Lateral ankle sprains are the second most prevalent athletic injury second to the knee, commonly seen in sports. The mechanism of injury involves inversion and often plantarflexion (the foot rolling in and pointing downwards) which most commonly occurs when landing from a jump, changing directions or landing on uneven surfaces.
What is it?
The ligaments on the outside of the ankle stretch, resulting in damage to the fibres, which is graded 1 to 3, with a grade 1 defined as mild damage without instability of the affected joint. A grade 2 sprain is a partial tear to the ligament and a grade 3 sprain is a complete tear or rupture of the ligament. The anterior talofibular ligament is the most commonly effected, followed by the calcaneofibular ligament and lastly, the posterior talofibular ligament. Commonly associated with traumatic ankle sprains are avulsion fractures where the ligaments pull hard on their bony attachments pulling a small fragment of bone off.
Symptoms of Lateral Ankle Sprain
You may hear a snap, click or feel tearing at the time of injury.
There will generally be varying degrees of swelling, redness and possibly bruising around the outside of the ankle.
The injury will generally be quite tender to walk on initially. Pain will usually be present on touching the tissue on the outside of the ankle and with rolling the foot in.
Management
Initial management of an ankle sprain involves allowing damaged tissue to settle and reducing inflammation through rest, ice compression and elevation (RICE) for the first 24-72 hours, depending on the severity of the injury. Anti-inflammatory medication is useful in settling inflammation and making the ankle more comfortable. Often the ankle will be strapped by your physiotherapist to support and take pressure off the damaged ligaments and allow the body to begin to repair them and crutches may be used if the patient is unable to weight bear. X-rays will be taken where the possibility of fracture is suspected.
The second phase of management involves massage and stretching to the ankle to restore full range of movement. When the ankle is damaged, much sensory information from the ankle to the brain is diminished, resulting in instability of the ankle and increased risk of secondary injury, often resulting in ankle injuries becoming recurrent or chronic. Your physiotherapist will structure a program of progressively more difficult balance and strengthening exercises for the ankle to improve control, protect the ankle and get you back on your feet as quickly as possible.
