Brief Outline of Ankle Sprain
Anyone involved in athletics is susceptible to an ankle sprain, an acute injury to any or all of the ligaments that support the ankle structure. Tearing or stretching of the ligaments can occur when the foot is rolled either medially or laterally, or twisted forcefully. High impact sports involving jumping, sprinting or running on changing or uneven surfaces often lead to ankle sprains. Basketball, football, cross country, and hockey are a few of the sports commonly associated with ankle sprains.
Anatomy and physiology
Lateral ankle sprains commonly occur when stress is applied to the ankle during plantar flexion and inversion, injuring the anterior talofibular ligament. The medial malleolus may act as a fulcrum to further invert the calcaneofibular ligament if the strain continues. The peroneal tendons may absorb some of this strain. Medial ankle sprains are less common, because of the strong deltoid ligament and bony structure of the ankle. The ligaments are stretched beyond their normal range and some tearing of the fibres may occur. Forceful twisting or rolling of the ankle, as with landing on the outside of the foot, can stretch the ligaments past their stretch point.
Cause of Ankle Sprain
Sudden twisting of the foot. Rolling or force to the foot, most commonly laterally.
Signs and symptoms
First-degree sprains: Result in little or no swelling, mild pain, and stiffness in the joint.
Second-degress sprains: Commonly exhibit more swelling and stiffness, moderate to severe pain, difficulty with weight bearing, and some instability in the joint.
Third-degree sprains: Result in severe swelling and pain, inability to bear weight, instability in the joint, and loss of function in the joint.
Complications if left unattended
Chronic pain and instability in the ankle joint may result if left unattended. Loss of strength and flexibility, and possible loss of of function may also result. Re-injuring the joint is much more likely as well.
- Second- and third-degree sprains may require immobilisation
- Third-degreee sprains may require surgery
Rehabilitation and prevention
Strengthening the muscles of the lower leg is important to prevent future sprains. Balance activities will help to increase proprioception (the body’s awareness of movement and position of the body), and strengthen the weakened ligaments. Flexibility exercises to reduce stiffness and improve mobility are needed also. Bracing during the initial return to activity may be needed but should not replace strengthening and flexibility development.
With proper rehabilitation and strengthening, the athlete should not experience any limitations. A slight increase in the probability of injuring that ankle may occur. Athletes who continue to experience difficulty with the ankle may need additional medical interventions, including, in rare cases, possible surgery to tighten the ligaments.