Chronic ankle sprains

Chronic ankle pain treatments – Prolotherapy Medical News

An ankle sprain is a common injury where one or more ligaments of the ankle become overstretched or torn, typically due to the ankle suddenly turning out. Once an ankle ligament is overstretched, the susceptibility to chronic ankle sprains becomes higher. Ligaments are taut tissues holding the ankle joint together and providing for smooth steps and strong jumps.  When the ankle ligaments, such as the anterior talofibular ligament, become damaged the joint becomes unstable.

There are three types of ankle sprain, separated into grades of severity.

  • The first, a grade one sprain, is the least severe. This occurs when the ligaments are slightly stretched out, causing minimal tearing of the tissue fibers. This is the type of injury that doesn’t cause severe pain, and the victim can usually “walk it off” without permanent damage.
  • A grade two sprain involves further tearing of the ligaments and can cause instability in the ankle joint. This type of sprain leads to a lot of swelling and tenderness, which makes it difficult to walk and move around.
  • A grade three sprain is indicated by a complete tear of the ligaments, and will make itself known with extreme pain, swelling, and lack of function.

The medical literature makes it clear, you must heal from the first ankle sprain or you are at higher risk of developing long-term ankle instability, chronic ankle sprains and eventually ankle osteoarthritis.


Doctors conducting joint research from the University of Virginia and University College Dublin confirmed this. They suggest that observing patients with the following conditions can predict who will have long-term problems

  • Impairments in motor control (defined as loss of function ie, limping) can predicate the onset of chronic ankle instability that can develop in the year after an acute lateral ankle sprain.
  • At the 2-week time point after acute ankle sprain – an inability to complete a single-leg drop landing  (jumping from a small platform and landing on one leg) and a drop vertical jump (jumping from a small platform, landing on both feet and then vertical jumping). Two out of three people who cannot perform this test at two weeks are at risk of chronic ankle problems.
  • At the 6-month time point, 85% of these patients exhibited further problems with ankle instability and the problems radiated into the knees and hips.1

If you are reading this article looking for answers to your chronic ankle problems then the above article research is likely a mirror reflection of what happened to you.

In this article we will present three non-surgical treatment options for chronic ankle pain. Prolotherapy, Platelet Rich Rich Plasma Therapy, and Stem Cell Therapy.


Prolotherapy for Chronic Ankle Sprains


Prolotherapy is a non-surgical  regenerative injection therapy that stimulates the natural healing of ankle instability and lessening the recurrence of ankle sprains.

Typically within three to six treatments, the ankle is feeling stronger and is in less pain. This is explained further in the video below.

Please also see Prolotherapy Patient Information.

  • Writing in the medical journal Practical Pain Management, doctors reported that patients treated for ankle problems with Prolotherapy had less pain, stiffness, crepitating, depressed and anxious thoughts, medication usage, as well as improved range of motion, walking ability, sleep and exercise ability. In addition Prolotherapy helped all patients on pain medications reduce the amount of medications taken.2

Platelet Rich Plasma Therapy for Chronic Ankle Sprains


Platelet Rich Plasma Therapy or commonly referred to as PRP is also a non-surgical injection technique that uses blood platelets as a “healing medicine to stimulate and repair soft-tissue healing. It is explained in the video below. Please see PRP Treatments for joint pain

Researchers from Duke University, University of Colorado, and from combined Israeli medical teaching institutions found that Athletes suffering from high ankle sprains benefit from ultrasound-guided PRP injections with a shorter return-to-play, rand less long-term residual pain.3


Stem Cell Therapy for Chronic Ankle Sprains


When chronic ankle sprains lead to continue deteriorating in the joint, many doctors may recommend utilizing stem cell therapy. Stem cells are typically taken from the patient’s fat or bone marrow and reintroduced into the ankle.

  • Doctor at the Royan Institute for Stem Cell Biology and Technology in Iran found that ankle osteoarthritis patients treated with stem cell therapy showed long-term benefit in pain and function. 4

Reported in Clinical Medicine Insights. Arthritis and Musculoskeletal Disorders – A 59-year-old female patient presented with a history of three years of right ankle pain following a lateral ankle sprain.

The patient was unable to walk more than 30 feet without severe ankle pain and had ceased all weight-bearing recreational activities.

Cortisone therapy had been unsuccessful and ankle fusion had been recommended. Based on X-ray and MRI findings, the patient was diagnosed with osteoarthritis, avascular necrosis of the talus, and synovitis.

The patient received four stem cell bone marrow and prolotherapy dextrose treatments over a period of eight months. At second treatment, the patient reported the ability to stand for long periods and walk for half a mile without pain. At third treatment, she reported improved range of motion, less frequent pain, and ability to take two mile walks on hilly, uneven ground, although steep climbs still induced pain. These gains were maintained throughout the treatment period.5


1 Doherty C, Bleakley C, Hertel J, Caulfield B, Ryan J, Delahunt E. Recovery From a First-Time Lateral Ankle Sprain and the Predictors of Chronic Ankle Instability: A Prospective Cohort Analysis.
Am J Sports Med. 2016 Apr;44(4):995-1003.

Hauser RA, Hauser MS, Cukla J, Dextrose Prolotherapy Injections for Chronic Ankle Pain Practical Pain Management Jan 2010

3 Laver L, Carmont MR, McConkey MO, Palmanovich E, Yaacobi E, Mann G, Nyska M, Kots E, Mei-Dan O. Plasma rich in growth factors (PRGF) as a treatment for high ankle sprain in elite athletes: a randomized control trial. Knee Surg Sports Traumatol Arthrosc. 2015 Nov;23(11):3383-92.

4. Emadedin M, Ghorbani Liastani M, Fazeli R, et al.Long-Term Follow-up of Intra-articular Injection of Autologous Mesenchymal Stem Cells in Patients with Knee, Ankle, or Hip Osteoarthritis. Arch Iran Med. 2015 Jun;18(6):336-44. doi: 015186/AIM.003.

5 Hauser RA, Orlofsky A. Regenerative Injection Therapy with Whole Bone Marrow Aspirate for Degenerative Joint Disease: A Case Series. Clinical Medicine Insights Arthritis and Musculoskeletal Disorders. 2013;6:65-72. doi:10.4137/CMAMD.S10951.

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