Ankle sprains occur in activities that require a rapid change of direction, especially if these take place on uneven surfaces. They also occur when a player, having jumped, lands on another competitors feet.
Ligamentous sprains are the most common, with inversion or rolling injuries accounting for 80% of ankle sprains. The higher occurrence is due to the relative weakness of the lateral ligaments compared with the medial ligament. As the strong medial ligament requires greater force to be injured, these sprains often take a lot longer to rehabilitate.
An ankle sprain may be accompanied by an audible snap, crack or tear, which, although often of great concern to the sportsperson and onlookers, has no particular diagnostic significance. Depending on the severity of the injury, the sportsperson may continue to play or may hop off the field. Swelling usually appears rapidly, although occasionally it may be delayed for some hours.
The onset of pain is very important. A history of being able to weight-bear immediately after the injury followed by a subsequent increase in pain and swelling as the person continues to play sport, suggests a sprain, rather than a fracture. The degree of swelling and bruising is usually an indication of the severity of the injury.
How long until I can return to sport?
The severity of the ankle sprain depicts the time away from sport. Return to sport is permitted when functional exercises can be performed without pain during or after activity. However, any sportsperson who has had a significant lateral ligament injury has an increased risk of injury recurrence for a minimum of 6 to 12 months post-injury. There are a number of methods to protect against these subsequent inversion injuries. Both external prophylactic measures (tape and braces) and neuromuscular training are effective in reducing this increased risk after an initial ankle sprain.
How can Physiotherapy help?
Physiotherapy treatment in the acute stage aims to reduce swelling, increase range and return normal walking. Following this period a rehabilitation program of strengthening, mobilization, balance, control and agility will need to be commenced before your ankle will be at its pre-injury function.
