Ankle sprains are something to which anyone and everyone relates to. A simple misstep can give you an excruciating amount of pain within microseconds. For Dancers, Rockstars, athletes, or any other sportsperson, a minor musculoskeletal sprain is common but yet deadly as in terms of the timing of it. It can cost step backs in their respective careers. Also, a severely sprained ankle may not heal properly as it could lose its range of motion and stability, resulting in recurrent sprains in the future.
Most Common people try to tough out ankle injuries by waiting to heal on its own and not seeking medical attention. But it is always advised to get a check-up to rule out the possibility of Ankle fracture. Hence, sometimes it can be self-tested by putting weight on the ankle and taking a few steps to ensure you didn’t break anything. Common practice would be to get an x-ray to ensure.
What Is An Ankle Sprain?
Ankle Sprains are the injury involving the Trisection of ligaments that surround and connect the bones of our leg and the foot. Ankle Sprains happens when these bands of ligaments are torn apart by accidentally twisting or turning of the ankle. These ligaments stabilize the joint and get sprained when they are forced to do movements beyond their range of capacity.
Being the most common Sports injury, the symptoms are quite easily observable and commonly known to all. They can still vary depending on the severity of the injury.
- Pain (Can last from few days to few weeks or maybe a month, depending on the severity of the sprain)
The Different Types of Ankle Sprains:
1) Inversion ankle sprains
Inversion ankle sprains are the most common type of soft-tissue injury. These types of sprains also go by name of the lateral ankle because the lateral ligaments of the foot joining the bone are involved in the injury. The function of the lateral ligaments is to prevent excessive inversion of the ankle. These lateral ligaments aren't much strong as the ones on the other side of the ankle, due to which inversion sprains are more likely to happen than eversion sprains.
The three primary ligaments named after the bones they connect are the anterior talofibular & posterior talofibular connecting the talus and fibula, and the calcaneal fibular connecting the calcaneus and fibula. The twisting of anterior talofibular and calcaneofibular is the cause of inversion ankle sprain. Once the foot turns inward, the instability in the posture and imbalance exert more pressure on the ligaments which they can’t handle causing them to crack and tear a little bit.
2) Eversion ankle sprains
These sprains also go by the name Medial sprains because of the medial and Deltoid complex ligaments involved in the injury, which is a group of four separate ligaments. These ligaments make up a triangular shape, which is the Greek letter Delta, hence the name. These four ligaments are the anterior tibiotalar, tibiocalcaneal, posterior tibiotalar, and tibionavicular. The names correspond to the bone they connect. Together they are deltoid group
Eversion ankle sprains are less common than inversion sprains because the deltoid ligament group is much stronger than the lateral ankle ligaments. Also, the bone fibula blocks the foot from moving to the other side while consequently generating greater ankle stability against excessive eversion. If somehow, the deltoid ligaments experience enough pressure to be the reason for the injury, there are chances of structural injuries along with deltoid ligament sprains, such as fracture or dislocation. Hence, always get an evaluated opinion from a licensed professional to rule out the possibility.
3) High Ankle Sprain
This type of sprain happens when ligament between the bones tibia and fibula gets damaged. The joint is called the ankle syndesmosis, hence the high ankle sprain is also known as Syndemosis sprain. The tight webbing of ligaments is bound together by the interosseous membrane. The severity of the sprain could be a first-degree high ankle sprain when the few ligament fibers of the interosseous membrane are damaged. Second-degree sprain when more damage is done to tibia-fibula joint and extreme damage to the interosseous membrane. A Third-degree high ankle sprain is when a joint is possibly dislocated and the interosseous ligament is completely torn apart.
High ankle sprains are caused mainly due to twisting injuries occurring from playing sports that have a lot of cutting and contact involved. For example, football, basketball, roller derby, etc. The twisting is caused by extreme ankle dorsiflexion and an external rotation of the shin bone.
But what causes an ankle sprain?
The reason why they occur could be many. Stepping onto the hole on the uneven surface, Putting Wrong foot forward while running, Rebouncing while playing sports, etc. However, the most common reasons are listed below:
1) Lack of Ankle’s muscular Flexibility
One of the most common reasons for an ankle sprain is the lack of ankle muscle flexibility. Ankle dorsiflexion is a movement of the ankle backward towards shin which limits the motion when the ankle becomes limited; the foot only has one option, to roll outward. The result is an ankle sprain. Hence exercise to improve fortifications are recommended
2) High Arched Foot
Another reason why some people frequently sprain their ankles is because of their foot anatomy. This is especially true in those that have a supinated foot. A supinated foot or high arched individual tends to place all their weight on the outside part of their foot. This perpetuates rolling your ankle. An orthotic may help these types of individuals.
3) Limited Strength & Proprioception
Last but not least, limited strength at your hip and muscles on the outside part of your leg, the Peroneals can cause an injury. Limited proprioception means a lack of balance and stability. Lesser the stability of the posture, the more will be the chances of the falling on the wrong foot.
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What you should do for an ankle sprain?
1) Bow down to P.R.I.C.E. Principles Initially
Protection, Rest, Ice, Compression, and The elevation is another derivative version of traditional R.I.C.E. principles. The P.R.I.C.E. should be must be followed for the first 48 – 72 hours immediately after the injury. The goal is to control the amount of swelling to, prevent further injury, and to reduce the pain.
P- Protection - Use ace bandage, over-the-counter brace, aluminum splint, sling, protective tape, etc. to partially immobilize the injured area.
R- Rest - A person should not indulge in activities that stress the injured area to the point of pain which causes slow healing. The purpose is to allow the body’s healing processes to naturally occur.
I- Ice- Cryotherapy is the use of cold treatments to treat injuries. Ice reduces swelling as well as decrease pain. Use a simple plastic bag of crushed ice to place over on the light barrier like a paper towel over the affected area for 10 to 15 minutes.
C-Compression- compression wrap should be applied to the injured area right after the Ice pack to minimize the swelling. Three-inch elastic bandages can be used for an adult’s ankle.
E- Elevation- Elevate the leg to a certain height to reduce the amount of blood flow to the injured area. The injured area has to be above the heart level. Controlling swelling can help decrease pain and speeds up recovery time.
2) Address the Root Cause of Your Ankle Sprain
For the right treatments and procedures to follow, one must know the root cause of the Ankle sprain to determine which type of Ankle sprain it is, and what ligaments are damaged. Always consult a doctor to rule out the possibility of fracture in severe cases. When you a physical therapist for foot and ankle physical therapy they can pinpoint this for you.
3) Restore Your Range of Motion
Range of Motion (ROM) exercises and stretches help the recovery. These basic stretches allow the healed ligaments to move gently. Flex, Circles, Alphabets, Towel Curls are few of the ROM stretches which can be done at home without anybody’s help.
4) Regain the Functional Strength
To gain back, the normal functioning strength of the ankle which has been severely injured from grade III sprain, it is important to follow the proper regime of exercises. ROM stretches helps with the basic movements which should be followed by advanced stretching exercises. After that move on to strengthening exercises and balance and control exercises to properly regain the entire functioning strength.
5) Consider Dry Needling
Dry needling is a new intervention that helps with an array of muscle, nerve, ligament, and tendon pathologies. The premise behind this treatment is reducing myofascial trigger points but also increases blood flow and connective tissue to the injured area. This may help expedite the healing process.
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About Author: Dr. Scott Gray
Dr. Scott Gray is an internationally recognized and expert physical therapist specializing in sport, athletic, and back and neck injuries. He is the inventor of a revolutionary form of treatment called the GRAY METHOD. This type of treatment unlike others, addresses the CAUSE rather than just your SYMPTOMS with a full body approach. For more information on how to ease or overcome your injury, go to www.backinmotionsspt.com.