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Sprained Ankle: When Do You Need Surgery?

| | Ankle

Dr. Markle talks about sprained ankles, their classification, and treatment without surgery.
Today, we’re talking about having a sprained ankle — what that means, some of the structures, the damages, as well as common questions we get from patients, such as “When do you need surgery for a sprained ankle?”

What Is a Sprained Ankle?

Your ankle is comprised of bones held together by a bunch of ligaments. These ligaments end up getting damaged when you sprain or roll your ankle. We classify having a sprained ankle in several different ways. Depending on the ligament damage, you can have:

  • Grade 1, which is basically mild stretching of the ligament or some micro tears.
  • Grade 2, which is a large, yet incomplete tear of those ligaments.
  • Grade 3 which is completely torn. A Grade 3 you can further break down into a completely torn tendon or ligament that is
    • Retracted (meaning it’s been completely pulled apart and off the bone)
    • Non-retracted (meaning it’s still in good alignment)

How long does it take to recover from a sprained ankle?

If you have a Grade 1 or Grade 2 injury, typically this is anywhere from one to four weeks of recovery. If you have a more severe injury, such as a high Grade 2 or a Grade 3, this can take three to six months of recovery on its own.

What are the symptoms of having a sprained ankle?

Generally, there is immediate onset of swelling and pain around the ankle (typically located on the outside of the ankle). Once you recover, sometimes the ankle becomes unstable, meaning rolling, spraining, or repeat injury to the ankle becomes much more prevalent.

What are the fastest ways to heal a ligament?

If you have a mild Grade 1 or Grade 2 injury, this can be accomplished two different ways:

1) A simple prolotherapy injection, which is a hypertonic dextrose injection utilizing ultrasound guidance to guide the needle directly into the ligament to inject it.

2) Using your own orthobiologic (such as platelet rich plasma, which is a concentration of your growth factors) that we inject into the ligament to encourage increased blood flow and stimulate your repair mechanisms to ideally get that Grade 1 or Grade 2 injury back towards normal tissue. If you have a more advanced injury, such as a Grade 2 or Grade 3 injury, utilizing stem cells or bone marrow concentrate typically is indicated. If it’s a high Grade 2, sometimes you can get away with utilizing PRP to facilitate your ankle pain recovery as well as improve the function of the ankle.

Patient Testimonial

Let’s take a brief minute to talk with a patient of ours about the experience he’s had with platelet rich plasma in his ankle:

Question: What Treatment was Suggested Prior to Visiting With Us?

“Surgery! I had three ankle surgeons say, “We’re going to have to, in order to get you to function, take part of your hamstring tendons or bicep tendons or cadaver tendons and put them from this ankle bone to that ankle bone, and you’re going to be off your feet for three months. Three surgeons want to do that. So I come to Dr. Markle, an injection once a year and 50 percent improvement, then 80, then 99. It’s pretty amazing.”

Question: What Kind of Results Have You Experienced Since Your PRP Injections?

“My name is Paul Berger, and I’m a medical doctor myself, but I’ve had multiple injuries to my ankle and to my wrist, so I’ve been coming to Dr. Markle for a few years now here for PRP injections, and when I first came about four years ago, I could no longer run, I tried to walk with a golf bag and every time I would twist, I would get sharp pains.

“He did an injection that improved it about 50 percent the first few months. He did another injection it the second year and it was up to about 75 or 80 percent improvement. Then we did one more, and now I’m running on single track over rocks in the mountains, steep ups steep downs, rock climbing, playing tennis again, which I just didn’t have the opportunity to play tennis before, but now I can  run back and forth and not have any limitations in my ankle.

“Once or twice a year, I’ll get a little tweak that, I think, oh did I cause some pain, I mean, did I cause some damage, but then I forget about it for months. So I’m still running on uneven ground and not always in the best shoes, so it’s pretty amazing that I can do a partial ankle twist and then and then have it resolved in seconds. It’s just amazing that I can do all these activities again and have maybe three seconds of pain twice a year.”

Do You Have a Sprained Ankle?

If you or anybody you know have been dealing with a sprained ankle that’s not recovering or have been told you need orthopedic surgery for that sprained ankle, feel free to give us a call. You can reach out to us on social media or give us a call directly. We are happy to set you up with either an in-person evaluation or a Telehealth evaluation to further discuss and evaluate your problem.

Related: Brostrom Ankle Surgery: Reasons to Avoid This Surgery

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