Ankle Sprains: The Basics

The ankle joint (talocural joint) is a hinge joint in that it moves back and forth in one direction only, propelling the body forward in walking, running and vertically in jumping.

It provides stability for the lower limb as the joints of the foot manouvre to navigate the ground, and the tibia and femur rotate to keep us balanced.

The subtalar joint lives under the ankle joint and this one allows the side to side movement – this is how the ankle ‘rolls’.

The ankle joint though is a box shape, like a cut out square ‘mortise’ joint in the carpentry of a timber cabinet edge.

Ligaments, tendons, and muscles play a vital role in supporting and controlling the ankle joint.

The most common ankle injury we see as Physio’s is a tear to the major lateral ligament, the ATFL.

A ‘sprain’ means a tear to some degree. The tear may range from numerous micro-tears that would not be seen to the naked eye, to complete rupture where the ligament is torn in two.

Physio’s follow a criteria to decide if an X-Ray is ordered and thus rule out a fracture. This is known as the ‘Ottowa Ankle Rules.’

The rehab of ankle ligament tears involves:

1. Managing pain & swelling. This may involve a CAM boot.
2. Possible surgery in more extreme cases
3. Restoring range of motion, if the hinge has become stiff
4. Restoring strength of the ligament & muslces
5. Restoring balance
6. Restoring function (hop, land, run etc)
7. Injury re-prevention: ongoing exercise of the ‘kinetic chain’

Poorly rehabilitated ankle tears may lead to re-injury and an unstable ankle joint, increase the risk of arthritis, or contribute to a knee injury.

It has been my experience that the ankle sprain is often underplayed, compared to a torn knee ligament.

Although, with good diligence, communication and persistence, quality outcomes can be achieved.

What’s been your experience?

Always a pleasure calling into the Raymond Terrace Magpies hallowed home ground and thanks for having me friends.

Evan : )