Heals a broken ligament

Torn ligament in the ankle


It often doesn't take much to get an ankle injury. One wrong step, a brief stumble or a little inattentiveness - you bend over. Even in sports, rapid movements and changes of direction can quickly lead to one Ankle trauma come. If the person concerned has a relatively strong twist, it is not uncommon for a ligament to tear in the ankle. But what should be done in such a case? How long does it take to heal? And what service can supports and orthotics do? These and other questions are answered in the following text.

 

Definition of the ligament tear

A torn ligament in the ankle is a partial or complete tear One of the ligaments in the upper ankle ruptured, which is also known in common parlance as the ankle. If the ligaments are partially or completely torn, they can no longer fulfill their functions adequately, which can lead to the affected joint Loses stability and is restricted in its mobility.

If there is a torn ankle ligament, one or more ligaments may be torn. Depending on the severity, doctors classify the various ligament injuries in the ankle joint into Grade 1 (ligament stretch / ligament strain), Grade 2 (partial ligament tear) and Grade 3 (complete ligament tear in at least one ligament). In the case of a torn ligament at the ankle, the connective tissue around the injury and the adjacent blood vessels are often injured or damaged and overstretched.

Immediate measures in the event of a torn ligament

If the ligament is torn, the so-called "BAD LUCK-Method "can be considered as an immediate measure. This is the abbreviation for the following areas:

  • Break. This means that you should take care of yourself immediately and no longer put any weight on the injured foot. Further exposure can not only worsen the injury, but also lead to even more pain and swelling.
  • ice. After an ankle trauma, which may result in a torn ligament, cooling the affected foot can help reduce swelling and pain. Of course, you can't repair injured ligaments through this, but it makes the first minutes and hours after an injury more bearable. It is not for nothing that you can see the immediate cooling of the injured area almost every day in top-class sport.
  • Compression (German: compression). Compression is also important, especially to reduce the swelling a little. If a compression bandage is quickly placed around the injured ankle, it can no longer bleed into the foot as much. This immediate measure not only reduces the swelling, but ultimately also ensures less pain.
  • Elevate. If there is a ligament injury in the foot, elevating the affected ankle can also prevent the swelling from becoming as severe. Even so, less blood can flow into the foot, and the first waste materials can be transported away via the lymph vessels. In addition, elevating the ankle is ultimately less painful than if the injured foot sagged.

The quickest possible measure is also deemed to be an immediate measure Examination by a doctor. After a torn ligament, pain relievers have also proven effective. As a rule, in acute cases, the doctor will give medication with the active ingredients ibuprofen or voltaren. Especially at night, these remedies help to get a reasonably restful sleep despite the injury.
The following immediate measures are indicated:

  • "PECH" rule
  • Examination by the doctor
  • medical therapy

 

Structure of the ankle and ligaments

The ankle joint is divided into two parts: the upper and lower ankle. The upper ankle joint is made up of the ankle joint fork, calf bone and shin bone and enables us to bend and stretch the foot. The lower ankle joint, which lies between the ankle bone and the tarsus and is made up of the ankle bone, the heel bone and the so-called tarsal row, can turn the foot outwards and inwards, i.e. raise and lower the inside and outside of the foot.

The various ligaments in our body consist of connective tissue and hold the individual joint bones together. All ligaments of the ankle joint, both the syndesmosis, which connects the tibia and fibula with one another, as well as the inner and outer ligament complex, are of great importance for stability under load and for joint guidance.

Most common cause: twisting ankle while exercising

Injuries such as stretching and straining the ligaments as well as a complete ligament tear at the ankle, especially the outer ligaments, are among the most common injuries in sports, but also in everyday life. A torn ankle ligament is one of the most common reasons why a patient visits the trauma surgery clinic. Especially people with a congenital one Connective tissue weakness tend to be more Twist and therefore have a greater risk of tearing an ankle ligament. 20 percent of all sports injuries can be traced back to a torn ligament in the upper ankle. While ligament tears of the outer ligaments in the upper ankle are the most common, the inner ligaments in the ankle are relatively rare.

During sporting activities, especially running and the Ball sports like soccer, Basketball but also hockey, the typical ligament tear in the ankle occurs. This is caused by the sudden application of force and the massive pressure caused by abrupt stopping. This is because the three outer ligaments of the upper ankle in particular are overstretched towards the outer edge of the foot until the ankle can tear. Internal ligament tears, on the other hand, are very rare because they are very stable and resilient.

You can only prevent a torn ligament to a limited extent. Coordinative exercises help strengthen the ligaments.

Symptoms: Severe pain and bruising

The typical symptoms of a torn ligament are strong pain as Swelling and bruising with blue discoloration (hematoma) on the affected area. If the ankle has a torn ligament, the foot is strong, depending on which ligaments are torn Limited mobility. For this reason, athletes who usually tear an ankle ligament can hardly put any strain on their feet. If there is no pressure or strain on the foot by stepping on it, this is an indication of a complete torn ligament in the ankle.

However, it can happen that a ligament tear in the ankle is less painful than a ligament stretch or strain, since a complete ligament tear also destroys pain receptors. It is therefore not always possible to infer the degree of the injury from the intensity of the pain. For this reason, if the patient has ankle pain, they should consult a doctor for diagnosis and treatment.

This is how the torn ligament is diagnosed

Since it is not always possible for the person concerned to choose between one Ligament stretching or a ruptured ligament in the ankle too distinguish, it is necessary to consult a doctor in the event of pain in the ankle. The doctor asks about the symptoms and the history of the accident or the history of the injury in an anamnesis interview. This enables the doctor to draw conclusions about the type and severity of the injury and to take further steps towards an exact diagnosis.

After the doctor said that Ankle joint felt thoroughly and has been examined for its stability, resilience and mobility, imaging procedures are usually such as X-rays claimed. With the X-ray images, possible broken bones can be excluded and misalignments can be detected. In order to be able to recognize the torn ligament on the ankle, one would have to Magnetic resonance imaging be performed. However, this is only used if the doctor's examination does not allow a clear diagnosis based on the symptoms found.

What treatment options are there?

The question of how to treat a torn ligament depends on several factors. First of all, it is important how many ligaments have been affected. Is there just one ribbon torn? Or several ligaments including the joint capsule? The question of which ligaments broke also plays an important role. While with outer ligament tears only rarely an operation If the syndesmosis is ruptured, it can look completely different again.

Conservative therapy

Torn ligaments in the ankle are usually treated conservatively. That is, you can get the affected foot not operated on, but gets the patient fit again in several phases. In the acute stage are only once Peace and quiet announced, you wait until the swelling has largely subsided. As a result, the patient is then targeted with a physical therapy treated. This can also consist of several parts.

Physical measures like

help fight pain and get the rest of the swelling out of the joint. At the same time, the patient can start exercising again in the form of strength or coordination exercises. The coordination exercises in particular play an important role here, as the interaction between the spinal cord, brain, nerves, tendons, ligaments and muscles must be relearned. Balance cushions, special balance tops or various exercises are used here. Under the guidance of an experienced therapist, the patient gradually returns to his previous level.

Operative therapy

In the case of external or internal ligament injuries in the ankle, surgery is more likely less common displayed. If, however, in addition to the ribbons, too bony parts affected can be a OP necessary become. Since the syndesmosis ligament is anatomically part of the ankle joint - and can also be damaged by an ankle trauma - tearing of this ligament can make an operation necessary.Even if this ligament is only torn, the overall stability of the ankle joint can be so severely limited that only an operation can help. During surgical therapy on the outer or inner ligaments, the injured ligament structures are sewn and free joint bodies are removed. Tear that Syndesmosis tape, not only is the band sewn, but an adjusting screw is also inserted between the tibia and fibula so that the band can heal in peace and stress-free. Alternatively, there is also the tight rope technique, which serves the same purpose.
Treatment methods for a torn ankle ligament:

  • conservative therapy
  • operative therapy
  • professional physio as part of both methods

Course of healing after conservative vs. surgical therapy

After an operation, the patient is usually absent longer than would be the case with conservative therapy - both for work and for sport. The reason: In an operation, in addition to the healing of the repaired ligament structures or bones, factors such as wound healing or the removal of the suture material must also be taken into account.

When looking at the healing process as a whole, however, both variants have a lot in common. For example, professional physiotherapy must be performed even after an operation. Because even if the ligaments have been surgically repaired, the coordination skills must be regained.

The same goes for strength, endurance and flexibility. The accompaniment of an experienced physiotherapist is therefore equally important for both methods.

Grace period - when can you do sports again?

There is no general answer to this question, as various factors are also important here. If a ligament is only stretched, a fairly short sports leave is usually sufficient. If a band or even several bands are torn, this period can be longer. As a rule, torn ankle ligaments heal within a period of four to six weeks out. Much depends on the therapy. Were the right immediate measures taken at the beginning? Has the patient taken care of himself sufficiently? Was the injury treated conservatively or surgically? What is the general "healing flesh" of the patient? With a rupture of the syndesmosis, the patient is absent for a long time. When the affected foot operated on must be then resumed sporting activity not before the end of three months to be expected. The adjusting screw alone is only removed after six weeks. Only then can the load be increased gradually.

In the case of ligament injuries in the ankle joint in particular, a special feature can often be determined: Many patients report that a tear healed faster than a stretch. Often, however, this is a rather subjective feeling on the part of the patient himself.

The likelihood of a new ligament rupture

If a patient twists and tears their ligaments more often, then over time it can happen susceptible for such an injury becomes. If ligaments tear often, they can become loose and unstable. If this is the case, then they can no longer fulfill their supporting and guiding properties. The joint capsule can also "wear out" and impair the stability of the foot. The result: Small stumbling blocks or bumps on the way are often enough to bend over again. In such a case, surgery can be performed to restore tension to the ligaments.

Bandages and orthotics for the ankle

Supports and orthoses have different functions. Immediately after the twisting trauma there is often a Rail prescribedthat immobilizes the foot. It also prevents the foot from twisting again. After a while, this can be exchanged for a neoprene stocking, which is often equipped with appropriate pads. In this way, a certain degree of stability can be achieved in the patient.

Other aids are often made available to competitive athletes in particular. A Orthosis made of carbon about is light and very comfortable to wear. In many cases, a plaster cast of the foot is made for this so that the orthosis can be built precisely. It then ensures stability during sporting activity. Also from a psychological point of view are Bandages and orthotics are very important. Since the patients tend to be hesitant and sometimes a little anxious to work, especially in the early days, bandages and orthoses give a feeling of security. There is no general answer to whether the patient will wear a bandage or orthosis even after injury and treatment. Some patients take them off soon, while others continue to wear them months or years after the ankle trauma.