1: Is it possible for the ankle to wear out?
Yes. However, it is not easy for this to happen as the ankle cartilage is extremely resistant. There is usually a cause, like a previous severe fracture, recurrent sprains or an infection of the ankle joint.
2: Can I ignore a sprained ankle and allow it to heal on its own?
No. A typical ankle sprain is usually one where there is an isolated tear of the anterior talofibular ligament (ATFL).
The consequences are loss of strength in turning the ankle outwards and proprioception, or the sense of body position awareness.
Patients will find that their ankles are ‘clumsy’ and weak, even for weeks after the swelling has gone down. They tend to have recurrent sprains.
Strengthening and balance exercises are needed to regain ankle stability and prevent future sprains.
A sprained ankle can also comprise injuries apart from the ATFL tear – some of these can be serious and you will need to see a doctor to exclude these injuries.
3: Is Tui Na, a form of Chinese massage, an effective way of treating sprained ankles?
When we do deep massage over the torn ligament or manipulate the joint – like in Tui Na – we may increase the bleeding in the area and separate the torn edges further, reducing the chances of the ligament regaining its integrity.
In ankle sprains, we need to address the instability by doing active balance and strengthening exercises, since position awareness and strength are not derived from Tui Na.
4: If I have injured my ankle, what activities should I avoid and for how long?
First, it is best to have your ankle injury examined and treated. All sporting activities should be avoided until the injury heals.
Sprains: It depends if the injury is acute or chronic. If acute, it is best to rest, ice, compress and elevate the ankle before undergoing physiotherapy. For chronic sprains, physiotherapy is recommended.
If patients improve with physiotherapy, then they can gradually go back to doing sports.
If there is no improvement, surgical repair of the ligaments is recommended.
Fractures: Surgical treatment is usually recommended, followed by physiotherapy. It may take about six months to a year before you can resume sporting activities.
Ankle arthritis: Activity levels are dictated by the pain experienced by patients. If the pain is mild, they are advised to limit activities to low impact sports, like swimming or cycling.
However, if the pain is severe or bothersome, it is recommended that patients undergo surgery.
5: What if my ankle still hurts a month after I injured it?
Then it is unlikely to be a simple isolated ATFL tear and you need to see your doctor. Most isolated ATFL tears feel much better within two weeks.
6: I have injured my ankle more than once. What are the consequences?
Repeat injuries to the ankle typically leave it in poorer condition and predisposes it to arthritis.
It is therefore recommended that the ankle injury be diagnosed and given the appropriate treatment.
7: I have ankle arthritis. Can I go for ankle replacement surgery?
Ankle replacement is generally suited for ankle arthritis patients who are above 50, do not do heavy manual work and are not overweight. It is not for the active, the young and manual workers who lift heavy loads. The ankle prosthesis is an artificial joint and can wear out with heavy usage.
8: Do I need to take supplements for ankle health?
No. Glucosamines have been recommended for joint health. However, there is no evidence that it helps in the ankle joint.