Conditions
Lateral ligament sprains of the ankle are one of the most common injuries, especially for sporting participants. The mechanism involves the foot rolling inwards and pointing downwards (inversion and plantarflexion), which most commonly occurs when landing from a jump, changing directions at speed or landing on an uneven surface (edge of path, opponents foot).
The ligaments on the outside of the ankle stretch, resulting in damage, which is graded from 1 to 3. A grade 1 strain is defined as mild damage with no joint instability. Grade 2 is a partial tear to the ligament and a grade 3 is a complete tear or rupture of the ligaments. Commonly associated with traumatic ankle sprains are avulsion fractures where the ligaments pull a small fragment of bone off. This is diagnosed via an X-ray.
Management
Initial management that produces the best results follows the POLICE acronym.
- Protection – early protection of the damaged ligaments via taping, bracing or a boot.
- Optimal Loading – early weightbearing and movement appropriate to the grade of injury and symptoms helps prevent unnecessary loss of function and assists early healing.
- Ice
- Compression
- Elevation
Unfortunately, a sprained ankle can increase your risk of re-injury by as much as 70%. However, with appropriate rehabilitation that risk is significantly decreased. The aims of physiotherapy treatment are:
- Regain full range of motion
- Strengthen the ankle and calf muscles
- Restore joint proprioception and balance reactions
- Restore normal function
- Incorporate speed, agility and sports specific exercises into the exercise program
- Provide a graduated return to training and competition