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Ankle Sprain

Most people sprain their ankle at least once in life, and especially active people tend to do it a few times. Before we get into ankle sprain, I would like to let you know more about the ankle anatomy.

The ankle joint is made up of three bones. 
  • The tibia: the major bone of the lower leg. It bears most of the body’s weight. Its bottom portion forms the medial malleolus, the inside bump of the ankle.
  • The fibula: the smaller of the two bones in the lower leg. Its lower end forms the lateral malleolus, the outer bump of the ankle.
  • The talus: the top bone of the foot.
Tendons connect muscles to bones.

Several muscles control motion at the ankle. Each has a tendon connecting it to one or more of the bones of the foot. Tendons can be stretched or torn when the joint is subjected to greater than normal stress. Chronic inflammation of a stretched or torn tendon is called tendinitis.

The ankle has many bones that come together to form the joint, so it has many ligaments holding it together. Stress on these ligaments can cause them to stretch or tear.

There are several major ligaments in the ankle, I will list out the common one:  

Three ligaments on the outside of the ankle that make up the lateral ligament complex, as follows:

    1. Anterior talofibular ligament (ATFL), which connects the front of the talus bone to the fibula, or shin bone
    2. Calcaneofibular ligament (CFL), which connects the calcaneus, or heel bone, to the fibula
    3. Posterior talofibular ligament (PTFL), which connects the rear of the talus bone to the fibula
    4. Deltoid ligament, a thick ligament which supports the entire medial, or inner, side of the ankle

The most commonly injured ligament is the anterior talofibular ligament that connects the front part of the fibula to the talus bone on the front-outer part of the ankle joint.

What causes ankle sprained?
  • Inversion injury 
  • Acute injury that forces the ankle joint beyond its normal range of motion, such as in a sports injury or falling off a curb.
  • Overuse injury caused by repetitive forces, such as repeated hard landings involved in sports such as long distance running and basketball
What are the signs and symptoms?

The symptoms of ankle sprains may include:

  • Pain or soreness
  • Swelling
  • Bruising
  • Difficulty walking
  • Stiffness in the joint

Ankle fractures are common injuries most often caused by the ankle rolling inward or outward. Many people mistake an ankle fracture for an ankle sprain, but they are quite different and therefore require an accurate and early diagnosis. They sometimes occur simultaneously.

What should I do when I sprained my ankle?
  • Rest. Stay off the injured ankle. Walking may cause further injury.
  • Ice. Apply an ice pack to the injured area, placing a thin towel between the ice and the skin. Use ice for 20 minutes and then wait at least 40 minutes before icing again.
  • Compression. An elastic wrap may be recommended to control swelling.
  • Elevation. The ankle should be raised slightly above the level of your heart to reduce swelling.
  • Medications. Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, may be recommended to reduce pain and inflammation. In some cases, prescription pain medications are needed to provide adequate relief.
  • Early physical therapy.
What can physiotherapy do?

Unfortunately, a sprained ankle can increase your risk of re-injury as much as 40-70%, but the correct post-injury rehabilitation exercises significantly decrease the risk.

There are essential treatment aims that need to be covered to effectively rehabilitate your sprained ankle and prevent recurrence.

  • Strengthening and proprioceptive exercises are strongly supported by research for reducing pain, returning to sport quickly and preventing further re-injury.
  • Mobilisation and manual therapy is also supported by research as helping to improve range of motion and reduce pain in the short term, and is a good addition to rehabilitation (alongside exercises).
  • Taping and bracing is also shown to be effective in reducing future injuries

In more severe cases, surgery may be required to adequately treat an ankle sprain. Surgery often involves repairing the damaged ligament or ligaments. The foot and ankle surgeon will select the surgical procedure best suited for your case based on the type and severity of your injury as well as your activity level.