IN COLLABORATION WITH

ANKLE

INJURIES

INTRODUCTION

Ankle sprains are caused by direct or indirect trauma to the ankle ligaments. In a sprain, the ankle ligaments that normally support the ankle are either stretched beyond their normal limits or torn outright as a result of this trauma.

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The sprain can occur when the ankle is forced beyond its normal range of motion, such as when people twist their ankle when making a sudden stop on an athletic field or track, walking or running on an uneven surface, or when tripping over an obstacle. If not treated, or with repeated sprains of the same tissues, pain and dysfunction from acute ankle sprains can become chronic.

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The complex design of an ankle makes it a relatively stable joint compared to other joints in the body, and this stability is essential to its function.

 

The ankle sustains 1.5 times of the body's weight in impact with every walking step, and up to 8 times the body's weight with each step when running or jumping. In high-impact activities, the normally stable ankle is subject to increased injury risk, especially when it turns or twists too far out of its normal range of motion.

ANKLE INJURIES COMMONLY OCCUR DURING

  1. Acute injury that forces the ankle joint beyond its normal range of motion, such as in a sports injury or falling off.
     

  2. Overuse injury caused by repetitive forces, such as repeated hard landings involved in sports such as long distance running and basketball. 

LIGAMENTS OF THE ANKLE

3 ligaments on the outside of the ankle make up the lateral ligament complex.

  1. Anterior talofibular ligament (ATFL)

  2. Calcaneofibular ligament (CFL)

  3. Posterior talofibular ligament (PTFL

  4. Deltoid ligament - a thick ligament which supports the entire medial, or inner side of the ankle

The anterior inferior Tibiofibular ligament (AITFL), which connects the tibia to the fibula
Two posterior fibular ligaments, which crisscross the back of the tibia and fibula:

  1. Posterior inferior Tibiofibular ligament (PITFL)

  2. Transverse ligament

ANKLE SPRAIN SEVERITY GRADING

GRADE 1 INJURY 

Minimal tearing of the affected ligaments. 

Cause of injury

Signs & symptoms

Minimal tearing of the affected ligaments. 

Tenderness, pain, and swelling of the injury site is minimal, but still enough to be noticed upon viewing or palpating (touching).

 

Slight bruising or discoloration of the skin may be present, and standing/walking impairment is also minimal.

GRADE 2 INJURY

Moderate tearing of the affected ligaments. 

Cause of injury

Signs & symptoms

Overstretch or landing on imbalance surface.

Swelling, pain, and tenderness at the injury site are moderate, some   loss of range of motion, ankle instability, ankle partially give way with standing or walking. Moderate bruising or skin discoloration may be present, trouble walking or standing.

GRADE 3 INJURY

Complete tearing or rupturing of the Ligament, with no individual fibres remaining intact.

Cause of injury

Signs & symptoms

Overstretch over landing on imbalance surface.

Swelling and tenderness at the injury site is significant, severe discoloration of the skin (black-and-blue, purplish-black). The ankle cannot support any weight, completely affect range of motion.

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Standing, walking, or turning of the foot is impossible.

TREATMENT

GRADE 1 & 2 INJURY 

Calls for RICE protocol.

R

I

C

E

Rest

Ice

Compression

Elevation

GRADE 3 INJURY 

Sprains and strains are usually unstable and require longer healing.

A. Casting

B. Rehabilitation

Initially used to support the affected ankle from further injury.

Patients may need to undergo a series of rehabilitation treatments, such as electrical stimulation and ultrasound, as well as strengthening exercises to help decrease pain and support the development of new tissue.

REHABILITATION

Physiotherapy is the primary part in ankle rehabilitation to regain optimal ankle strength and performance. Ankle rehab programs begin with non-weight bearing ankle motion exercises.

 

Increase reps as you get stronger for progression.