Medial Ligament Injury
Injury to the medial (inner) ankle ligaments (deep and superficial Deltoid Ligaments (DL)) can cause swelling, bruising, stiffness and pain, particularly on the inner aspect. There can be difficulty in weight bearing and often, once the acute injury has settled, there can be instability symptoms as well.
What causes it?
The DL can be injured from an inversion (where the foot/ankle are moved inwards) or an eversion (where the foot/ankle is moved outwards) force. This can happen during sports such as basketball or soccer or from more minor trauma.
Sometimes there can be bony or tendon injury concurrently. 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, then 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 improve symptoms for many people, but in some situations where the problem is 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.