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Ankle Sprains

think we all know someone who has sprained an ankle, including ourselves. From stepping wrong when walking your dog to jumping to catch a ball and landing funny, ankle sprains are the most common injury of the ankle joint. When a sprain occurs, there is a stretch or tear of the ligaments surrounding the ankle. This occurs due to the ligaments being pulled beyond their normal range of motion. Read along to learn some more about the anatomy of the injury as well as some stretches and exercises that can help protect the ankle!

Statistically, lateral (or outside) ankle sprains are the majority of ankle sprains, where the foot rolls inwards (inversion sprain). With this mechanism of injury, the ATFL (anterior talofibular ligament) is most frequently injured. Less commonly, when the foot rolls outwards, AKA medial (or inside) sprain, the deltoid ligament is frequently injured (eversion sprain). 

When speaking on risk factors of all types of ankle sprains, there are extrinsic and intrinsic factors. Extrinsic factors include:

  • History of previous ankle sprains

  • Shoe type

  • Duration or intensity of an activity

It is common for those who have previously sprained their ankle to sprain again due to factors including the previously injured ligament not healing properly. 

Intrinsic factors include:

  • Sex

  • Limb dominance

  • Foot anatomy

Interestingly, studies show that it is more likely for those who are left leg dominant to sprain their ankle than those who are right dominant. 

Ankle sprains can range from a slight stretch or damage to the fibers to a full rupture of the ligament. When classifying sprains, things get complicated depending on the amount of ligaments involved. When it is certain only one ligament was injured, the grading system goes as such:

  • Grade I: minor stretch/damage to fibers

  • Grade II: partial tear of ligament

  • Grade III: complete rupture of ligament 

On the other hand, when multiple ligaments were injured, the grading system differs. In this case the system goes off of the severity of the injury:

  • Grade I: mild impairment - minor swelling/tenderness with little impact to function

  • Grade II: moderate impairment - moderate swelling, pain, and tenderness with decreased range of motion

  • Grade III: severe impairment - major swelling, tenderness, and loss of function

Once an ankle sprain is classified, recovery can then be determined. When talking about a mild sprain, recovery can take between 5 and 14 days. In this time rehabilitation includes decreasing pain and swelling as well as protecting the ankle from further injury. More severe sprains can take 3 to 12 weeks, or even more, to recover. Rehabilitation will also include reducing pain and swelling but a focus will take place on restoring movement and stability through physical therapy. The healing process for any sprain can be put in 3 phases, which include:

  • Inflammatory phase - occurs immediately after the injury and can last 2 to 7 days. 

  • The goal of this phase is to reduce pain and swelling and to protect the ankle from any further injury by using the RICE method (rest, ice, compress, elevate)

  • Proliferative phase - begins once inflammation has decreased and can last for 4 to 6 weeks.

  • The goal of this phase includes bettering ankle function, working on weight bearing, and increasing range of motion while still protecting the ankle from another injury

  • Remodeling/maturation phase - the final phase of healing is long term and variable.

  • This phase includes lots of rehab exercises including balance/coordination, muscle strength, mobility, and weight bearing

Working on exercises and stretches that can protect your ankle are important to help minimize the chance of an injury. Many times balance/coordination and smaller muscles surrounding the ankle are ignored in training. Incorporating the following stretches and exercises into your routine can help protect the ankle and prevent injury:

  • Gastrocnemius stretch

  • Soleus stretch

  • Sit on heels

  • Double leg to single leg calf raises

  • Banded inversion/eversion

  • Balance on full foot to ball of foot

Check out the IG post on May 30, 2024 to see how to perform these exercises! Don’t be left out this summer in all the outdoor activities and protect your ankles!

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