A medial (deltoid) ankle ligament injury is a sprain or tear of the strong ligament on the inner side of the ankle. It usually happens when the foot twists outwards, and it may occur alongside a fracture.
The deltoid ligament is a broad, fan-shaped band of tough tissue on the inner side of the ankle. It connects the bony bump on the inside of the ankle (the medial malleolus) to bones of the foot, and helps stop the ankle rolling inwards. Because it is so strong, it is injured much less often than the ligaments on the outer side of the ankle. Injury usually needs a larger force, typically when the foot twists outwards.
Because of that force, a deltoid injury may come with other damage. This can include a break in the ankle bones or the fibula, or an injury to the syndesmosis, the ligaments joining the two lower leg bones just above the ankle. This is sometimes called a high ankle sprain. These injuries can affect how stable the ankle is and may need a different treatment plan, so checking for them early is important.
The doctor asks how the injury happened and examines the ankle, foot and lower leg. This includes checking for bone tenderness, swelling and whether you can take weight.
Doctors use a set of simple checks, known as the Ottawa ankle rules, to judge whether a bone injury is likely. These include tenderness over certain parts of the ankle and foot bones and whether you can take four steps. If a fracture is suspected, an X-ray is arranged by referral.
Where it helps, an ultrasound scan can look at the deltoid ligament and nearby tendons and ligaments to help judge the extent of the injury.
If the ankle seems unstable, a syndesmosis injury is suspected or recovery is slower than expected, an MRI or an orthopaedic opinion may be arranged by referral.
Your plan depends on what the assessment finds. These are the options we most often discuss.
In the first few days, relative rest, ice, compression and raising the leg may help control pain and swelling. Crutches or a walking boot may be advised for more significant sprains.
An ankle brace or taping may help support the inner ankle as you return to walking and sport.
Learn moreA staged programme restores movement, strength and balance, then builds up to running, jumping and sport-specific drills. This is an important part of reducing the risk of injuring the ankle again.
Learn moreOnce the early pain and swelling have settled, hands-on joint mobilisation may help if the ankle remains stiff.
Learn moreSimple pain relief or anti-inflammatory medicines, where suitable for you, may help in the early stages.
If there is a fracture, a syndesmosis injury or an unstable ankle, the clinic will refer you to a fracture clinic or orthopaedic surgeon. Some of these injuries need a cast, boot or surgery.
Medial ankle sprains often take longer to recover than the more common outer ankle sprains. Many people with a mild sprain are walking normally within a few weeks, while more severe sprains can take several months before a full return to sport. Where there is also a fracture or syndesmosis injury, recovery is usually longer and follows the specialist's plan. Time frames vary, and completing a rehabilitation programme may help the ankle regain strength and balance.
Most ankle sprains affect the outer ankle, when the foot rolls inwards. A medial sprain affects the inner ankle and usually happens when the foot twists outwards. It is less common and more often linked with fractures or syndesmosis injuries, so it is assessed with extra care.
Not everyone does. The doctor uses examination findings, based on the Ottawa ankle rules, to judge whether a fracture is likely. If it is, an X-ray is arranged by referral. Sometimes X-rays taken while standing are needed to check that the ankle joint is stable.
A high ankle sprain is an injury to the syndesmosis, the ligaments that hold the two lower leg bones together just above the ankle. It often happens with the same twisting force that injures the deltoid ligament. It tends to take longer to recover, and some cases need an orthopaedic opinion.
This depends on how severe the injury is. A return is usually considered once you can walk, hop and change direction without pain, and your strength and balance are close to the other side. Returning too early may raise the risk of injuring the ankle again, so your doctor can guide each step.
No. Inflexion Clinic is a private GP clinic, so you can book directly. Book online or call the clinic on +65 6222 7864.
Our clinicians will take a proper history, examine you, and give you a clear plan on the day.