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I see a lot of ankle sprains. They are one of the most common sports injuries, particularly in sports requiring changes of direction, hopping, jumping, and landing.
The usual sprain is an injury to the ligaments on the outside of the ankle, as the foot rolls under you. Ligaments are the bits of rope that hold your joints together. Ligaments take the strain if a joint is moved further than it should go. The ligaments will stretch about 4%, but after that will start to tear and will completely rupture at 8% stretch. Ligament injuries are painful, with bleeding and swelling. Commonly a large egg of swelling makes an ankle sprain look nice and dramatic. |
The severity of the ankle sprain can be graded I to III, depending on the amount of damage done to the lateral ligaments.
Grade I injuries, you can usually keep running on at the time of injury, and, although sore, there is not a resulting laxity in the ligaments. Most people are able to return to sport within 7 days.
Grade II injuries are too sore to keep running on at the time of injury. There is a resulting laxity or stretch in the ligaments. Return to sport will be 4 to 6 weeks.
Grade III injuries are a complete rupture of the ligament and usually involve some damage to other structures also. They can be 10-12 weeks or more before return to sport.
It’s important to get your ankle sprain assessed to determine the grade of injury and whether any other structures have been damaged, and to get advice on the best management, so you can get back to sport ASAP.
Grade I injuries, you can usually keep running on at the time of injury, and, although sore, there is not a resulting laxity in the ligaments. Most people are able to return to sport within 7 days.
Grade II injuries are too sore to keep running on at the time of injury. There is a resulting laxity or stretch in the ligaments. Return to sport will be 4 to 6 weeks.
Grade III injuries are a complete rupture of the ligament and usually involve some damage to other structures also. They can be 10-12 weeks or more before return to sport.
It’s important to get your ankle sprain assessed to determine the grade of injury and whether any other structures have been damaged, and to get advice on the best management, so you can get back to sport ASAP.
Ankle injuries may require a day or two of rest and protection, sometimes on crutches and/or in a boot. Good initial management is crucial. Look after the ankle with regular ice, good compression, elevation, and anti-inflammatory medication.
Management then addresses:
I like to progress ankles quickly. Walk on it as soon as you can, and progress through a program of increasing weight bearing, walking, jogging, running, and return to play as quickly as possible.
Although you may return to sport fairly quickly, it is important to do rehab exercise to improve strength and balance in the ankle to prevent recurrent injuries. It is very common for people to go over on their “bad” ankle again and again due to a lack of appropriate rehab.
The ankle may stay sore for a while after you’ve returned to full sport, and some ongoing stretching, strengthening and balance exercises is essential to avoid further problems.
Management then addresses:
- Range of movement at the ankle
- Stiffness in the joint
- Taping
- Bracing
- Recovery of the ligaments
- Resolution of swelling
- Scar tissue management
- Balance exercises
- Strengthening of the muscles that protect the ligaments
- Return to sport
I like to progress ankles quickly. Walk on it as soon as you can, and progress through a program of increasing weight bearing, walking, jogging, running, and return to play as quickly as possible.
Although you may return to sport fairly quickly, it is important to do rehab exercise to improve strength and balance in the ankle to prevent recurrent injuries. It is very common for people to go over on their “bad” ankle again and again due to a lack of appropriate rehab.
The ankle may stay sore for a while after you’ve returned to full sport, and some ongoing stretching, strengthening and balance exercises is essential to avoid further problems.
