Have you just had a torn ankle ligament? Are you wondering about the treatment and recovery timeline?
In this article I will answer your frequently asked questions about ankle torn ligaments and treatment options.
I will rely on my knowledge as a diagnostic radiographer and on medical scientific studies.
Happy reading!😃
Any questions? remarks? Let’s meet in the comments section at the end of this article.🙏
Last updated: Dec 2024. Written by Juliet Semakula, a diagnostic.
Disclaimer: no affiliate links.
▶️What is meant by ankle ligament rupture?
The ankle joint is surrounded by different ligaments which are divided into three groups.
1️⃣The lateral ligaments.
2️⃣The deltoid ligament on the medial side.
3️⃣The ligaments of the tibiofibular syndesmosis that join the distal epiphysis of the bones of the leg (tibia and fibula).
These ligaments insert into the bones of the foot and help to stabilise the ankle, to prevent it from twisting in all directions with each step.
When you twist your ankle, these ligaments can
🟣 Distend or stretch
🟣 Break partly on one end or their width.
🟣 Break completely into two.
A sprain occurs when these ligaments have been stretched beyond their limits
Picture of a person’s foot with a torn external ankle ligament.
When you go to the doctor after an examination, you may be told what kind of ankle sprain you have got.
▶️The 3 types of ankle ligament injury.
Ankle ligament injury is the most frequent cause of acute ankle pain and how the ligament is stretched, partially or completely torn will determine the stages of severity of the sprain.
🟡The most common mechanism of injury to the ankle ligaments is inversion of the foot. If it is mild, it will be stage 1 or grade 1 sprain.
🟡For partially torn moderate ankle sprain, it will be stage or grade 2 sprain.
🟡For severe ankle sprain the ligament is completely torn and this is stage or grade 3 sprain.
An eversion injury will cause damage to the deltoid ligaments. While a hype dorsiflexion trauma might cause an injury to the syndesmotic ligaments
A total rupture involves the calcaneofibular ligament and the posterior talofibular ligaments as well.
But be rest assured, even if you have a serious sprain the pain associated with a sprained ankle will not necessarily last longer as well.
▶️How do you know if your ankle ligament is torn?
The only way you can be sure it is a sprain and not something else is consulting a healthcare professional who is used to diagnosing sprain.
You may experience some of these symptoms after your injury.
🟡Pain and swelling
🟡A wobbly unstable joint in the ankle
🟡A pop or snap felt at the time of the injury.
🟡Limited movement mainly because of pain.
🟡Pain, especially when you bear weight on the affected foot.
🟡Tenderness when you touch the ankle.
🟡Bruising at the site of injury.
You may have symptoms above but sometimes these symptoms are the same for a fractured ankle or other rarer ankle problems or nerve damage.
▶️The relevance of imaging tests for diagnosis.
Having symptoms alone do not confirm that you have sprained your ankle.
When you go to the doctors you will have to be examined and sometimes x-ray imaging will be requested to rule out any other associated injuries.
An x-ray will be requested to rule out other injuries as fractures but not ligaments because they usually do not show torn ligaments.
An MRI scan may be requested to confirm the diagnosis and assess the severity. It can also diagnose damage to nearby joints and tendons
▶️Treatment of an ankle sprain or tear.
For most patients I see, the symptoms of an ankle sprain usually settle with selfcare.
Those with persistent symptoms beyond a year may need treatment.
Treatment options
1️⃣Self-care at home
♦️Your doctor will advise you to rest and take the weight off your injured leg for a day or two.
♦️You will be advised to apply ice packs to help relieve the pain and reduce the swelling. Wrapping ice cubes or a bag of frozen peas in a towel and apply the ice pack for 10 to 30 minutes.
Do not apply ice directly to the skin as it may damage the skin.
♦️ Wearing compression stocking or strapping may help to reduce swelling and support the ankle.
♦️Elevating your leg will also help reduce the swelling.
♦️Gentle exercises to your ankle are recommended when comfort allows to prevent stiffness.
2️⃣Non-Operative-physiotherapy
When you have had a severe sprain or if symptoms persist you may need physiotherapy to help improve your symptoms with simple exercises.
♦️Exercises will concentrate on strengthening the ankle muscles and on improving ankle balance.
♦️You may be given an ankle brace to help support your ankle and this may ease your symptoms.
3️⃣Operative options
Surgery will only come in if all non-operation options are not helpful. It is usually reserved for patients with lateral ligament ruptures to avoid unnecessary invasive treatment and risk of complications
Occasionally when you have sprained the lateral ligament of the ankle. It is very difficult to heal properly resulting in weakness and ankle instability.
Also, when you have damage to surrounding joints or tendons this may cause persistent pain and swelling.
So surgical treatment will depend on how bad the severity of the lateral ligament and the surrounding soft tissue is damaged.
The aim of surgery is to reduce your pain, reduce instability and improve your function.
The two types of surgery for the lateral ligament complex injuries are:
1️⃣Your injured ligament will be tightened and re-attached.
2️⃣Or a nearby tendon can be used to replace the ligaments.
This surgery is usually done under general anaesthetic. You may be able to go home that day or may require an overnight stay in the hospital.
These decisions depend on your health and social situation. A decision will be made with you.
Post operation recovery.
After the surgery your leg will usually be in a below knee cast or boot for approximately 6 weeks depending on the severity of ligament damage.
It is important to keep your foot elevated. This reduces the swelling and helps the wound heal.
You will be given a follow up after two weeks to have the wound reviewed.
When you come out of your cast or splint physiotherapy may be arranged to help you with simple movements.
It usually takes six months for the ligaments to heal and usually a year to recover if you have had surgery.
▶️How long does swelling last after an ankle ligament rupture?
After you have had an ankle sprain, you will experience pain and swelling straight away.
What causes this swelling:
Swelling is a kind of inflammation when there is increased movement of fluid and white blood cells into the injured area.
The release of chemicals and the compression of nerves in the injury causes swelling which is a normal health phenomenon.
These chemicals contain nutrients and other subsistence that will help damaged tissues heal.
The tears may take several weeks to heal, and swelling may take up to 2-3 weeks or longer. In some people swelling may even last several months or years later.
But your ligament can be completely healed and functional even if you still have swelling. This should not be a sign of concern or non-healing. But if worried you can always consult your doctor.
Swelling will depend on the amount of stretching and tearing of the ligaments. Typically swelling lasts 2 to 3 days or more.
You may notice more swelling in the evening after a lot of walking. It will get less with time and healing will take place more rapidly if you follow your doctors’ instructions.
▶️How long does pain last after an ankle ligament tear?
Based on research studies done with patients with previous ankle sprain injuries, after a follow up.
The assessment and measurement of pain after a severe ankle sprain (grade 3) is presented as:
🟢 Pain decreased rapidly within the first 2 weeks after injury.
🟢Pain continued to decrease after that, although more slowly.
🟢The proportion of patients who reported that they experienced pain after a follow-up period of 1 year or longer still ranged from 5% to 33%.
🟢Even after 3 years follow-up, 5% to 25% of patients still experienced pain.
Rogier et al 2008
▶️How long does it take for an ankle ligament to heal?
A systematic review study published in 2008 to determine the healing time of lateral ankle ligaments after it is torn or stretched.
Here is what was concluded:
🟢Stability of an ankle sprain ligament took at least 6 weeks to 3 months after injury for healing to occur.
🟢Some people even after 6 weeks to 1 year still had objective mechanical softness and subjective ankle instability.
Hubbard 2008
When you have had an ankle sprain, you may read or hear that healing time for a ligament will take 2 weeks for mild grade I injury, 6 weeks for grade II moderate injury and 6 months to a year for severe grade III injury
Why do these durations vary?
In the medical field usually different criteria is used to define the healing of a ligament: some based on:
🟢Soft tissue damage returning to normal.
🟢Swelling and pain decreases or disappears.
🟢Physical therapy to restore joint stability and function.
Regardless of the type of injury, your body’s natural healing process and the doctor’s tips will help to speed up your recovery.
What you should know is that it is possible to gradually resume your activities even if the ligament is not completely healed.
▶️What is the total healing time for an ankle ligament after rupture?
| phase | Timeline recovery |
| You have much less pain | Within 2 weeks, a rapid improvement of pain experience was seen in most patients with acute ankle sprains. |
| Swelling decreasing | Most swelling resolves after 2- 3 weeks but some may have permanent swelling. Some studies show that within 6 weeks follow-up, there might be some difference in persistence of swelling.(Rogier et al 2008) |
| Resume walking without crutches | A few weeks |
| Resume sports like bike riding | A few days to a few weeks or even months depending on the activity and its intensity |
| You can drive your car | A few days to a few weeks |
| Grade I sprain full recovery | Can take 1-3 weeks |
| Grade II sprain full recovery | Can take 3-6 weeks |
| Grade III sprain completely ruptured. | A few weeks to a few months. 50 % of people say they are completely healed in 2 weeks max. And when you ask people who have had a sprain 3 years after the sprain, 85% say they are completely healed (Van Rijn 2008) |
Recovery times after a torn ankle ligament.
▶️Is it OK to walk with a torn ligament?
Yes, you can still walk on a torn ligament, thanks to the other ligaments and supporting structures in your ankle.
But you may feel a lot of pain and a sensation of weakness and instability as you walk. Try to reduce your activity and walk as normally as possible.
Simply walking and stretching your foot will help to make the muscles and ligaments stronger and more flexible.
You can decide to rest your ankle in the first days after injury until pain allows. You should not push your body too much.
Focus more on gentle stretching and strengthening the muscles and ligaments.
Avoid forceful or strenuous activities, like running or jumping, until the pain and swelling has settled.
We have come to the end of this article, wishing a quick recovery.
Any questions let’s meet in the comments section. Below are some of the articles I have used.
📚Sources.
Golanó P, Vega J, de Leeuw PA, Malagelada F, Manzanares MC, Götzens V, van Dijk CN. Anatomy of the ankle ligaments: a pictorial essay. Knee Surg Sports Traumatol Arthrosc. 2010 May;18(5):557-69. doi: 10.1007/s00167-010-1100-x. Epub 2010 Mar 23. PMID: 20309522; PMCID: PMC2855022.
Vuurberg G, Hoorntje A, Wink LM, van der Doelen BFW, van den Bekerom MP, Dekker R, van Dijk CN, Krips R, Loogman MCM, Ridderikhof ML, Smithuis FF, Stufkens SAS, Verhagen EALM, de Bie RA, Kerkhoffs GMMJ. Diagnosis, treatment and prevention of ankle sprains: update of an evidence-based clinical guideline. Br J Sports Med. 2018 Aug;52(15):956. doi: 10.1136/bjsports-2017-098106. Epub 2018 Mar 7. PMID: 29514819.
Van Rijn RM, van Os AG, Bernsen RM, et al. What is the clinical course of acute ankle sprains? A systematic literature review. Am J Med 2008;121:324–31.
Rogier M. van Rijn, Anton G. van Os, Roos M.D. Bernsen, Pim A. Luijsterburg, Bart W. Koes, Sita M.A. Bierma-Zeinstra,What Is the Clinical Course of Acute Ankle Sprains? A Systematic Literature Review,The American Journal of Medicine,Volume 121,Issue 4,2008,Pages 324-331.e7,ISSN 0002-9343,