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Ankle Sprains…

The ankle joint is one of the most frequently injured areas for those participating in recreational or competitive athletics. Approximately 85 percent of all injuries to the ankles are sprains of which over 80 percent involve the lateral (outside) ligament complex. Injury to the ankle occurs in running as well as jumping types of sports such as basketball, football, soccer and gymnastics. The majority of the injuries to the ankle are characterized as being minor to moderate and are quite responsive to rehabilitation that the patient can perform. Recovering from an ankle sprain involves early recognition, evaluation, as well as implementation of the appropriate techniques to minimize prolonged pain and disability which will affect ultimate return to activity.

Anatomy And Mechanics Of The Ankle Joint
The three major groups of ligaments which support the ankle joint are lateral collateral (outside), medial collateral (inside) and tibiofibular (front and back) ligaments. Of these groups of ligaments, the anterior lateral ligaments are the weakest of the ankle ligaments and most frequently injured. Generally these are injured by inversion. Serious injury results when the ankle suffers an eversion (ankle turned outwardly) stress.

Many different movements can lead to a sprain. Common scenarios include: a poorly executed cutting maneuver enhanced by inadvertent foot fixation; landing on an irregular surface such as another players foot or a rutted playing field; and uncontrolled landing from jumps.

The effects of ankle sprains include pain, immediate loss of activity, and weakening of support structures causing chronic instability (the tendency for the foot to give away or rollover). The duration of this instability is dependent on the severity of the injury. It is important to institute proper treatment to avoid chronic instability and repetitive ankle sprains in the future.

Ankle sprains are divided into three categories according to their severity:

First-degree Sprains
Mild injury, some fibers torn, little or no hemorrhage, pain mainly on the outside of the ankle, no loss of function, no loss of ligament strength.
Second-degree Sprains
Moderate injury, a tear in the ligament, pain usually on the outside ligament, may be inside also, swelling and hemorrhage, decreased motion, mild to moderate loss of function.
Third-degree Sprains
Severe injury, complete ligament separation, total loss of function, diffuse swelling and hemorrhage.
The diagnosis of ligament sprains is made by a combination of an accurate history detailing the exact mechanism of injury, physical examination, x-rays and sometimes more specific diagnostic studies.

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