Ankle sprains are one of the most common sporting injuries – and are most prevalent in sports such as basketball and netball. However they are becomming more and more common with an increase in recreational running - particularly on uneven ground.
As a quick background:
- Ankle sprains accout for an estimated 1-1.5million A&E visits per year.1
- You are much more likely to injure the lateral aspect (outside) of your ankle, than the medial (inside).
- Once sprained, you have over a 50% chance of re-injuring that ankle (reduced through effective rehabilitation).2
- A sprain involves to damage to ligaments that support our joints.
- A strain involves the stretching or tearing of muscle fibres.
The most common form of ankle sprain is an inversion injury, which involves the ankle 'rolling' outwards while the foot is planted, stressing the ligaments supporting the lateral aspect (outside) of the ankle joint. These ligaments (particularly the Anterior talofibular, and calcaneofibular ligaments) are put under excessive force, stretching them beyond their physiological limits and causing microtears within the fibres.
Sprains can be classified into 3 types:
- First degree - partial tear of ligament
- Second degree - incomplete tear with moderate functional impairment
- Third degree - complete tear and loss of integrity of ligament
In a majority of cases, not only are the ligaments affected, but also the muscles and nerves running over the joint, and sometimes the joint surfaces themselves. It is important then, to be able to recognise symptoms of an ankle sprain, and how they relate to the structures within your ankle. The most common symptoms are:
- Immediate inflammation (swelling, redness and increased temperature) around the entire ankle joint - An influx of inflammatory exudates and oedema from the blood is your body's natural defence system.
- Inability to weight bear.
- Pain - nerves become much more sensitive, especially to the chemicals that your body floods to the injury site.
- Loss of movement and strength (associated with inflammation, and inhibition of skeletal muscle).
- Bruising along the bottom of your foot, both inside and out (particularly with more severe sprains - Grade II +). A decrease in skeletal muscle pump combined with ruptured blood vessels means blood pools at the bottom of the foot due to gravity.
- Joint stiffness - possibly from synovial thickening around joints and the lack of movement within them.
Getting the strength back...
Follow the link below for an example of a PhysioFitness exercise programme that may be used alongside other treatments to rehab an ankle sprain....
Hints and Tips For Ankles
- Use good fitting / well done-up footwear, particularly when on uneven ground.
- If you have previous ankle injuries, you are statistically more at risk of further injury.
- However, immediate treatment will ensure faster return to full function and reduce joint stifness.
- Balance is key, everything starts at your ankle.
- Be pro-active, spending time on prehab is better than spending money on rehab!
1. NHS., 2010 http://www.nhs.uk/conditions/sprains/pages/introduction.aspx
2. Yeung, M. S., et al., 1994. An epidemiological study on ankle sprains. Br J Sp Med; 28(2)
3. Hertel, J., 2000. Functional Instability Following Lateral Ankle Sprain. Sports Med; 29: 5(1): 361-371(11)
Written by Declan Foley