Ankle sprains are among the most common musculoskeletal injuries, affecting individuals of all ages and activity levels. These injuries occur when the ligaments that connect the bones of the ankle joint are stretched or torn due to sudden twisting or rolling movements. Understanding the various types of ankle sprains is crucial for accurate diagnosis, appropriate treatment, and successful recovery. In this blog, we’ll dive into the world of ankle sprains, exploring their different types, causes, and degrees of severity.
1.) Lateral Ankle Sprains: Lateral ankle sprains are the most prevalent type and occur when the foot rolls inwards (inversion) excessively. This movement stretches or tears the ligaments on the outside of the ankle. The three primary ligaments affected are the anterior talofibular ligament (ATFL), the calcaneofibular ligament (CFL), and the posterior talofibular ligament (PTFL). Lateral ankle sprains are often classified into three grades based on the severity of the ligament damage. These are common in running and cutting sports such as football, and soccer.
2.) Medial Ankle Sprains: Medial ankle sprains are less common and involve stretching or tearing of the ligaments on the inside of the ankle due to the foot rolling outwards (eversion). The deltoid ligament, a strong and broad ligament on the inner side of the ankle, is most commonly affected in this type of sprain.
3.) High Ankle Sprains (Syndesmotic Sprains): High ankle sprains occur when there is excessive outward or inward twisting of the ankle joint. Unlike lateral and medial sprains, which involve the stretching or tearing of individual ligaments, high ankle sprains involve the syndesmotic ligaments that connect the tibia and fibula bones. These sprains are often more severe and may require a longer recovery period. These are common in hockey due to the skate boot limiting range of motion of the lower ankle.
4.) Bimalleolar and Trimalleolar Sprains: Bimalleolar sprains involve the stretching or tearing of two of the three major ligaments that stabilize the ankle joint—typically, the ATFL and the CFL. Trimalleolar sprains involve damage to all three major ligaments, often accompanied by a fracture of the medial or lateral malleolus bones. These sprains are more complex and require thorough evaluation and management.
Ankle sprains can be caused by a variety of factors, including:
Degrees of Severity
Ankle sprains are typically classified into three degrees of severity:
1.) Grade I: Mild sprains involve slight stretching of the ligaments without tearing. There may be minimal pain, swelling, and stiffness.
2.) Grade II: Moderate sprains involve partial tearing of the ligaments. This type of sprain causes more significant pain, swelling, and bruising.
3.) Grade III: Severe sprains result from complete tearing of the ligaments. This type of sprain causes intense pain, significant swelling, and possibly joint instability.
Ankle sprains, though common, can cause significant pain and discomfort. Proper management and rehabilitation are crucial for a complete recovery and to prevent long-term complications. Physiotherapy plays a vital role in this process, offering targeted interventions that aid in healing, restore mobility, and prevent future sprains. In this article, we’ll delve into the ways in which physiotherapy assists individuals in recovering from ankle sprains.
The Role of Physiotherapy in Ankle Sprain Recovery
1.) Early Assessment and Diagnosis: A physiotherapist begins by conducting a comprehensive assessment to determine the extent of the injury. This involves evaluating the range of motion, strength, stability, and overall function of the affected ankle. Accurate diagnosis guides the development of a tailored treatment plan.
2.) Pain Management: Pain is a common symptom of ankle sprains, and a physiotherapist employs various techniques such as manual therapy, soft tissue mobilization, and modalities like ultrasound or electrical stimulation to alleviate pain and reduce inflammation.
3.) Restoration of Range of Motion: Ankle sprains can lead to restricted joint movement. Physiotherapists employ specific stretching exercises and manual techniques to gradually restore the normal range of motion in the ankle joint.
4.) Strengthening Exercises: Weakness in the muscles surrounding the ankle can contribute to instability. Physiotherapy programs include exercises that target these muscles, helping to enhance their strength and provide better support to the injured joint.
5.) Balance and Proprioception Training: Ankle sprains often lead to diminished balance and proprioception (awareness of one’s body position). Physiotherapists employ specialized exercises on wobble boards, balance discs, and unstable surfaces to improve proprioception and reduce the risk of future sprains.
6.) Functional Rehabilitation: Physiotherapists focus on restoring the ability to perform daily activities and sports-specific movements. This involves designing exercises that mimic real-life tasks, gradually progressing from basic to complex activities.
7.) Manual Therapy: Hands-on techniques such as joint mobilization and manipulation are used by physiotherapists to enhance joint mobility, reduce stiffness, and improve overall function.
8.) Gait Analysis: An altered gait due to an ankle sprain can lead to compensation patterns that affect other parts of the body. Physiotherapists analyze an individual’s walking or running pattern and make necessary corrections to prevent secondary issues.
9.) Taping and Bracing Guidance: Physiotherapists provide guidance on the proper use of ankle taping or bracing during the recovery phase. This support can aid in preventing re-injury while the ligaments heal.
10.) Progressive Exercise Programs: As healing progresses, the physiotherapist modifies the exercise program to include more challenging activities. This gradual progression ensures that the ankle becomes stronger and more resilient over time.
11.) Education and Self-Management: Physiotherapists educate patients about their condition, including the healing process, the importance of adherence to the exercise regimen, and how to recognize signs of potential complications.
12.) Prevention Strategies: Physiotherapists work with patients to identify factors that contributed to the initial sprain and develop strategies to prevent future occurrences. This may involve guidance on proper footwear, warm-up routines, and specific exercises to strengthen vulnerable areas.
Physiotherapy is a cornerstone in the recovery journey of individuals with ankle sprains. By employing a holistic approach that addresses pain management, restoration of mobility, strengthening, balance training, and functional rehabilitation, physiotherapists play a pivotal role in helping patients regain their quality of life. From the initial assessment to the final stages of recovery, their expertise guides individuals towards a complete healing process and empowers them to return to their daily activities and sports with confidence and reduced risk of re-injury.
Massaging a sprained ankle is generally not recommended during the initial stages of injury. Applying pressure to the affected area could worsen swelling and inflammation. Instead, focus on rest, ice, compression, and elevation (RICE) for the first 48 to 72 hours after the injury. Consult a medical professional for guidance on when and how to incorporate massage into your recovery process.
While mild sprains can often be managed at home, it’s important to properly assess the severity of the injury. Rest, ice, compression, and elevation (RICE) are initial steps for reducing pain and swelling. Gradually reintroduce weight-bearing and movement as pain subsides. However, for moderate to severe sprains or if you’re unsure, consult a healthcare provider for an accurate diagnosis and appropriate treatment plan.
It’s generally advisable to remove any compression wrap or bandage before going to bed. This allows the injured area to receive adequate blood flow and prevents the potential of constriction during the night. However, follow the guidance of your healthcare provider, as they may recommend specific protocols based on the severity of your sprain and your individual needs.
Dr. Hadbavny holds a chiropractic fellowship in sports sciences. This means he has an additional five years of post-graduate training, extensive experience with complicated injuries and sports injuries.
He has worked with various local, provincial and national level athletes including Tennis Canada, Pacific FC, Victoria Highlanders FC, Victoria Ironman, Canada Games, BC Summer and Winter Games.
The information presented in this blog post is for educational purposes and should not be interpreted as medical advice. If you are seeking medical advice, treatment or a diagnosis, consult with a medical professional such as one suggested on this website. The Clinic Accelerator Inc. and the author of this page are not liable for the associated risks of using or acting upon the information contained in this article.
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