EXPERT ADVICE: How to deal with ankle pain from injuries with leading physiotherapist Tim Allardyce

 Physical Therapist, Tim Allardyce from Surrey Physio, gives professional advice on how to diagnose and treat common ankle injuries such as twists and sprains. 

Question: I have an ankle injury and may have cartilage injury in both feet.  How long does an ankle injury and cartilage injury take to heal? -Sandi

Expert’s response:

Dear Sandia

The first thing to establish is an accurate diagnosis. When you say you “may” have a cartilage injury in both feet, how was this diagnosed? I would question the diagnosis because cartilage injuries, per se, are actually quite rare in the feet and for both feet to occur together, it would be unusual. Unless of course, you have suffered a previous fracture to both feet, there could some degenerative changes occurring, or if you are over the age of 50-60 you might have degenerative change.

So I would say the first thing you need to do is to get your feet checked by a physiotherapist, osteopath or podiatrist. Let them examine and assess the feet, and to establish a diagnosis. If that’s not possible, then you may need to get a referral for an MRI scan. If the problem is with both feet, this would be considered two parts, and would require two scans. Prices have come down significantly and some centres charge as little as £200-250 per body part.

Without proper rehabilitation your ankle will likely be weak and susceptible to further sprains.

If the problem is cartilage, healing can take months and possibly over a year. Cartilage often does not repair very well, but it really depends on where the cartilage tear is, and how bad the tear is. Complicated degenerative cartilage problems may never recover, and in these cases, a surgeon may opt to fuse the bones affected to stop further degeneration. However, if you are lucky, you may just find your foot adapts to the cartilage problem and with time the pain simply disappears.

The most common ankle injury by far is a ligament sprain. Its incredible common and it’s not unusual to see it both sides. Typically females who are sporty (especially who have played netball) are prone to ankle sprains. During an ankle sprain, the ligament(s) around the ankle can tear. Once the ligament tears, without proper rehabilitation your ankle will likely be weak and susceptible to further sprains.

75 per cent of all ankle sprains are recurrent, meaning that when they occur it’s probably not the first time

In fact, around 75 per cent of all ankle sprains are recurrent, meaning that when they occur it’s probably not the first time. Ligament injuries are graded I, II and III, with I being a smaller sprain taking about 4-6 weeks to heal, grade II a more severe sprain taking 6-12 weeks to heal, and grade III a rupture taking 3 months + to heal. Working with a physiotherapist is essential to help promote healing, and increase strength around the ankle. If that’s not an option, then you can look at doing some exercises on your own but start gently, and stop the exercise if you get any pain.

If you have a freshly sprained ankle ligament, we recommend resting it or only applying minimal weight bearing through the joint for the first 48 hours, and using ice to the ankle joint to reduce swelling:

Use these exercises to gain mobility to your ankle:

Balance exercises can be very useful and here are some I would suggest:

and then progressing to eyes shut:

You can also use a wobble board

Or you can use a BOSU ball – start with the curved side up

and progress to the flat side up

Try this advice first, but Sandia feel free to come back to us if you have any more information about your diagnosis.

Tim Allardyce is a physiotherapist who  works with the Surrey Physiology Clinic. He specialises in sports physiology and osteopathy. Visit his company’s page at surreyphysio.co.uk

(All videos in this post courtesy  rehabmypatient.com)