Ankle Pain and Ankle Injuries

A torn or stretched ankle ligament can occur from simply walking down the street or when playing vigorous sports. The damage can range from mild to severe. A complete tear of the ankle ligament can cause your ankle joint to partially dislocate. This might sound like a pop and can be as painful as an ankle fracture. Immediate medical attention is required to determine the extent of your ankle injury.

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Ankle Instability Increases Your Risk for Chronic Ankle Pain
Mild ankle injuries benefit from medical attention too. Ankle sprains that don’t heal properly can weaken your ankle over time and lead to chronic ankle pain. Ankle instability can put you at increased risk for chronic ankle pain and ankle arthritis. Duke foot and ankle experts use a variety of imaging techniques to evaluate your ankle injury, including X-rays to look for broken bones, and MRI and ultrasound to evaluate the health of your soft tissues, including ankle tendons, cartilage and ankle ligaments.

Ankle sprains can be treated with the RICE (rest, ice, compression, elevation) method, ankle bracing, and nonsteroidal anti-inflammatory medications. When that's not enough, your foot and ankle specialist may recommend one of the following nonsurgical treatment options.

Steroid Injections

May be recommended to reduce pain and inflammation and increase ankle joint mobility.

Platelet-Rich Plasma Injection

This emerging technique is thought to regenerate torn and injured ligaments and tendons in the ankle joint. Plasma, which contains the body’s own growth factors -- substances that stimulate cell growth and promote healing -- is extracted from the patient’s own blood and injected into injured tissue. Studies suggest it may shorten healing time and possibly eliminate the need for surgery.

Stem Cell Injection

Stem cells can be extracted from your abdominal fat or bone marrow and then injected into your damaged ankle joint. The stem cells contain growth factors that promote healing, anti-inflammatory properties that reduce swelling, and hyaluronic acid, which lubricates and promotes new cartilage growth. The procedure may be recommended for people with ankle joint, tendon, or ligament injuries, including ankle sprains and ankle arthritis. The outpatient procedure is proving effective at reducing pain and stimulating the healing process. In some cases, it may delay the need for ankle surgery. 

Physical Therapy

Our ankle-specific physical therapists can help you avoid stiffness, increase your ankle strength, and prevent ankle instability. They work closely with your doctor to create a personalized sport- and activity-specific therapy plan to improve your mobility and strengthen your ankle, its muscles, and tendons. Your plan may include resistance exercises, water exercises, balance training, and endurance and agility exercises. 

Ankle surgery may be recommended if you have persistent ankle instability and chronic ankle pain that has not responded to months of nonsurgical treatment. Ankle surgery may be needed to clean out the joint or repair and/or reconstruct torn ligaments. If arthritis has caused extensive damage to your ankle joint, you may be a candidate for ankle fusion or ankle replacement surgery.

Ankle Arthroscopy

A tiny tube-like device with a camera at its tip -- called an arthroscope -- is inserted into the ankle joint through small incisions. Ankle arthroscopy allows your ankle surgeon to view your joint, clean away chipped bones and scar tissue, and repair or reconstruct ankle tissues that may be torn or stretched.

Ankle Ligament Reconstruction

Severely torn ankle ligaments may be repaired or reconstructed using tendons taken from elsewhere in the body or from donor tissue.

Ankle Fusion

Ankle arthrodesis, or ankle fusion, may be recommended if you have severe ankle arthritis and are not a candidate for ankle replacement surgery. Two bones below the ankle joint are fused together to reinforce the ankle and reduce ankle instability. The long-lasting procedure reduces pain and restores some function.

Ankle Replacement Surgery

Also referred to as ankle arthroplasty, this procedure can be the treatment of choice for severe ankle arthritis and damaged ankle joints. A metal or plastic ankle implant replaces the diseased ankle joint. Total ankle replacement surgery reduces pain and restores maximum function.

Innovative Avascular Necrosis Treatment

Chronic ankle pain can be a sign of avascular necrosis, a condition that occurs when the blood supply to the ankle is disrupted and can result in the death of ankle bone tissue. This can be extremely debilitating and painful, and even put the ankle at risk for amputation. Duke foot and ankle surgeons and plastic surgeons perform complex procedures that restore blood supply to the ankle bone in the face of serious ankle trauma, fractures, and joint damage. We are also using 3D printing to create replacements for foot and ankle bones when avascular necrosis is present. This innovation can prevent the need for amputation and help you regain much of your normal ankle function.

Sports Medicine Specialists
Our sports medicine specialists are trained to care for sports-related injuries and specialize in the treatment of every level of athlete. They include primary care doctors, physiatrists, physical therapists, and orthopaedic surgeons. They help you recover from an ankle injury, prevent injury, and can work with you to improve your sports performance. They help active individuals return to the activities they love. 

Extensive Experience
Duke foot and ankle experts perform hundreds of foot and ankle procedures each year. They are board certified and fellowship trained in foot and ankle surgery.

Leading Ankle Researchers
Our foot and ankle surgeons' extensive research on ankle sprains, ankle instability, and ankle arthritis has informed the way we approach treatment. We understand how ankle instability changes the forces that impact the ankle. The results of our research help us get you back on your feet faster.

Ankle Repair and Ankle Reconstruction Surgery
Our foot and ankle surgeons use the latest techniques to repair and reconstruct ankle joints with bone and tissue grafts. These advances can result in less pain and better function.

Ankle Replacement Surgery Advances
We have extensive experience with the newest ankle implants and procedures. We were involved in the development or refinement of many of the ankle implants used in total ankle replacement surgery. Some of the newer ankle implants are only available at major ankle centers like Duke. They get you back to weight-bearing activities sooner.

Minimally Invasive Techniques
When ankle fracture or ankle trauma is present, we use minimally invasive surgical techniques. The small incisions translate to faster recoveries and a quicker return to your daily activities.