Ankle sprain is a common injury which happens when the ankle is bend more than normal. This over stretch weakens the ligaments that hold the bones together. The ankle consists of 3 joints. The joints are between the lower end of two long bone s in your leg Tibia and Fibula and two bones in your feet called as Talus and calcanium. Together with the muscles and ligaments the bony ends on the sides of your long bones called as malleoli provides stability to the joint. As the ankle is least stable in foot down position, where most stability is provided by the ligaments, injuries are common when foot is in this position.
There are two types of sprains an inversion injury happens when the foot rolls inwards and causes injury to the ligaments on the outside of the ankle called as lateral ligaments. Most of the time a ligament called as anterior talofibular ligament(ATFL) is injured which is the weakest of the lateral ligaments. An eversion injury happens when the foot is rolled outwards it causes injury to the ligaments on the inside called as medial ligaments or Deltoid ligament. As the medial ligament requires a greater force to be injured these sprains always take longer to rehabilitate.
Ankle sprain Symptoms
Pain, bruising and swelling and difficulty to weight bear are the initial symptoms. The location of pain indicates which ligament is injured. In severe injuries where there is complete rupture of ligament you will feel instability the ankle joint. In case of severe ankle sprain there is a chance of associated fractures.
Ankle sprain Treatment.
Your physiotherapist will be able to assess the possibility of some of the common fractures using a palpation method called as Ottawa ankle rule. The other aims of ankle examination are to check for any instability, loss of range of motion, reduced strength reduced proprioception and associated injuries.
Initial treatment is focussed on protection of the joint using taping, bracing, air cast boots or crutches if needed, optimal loading that means the right amount of activity to stimulate healing, ice, compression and elevation(POLICE). Ultra sound therapy, Laser acupuncture taping, bracing, and exercises are used to reduce pain and inflammation. Manual therapy and exercises are used for improving the range of motion, strength and joint position sense(proprioception). Once all the movement are pain free and there is adequate muscle strength and proprioception, functional exercises can be started based on the persons functional needs.
Healing of ligaments takes about 6 weeks, but also depends on the severity of the injury and other medical problems which you might have. Everyone recovers from the injury at different rates. As the ligament is healing it is important to do specific exercises advised by your Physiotherapist to improve flexibility and strength .It is very important to complete the whole rehabilitation process to reduce the chances of re injury.