Within the sporting and general population, ankle sprains are a common injury. Ankle sprains are the ligaments surrounding the injured area are either partial torn or ruptured. Ligaments are bands of fibrous tissue that connect one bone to another. General practitioners and physical therapists often classify sprains into grading systems, from 1-3 (G1-G3). These grades are;
- G1- mild sprain, which happens when you overstretch a ligament. You may have mild swelling, bruising and pain around your ankle, but you should be able to put some weight on your foot.
- G2- a moderate sprain. This happens when you overstretch and partially tear a ligament. You may have quite a lot of swelling, bruising and pain around your ankle, which may feel a little unstable (wobbly). You may find it difficult to put weight on your foot.
- G3-a severe sprain, which happens when you completely tear a ligament. The swelling, bruising and pain around your ankle are usually very bad. Your ankle may feel quite unstable (wobbly) and you won’t be able to put any weight on your foot without a lot of pain.
Many studies have shown that 10% to 30% of all athletic injuries are ankle injuries. In high-risk sports, ankle sprains account for 70% or more of all reported ankle injuries. Lateral ankle sprains (LAS) are among the most common injuries within the ankle. Falls, awkward landings from jumps and stepping on another player’s foot often occur in sports. LAS usually occur with inversion mechanisms. This mechanism (MOI) involves the ankle rolling in such a way that the outer border of the foot contacts the ground. Within the general population however, LAS can still be common due to the MOI involving a downward and inward motion of the foot. Many examples could be; Walking the dog and landing in a pot hole, going shopping and accidently drop off the pavement or going for a jog.
The talocrucal (ankle joint) is a hinge joint between the inferior (below) surface of the tibia and the superior (above) surface of the talus. It allows the movements of plantarflexion and dorsiflexion. The talocrural joint receives ligamentous support from a joint capsule and several ligaments, including the anterior talofibular ligament (ATFL), posterior talofibular ligament (PTFL), calcaneofibular ligament (CFL). These ligaments are either injured individually or all involved during LAS. The ATFL, PTFL, and CFL support the lateral aspect of the ankle, therefore if inadequate rehabilitation or poor injury management can lead to repetitive ankle sprains AKA Chronic ankle instability.
Ankle sprain treatment involves immediate first aid to reduce pain and swelling, rest to allow healing, followed by a rehabilitation program to restore full mobility, strength, and proprioception or coordination to prevent re-injury. Here is what you should do in the event of LAS;
- Apply the PRICE principles (protection, rest, ice, compression and elevation) as soon as possible after injury. It is important to rest the ankle to prevent further damage. Apply ice wrapped in a wet tea towel to prevent ice burns, or better still a cold therapy and compression wrap will reduce pain, inflammation, and swelling. Elevating the ankle can also help reduce swelling by allowing tissue fluids to drain away.
- Wear an ankle brace or support to protect the injured ligaments and provide compression. Initially, a simple elastic compression sleeve or support is ideal, whilst later in the rehabilitation process, a stronger brace with additional lateral support at the side may help protect the ligaments.
NHS treatment or private injury clinic
- Generally the NHS would have physiotherapists run through a full rehabilitation program to aid in the healing of the ligaments within the ankle whilst decreasing any predisposing factor from occurring during the program.
- However, if the waiting list is to long try looking for a physical therapist, sports therapist or physiotherapist within a private clinical setting. There usual treatment guidelines for ankle sprains are;
- Mobility exercises for the ankle can start very early in the rehabilitation process from day 2 in mild to moderate sprains. As a sprain can make the joint stiff, performing mobility exercises and stretches will help increase the range of movement.
- Strengthening exercises are important to help prevent any further injuries. They can be started as soon as the pain has lessened, although exercises that involve sideways movements should be avoided in the early stages.
- Proprioception exercises are performed to fire up the muscles around the ankle joint to prevent injuries from reoccurring. These can range from standing on one leg (which can be increased in difficulty by closing your eyes and standing on an unstable surface) to hopping (when pain allows).
- Functional exercises- lunges, step backs and jumps will help build up strength and the muscles until you are able to train fully. The intensity of the exercises should be increased slowly, it is important not to rush the process.
If you have ever had a LAS or know anyone who has please feel free to share this information. Enjoy the blog as more injury related blogs are to follow. 🙂