What is a Lateral Ankle Sprain?
Understanding your injury – Brisbane Physiotherapy Edition.
Overview of Lateral Ankle Sprain:
Description
- An ankle sprain involves the stretch or tear (partial or complete) of the ligaments of the ankle.
- Lateral ankle injuries are far more common than medial ankle injuries due to the relative instability of the lateral joint and weakness of the lateral ligaments compared to the medial ligaments.
- The lateral ankle consists of three ligaments:
o ATFL (anterior talofibular ligament)
o CFL: (calcaneofibular ligament)
o PTFL: (posterior talofibular ligament)
- Lateral ligament injuries occur in activities requiring rapid changes in direction, especially if these take place on uneven surfaces (e.g. grass fields). They are also seen when a player, having jumped, lands on another competitor’s feet. They are one of the most common injuries seen in basketball, volleyball, netball and most football codes.
Presentation
- Mechanism of injury: Lateral ankle sprains usually occur during a rapid shift of body center of mass over the landing or weight-bearing foot. The ankle rolls outward, whilst the foot turns inward causing the lateral ligament to stretch and tear.
- Pain especially when putting weight on affected foot
- Associated audible snap, crack or tear sound when injury occurs.
- Swelling usually appears rapidly, although occasionally it may be delayed some hours.
- Limitations in ankle range with associated instability
- Previous history of ankle injuries/instability
- Depending on the severity of the sprain an athlete may continue to play or may rest immediately.
Ligament Tear Grades
- Grade I – disruption of some collagen fibres, minimal swelling and tenderness with little impact on function.
- Grade II - Disruption of considerable proportion of collagen fibres. Moderate swelling, pain and tenderness with decreased range of motion and ankle instability.
- Grade III – complete disruption of collagen fibres. Significant swelling, tenderness, loss of function and marked instability.
Lateral Ankle Sprain Management
Treatment
- The management of lateral ligament injuries of all three grades follows the same principles.
- After minimizing initial swelling and reducing pain, the aims are to restore ankle range, muscle strength and proprioception, and then commence a progressive sport-specific exercise program.
- Initial management: RICE – raise, ice, compression, elevate
- Treatment techniques utilized:
Massage – to reduced swelling
Joint mobilization – to restore ankle range of movement
Strengthening exercises – calf and peroneal muscles
Proprioception exercises
Functional exercises when pain has completely diminished – jumping, hopping, twisting, figure-eight running.
Running programs
Sports-specific exercises
- Any athlete who has had a significant lateral ligament injury shoulder use protective taping or bracing while play sport for a minimum of six to 12 months post-injury.
Prognosis: most lateral ankle sprains take 2-6 weeks to heal, but grade 3 sprains can take as long as 12 weeks.