Ankle Sprain – Physical Therapy

Ankle sprains are common place in both a sporting environment and during everyday life. The most common types of ankle sprains are an inversion ankle sprain and an eversion ankle sprain. With an inversion ankle sprain, the anterior talofibular ligament is disrupted and possibly the calcaenofibular ligament on the outside of the ankle. With an eversion ankle sprain the medial ligaments are damaged.

Inversion Ankle sprain

Inversion sprains are four times more common than eversion sprains due to the congruency of the ankle joint and the relative weakness of the medial ligaments. In adherence to the Ottawa ankle rules, an X- ray for an ankle sprain is only necessary if there is pain on the malleolar zone and any one of the following:

• Bone tenderness over the lateral malleolus to 6cm above
• Bone tenderness over the medial malleolus to 6cm above
• Tenderness over the the base of the fifth metatarsal
• Tenderness over the navicular
• Inability to weight bear both immediately and at clinical assessment (4 steps)

A common consensus regarding risk factors have not been established in the literature. Some possible risk factors proposed are leg dominance, weight, height, ligament laxity and previous ankle injury.

Symptoms

• Ankle pain
• History of a trauma
• Swelling
• Bruising
• Difficulty to weight bear.

Treatment

Initial treatment of ankle injuries involves POLICE (Price – protection, O – optimal -, L – loading, I – ice, C  -compression and E – elevation). Ice the ankle for 10-15 minutes every few hours. For optimum rehabilitation, early movement is essential. Therefore once the pain allows, drawing small circles/alphabet with your foot is a considered early rehabilitation exercise. Strength, control, propriception and kinetic chain should also be addressed in a comprehensive rehabilitation plan.