The mechanism of ankle sprains occur in either a lateral or medial direction, with the lateral injury (inversion sprain) being the more common of the two. Inversion sprains may involve ligamentous damage to the anterior talofiblular ligament, posterior talofibular ligament, calcaneofibular ligament, and the posterior tibiofibular ligament. As the severity of your injury increases, so goes the potential damage to these ligaments. Medial injuries (eversion sprains) are rare in comparison to inversion type sprains, and typically involve injury to the deltoid and tiobiofibular ligaments. Another type of ankle sprain is a high ankle sprain, also known as a syndesmotic ankle sprain, as it involves the syndesmotic ligaments that connect the tibia and fibula. This injury is common when the tib-fib comlex rotates laterally.
As stated many times throughout this blog, I would recommend seeing your physician/physical therapist if you are unsure as to how to deal with this injury or if you feel as though your injury is severe. There is no substitute for skilled care, as your healthcare professionals are the leading experts in dealing with these afflictions. With this is mind, in the event we are dealing with a minor injury, let's take a look at how you can deal with these injuries.
Our first step in managing these injuries is to first follow the PRICE principal. Following this principal can limit the amount of swelling in your ankle/foot and allow for quicker return to function.
- Protect the injured area
- Rest the injured area
- Ice the injured area
- Compress the injured area
- Elevate the injured area
Our next step is allowing the ankle to heal, without causing further restrictions at the knee/hip/back because of altered gait/overprotecting the ankle. This would entail keeping activity to a minimum (don't jump right back into the activity that got you hurt in the first place!), but making sure to keep the ankle moving/exercising within pain tolerance. Strengthen via walking/exercise and you should be ready to take the next step in about 2-3 weeks.
Now that our ankle is nice and strong, are we ready to get back to action? Potentially. If you feel as though you aren't confident in your ankle, you are potentially lacking proprioceptive input in your ankle. What does this mean? Well, you have a strong ankle, but you also have a dumb ankle. Brandi L. Ross, ATC, states, "Proprioception is defined as the ability to establish a sense of position in space, especially at a joint. This function is associated with the joint mechanoreceptors and are interrelated. If the mechanoreceptors are damaged when an ankle sprain occurs, proprioception will be affected, which results in a reduction in the body's ability to balance. Thus, proprioception will not be an effective mechanism for reducing the chance for further injury. Reeducation of the mechanoreceptors becomes a vital key to returning an individual to a perceived sense of stability." After 4-6 weeks of incorporating proprioceptive exercise to your normal strengthening program, you should be ready to go!
Here are some examples of exercises you can do, but if you aren't feeling confident, don't rush it. Start slow and eventually work your way up to the more advanced exercises. Furthermore, if you as though you aren't progressing and you are still dealing with a lot of pain after a month or so, I implore you to see a physician/physical therapist.
Finally onto a discussion of footwear. One would be lead to believe that the higher the ankle support along the side of a shoe, the less likely you are to experience an ankle injury. In fact, it was more or less taboo to wear a low-top shoe in basketball because of fear of ankle injury. This couldn't be farther from the truth.
Countless research has been done on this subject and one conclusion is clear: the height of your shoe's ankle support has no bearing on the incidence of ankle injury. If you step on someone's foot and roll your ankle, there is nothing you can really do about that. But what you can reduce, is the amount of stress placed on the ankle during abnormal positions. Via the exercises shown above, the body is able to react quicker to abnormal situations, decreasing the likelihood of a repeat injury. When it comes to selecting a shoe, pick what feels comfortable on your feet, and what you feel is going to allow you to perform at a high level.
Hope this post helps with your ankle injuries! If you have any questions, feel free to email me at jcachodpt@gmail.com. Hope everyone is having a great week!
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