A medical condition where ankle ligaments become overstretched, partially torn or totally torn. This happens with sharp movements like turning or rolling the foot. The lateral ankle sprain, where the foot is inverted, rolling out to the side with inside arch facing upwards, damaging one or more ligaments on the outside of the ankle is one of the most common sports injuries or occurs on a night out falling off high heels!
Anatomy: The structure of the bones, muscles and ligaments inside the ankle is more stable, making lateral (outside) sprains more common. Ligaments are strong elastic bands of tissue that connect bone to bone. In walking most weight is placed on the outside of the foot when striking the ground, naturally causing inversion of the ankle joint. The talofibular ligament, connecting the talus foot bone to the fibula lower leg bone is most commonly injured; the calcaneofilbular, connecting calcaneum foot bone to fibula can also be injured in more severe sprains as well as the anterior and posterior tibiofibular ligaments connecting tibia leg bone to fibula.
Symptoms: Pain, swelling, tenderness and bruising around the joint. An overstretched ligament has microscopic tissue damage, with less severe symptoms; weight bearing is possible though not running or jumping. A partial tear of ligaments is more severe causing more severe symptoms and affecting weight bearing so crutches are needed. A complete tear produces even more severe symptoms and may require surgical repair and /or a walking boot or splint plus crutches.
Causes: Sporting injuries, sudden change in speed or direction, falls, collisions, over-reaching. Excessive force through the ankle joint causes the damage.
Diagnosis: Your doctor will check for symptoms as well as testing movement, joint stability and weight bearing ability; and ask if you are taking anti-coagulants that reduce the blood’s ability to clot. In severe cases X-ray or MRI may be needed and to rule out fracture.
Treatment: This should be started immediately. PRICE is often used: Protection, Rest, Ice, Compression and Elevation. Pain mediation may be needed. Ibuprofen tablets can help reduce swelling and inflammation, though may delay healing if taken in the first 48 hours. Restorative exercises, gentle at first are important to maintain flexibility and strength and prevent muscle atrophy (wasting). An ankle brace or taping is helpful to prevent re-injury when returning to sports. Surgery in extreme cases. Avoid HARM in the first 72 hours: Heat, Alcohol, Running, and Massage.
Wear correct footwear, warm up properly before exercise and stretch to cool down afterwards. Do regular strengthening and flexibility exercises, using proper technique; be aware that muscle tiredness can affect your ability to control movements accurately. Eat a healthy, balanced diet to keep muscles strong. Prevent falls by keeping house and garden clear of obstacles.
Gentle techniques to help reduce swelling and increase blood flow. Test function and flexibility of all joining ligaments and muscles; treat to improve strength and reduce tension, pain and swelling. Assess and treat fascial connections, reduce trauma to the tissues. Specific taping may be required for stability and support. Assess movement of spine and neck which can be compromised if walking badly due to pain/injury. Restorative exercises. Recovery time varies from a few weeks to months or years depending on severity and the individual. Preventing re-traumatising the injury is vital, especially with children who find it difficult to stay still and sports people.
We are happy to advise you on your health matters and offer a free 15 minute joint and spinal check, without obligation.
Lin Bridgeford DO KFRP MICAK MICRA FSCCO MSc
Registered Osteopath & Kinesiologist & Yoga Teacher
Aether Bios Clinic
Tel: 01273 309557
Mobile: 07710 227038