Ankle injuries are one of the most common injuries in sports and activities that involve running, jumping, collisions or changing direction. Most people have experienced some form of ankle injury, ranging from a mild sprain or little tweak that can be walked off over a few minutes, to nasty things like fractures, ligament ruptures or dislocations. Being a complex and mobile joint with a large range of movement in multiple directions, there are many things that can go wrong when the joint is forced into a place it doesn’t want to be. With two long bones in the lower leg, seven tarsal (ankle) bones, and nineteen more in the forefoot and toes, there are a huge number of articulations and joints. Each requiring stabilisation with ligaments and joint capsules, articular cartilage to protect the bone surfaces as well as muscles and tendons to move everything. As you can imagine, there are a lot of things to damage!
- Ankle problems usually involve one or a combination of the following:
- Lateral ligament or inversion sprain
- Peroneal muscle or tendon strain
- Lateral joint compression
- Subtalar joint issues
- Midfoot sprain
- High ankle sprain
- Medial ligament (eversion) sprain
- Instability due to motor control deficits
By far the most common acute ankle injury involves an inversion sprain, which puts at risk the lateral ligaments which are the anterior talofibular ligament (ATFL), calcaneofibular ligament (CFL) and posterior talofibular ligament (PTFL). As well as the peroneal muscles/tendons, the lateral joint capsule, and the 5 th metatarsal bone, and occasionally other structures too. This is your classic rolled ankle, usually involving pain and swelling on the outside of the ankle. Sometimes it can be painful to walk, and it definitely makes any strenuous exercise or sport difficult.
Diagnosing ankle injuries clinically is usually quite accurate and a diagnosis can be made by a
physio without the need for imaging or scans. However, if a fracture or other significant
pathology is suspected, an X-ray or MRI may be required – your physio can refer for this.
Treatment of an injured ankle involves settling the pain and swelling, restoring the ability to move normally and retraining balance and proprioception. Occasionally a walking boot is required, but the sooner you are back on your feet the better to minimise further deficits and ensure a faster and full recovery. Treatment options vary depending on the diagnosis, but can include stretching, joint mobilisation, muscle strengthening and balance retraining, among others. Because treatment does vary a bit depending on the nature of the injury, an accurate diagnosis is important to guide your prognosis and recovery.
Written by Tom Sheehan – BA (Sp & ExMgt), BAppSci (Ex & SpSci), MPhty, APAM
If you have recently injured your ankle or are suffering from any musculo-skeletal complaint, then the staff at Northside Sports Physiotherapy can guide and assist you.
Call your nearest practice to book in an appointment:
Hornsby – 9476 1666
Wahroonga – 9489 4588
Lindfield – 9489 4588