Ankle sprains are very common injuries – almost everyone has experienced one at some point in their life. They are especially common among athletes and it is important that these injuries are treated and rehabilitated properly to avoid reoccurrence or development of a chronic injury.
Types of Ankle Sprains
Inversion ankle sprains are the most common type of ankle sprains. They involve a stretching or tearing of the lateral ligaments, which are on the outside of the ankle. There are 3 ligaments located on the outside of the ankle: the anterior talofibular ligament, calcaneofibular ligament, and posterior talofibular ligament. The injuries to these ligaments represent approximately 85% of all ankle sprains. The most frequently injured ligament is the anterior talofibular ligament.
Eversion ankle sprains are less common, they occur when the ankle is rolled outward causing injury to the ligaments on the medial side (inside) of the ankle.
The most common risk factor for an ankle sprain is previous history of a sprain. A previous sprain may compromise the strength and integrity of the stabilizers and ligament. Sprains can also interrupt sensory nerve fibers. Other factors include bracing, shoe type, and intensity/duration of the competition or activity.
Prevention and Treatment
Some signs and symptoms of an ankle sprain include:
- Altered ability to bear weight
- Tenderness – of the soft tissue or bone
- Crepitus (abnormal popping, cracking, or grinding of the affected joint)
If you are unable to weight bear and have bony tenderness you will want to rule out a fracture by getting an x-ray. The Ottawa Ankle Rules provide a good guideline for when imaging is recommended.
- Initial treatment: 48-72 hours after an ankle sprain a good way to reduce pain and swelling is by following RICE (Rest, Ice, Compression, and Elevation).
- Sub-Acute Treatment:
- Restore ROM: Moving ankle/foot through a pain-free active range of motion.
- Proprioception/Balance: Single leg balance on floor/ground and on compliant surfaces.
- Strength: Use a Theraband as resistance against movement in all planes of motion.
Bracing is also a good option to help prevent ankle sprains.
Basic Recovery Timeline
Mild Ankle Sprain: Full recovery can usually be seen within 14 days.
Severe Ankle Sprain: Recovery can last anywhere from 4-6 weeks. During this time the tissue will move through the 4 stages of recovery which are: Inflammation, Proliferation, Remodeling, and Maturation. For more information on each phase click here.
How Physical Therapy Can Help
If you are experiencing symptoms similar to what is described above it is important to rehabilitate the ankle properly to avoid reinjury. Physical therapists are movement specialists fully equipped to treat and rehabilitate any injuries you may be experiencing. If you have any questions or concerns you would like to discuss with one of our physical therapists, we encourage you to schedule a free screen with us!
Roos KG, Kerr ZY, Mauntel TC, Djoko A, Dompier TP, Wickstrom EA. The epidemiology of lateral ligament complex ankle sprains in National Collegiate Athletic Association sports. American journal of sports medicine. 2016.The American Journal of Sports Medicine Vol 45, Issue 1, pp. 201 – 209
Beynnon, B. D., Murphy, D. F., & Alosa, D. M. (2002). Predictive factors for lateral ankle sprains: a literature review. Journal of athletic training, 37(4), 376.