Lateral Ligament Injury
Injury to the lateral (outer) ligaments (Anterior Tibiofibular (ATFL), Calcaneofibular (CFL) and Posterior Tibiofibular (PTFL) Ligaments) of the ankle can cause swelling, bruising, stiffness and pain. There can be difficulty with weight-bearing and can be exacerbated if there is an associated bone injury. Often, once the acute injury has settled, there can be instability symptoms as well.
What causes it?
The ATFL, CFL and PTFL are usually injured when the foot is forcibly inverted (moved inwards) such as when landing from a jump in basketball or when playing soccer. Sometimes there can be bony or tendon injury concurrently. The tears need not be complete to cause significant symptoms.
How can I help myself?
It is useful to reflect on how and when the injury was sustained, to understand the mechanism and what else might be injured. If there is considerable swelling, pain and bruising, offloading with crutches or bracing the ankle can help as will following PRICE.
If there is considerable pain, pain killers, such as anti-inflammatories, can make the symptoms more tolerable.
When to seek help?
If you have tried to resolve the problem without much improvement and if your mobility or function is impaired, it would be good to have your problem assessed as soon as possible.
What are the treatment options?
Once your clinician assesses you with a thorough history and examination, they may undertake an X-ray to look for bony injuries, such as fractures, or an ultrasound scan to look at the ligaments and for associated tendon injuries.
Rehabilitation with a physiotherapist or podiatrist can alleviate symptoms for many people, but in some situations where symptoms are not settling or there is ongoing instability, then an MRI may be needed for further investigations. If tears are partial, then prolotherapy injections may help, but if the damage is more extensive, then a surgical intervention might be needed.