A sprained ankle is one of the most common injuries presenting to physiotherapy clinics on a daily basis. The lateral ligament complex (outside of the ankle) is frequently the injured structure, this consist of three ligaments; 1) Anterior talofibular ligament 2) Posterior talofibular ligament and the 3) Calcaneofibular ligament.
These ligaments are overstretched or torn with an inversion mechanism (rolling the ankle in) as the outside of the joint is opened. The inside of the joint is compressed with this mechanism and can be a cause for ongoing medial ankle pain.
Grades of Ligament sprains:
- Grade 1- up to 20% of the ligament tearing
- Grade 2 – (partial tear) up to 50% ligament tearing
- Grade 3 – over 80% tearing of the ligament fibres.
Grade 1 sprains generally recover with 1-2 weeks and respond well to physiotherapy. The patient can often weight bear immediately after the injury and there is often mild swelling which settles quickly. A grade 2 sprain or partial tear is a more severe injury characterised by inability to weight bear, moderate to severe swelling and more significant pain. These patients often require crutches to walk and may take up to six weeks to fully recover. A grade 3 rupture can take up to 3 months to rehabilitate and in some cases may require surgery to repair the ligament.
Initial treatment for ankle sprains should follow the RICE principle; rest,compression, ice and elevation. Ice buckets work well initially to reduce swelling. Once the patient is able to weight bear rehabilitation commences with active range of motion, calf strengthening, balance re-training and sports specific training. Most patients who sprain an ankle will be back to full functioning within six weeks, however ,there is a small group of patients who will have ongoing pain and swelling which may require further investigations such as an MRI.
All physica staff have received extra training in the assessment and management of ankle sprains. We will perform an accurate assessment giving you a diagnosis with a rehabilitation program to follow so you are back on the sporting arena ASAP.