Ankle sprains are one of the most common sports injuries when the ankle rolls inwards or outwards. This can be a result of a fall, a sudden twist, or landing on the side of the foot during jumping activities. It could also happen when one misses a step or trips over a curb.
Causes
- The ankle joint is made up of 3 bones – the talus, the fibula (the protruding bone on the outside of the ankle) and the tibia (the protruding bone on the inside of the ankle).
- Ligaments, which are the primary stabilizers of the ankle, hold these bones together.
- On the inside of the ankle, the deltoid ligament, which is thick and strong, provides joint stability. Injury to the deltoid ligament can happen when the foot is twisted outward – known as an eversion sprain.
- On the outside of the ankle, 3 small separate ligaments – the anterior talofibular ligament (ATFL), the posterior talofibular ligament (PTFL) and calcaneofibular ligament (CFL) – provide joint stability. Injury to any of these ligaments happens when the foot is twisted inwards – known as an inversion sprain. An inversion sprain accounts for 80% of all ankle sprains, and the ATFL is the most commonly injured ligament.
Common Signs and Symptoms
- Pain either on the inside or outside area of the ankle
- Increasing difficulty in walking / putting weight on that foot
- Swelling and redness
- Bruising
The severity of the injury can be determined by the degree of disability immediately and subsequently after injury, and by the degree of swelling and bruising.
How can a Physiotherapist help?
- An assessment by your physiotherapist can determine the severity of the ligamentous injury, the instability of the ankle joint, and to exclude damage to other structures in the ankle joint.
- Management of ankle sprains follow the principles of reducing pain, managing swelling, restoring range of movement, improving muscle strength and improving joint proprioception and balance.
- The initial management of RICE (Rest, Ice, Compression, and Elevation) and restricted weight-bearing in the acute stage of injury is important.
- Treatment may consist of soft tissue release, joint mobilisations, exercises, taping and ultrasound therapy. A sport-specific rehabilitation program will be implemented to facilitate safe return to the desired sporting activity.
Ankle sprains are painful and can be debilitating.
