Repeat ankle sprains can have a long-term impact beyond the inconvenience of getting about. Here orthopaedic surgeon DR JEFFREY TAN gives advice on ankle instability and pain caused by sprained ankles.
Tell us about the ankle and the role it plays in our body.
It’s a hinge joint that allows the body to move, maintain balance and transfer weight to the foot. Ankle ligaments on the inner and outer side of the ankle prevent the joint from twisting, folding or collapsing, and absorb shock when the foot hits a surface.
A normal healthy ankle should allow you to perform full movements during daily activities and exercises without pain, swelling or impingement. These actions include dorsiflexion (foot pointing up), plantarflexion (foot pointing down), inversion (foot turning inwards) and eversion (foot turning outwards). The ankle should also be stable enough to support up to eight times your body weight when you run and allow you to walk on uneven surfaces without twisting easily.
What are the main causes of a sprained ankle?
Recurrent sprains most often occur due to inadequate rehabilitation, which prevents proper recovery of injured lateral ankle ligaments. As a result, the ligaments remain stretched, weak or unstable. Additionally, the muscles on the outer aspect of the ankle may remain compromised and inadequate to counter the effect of a sprain.
People with a history of previous ankle injuries are at risk – with athletes who participate in court and field sports at the highest. Walking on slippery or uneven surfaces can increase the chances of injury. People with excessive inverted heel posture (termed “hindfoot varus”) are also prone to recurrent sprained ankles.
How do repeated sprained ankles impact joint health long-term, and when should someone seek help?
How do repeated sprained ankles impact joint health long-term, and when should someone seek help?Sprained ankles may result in torn ankle ligaments. There are different grades of injury, such as a strain, incomplete tear or a high-grade complete tear. It may involve just a single ligament or a combination of ligaments. If the torn ligaments aren’t completely healed or adequately rehabilitated after each injury, this will cause chronic instability, a condition where the ankle becomes unstable and more susceptible to repeated injury again in the future.
Repeated sprains may result in scar tissue that impinges on ankle movements and causes pain. Some repeated sprained ankles unfortunately cause cartilage injuries in the joints which may not heal, resulting in chronic pain or even arthritis in the long term.
While a mild sprain may heal with rest, people who remain symptomatic (pain, swelling or limping) after a serious sprain or have a history of recurrent ankle sprains should seek medical help. A foot and ankle specialist can help to assess the injury and formulate a treatment plan to help them rehabilitate and heal appropriately.
What treatment options work best for chronic ankle instability?
We usually start with a trial of conservative treatment, including a course of rehabilitative physiotherapy to restore muscle strength and train the balancing and proprioception function (sense of position) of the ankle. Bracing, sports taping of the ankle and wearing high-cut running shoes that wrap around the ankle may be tried for sporting activities.
Surgery that involves repair of the lateral ankle ligaments may be needed for more severe instability which fails all the above conservative measures.
Describe your approach to patient care in four words.
Don’t neglect sprained ankles!
About the doctor
Dr Jeffrey Tan is a consultant orthopaedic surgeon with over 18 years’ experience, specialising in lower limb reconstruction, with a particular focus on foot and ankle surgery.
Island Orthopaedics
Mount Alvernia Medical Centre and Gleneagles Medical Centre.
6356 0588 | 8764 6107 iog.com.sg
This article first appeared in the March 2025 edition of Expat Living. You can purchase the latest issue or subscribe, so you never miss a copy!
To make the most of living in Singapore, read our latest City Guide here for free!
