Ankle Sprains

Types of Ankle Sprains

An ankle sprain occurs when the ankle is forced too far in one direction resulting in a tear to the supporting ligaments. Due to the anatomy of the ankle, there are three classifications of ankle sprains.

1. An inversion ankle sprain, where the sprain occurs to the outside of the ankle.
2. An eversion ankle sprains where the sprain occurs to the inside of the ankle.
3. Lastly, a high ankle sprains where the sprain occurs higher up affecting the syndesmosis.

Inversion Ankle Sprains

These are the most common type of ankle sprain, they occur to the ligaments on the outside of the ankle. The lateral ankle is stabilised by three ligaments that run between the fibula and bones of the foot. The most commonly injured ligament is the anterior talofibular ligament (ATFL) although multiple ligaments can be damaged depending on the direction of force.

Eversion Ankle Sprains

They are less common as they occur when the foot is forced into eversion (outwards) placing the deltoid (inside) ligament under stress. More force is required to damage the deltoid ligament, healing times tend to be twice as long compared to inversion ankle sprains.

High Ankle Sprains

The syndesmosis holds the shin bones, the tibia and fibula together at the ankle. These injuries usually occur when a torsional or rotational force is applied to the ankle. The most common method for this to occur is when the foot is planted and the tibia and fibula bones rotates inwards. High ankle sprains are more severe than eversion and inversion ankle sprains and you should seek medical attention from your doctor of physiotherapist.

Ankle Ligament Tears

Grade 1

Grade 1 ankle sprains are categorised as having less than 50% of each ligament torn. These may be painful, have mild bruising or swelling. These symptoms often settle within a few days with rest ice elevation and compression and the underlying sprain heals within about 6 weeks.

Grade 2

Grade 2 ankle sprains are categorised as having more than 50% of each ligament torn with some fibres remaining intact. You will often experience pain, moderate to severe swelling, bruising and difficulty walking initially. The ankle can feel unstable when moving in the direction of the sprain. Instability, reduced balance and confidence are often noticed. Ankle sprains cause a loss of proprioception (the brains ability to detect where your ankle is in space). It can take 8-12 weeks for an inversion ankle sprain to heal and for balance and confidence to be restored.

Grade 3

Grade 3 ankle sprains are categorised as a full rupture as no fibres remain intact. These ankle sprains often have significant swelling, bruising and instability. It can take 12 or more weeks for healing and for function to be restored depending on the number of ligaments affected.

Ankle Sprain Rehabilitation

The initial phases of managing an ankle sprain are crucial as it will impact the length of your rehabilitation. Staying off your ankle and reducing the swelling through compression and ice is a great way to manage an acute ankle sprain.

Taping or using an ankle brace to restrict your ankle movement to allow the ligament to heal is crucial in your rehabilitation. This will restrict ankle movement in the appropriate places without altering your walking mechanics.

Once your ankle has settled, your physiotherapist will be begin you on an exercise program designed to strengthen the affected muscles and tendons from your ankle sprain.

A good measure to find out how strong your ankle needs to be, is the number of single leg calf raises you can do for your age and gender.

Return to Sport

Once you have gained sufficient strength in your ankle, your physiotherapist will progress you to the plyometric phase on your rehab. A common desired activity is wanting to return to running, whether it be a Sunday morning job or on the sports field.

Being able to hop on a single leg requires a high level of strength and control, having a poor hop can put you at significant risk of developing another ankle sprain, particularly with sporting activities. To assess your hopping ability, a commonly used test is the side hop test.

Why You Should Choose Link Health and Fitness

We have experienced senior clinicians with one of the best equipped facilities on Auckland’s North Shore. Our patients have access to a full gym and Pilates studio and a physiotherapist is always available during staffed hours to offer you additional support.

We are part of several ACC programs, and you may be eligible to receive fully subsidised healthcare for your injury. To find out more don’t hesitate to book online or contact us on 09 5536565.