Ligaments are soft connective tissue between bones. Foot ligament injuries are commonly caused by the twisting or stretching of the feet beyond their normal range of motion. Ankle sprains often result in injuries to the anterior talofibular ligament. These are also the most common type of sprain that results in ligament injury. It is worth knowing that a sprain differs from a strain. Sprains affect the ligaments while strains are felt on the tendons.
Improper footwear and walking or running on uneven surfaces can lead to foot sprains characterized by injured ligaments. If you participate in sports such as football or athletics, you need to wear proper footwear for balance and cushioning.
Ligament injuries are graded as minor, moderate, or severe. If the ligament is mildly stretched or torn, the injury is considered minor. Larger tears mean that the injury is a moderate one. If the ligaments are completely separated from bone, then the injury is classified as severe. Your age and health are factors that influence the time taken for the injury to heal.
What are the Symptoms of Ligament Injury?
- Inflammation – The injured part of the foot swells and may turn red.
- Pain – You’ll feel pain immediately after the injury. The pain can persist for days before subsiding along with the inflammation. It is felt more acutely on trying to place your weight on the foot.
How to Diagnose Ligament Injuries?
Foot and ankle sprains are common causes of ligament injuries. Correct and timely diagnosis of such sprains and the resultant ligament damage is essential for initiating treatment. The foot is made up of 26 bones and 33 joints. The following diagnostic tests help doctors determine the nature of ligament injury.
- X-rays – X-rays help doctors to eliminate fractures as a cause of swelling. Ankle dislocations show up on X-rays.
- MRI Scans – These scans develop images of the soft tissue and can help doctors understand the extent of damage as well as the location of damage to the ligaments.
How to Treat a Foot Ligament Injury?
The treatment varies with the severity of the injury. Injuries graded minor to moderate can take up to four weeks to heal. Severe injuries can take up to two months and may necessitate a cast. For a really bad ligament tear where the tissue has been torn free off the bones, surgery may be required to reattach the ligaments. Recovery from such a surgery can take up to 8 months.
Common treatment procedures include:
- Doctors advise rest to allow the ligaments to heal. You should avoid putting pressure on the injured foot.
- Ice packs help bring down inflammation. Apply ice packs up to four times a day, for 15 – 20 minutes each time. Continue with the ice packs even after gradually resuming physical activity.
- Anti-inflammatory medication is prescribed to reduce pain. The medication may be an NSAID or a steroid.
- Orthotic supports can help in absorbing the impact on the recovering foot during walking and running.
- Elevating the injured foot drains the fluids from the site of the inflammation and speeds up the recovery process.
- Compressive bandages help control swelling in the early days of the injury. These help mitigate pain as new scar tissue is formed.
- Physical therapy helps in regaining muscle control after injuries to the ligaments. Your doctor and physical therapist will advise you on the right type of exercise and the appropriate time to begin.
- As mentioned above, surgery may have to be performed to repair injured ligaments or reduce bones and alter muscle to allow the ligaments to attach correctly.
Early treatment and physiotherapy interventions help the injury heal faster, bring pain relief quicker, allow the patient to get back to full activity within a shorter span of time, and ensure that biomechanical faults do not creep in due to scar tissue formation and lack of movement.
A delay in treatment or worse no treatment can result in unnatural scar tissue formation, stiff muscles and joints, and weakness in the affected area. Also, the pain may never really go away.
When Should I Visit the Doctor?
A minor ankle sprain with a mildly stretched ligament does not require a visit to the doctor. The swelling and pain will usually subside in a coupe of days. However, if the injury is causing unbearable pain that is seriously hampering movement or if the pain has not subsided even after a few days then you should schedule an appointment with a doctor.
It is possible that the severity of the injury leaves no room for doubt that a visit to the hospital is required. A ligament injury can be considered this severe if you simply cannot place your weight on the injured foot, if the injured ankle cannot be moved, if the ankle appears out of shape, and if the pain and swelling are also present in the calf and below the knee.
Your doctor will help you with answers to questions about the nature of the injury, activities to do and those to refrain from, safe pain medications, time taken for recovery, chances of relapse, and how to ensure a quick return to full activity.
Returning to Activity After the Injury
A gradual return to activity is advised after the recommended period of rehab. Resuming activity before the injured ligaments have healed fully may worsen the injury. A delay in giving the foot some exercise and movement may lead to the formation of scar tissue that can impede a full range of motion. Therefore, consult your doctor on the most opportune time for easing back into relevant physical activity after a foot ligament injury. The severity of the injury decides when you can make a return to activity. Pace yourself and perform stretches and exercises to facilitate healing and prevent stiffness. While some discomfort when you first return to activity is to be expected, a sudden increase in pain or discomfort may be a signal that you need to slow down. For most mild to moderate ligament injuries to the feet, you can begin placing some of your weight on the injured foot after the pain has subsided and the inflammation has reduced.
As far as returning to full-fledged sporting activity is concerned, you can do so after you can run, jump, and stretch without feeling pain and you can feel that strength has returned to the injured foot.
Wear protective footwear when exercising your foot or walking after a ligament injury. A high-top shoe supports the ankle while a stiff sole helps maintain balance. Avoid walking in slippers or sandals as these can stress the injured area and trigger inflammation and pain. Ice the feet after a session of physiotherapy or exercise.
Tips for Preventing Ligament Injuries
Ankle injuries can result in pain and temporary disability. In some cases, the loss of mobility may last for a long time. As the old adage goes, prevention is better than cure. We must do what we can to prevent foot ligament injuries.
Proper footwear plays a very important role in helping us prevent ligament-damaging injuries.
Orthopedic surgeons recommend ankle-supporting high-top shoes because there are studies that show the beneficial effects of these shoes in improving foot stability by preventing extra inversion. However, you can achieve the same feel of a snug fit by wearing regular sneakers that fit well and offer proper cushioning. It is also interesting to note that high-top shoes, braces, and tapes can delay the activation of the foot evertor muscles that can help prevent ankle sprains.
A podiatrist or physiotherapist may recommend a combination of low-top shoes with air-cast braces or semi-rigid orthoses for optimum ankle support. This is of particular use for athletes in high-risk sport such as basketball, martial arts, and soccer. The best shoes for preventing ankle sprains are those that would minimize inversion and eversion strains on the ankles.
Replace worn out shoes that can no longer provide ankle support or cushion the feet from impact.
Apart from proper footwear, ankle strength plays a very important role in ensuring that excessive sideways flexion of the ankle does not result in injury. Strong ankle joints and surrounding muscles prevent sudden and severe foot eversion and can prevent or mitigate damage. Regular activity and exercise along with a healthy diet keeps the soft tissues and bones of our body in good shape.
When walking or running, keep your eyes open for slippery or uneven surfaces. It may not always be possible to avoid these surfaces, therefore, alertness is important to maintain balance. Wear appropriate footwear for the occasion, for example, if you’re going trekking and climbing then you must wear shoes that offer good grip and heel support. Similarly, running on a hard road calls for shoes with better cushioning as against shoes that you can wear while running on sand or on the beach. Avoid exerting your feet beyond their limit. You can easily make out when you’re fatigued. Maintain a healthy weight. Obese individuals are at greater risk of ligament injuries from foot sprains.