A Cruel Twist; Kickstarting a Fitness Regime? Take Care or You'll Do Yourself a Mischief

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Byline: Annabel Venning

Madonna suffered an injury to one while rehearsing for her last tour. Actress Angelina Jolie twisted hers while pregnant in 2008. As for David Beckham, an ankle injury almost ended his career.

But you don't need to be a pop star or footballer to suffer from one. Indeed, Simon Moyes, consultant orthopaedic surgeon, says the first two months of the year are his busiest - as an excess of exercise zeal, combined with wet and icy conditions, lead to a sharp rise in twists and sprains.

'You are more likely to injure your ankles if you are getting back into sport, for example as part of a New Year regime, and your ligaments are not used to it,' he warns.

'Ligaments are the cables of tissue that hold joints in place - they should be fairly tough but with some stretch, like elastic bands, allowing the joint a limited range of movement.

'You need to build ligament strength gradually, ideally with a supervised training programme, and not do too much too quickly otherwise they can tear and fray like the fibres of a rope.' IGNORE AN ANKLE INJURY AT YOUR PERIL Ankle injuries account for around 1.5million visits to accident and emergency each year, according to health insurers Bupa.

Sprains - injuries to the ligament - occur when the tissue is stretched beyond its normal range, for example when the ankle is twisted further than the ligaments allow, often when running or jumping, or is placed suddenly on uneven ground.

The ankle usually becomes bruised and swollen as a result. There are grades of severity - grade one is mild stretching, grade two is a partial tear of a ligament and grade three is a severe or total tear.

If these injuries are not treated properly the ligaments become permanently weakened, causing chronic ankle instability, a painful condition that can result in permanently swollen ankles and restricted mobility.

'If they are repeatedly injured they become elongated and flattened, like ribbons, and cannot hold the joint properly in place, allowing too much movement,' says Moyes.

If the injury is to the lateral ankle ligaments, the fan-shaped structure of ligaments that runs from the tip of the fibula (the main bone in the lower leg) on the outer aspect of the ankle to the talus (the main ankle bone) supporting the ankle joint, the ankle becomes unstable and prone to rolling, leading to further sprains.

IMMEDIATE TREATMENT IS ESSENTIAL

If you do injure your ankle it is vital to get it treated. If not, it may remain unstable and at risk of further injury.

Excess scar tissue or growths of bone, known as spurs, can develop, causing extreme pain and discomfort. 'If your ankle is swollen and bruised and you are limping, you should go to A&E,' advises Moyes. 'You will need a splint, which immobilises the joint and gives support, and physiotherapy.'

If, after three months, these nonsurgical approaches have not worked and the ankle is still painful, you should insist on being referred for a consultation with an orthopaedic surgeon specialising in joint injury.

THE 'PANTS OVER VEST' SOLUTION

First an MRI scan assesses the damage to ligaments and bones. …