Lateral Ankle Sprains
by Jai Sappal
Mechanism of Injury
A lateral ligament injury can happen as pictured, where the foot is placed in excessive inversion (where the bottom of your foot faces inward). Most typically when you put your foot on the edge of a step or curb, or step on a rock. It can also be combined with excessive plantar flexion (pointing your toes down). This can result in damage to the ligaments and if it is bad enough, can damage other structures as well. Healing time will depend on what has been injured and to what degree.
What is Injured?
Ligaments are not as flexible as muscles. This lack of elasticity provides structural support between joints, essentially attaching the bones to each other. Therefore, excessive forceful movement in one direction can cause these ligaments to stretch beyond their actual length, resulting in strain or tear to the fibres of the ligament.
The ligament that is frequently injured for a lateral ankle sprain is called the Anterior Talofibular Ligament (ATFL). The other ligaments may also be damaged. They are called your Calcaneofibular Ligament (CFL) and Posterior Talofibular Ligament (PTFL). Other structures around the ankle include your bones, tendons, the syndesmosis, as well as various other ligaments on the other side of the ankle. Sometimes when a ligament is pulled too strongly a small chip of the bone that it is attached to pulls away, this is called an avulsion fracture. It is also possible to dislocate tendons from their sheaths around the ankle.
What Should I do?
The first thing you will notice if you’re injured is the pain. Typically, an ankle sprain is associated with swelling and often spectacular bruising as well. In the case of a mild sprain the pain will be mild, and swelling resolve quickly, however a more severe ligament sprain or if you have injured other structures around the ankle the pain will be more severe, and will not resolve over the first 24 hours or so. Generally the goals of rehabilitation are to get the ankle moving as soon as possible within the constraints of pain and also depending on the severity of the injury to the tissues. Appropriate exercise resumed as early as possible will ensure the best outcomes for all ankle related injuries – however this will depend and vary significantly depending on the injury itself. From a return to running and sport within a few days to a week for the mildest end of the spectrum to possible management in a boot for a short period in the case of avulsion fractures. Our team loves ankles – and we are experts at assessing whether you are likely to be ready for a return to normal activity ina short timeframe, or if it will need a little more thorough rehabilitation to prevent longer term problems and ensure the best outcome. Get in touch with us here if you have any questions, or take a look at this ankle article too.
If you would like to ask me a question about ankle sprains or anything else that I may be able to help you with you can text me a message via 0480 030 785.
Jai Sappal
Physiotherapist
Peak Health Services.
Related articles: Ankle Sprains: Why RICE Isn’t Going To Cut It For You.