Ankle sprains are very common in the athletic population. Approximately 14% of athletic injuries are ankle sprains and I’m sure if you’re reading this you’ve probably experienced an ankle sprain. Certain sports have a higher frequency of ankle sprains that they are; soccer, basketball, running, and football. After experiencing an ankle sprain about 1-in-3 athletes will still have residual complaints about 9 months after the initial injury! When an ankle sprain occurs, 95% of the time it is a result of an inversion injury. This occurs when an athlete is running straight and makes a sudden cut. Jumping can also cause ankle sprains if an athlete does not land properly or lands on another player’s body and rolls the ankle. Lateral ankle sprains are the most common type of injury with the Anterior talofibular ligament (AT FL) being the most common ligament to be injured. The medial aspect of the ankle is protected by a fan-shaped ligament called the deltoid ligament.
Ankle sprains are classified into three grades. Grade 1 sprains are very mild and usually occurs when the ATFL is stretched. Recovery from this usually last between 1 to 2 weeks. Mild swelling, difficultly with hopping, and pin point tenderness over the stretched ligament are generally seen. Grade 2 sprains are moderate in nature and can occur when a complete or partial tear of the ATFL and injuries to the surrounding ligaments. There will most likely be a distinctive limp with the person being unable to run, hop, or raise their toes. There will be swelling and bruising and in general, recovery can take about 2 to 6 weeks. Grade 3 sprains are the most severe and debilitating. The athlete will be unable to bear weight and the injury is extremely painful. This usually indicates a complete tear of the ATFL and the calcaneofibular ligament. There will be significant swelling and bruising and the recovery time to return to play is usually between 1 to 3 months.
If you suffer from an ankle sprain it’s important to stop activity immediately and have it evaluated. Rest, ice, compression, and elevation (RICE) is a great place to start helping the injury heal. If an athlete suffers a minor ankle sprain a simple side line evaluation can be done by a trained professional and put the athlete through a variety of tests. Fist the athlete must be able to walk without a limp. If they pass then a hop test is performed. After that they must demonstrate they can jog forward and backwards followed by running at a higher speed forward and backwards. If they pass all of those the last test is figure-eight or side-to-side running and jumping. If there is no pain the ankle should always be taped and then the athlete can return to play.
It’s very important for grade 2 and 3 sprains to seek medical treatment. A recent study found that delayed rehabilitation is associated with recurrence and higher medical care use after ankle sprain injuries. Care for these injuries begins by reducing inflammation as quickly as possible, structural stabilization, passive mobilization, increased ability to bear weight, strength/muscular stabilization, functional stabilization and proprioception, and finally establish a home rehabilitation program.
In conclusion, it’s always better to have your ankle evaluated by a knowledgeable healthcare provider than just wait for the pain to go away. If the ankle sprain does not heal correctly or a self-prescribed rehab program does go as prescribed a future injury is more likely. The biggest indication of an athletic injury is a previous injury!
Hyde, T. E., & Gengenbach, M. S. (2007). Conservative management of sports injuries. Jones and Bartlett Publishers.
Delayed Rehabilitation Is Associated With Recurrence and Higher Medical Care Use After Ankle Sprain Injuries in the United States Military Health System. Journal of Orthopaedic & Sports Physical Therapy. Published Online:November 30, 2021Volume51Issue12Pages619-627
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