Ankle sprains make up the most common injury in sport and is often an injury see in the general population with injuries occurring at work and home. We often see these injuries in sports such as dancing, netball, basketball, rugby and football/soccer.
Ankle sprains can just be that, a sprain of the ligaments on the outside of the ankle. The injury usually occurs to the ATFL and/or CFL ligaments.
Now, if treated right and rehabilitated, return to sport can be done efficiently and well. If rehab is poor, chronic ankle issues can arise, such as chronic ankle instability, pain, poor sport performance and an increased risk of re-injury.
When an ankle sprain appears and sounds unusual, is behaving differently or is not progressing, we may have a different injury present. An important component of coming to the right diagnosis is getting a thorough history and listening closely to the mechanism of injury. This can direct to the correct diagnosis which may be more subtle than a straight forward ankle sprain.
Mechanisms and potential diagnosis can include:
Inversion injury (ankle rolls outwards)Lateral/outside ligament ankle sprain Ankle fractures
– Medial/inside talus compression/fracture
– Lateral malleolus fracture
– Fibular growth plate fracture Fractured base of 5th metatarsal Anterior process of calcaneus fracture Peroneal tendon injury
Eversion injury (ankle rolls inwards)Medial ligament injury Syndesmosis injury Ankle fracture – Medial malleolus fracture Tibialis posterior tendon injury
Compression injuryPossible osteochondral/cartilage injury of the ankle joint (Talus)
The injuries in italics are the common presentations based around these mechanisms. Other injuries listed here are important things to consider should a patient present with a recent ankle sprain or a sprain that is not progressing as expected. These other injuries should be considered and investigated as they can change the management and rehabilitation plan.
Rehabilitation, as stated above, is key to returning to sport at the highest level, regardless of the injury. Correct rehab after diagnosis is made, with movement, strength and conditioning, proprioceptive/balance exercises and graded return to play will allow optimum return to sport and hopefully prevent another sprain or injury occurring.
Taping and bracing following injury may help in preventing a reinjury (secondary injury). There is also some thought (see paper – Ankle Bracing is Effective for Primary and Secondary Prevention of Acute Ankle Injuries in Athletes: A Systematic Review and Meta-Analyses – https://link.springer.com/article/10.1007/s40279-018-0993-2) that taping and bracing may help with preventing an initial (primary injury) ankle sprain. See our ankle taping video below. We also stock ankle braces – give us a call or drop by if you would like advice on both.
If you have a recent ankle injury or are experiencing persistent ankle pain/issues following an injury, give us a call on 4356 2588, and we would be more than happy to help. Alternatively, you can book an appointment online via the button below.
Brukner and Khan’s – Clinical Sports Medicine, 5th Edition
Ankle Bracing is Effective for Primary and Secondary Prevention of Acute Ankle Injuries in Athletes: A Systematic Review and Meta-Analyses – https://link.springer.com/article/10.1007/s40279-018-0993-2
Thanks to Coast Sport Physiotherapist Matt for preparing this blog. You can find out more about Matt here.