Frequently Asked Questions

Years ago, I sprained my left ankle badly. After a long time, it finally got better on its own. Now I keep injuring the calf muscle. I'm worried it might tear. What can I do to keep from respraining the ankle and/or tearing the Achilles tendon?

Most experts agree the road to recovery and prevention of reinjuries is a solid, consistent rehab program at the time of the acute sprain. Once the swelling is under control and the acute injury has been dealt with, then it's time to retrain the joints and soft tissues. This is done most safely under the supervision of a physical therapist. Range-of-motion exercises, strengthening, and proprioception training are introduced and gradually progressed. Proprioception refers to the joint's sense of position. Specific training is also needed to restore balance and postural control. This phase is referred to as functional training. With this type of management, patients return to sports and/or work faster with fewer symptoms. They report higher levels of personal satisfaction with their results. And they have fewer episodes of reinjury. Delayed repairs can also cause recurrent injuries. Overstretching the ligaments and multiple injuries can end in a failed result. When conservative care isn't enough and ankle instability persists, then surgery may be needed to repair or reconstruct the ankle. The new injury of the calf muscle and Achilles tendon may or may not be as a result of the previous ankle injury. With all that is going on, it may be a good idea to see an orthopedic surgeon for an evaluation. Find out what's wrong first before trying different methods of treatment. It's possible that a program of retraining is needed for the ankle and surrounding soft tissues. Now is a good time to pursue this before more serious injuries occur.

Nicola Maffulli, MD, MS, PhD, FRCS, and Nicholas A. Ferran, MBBS, MRCSEd. Management of Acute and Chronic Ankle Instability. In Journal of the American Academy of Orthopaedic Surgeons. October 2008. Vol. 16. No. 10. Pp. 608-615.

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