Having played soccer all my life, ankle sprains or “a rolled ankle” are issues that are quite commonly seen in the sport and I am quite familiar with them, having been on the receiving end.
What is it?
It is an injury, damage or overstretching of one or more ligaments in the ankle as well as the surrounding tissues. These ligaments are important as they form a link between the bones in the ankle and foot, as well as provide support and stability to the joint. The two types of ankle sprains are lateral and medial ankle sprains.
A lateral ankle sprain is damage or injury to the ligaments on the outer (lateral) aspect of the ankle. These injuries are usually a result from the ankle going into inversion with plantar flexion (ankle and toes turned inwards while the toes are being pointed down) while a medial ankle sprain is usually due to eversion with dorsiflexion (ankle and toes pointing out while the toes are pointing up). Lateral ankle sprains are more common than medial ankle sprains. A medial ankle sprain is usually rare due to a couple of reasons. Firstly, the fibula bone prevents the ankle from rolling far enough to sprain or cause ligament damage on the inner aspect of the ankle. Due to this, its important to get an x-ray as soon as possible because the fibula bone can get fractured. Secondly, the medial ligament, also known as the deltoid ligament, is stronger than the ligaments on the outer aspect of the ankle. So there would have to be a substantial amount of force to cause a medial ankle sprain.
The greatest risk factor for ankle sprains is a previous history of sprains. Previous sprains cause ligament scarring and excess looseness of the ankle joint, increasing the reoccurrence of a sprain. Poor rehabilitation or recovery after a previous sprain can also cause a recurring sprain due to weakness in the muscles surrounding the joint. Some of the other risk factors include playing a contact sport, weak ligaments, high foot arches, weight-bearing on the injured limb at the time of the injury, the condition or surface of the pitch, as well as ankle instability or increased laxity.
***Grades of Sprains***
Ankle sprains are described based on their severity and they can be classified into 3 grades.
Grade 1: Least severe. Ligaments are overstretched. There will be swelling present for at least the first 4-7 days. There will only be mild tenderness and pain. Usually there is no joint instability, bruising as well as no difficulty weight bearing, although it is not uncommon to have issues with weight bearing immediately after the injury.
Grade 2: Slightly more serious. Partial tear. Once again, swelling is evident and the pain, as well as tenderness, will be moderate. There will be pain with weight bearing and walking with mild to moderate joint instability. With a grade 2 sprain, there will be a loss of range of motion and function in the ankle joint.
Grade 3: Severe because it is a full tear/rupture of the ligaments. There will be severe pain, swelling, tenderness and bruising with the patient unable to bear weight on the ankle. Instability and loss of function as well as range of motion will be present. These can sometimes be associated with a fracture.
Come down to Thrive Wellness-Centre to see me and I’m sure I’ll be able to help! I will be posting more information on how chiropractors can help with this issue as well as things you can do to reduce the recurrence of this injury. Stay tuned!