All about Ankle Sprains

The ankle joint is the second most likely joint to be injured in sport, with ankle sprains being the most common injury to the ankle joint. Research indicates that 85% of ankle sprains involve stretching or tearing of the lateral ligaments on the outer side of the ankle. Lateral ankle sprains primarily occur in sports where primary movements involve jumping/landing, change of direction and acceleration/deceleration (i.e netball, basketball, hockey and football).

Common signs and symptoms of a lateral ankle sprain involve the following:

1. Pain: the pain is often immediate, sharp with movement and worsens with weightbearing. Aching is also common at rest.

2. Swelling and bruising: it is not uncommon to notice swelling and bruising around the ankle in the hours and days following injury.

3. Limited movement: movement in the ankle can often be limited following injury due to pain, swelling and muscle guarding.

4. Instability: in more severe cases, it is normal that you may experience a feeling of instability or ‘giving way’ during weight bearing activities

Evidence-based management strategies for lateral ankle sprains involving a comprehensive approach focus on addressing pain, restoring joint mobility, strengthening muscles, improving balance, promoting functional and return to sport.

The following are common evidence-based management strategies that you will be guided through by your physiotherapist:

1. PEACE (protection, elevation, avoid anti-inflammatories, compression, elevation) LOVE (load, optimism, vascularisation, exercise)

2. Manual therapy: manual therapy techniques such as joint mobilisation and soft tissue release can help restore normal joint mechanics, reduce pain and improve range of motion

3. Therapeutic exercise: progressive exercises focusing on strengthening the ankle, calf muscles and lower limb stability are vital for functional recovery. These may include balance and proprioceptive training, resistance exercises and neuromuscular control exercises.

4. Functional rehabilitation: integrating sport-specific or activity-specific exercises into the rehabilitation is crucial for a safe return to sports or daily activities. This includes agility drills, sport-specific movements and gradual progression of activities to improve functional performance.

5. Patient education and injury prevention: educating patients on diagnosis, management and prevention strategies is key in reducing the risk of re-injury. Addressing modifiable risk factors such as muscle imbalances or biomechanical abnormalities is also integral.

Madison Jamieson: Physiotherapist, PROmotion Health

Madison is lucky enough to be working alongside East Fremantle Sharks in the West Australian Netball League and the U18s WA Women’s Hockey Team which allows her vast exposure to diagnosis and management of ankle injuries. If you have an ankle injury you would like guidance on, contact the team at PROmotion to start your rehabilitation journey.

References:

Chen, E. T., McInnis, K. C., & Borg-Stein, J. (2019). Ankle sprains: evaluation, rehabilitation, and prevention. Current sports medicine reports, 18(6), 217-223.

Dubois, B., & Esculier, J. F. (2020). Soft-tissue injuries simply need PEACE and LOVE. British journal of sports medicine, 54(2), 72-73.

Halabchi, F., & Hassabi, M. (2020). Acute ankle sprain in athletes: Clinical aspects and algorithmic approach. World journal of orthopedics, 11(12), 534.