Understanding ankle sprains

In our previous post, we covered shoulder pain and the different reasons why a shoulder complex might hurt. For this post, we’ll be looking a little more into another area that is very commonly injured – our ankles! A “sprained ankle” is one of the most common injuries that can occur when the ligaments around the ankles are stretched beyond their normal range. We’re sure that you or someone you know might’ve had their ankles sprained at some point in time before.

To bring some understanding, ligaments are bundles of connective tissues that connects adjacent bones together. They help to keep our joints stable and prevent excessive movements. They are non-elastic, meaning that when they are pulled beyond a certain range, they can be torn or injured. Hence the reason ankles are susceptible to regular injury.

 

Classification – How severe is my sprain?

There are varying degrees of ankle sprains, with milder sprains being easier to rehabilitate.

Different grades of ankle sprains

 

  1. Grade 1 – Ligaments are stretched, not torn. Swelling may be mild, and without any feeling of instability (ankle giving way). Function is not affected, so while walking might be uncomfortable and stiff for a week or so, it is still possible.
  2. Grade 2 – Ligaments in the ankle are partially torn. Bleeding may occur in the surrounding areas, causing bruising and discolouration. Swelling may also get worse over the period of a week, damaged areas tender to touch, and function such as walking or climbing stairs will be painful.
  3. Grade 3 – The most severe type of sprain, where at least one ligament is completely torn. The ankle will feel unstable or “wobbly”, bearing weight on it will be usually impossible due to severe pain.

 

Anatomy – What’s actually being injured here?

Different mechanisms of injury produces different types of sprains. In the case where your ankle “rolls over” itself, whereby the ankle turns in like the picture below, and may occur with sudden pivoting or turning movements, the lateral (outside) ligaments get injured. We call this a lateral ankle sprain.

The ligaments involved in this type of sprains are the a) anterior talofibular ligament (ATFL), b) posterior talofibular ligament (PTFL), and c) calcaneofibular ligament (CFL). Usually not every ligament will be torn, and the ATFL is the most commonly injured ligament, accounting for 73% of lateral ankle sprains.

Medial (inside) ankle sprains are less commonly occurring, comprising of only 6% of all ankle sprains and the involved ligaments are a group of ligaments collectively called the deltoid ligament. Gymnasts may sustain such a sprain when they miss a landing and land on the insides of their heels, or an opposing rugby player performing a slide tackle to the opponents side, causing the players’ ankle to roll inwards.

 

Treatment – How can I get better?

Rehabilitation after an ankle sprain focuses on several stages:

  1. Reduction of pain and swelling (e.g. P.OL.I.C.E see here)
  2. Regaining back mobility of the ankle
  3. Strengthening of the surrounding muscles
  4. Stabilisation: Increasing the sensing ability of the ankle to balance itself during activities

All these stages have one end goal in mind – to progressively reduce pain and to regain back the mobility, strength, and stability of the injured foot so that daily function can be restored.

We hope that we’ve been able to help make you understand what happens when your ankle gets injured. Seeking proper rehabilitative care for your ankles after an injury is important to prevent future instability of the ankle which highly increases the chances of a recurring sprain that might take longer to heal. Here at Spinefit Chiropractic, we care about your goals to return to function and sports. Give us a call or drop us an e-mail to book an appointment today so that we can work together with you to get you back on track!