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Sprained Ankle
A sprained ankle is a very common type of ankle injury. A sprain is stretching and or tearing of ligaments (you sprain a ligament and strain a muscle).The most common is an inversion sprain (or lateral ligament sprain) where the ankle turns under so the sole of the foot faces inwards, damaging the ligaments on the outside of the ankle.
A medial ligament sprain is rare but can occur particularly with a fracture. This happens when the ankle rolls the other way, so the sole of the foot faces outwards, damaging the ligaments on the inside of the ankle.
The most common damage sustained in a sprained ankle is to the anterior talo-fibula ligament shown towards the front of the image opposite. This ligament, as the name suggests, connects the talus (ankle bone) with the fibula (smaller of the two bones in the lower leg). If the sprain is severe there might also be damage to the calcaneo-fibula ligament (connects the heel bone to the fibula) which is further back towards the heel. This ligament only becomes injured in more severe injuries due to its increased strength and laxity whilst the toes are pointed (a common position for injuries).
In addition to the ligament damage there may also be damage to tendons, bone and other joint tissues, which is why it is important to get a professional to diagnose your ankle sprain. Complete ruptures of the anterior talo-fibular, calcaneo-fibular and posterior talo-fibular ligaments results in dislocation of the ankle joint and is often associated with a fracture.
Symptoms: A sprained ankle is classified into three categories depending on severity.
First degree ankle sprain:
Some stretching or perhaps minor tearing of the lateral ankle ligaments. Little or no joint instability. Mild pain. There may be mild swelling around the bone on the outside of the ankle. Some joint stiffness or difficulty walking or running
Second degree ankle sprain:
Moderate tearing of the ligament fibres. Some instability of the joint. Moderate to severe pain and difficulty walking. Swelling and stiffness in the ankle joint
Third degree:
Total rupture of a ligament. Gross instability of the joint. Severe pain initially followed later by no pain. Severe swelling.
Ankle sprain treatment
Treatment of a sprained ankle can be separated into immediate first aid and longer term rehabilitation and strengthening.
Immediate First Aid for Ankle Sprains:
Aim to reduce the swelling by DR .ICE. (Diagnosis Rest, Ice, Compression, Elevation) as soon as possible.
D is for diagnosis. It is important to get the correct diagnosis from the start. If other factors such as an avulsion sprain (where a bone fragment is pulled away from the bone) are suspected then treatment may be different.
R is for rest. It is important to rest the injury to reduce pain and prevent further damage. If you need crutches then use them! People with crutches get more sympathy! Many therapists advocate partial weight bearing as soon as pain will allow. This is thought to accelerate rehabilitation.
I is for ICE or cold therapy. Applying ice and compression can ease the pain, reduce swelling, reduce bleeding (initially) and encourage blood flow (when used later). Apply an ice pack or similar immediately following injury for 15 minutes. Repeat this every 3 hours.
C is for compression - This reduces bleeding and helps reduce swelling. A Lousisana wrap bangdaging technique is excellent for providing support and compression to a recently injured ankle.
E is for Elevation - Uses gravity to reduce bleeding and swelling by allowing fluids to flow away from the site of injury. So put your feet up and get someone else to wait on you!
In addition to immediate first aid the athlete can do the following:
Protect the injured ankle by taping or an ankle support. Tape can also be used during the rehabilitation phase to protect the joint and give proprioceptive feedback to the ankle without risking further injury. When partial weight bearing an ankle support or taping method can protect the lateral ligaments (allowing them to rest) while ensuring forwards and backwards motion is allowed keeping the rest of the joint healthy.
What can a sports injury specialist do about it?
A sports injury specialist will undertake a thorough assessment of the injury so time is not wasted treating the wrong condition. A doctor may prescribe anti-inflammatory medication to help with pain and swelling. Reduce swelling by compression devices or taping techniques. Use ultrasound and laser treatment to reduce pain and inflammation and promote healing. Use cross friction massage to promote healing and reduce scar tissue development.
Prescribe a full ankle rehabilitation programme to strengthen the joint and help prevent future ankle sprains.
A sprained ankle is a very common type of ankle injury. A sprain is stretching and or tearing of ligaments (you sprain a ligament and strain a muscle).The most common is an inversion sprain (or lateral ligament sprain) where the ankle turns under so the sole of the foot faces inwards, damaging the ligaments on the outside of the ankle.
A medial ligament sprain is rare but can occur particularly with a fracture. This happens when the ankle rolls the other way, so the sole of the foot faces outwards, damaging the ligaments on the inside of the ankle.
The most common damage sustained in a sprained ankle is to the anterior talo-fibula ligament shown towards the front of the image opposite. This ligament, as the name suggests, connects the talus (ankle bone) with the fibula (smaller of the two bones in the lower leg). If the sprain is severe there might also be damage to the calcaneo-fibula ligament (connects the heel bone to the fibula) which is further back towards the heel. This ligament only becomes injured in more severe injuries due to its increased strength and laxity whilst the toes are pointed (a common position for injuries).
In addition to the ligament damage there may also be damage to tendons, bone and other joint tissues, which is why it is important to get a professional to diagnose your ankle sprain. Complete ruptures of the anterior talo-fibular, calcaneo-fibular and posterior talo-fibular ligaments results in dislocation of the ankle joint and is often associated with a fracture.
Symptoms: A sprained ankle is classified into three categories depending on severity.
First degree ankle sprain:
Some stretching or perhaps minor tearing of the lateral ankle ligaments. Little or no joint instability. Mild pain. There may be mild swelling around the bone on the outside of the ankle. Some joint stiffness or difficulty walking or running
Second degree ankle sprain:
Moderate tearing of the ligament fibres. Some instability of the joint. Moderate to severe pain and difficulty walking. Swelling and stiffness in the ankle joint
Third degree:
Total rupture of a ligament. Gross instability of the joint. Severe pain initially followed later by no pain. Severe swelling.
Ankle sprain treatment
Treatment of a sprained ankle can be separated into immediate first aid and longer term rehabilitation and strengthening.
Immediate First Aid for Ankle Sprains:
Aim to reduce the swelling by DR .ICE. (Diagnosis Rest, Ice, Compression, Elevation) as soon as possible.
D is for diagnosis. It is important to get the correct diagnosis from the start. If other factors such as an avulsion sprain (where a bone fragment is pulled away from the bone) are suspected then treatment may be different.
R is for rest. It is important to rest the injury to reduce pain and prevent further damage. If you need crutches then use them! People with crutches get more sympathy! Many therapists advocate partial weight bearing as soon as pain will allow. This is thought to accelerate rehabilitation.
I is for ICE or cold therapy. Applying ice and compression can ease the pain, reduce swelling, reduce bleeding (initially) and encourage blood flow (when used later). Apply an ice pack or similar immediately following injury for 15 minutes. Repeat this every 3 hours.
C is for compression - This reduces bleeding and helps reduce swelling. A Lousisana wrap bangdaging technique is excellent for providing support and compression to a recently injured ankle.
E is for Elevation - Uses gravity to reduce bleeding and swelling by allowing fluids to flow away from the site of injury. So put your feet up and get someone else to wait on you!
In addition to immediate first aid the athlete can do the following:
Protect the injured ankle by taping or an ankle support. Tape can also be used during the rehabilitation phase to protect the joint and give proprioceptive feedback to the ankle without risking further injury. When partial weight bearing an ankle support or taping method can protect the lateral ligaments (allowing them to rest) while ensuring forwards and backwards motion is allowed keeping the rest of the joint healthy.
What can a sports injury specialist do about it?
A sports injury specialist will undertake a thorough assessment of the injury so time is not wasted treating the wrong condition. A doctor may prescribe anti-inflammatory medication to help with pain and swelling. Reduce swelling by compression devices or taping techniques. Use ultrasound and laser treatment to reduce pain and inflammation and promote healing. Use cross friction massage to promote healing and reduce scar tissue development.
Prescribe a full ankle rehabilitation programme to strengthen the joint and help prevent future ankle sprains.
