What is a sprained ankle? – Blog By Kara Giannone
An ankle sprain occurs when your ankle ligaments are overstretched. They can vary greatly in severity from a minor “rolled ankle” to a complete ligament rupture with or without bone tendon or muscle injury. They are graded as 1, 2 or 3 depending on the severity.
Anatomy of the ankle
The ankle, referred to as the talo-crural joint or true ankle joint, consists of three bones – the tibia, fibula and talus and is responsible for plantarflexion and dorsiflexion of the ankle. The subtalar joint lies underneath the true ankle joint and is the articulation between the talus and calcaneus. It assists the talo-crural joint in inversion and eversion. Most ankle sprains occur from an inversion mechanism of injury (rolled in).
The most commonly injured ligaments of the ankle are the lateral ligaments which sit on the outside of the ankle. These include the anterior talofibular ligament, calcaneofibular ligament and posterior talofibular ligament. The ligament on the inside of the ankle is called the deltoid ligament which is much stronger and hence more difficult to injure.
High ankle sprains refer to injury to the inferior tibiofibular ligaments and syndesmosis which bind the tibia (shin bone) and fibula (calf bone) together above the ankle. A high ankle sprain is a much more debilitating injury, requiring a longer recovery time.
What causes an ankle sprain?
Ankle sprains occur most commonly by a sudden twisting or rolling action of your ankle often on unstable irregular surfaces. The ligaments affected is determined by the direction the foot rolls. The most common ankle sprain is the ligament on the side which occurs when the foot is turned in as shown below.
Certain factors can put a person at greater risk of spraining their ankle including poor footwear, previous injury, reduced strength, poor biomechanics or poor balance receptors.
What are the symptoms of a sprained ankle?
- The mechanism of rolling your ankle is a clear indicator that you are likely to have sprained your ankle
- You may hear a popping or cracking sound at the time of injury
- The injured ligaments will be quite tender to touch in that initial phase
- Swelling and bruising
- Generalised ankle pain
- In the cases of a severe ankle sprain, you may have difficulty walking and may require the use of crutches to mobilise.
How is a sprained ankle diagnosed?
Physiotherapists will take a thorough history and conduct a comprehensive clinical examination to effectively assess and diagnose ankle sprains. Furthermore, to exclude certain fractures or ligamentous injuries, it may be required to refer for imaging like a X-RAY, MRI or CT scan.
Management of an ankle sprain
A person who sprains their ankle is up to 70% more likely to re-sprain their ankle without the correct post-injury rehabilitation.
In the initial 72 hours post injury, it is essential to use the principles of R.I.C.E – This include rest, ice the affected area every 2 hours for 20 minutes, compress the ankle with a compression bandage and elevate in order to manage pain and swelling.
Physiotherapy is crucial in the management of ankle sprains. It is important in managing pain and improving range of movement, strength, proprioception, balance and assist in return to your pre-morbid level of activity.
Physiotherapy treatment may include:
- Gait re-training
- Biomechanical correction
- Exercise prescription including sport specific training
- Soft tissue massage
- Sport specific training
- Electrotherapy and more!
At Total Physiocare Heidelberg, Reservoir, Camberwell and Footscray, we specialise in accurate assessment, management and return to sport or level of activity for clients presenting with ankle sprains.
Blog post by Kara Giannone