What is an ankle sprain?
An ankle sprain refers to tearing or stretching of the ligaments in the ankle. Inversion sprains, (ankle twists laterally) account for 70-85% of all ankle sprains. The most commonly injured ligament is the anterior talofibular AKA the ATFL. Injury to this ligament results in swelling and pain on the outside of the ankle. Other ligaments include: CFL or calcaneal fibular ligament and the PTFL or posterior talofibular ligament.
Anatomy 1. The ATFL or anterior talofibular ligament connects the talus to the fibula on the lateral side of the ankle.
2. The CFL or calcaneal fibular ligament, which connects the fibula to the calcaneus below.
3. The PTFL or posterior talofibular ligament not as commonly torn. It runs more in the back of the ankle.
What causes an ankle sprain?
- Risk factors include various activities, such as netball, football and jumping sports, in which an athlete can land poorly on the ankle, or step on another athletes foot, causing a buckling the ankle.
- Some people are predisposed to ankle sprains due to a supinated foot type. This typically means the arch is higher and the foot is rolled outwards. This is because it is easier to turn on the ankle as the foot naturally sits in a more hyper extended position than those with a neutral or pronated foot type.
- Previous ankle sprains are a risk factor for future ankle sprains, especially those injuries which haven’t been properly rehabilitated, causing a greater level of ongoing instability in the affected ligaments.
- Those who have weak peroneal muscles, which are those that run along the outside of the ankle, may be more predisposed. This is because these muscles hold the lateral side of the ankle up, and help to prevent the foot from turning in.
Treatment
Occasionally an ultrasound and x-ray is required to confirm the diagnosis, and rule out other injuries such as a stress fracture or muscle tear, however 95% of the time your Podiatrist will be able to clinically diagnose an ankle sprain from your past medial history, recollection of the time of injury and symptoms.
For the initial inflammatory phase of healing (Days 1-7)
The best treatment method for this phase of soft tissue healing is R.I.C.E (Rest, Ice, Compression, Elevation). The goal of this is to reduce the inflammation. On day 3 we recommend that to begin loading the ligaments using minimal resistance theroband therapy.
For the repair stage of healing (Day 3 - 3 weeks)
The beginning of this phase is when the signs of inflammation (swelling, heat, redness, pain) reduce. Once the patient has a full range of motion concentric strength exercises can commence, such as calf raises.
For the remodeling stage of healing (2 weeks - 6 months)
The main goal of this stage is to prevent poor healing or shortening of the ligament, which in tern will help with preventing reoccurrence. This includes proprioception exercises on a wobble board as well as sport specific activities to improve strength, flexibility, agility and endurance.
Prevention
The best way to prevent ankle sprains is following the treatment plan properly, and wearing good footwear during activity. Taping before playing sport is also an effective way at reducing the likelihood of ankle sprains, however it must be done correctly. Click on the link below for a step by step guide on ankle taping.
https://www.facebook.com/stepforwardpodiatry/videos/vb.523180177797398/1009581135823964/?type=2&theater
Make sure you come to see your friendly podiatrist at Step Forward Podiatry for specific exercises and advise, because we all know…
