Definition
Ankle sprain is where one or more of the ligaments of the ankle are partially torn.
How does it happen?
An ankle sprain can happen to anyone and it is a common injury. The lateral ligament injuries represent approximately 85% of all ankle sprains. However, it is found out the injuries is highest among the sport population. Lateral ankle sprains usually happen during a rapid shift of the body center of mass over the landing or weight-bearing foot. The ankle rolls outward, whilst the foot turns inward causing the lateral ligament to stretch and tear. When a ligament tears or is overstretch, its previous elasticity and resilience rarely returns. The less common mechanism of injury involves a forceful eversion movement at the ankle injuring the strong deltoid ligament. A syndesmotic sprain (high ankle) occurs when the foot is externally rotated of the leg combined with dorsiflexion of the ankle.
| Aspect | Mechanism of Injury | Ligaments |
| Lateral | Inversion and plantarflexion | Anterior talofibular ligament Calcaneo-fibular ligament Posterior talofibular ligament |
| Medial | Eversion | Posterior tibiotalar ligament Tibiocalcaneal ligament Tibionavicular ligament Anterior tibiotalar ligament |
| High | External rotation and dorsiflexion | Anterior-inferior tibiofibular ligament Posterior-inferior tibiofibular ligament Transverse tibiofibular ligament Interosseous membrane Interosseous ligament Inferior transverse ligament |
Clinical Presentation
- Patient presents with inversion injury or eversion injury to the ankle may have history of ankle injuries or instability
- Only able to partial weight-bear on the injured leg.
- If patient describe present of cold foot or paraesthesia suggesting neurovascular compromise of peroneal nerve.
- Tenderness, swelling and bruising can occur on either side of the ankle
- No bony tenderness, deformity, or crepitus present
- Symptoms is replicated by passive inversion or plantar flexion with inversion.
- Shows positive in anterior drawer test, talar tilt test, or squeeze test (depending on which structures are involved)
Management
Depending on the severity of the sprain:
A mild sprain can take up to 14 days to recovery. A first-time ankle sprain can be resolve quickly with minimal intervention. However, it is noted that the recurrence rate of first-time lateral ankle sprains is 70%. It is still recommended to seek for a physiotherapist to minimise the recurrence of lateral ankle sprains.
A severe ankle sprains can take up to 21 days or longer for an athlete. In the early stages, the goal is to reduce the swelling and pain while improving the blood circulation for about 2 to 3 days. Approximately the 4th or 10th days, the main goal is to restore and recover the foot and ankle function including improving the load carrying capacity. Once the previous goal is achieved, the therapist will focus on improving the muscle strength, ankle stability, foot and ankle motion, and mobility especially walking, climbing up the stairs, and running. Lastly, the therapist will work on your walking skills, improving the load-carrying capacity, and incorporating exercises that are able to improve the skills needed during your daily activities in work as well as in sports.
However, you should not neglect your pain and avoiding consulting a physician. A physical therapist will be able to diagnosis and guide you through the necessary steps to be taken and ensure your ankle receive the proper treatment.
Article prepared by Teo Jene
Physiotherapist of Your Physio Ampang