an office.”

What Are Good Treatments for a Mild Ankle Sprain?

  • A good rule of thumb is RICE – Rest, Ice, Compression, Elevation.
  • An over-the-counter wrap can help with the compression part, limiting movement of the ankle.

How Do You Treat a More Severe Ankle Sprain?

  • Sometimes, immobilization is needed: your orthopedic provider may fit you in a boot or prescribe crutches for a period of time to allow the ankle to heal.
  • Physical Therapy is often an integral part of treating an ankle sprain.  Our physicians often prescribe physical therapy as a way to see if you can get better on your own or if more action may be needed. Our Physical Therapists work with you as a team to build back strength, range of motion, stability, and confidence on your feet.
  • When inflammation won’t go away, our orthopedic providers sometimes inject the affected area with a steroid.

Close follow-up with an orthopaedic provider is important, as other injuries can occur along with an ankle sprain.  A sprain might mask something more serious, like a fractures, tendon tear, or cartilage injury.

When is an Ankle Sprain More Than An Ankle Sprain?

If you’re experiencing persistent swelling, feelings of instability, trouble on uneven ground, weakness in the ankle, or it just feels like something isn’t right, then you may be suffering from something more than an ankle sprain. If the sprain isn’t getting better, the first step is to consult with an orthopedic physician who specializes in the foot and ankle.

It’s better to be proactive.  Untreated, conditions can worsen into chronic ankle sprains and instability, which can be debilitating.  This may make arthritis of the ankle more likely, especially if the ankle is allowed to continue to deteriorate.

Diagnostic imaging is the next step to determine the best method to treat your ankle. With an MRI, an orthopedic provider can work with you on an approach to treat any underlying conditions or extensive injuries.

“Sometimes, surgery is even necessary,” explains Dr. Viens. The procedure can be anything from minimally-invasive arthroscopy to a ligament tightening procedure. Chronic ankle instability occurs when ligaments and tissue aren’t sufficient to stabilize the ankle. In these cases, they must be recreated. Advanced technology and better understanding of ankle ligaments have enabled us to offer procedures to anatomically reconstruct the ligament to create a stable ankle.

Dr. Viens shares one of the reasons he pursued the subspecialty of foot and ankle surgery is its opportunity for growth. “There are new technologies that have advanced over the last decade.  It’s an opportunity to help more patients who previously were told there were not a lot of great options for them,” says Dr. Viens.  He treats patients in the greater Research Triangle Park area, at the Chapel Hill, Durham, and Southpoint offices of EmergeOrtho, often performing surgeries at North Carolina Specialty Hospital and Triangle Orthopaedics Surgery Center.