Ankle sprains are one of the most common sport injuries, especially sports involving running and jumping such as basketball, soccer, and dance. In addition, any sport that requires landing on one foot or cutting maneuvers are common motions that can cause an ankle sprain.
When it comes to ankle sprains, they can occur two different ways. The most common is a lateral or inversion ankle sprain, with 85% of ankle sprains being lateral ankle sprains. Lateral ankle sprains occur most often when someone rolls their ankle and the foot turns inward. There are three ligaments on the lateral or outside region of your ankle. The three ligaments are the anterior talofibular ligament, the calcaneofibular ligament, and the posterior talofibular ligament. Medial or eversion ankle sprains account for only 3-5% of ankle sprains and occur when someone rolls their ankle and their foot turns outward. The ligament involved with medial ankle sprains is the deltoid ligament.
There are also different classifications of ankle sprains, grade I (mild), grade II (moderate), and grade III (severe). In a grade I ankle sprain, the ligaments are stretched without any tears. There is also some swelling and mild tenderness present but no instability noted. A grade II ankle sprain involves partial tears in the ligaments, moderate pain, swelling, and tenderness. There may also be range of motion restrictions and mild to moderate instability noted. Grade III ankle sprains are the most severe and involve complete ligament rupture, marked swelling and tenderness, and marked range of motion limitations and instability.
Eighty to eighty five percent of ankle sprains are successfully treated with functional ankle rehabilitation through physical therapy and only 15-20% have recurrent ankle instability and re-injury. Initially in the acute phase following the injury, you should avoid placing your ankle in the position in which it was sprained. In addition, applying the concepts of resting, icing, compression, and elevation are key to initiate the healing process and prevent any further damage to the ligaments involved. In this phase, the therapist’s goals are to control inflammation and pain as well as strengthen muscles of the knee and hip joint to keep the leg strong while recovering from the ankle sprain. Following the initial phase of physical therapy treatment, your therapist will begin having you perform pain free ankle range of motion as well as applying some passive range of motion to ensure there is no loss of ankle range of motion. Ankle strengthening may also be initiated during this phase. Next, your therapist will progress ankle range of motion and strengthening to help stabilize and support your ankle. You may also begin balance exercises to improve proprioception at the ankle. Proprioception is your body’s sense of the position your joints. When proprioception at the ankle is impaired, re-injury may occur so it is a very important concept when recovering from an ankle sprain. The last phase of your treatment may include reintroducing sport specific strengthening and activities to allow for your return to sport. There are also some preventative measures that may be taken following an ankle sprain, including the use of an ankle brace or ankle/foot taping. These techniques help support your ankle and help prevent re-injury.
If you have experienced an injury to your ankle and have any of the symptoms noted above, contact Total Performance Physical Therapy to make an appointment and start your treatment today!