Minor Injuries: Seeking Treatment in a Timely Manner

You've been plagued by frequent ankle sprains for years. Your doctor has diagnosed you with a chronic ankle instability. The cure for you is replacement of the worn ankle joint with an artificial one. Here is what you can expect from this ankle surgery and the subsequent recovery to get you back up on your feet and free of the fear of having another ankle sprain.

What This Surgery Does to Cure Your Ankle Instability

Your ankle is made up of the lower leg bone, the tibia, resting on an ankle bone, called the talus. Ligaments hold these two bones together and tendons attach muscles to the bones. This arrangement allows your ankle joint to move in multiple directions while holding it secure. In the case of ankle instability, the bones can be deformed, or the ligaments and tendons become overstretched so the joint doesn't stay in place.

During the joint replacement procedure, the orthopedic surgeon reshapes the tibia and talus to receive the artificial joint components. These are made of metal and plastic and designed to fit firmly and move smoothly together. The ligaments and tendons are reattached to the bones to hold the ankle together more securely. The result is an ankle that has less freedom to move out of alignment, which reduces your risk of spraining your ankle.

Recovery After the Surgery

You'll spend a few days off of the ankle while the tissues heal. Ligaments heal slowly because they lack the blood supply of other soft tissues. While they are healing, you're at risk of injuring the ankle by putting too much stress on it. Your doctor will have you keep weight off of your ankle and may have you wear an ankle support to keep it fixed in place. You'll see the orthopedic doctor a few days after surgery and, if they are satisfied with the rate of healing, they will have you begin physical therapy to regain full use of the ankle.

Physical Therapy

Your ankle will be stiff and the muscles weak from lack of use. Physical therapy builds your ankle back up so you have normal movement and support as you walk. The initial phase of therapy addresses ankle movement and then is followed by strengthening work. You'll spend several weeks in each phase to regain full use of your ankle.

Range of Motion

The first step in your physical therapy is to stretch out the muscles in and around the ankle joint so you have normal movement in all directions. There are two phases to this step:

• Passive range of motion - The physical therapist moves the ankle for you through all of its motions. They slowly stretch out the muscles without putting too much stress on the joint. The therapist will show you how to do this yourself at home between sessions.
• Active range of motion - As you begin to get back normal motion in the ankle, the therapist will have you move the ankle by itself through all of its directions. They will measure your progress at each session. When your ankle has achieved nearly normal movement, you'll begin the next phase of physical therapy.

Muscle Strengthening

Now that your muscles have been fully stretched out to their normal lengths, you'll begin strengthening the muscles. The therapist will have you work with resistance machines and you'll begin walking more. You'll set a pace with the therapist which comfortably exercises the ankle without putting too much stress on it. Weeks into your recovery, you can still overwork your ankle and injure the ligaments and tendons. This can set your recovery back several weeks and may even require additional surgery. Talk to your doctor, such as Surgery Center of Kenai, for more help.