Written by Michelle Champlin BSc Pod., M.Ch.S., S.R., Ch., (UK)
The deltoid ligament (also called the medial ligament) is a strong band that connects your lower leg bone (tibia) to the inner side of your ankle (also called the ‘medial’ side of your ankle). This triangular shaped ligament supports your ankle and prevents it from over rotating to the outer side. Strong, connective fibrous band, it is one of the strongest structures in the body.
Fortunately, due to the strength of this ligament and the anatomy of the ankle, a deltoid ligament tear is rare. Ankle sprains typically result from overexertion of the lateral ligament on the outside of the ankle, that connects the thin leg bone (fibula) to the heel bone (talus). This happens when you go ‘over’ on your ankle typically, onto the outside of your ankle. A deltoid ligament tear or sprain is caused by force in the opposite direction, and may be caused by a severe trauma resulting in outward twisting of the ankle, which is usually associated with a broken fibula bone too. Sometimes, we see this injury in footballers who may have suffered a sliding tackle onto the inside of their foot.
Deltoid ligament sprains (eversion) affect the inside of the ankle
Other than an acute trauma, a deltoid ligament tear can also result from chronic overuse and wear and tear of the ligament. Since this ligament supports the long medial arch on the inside of the foot, people who are ‘knock-kneed’ and have flat feet are generally more likely to be injured from it, as more weight and strain is put through the medial aspects of the foot and ankle as the entire ankle joint rolls in. Common symptoms of deltoid ligament tear include pain that radiates from the inner ankle, swelling, and bruising. The severity of these symptoms varies according to the extent and cause of your injury.
How to Treat a Deltoid Ligament Tear / Sprain
Most injuries to the deltoid ligament can be treated without surgery. Most patients improve with rest, ice application, elevation of the leg, and pain killers using non-steroidal anti-inflammatory drugs (NSAIDs). You can read more about RICE guidelines here.
For worse ligament injuries, a few weeks in an aircast to stabilize and support the ankle may be recommended by your Podiatrist.
As with any ankle sprain, these should be treated with the same care as a break and can be just as serious as a fracture on impacting long-term foot and ankle posture. Particularly if the strain is due to an underlying biomechanical issue such as flat feet, your Podiatrist will likely prescribe custom corrective orthotics to lift and tighten the arch and correct ankle alignment. This is another reason that it is important to correct foot and ankle alignment issues in children, avoiding more serious complications later in life.
Lastly, surgery may be advised in some cases to a specialist foot and ankle orthopaedic surgeon, if the sprain has not responded to the conservative measures above, or if the ligament tear is severe.
For foot and ankle related pain or injuries, contact the experts at Dubai Podiatry Centre.
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