A sprain is an injury to the ligaments and capsuloligamentous structures of a joint, but it does not involve muscles or tendons. In the ankle joint — the joint of the talus — the mechanism of injury is a sudden inversion movement: the foot rolling inward at the forefoot. Through this mechanism, the lateral collateral ligament is injured. Less commonly, a sprain occurs through the opposite mechanism — the foot rolling outward — in which case the ligament injured is the medial collateral ligament. It is a particularly common injury, and it ranges in severity according to the strain placed on the ligaments, from a mild injury (grade 1) and a partial tear (grade 2) all the way to a complete tear (grade 3). The injury can occur from:
• A fall that throws the weight onto the ankle and rolls the foot
• Landing after a jump or a step
• Walking on uneven surfaces
• A blow to the foot during athletic activities
The Symptoms
The symptoms the patient experiences depend on the severity of the injury and include:
• Pain, especially when bearing weight on the limb
• Pain on palpation
• Bruising
• Swelling
• Limited range of motion of the joint
• Possible joint instability
In more severe injuries, the patient may feel a crackling sensation at the moment of injury.
Risk Factors
The factors that increase the likelihood of an ankle sprain are:
• Sports involving jumping and sudden changes of direction
• Uneven ground
• A previous ankle injury
• Poor physical condition
• Unsuitable footwear
Complications
If an ankle sprain is not treated properly, it can lead to chronic conditions such as:
• Chronic ankle pain
• Ankle instability
• Arthritis
• Recurrent injuries
How Physiotherapy Can Help
The first priority is reducing pain, which in some patients can be extremely acute. This is achieved through a combination of treatment options, such as specialised massage and the application of electrotherapy, which will reduce the pain in every case. The limb is then mobilised with specialised exercises. Gradually, as movement increases, strengthening exercises are introduced that will restore the foot and protect against possible future injuries. The interventions applied are:
Differential Assessment
Assessment by the Physiotherapist is essential in order to rule out — or confirm — the coexistence of a fracture and a referral to a Doctor. The assessment requires a detailed medical history, a description of the mechanism of injury, and the performance of clinical tests.
What can I do myself if I have an ankle sprain?
In the event of an ankle sprain, you should do the following immediately:
• Keep the foot elevated so that the swelling does not worsen too much
• When sitting, use a support so that the ankle is roughly at knee height
• When lying down, place a pillow under the entire foot so that the ankle is higher than the body
• Apply ice wrapped in a towel to the ankle for 20 minutes, 4–5 times a day
• Keep it wrapped with an elastic bandage or ankle brace for 30 minutes and then leave it free, 4–5 times during the day
• Protect it and move around with a walking aid so that it is not overloaded and no sudden movement occurs
For the treatment of sprains, call PhysioDanali today for specialised advice from the Physiotherapist!
• Rhon DI, Fraser JJ, Sorensen J, Greenlee TA, Jain T, Cook CE. Delayed Rehabilitation Is Associated With Recurrence and Higher Medical Care Use After Ankle Sprain Injuries in the United States Military Health System. J Orthop Sports Phys Ther. 2021 Dec;51(12):619-627. doi: 10.2519/jospt.2021.10730. PMID: 34847698.
• Denegar CR, Hertel J, Fonseca J. The effect of lateral ankle sprain on dorsiflexion range of motion, posterior talar glide, and joint laxity. J Orthop Sports Phys Ther. 2002 Apr;32(4):166-73. doi: 10.2519/jospt.2002.32.4.166. PMID: 11949665.
• Denegar CR, Hertel J, Fonseca J. The effect of lateral ankle sprain on dorsiflexion range of motion, posterior talar glide, and joint laxity. J Orthop Sports Phys Ther. 2002 Apr;32(4):166-73. doi: 10.2519/jospt.2002.32.4.166. PMID: 11949665.
• Mayo Clinic. Sprained Ankle.