Ankle Sprains
By Sameera Withanage
Introduction
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Ankle sprains are common musculoskeletal injuries that can affect individuals of all ages and activity levels. Whether caused by a misstep on uneven terrain or a sports-related incident, ankle sprains can lead to pain, swelling, and decreased mobility. The ankle joint ranks second in sports-related injuries, with lateral ligament injuries constituting approximately 85% of all cases. Notably, females and children exhibit higher rates of ankle sprain incidence.
Ankle sprains often result from rapid shifts in body mass over a weight-bearing foot, causing the ankle to roll outward, stretching and tearing ligaments. Factors such as plantar flexion and forceful eversion movements can increase the likelihood of sprains. Understanding the specific ligaments involved, like the Anterior Talofibular ligament (ATFL) in lateral sprains, is crucial for accurate diagnosis and treatment.
Patients with ankle sprains commonly present with pain, tenderness, swelling, bruising, difficulty bearing weight on the affected foot and instability. Immediate attention should be given if you experience one or more of the above symptoms. The initial first aid includes following the PRICE method: Protect – the affected area from further injuries, Rest – stop the activity and rest the injured joint; Ice – use ice packs every two hours, applied for 15 minutes; Compression - bandage the joint firmly, extending up the calf and down the foot; Elevation – elevate the injured ankle above the heart height if possible.
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Physiotherapy Management
Physiotherapy is a key component in the comprehensive management of ankle sprains. The healing process includes three main phases: Inflammatory, proliferative and remodelling. During the inflammatory phase, initial focus is set on the PRICE protocol (Protect, Rest, Ice, Compress, Elevate).
As pain and swelling decrease, the emphasis shifts to strengthening and stabilizing the ankle. This phase is critical for preventing recurring ankle sprains and restoring normal function with the use of a progressive exercise program that includes targeted exercises to enhance muscle strength, proprioception, and range of motion. Since ankle sprains can lead to a loss of balance and proprioception, the treatment plan includes specific exercises and activities to enhance your balance, coordination, and proprioception, improving the body's ability to sense its position and respond effectively to changes in terrain.
The final stage of the physiotherapy treatment plan focuses on functional rehabilitation, incorporating activities that mimic the demands of daily life or specific sports. This phase ensures that individuals regain the confidence and ability to perform their regular activities without fear of re-injury.
Ankle sprains demand a thorough understanding of their epidemiology, mechanisms, and clinical presentation. But, with a holistic and comprehensive approach it is easier to reach for a successful recovery.
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