© Roland Jeffery Physiotherapy 2011 Phone: (09) 444-7643 Website: www.rjphysio.co.nz

Ankle Sprain What is a sprained ankle? The most common type of ankle injury is a sprained ankle. A sprain is generally a stretching or tearing of the ligaments. There is a difference between a strain and a sprain. A sprain is an injury to a ligament, while a strain is an injury to a tendon or muscle. An ankle sprain is an overstretching or tearing of one or more ankle ligaments. Sprains to the outer side of the ankle make up most of all ankle sprains. An ankle sprain is common in football and can occur on uneven playing fields or when tackling an opponent. The extent to which a player can sprain their ankle can be vastly different. The most common damage done in an ankle

sprain is to the talo-fibula ligament (See Figure 1). If the injury is worse a player might also damage the calcano-fibula ligament or capsule. In addition to ligament damage the player may also strain some tendons (See Figure 2).

There are three grades of ligament sprain: Grade 1 Generally this involves some stretching or possibly some slight tearing of the ligament, little or no joint instability, little swelling, mild pain and some joint stiffness.

Grade 2

This involves some tearing of the ligament fibers, moderate instability of the joint, swelling and stiffness and moderate to severe pain. Walking will be difficult and you will usually be unable to continue playing.

Grade 3

Normally this grade of ankle sprain involves a complete or total rupture of a ligament, gross instability of the joint, severe swelling and severe pain. Often the player will not be able to walk immediately after this injury and may also notice bruising. The player will not be able to move their ankle freely.

Figure 2: Ankle Anatomy - Tendons

Figure 1: Talo-fibula ligament.

© Roland Jeffery Physiotherapy 2011 Phone: (09) 444-7643 Website: www.rjphysio.co.nz

How do ankle sprains occur? The ankle joint has many ligaments that provide stability by limiting the amount of side-to-side movement. Ankle sprains are usually caused by an excessive rolling of the foot onto its outer edge so that the sole of the

foot is turned inwards. (See Figure 3). This causes the ligaments on the outer side to overstretch and tear. If the player has a history of previous ankle sprains then they are more likely to have repeated ankle sprains than players who have not injured it before.

What can the player do? Rest is the first thing a player should do - stop training or playing football. A player can aim to reduce the swelling by using the RICE method of treatment (Rest, Ice, Compression and Elevation) as soon as possible. Initially the player can protect the injured ankle by taping or a support or brace. The player may need to use crutches if they have difficulty putting weight onto the ankle or walking is uncomfortable. All players should see a physiotherapist who can advise on rehabilitation, including mobility and strengthening exercises and

more importantly advise you on when they should return to training.

RICE Treatment. Rest

Rest reduces further damage – stop playing or training as soon as the injury occurs. Avoid as much movement of the injured part as possible to limit further injury. Don’t put any weight on the injured ankle.

Ice

Ice cools the tissue and reduces pain, swelling and bleeding. Place ice wrapped in a damp towel onto the injured area – don’t put ice directly onto bare skin. Hold the ice pack firmly in place with a bandage. Keep ice on the injury for 15-20 minutes every 2 hours for the first 48 hours. Don’t put any weight on the injured ankle.

Figure 3: Ankle sprain.

Ankle Strapping Ice Packs.

© Roland Jeffery Physiotherapy 2011 Phone: (09) 444-7643 Website: www.rjphysio.co.nz

Compression

Firm bandaging can help to reduce bleeding and swelling. Ensure that bandaging is not so tight that it cuts off circulation.

Elevation

Elevation helps to stop bleeding and reduce swelling. Raise the injured ankle on a pillow for comfort and support Keep the injured ankle raised as much as possible.

What can a sports professional do?

A sports professional, usually a physiotherapist or sports doctor will assess your injury and be able to give you a diagnosis. To begin with the physiotherapist will aim to reduce swelling and pain – using the RICE method of treatment, compression and possibly electrotherapy (for example ultrasound). A sports doctor may prescribe anti-inflammatory medication. Later, when the ankle begins to heal a physiotherapist may use stretching techniques, friction massage, acupuncture and a rehabilitation program will be prescribed. This will include balance exercises, strengthening and football specific skills (See Figure 4). The sports professional will advise you when to return to running, training and eventually playing football. Most ankle sprains make a full recovery.

Compression

bandage.

Figure 4: Wobble board.