Ankle Injuries

Fig.1 lateral ligaments of the ankle.

Fig.2 medial ligaments of the ankle.

Early, Self Management of Ankle sprains.

Ankle sprain injuries are common. Their severity is variable and depends on the extent of trauma involved. The most common mechanism of injury is to roll over the ankle in an outward direction. This causes the ligaments on the outside or lateral side of the ankle to be stretched (see fig.1.)

More rarely, the ankle is rolled in an inward direction and the damage occurs to the deltoid or medial ligament (see fig 2.)

Ankle sprains are classified in the following way according to the extent of ligament damage:-

• Grade 1 – stretching of the ligament(s) only
• Grade 2 – stretching and partial tearing of the ligament(s)
• Grade 3 – complete rupture of the ligament(s.)

A fourth situation can occur with severe sprains where a small fragment of bone (usually the fibula and occasionally the tibia) is distracted as the ligament is stretched. In this case and with grade 3 tears, the ankle may need to be immobilised in a cast and possibly require surgery. In all grades of sprain there is likely to be pain, swelling and/or bruising at the site of injury. These effects can be minimised by employing the flowing self management techniques.

1) Apply ice to the area immediately following injury. This can be in the form of a specialised gel pack, crushed ice or frozen peas. Apply the ice for 10-15 mins. with the foot elevated above the level of the hip. This may be repeated hourly or 2 hourly for the first 24 hours depending on the extent of injury. After this time, continue to apply ice at least 3 times a day until the swelling is significantly reduced.

2) Compression applied to the area can also help to reduce the effects of swelling. This can be in the form of tubigrip. The tubigrip bandage should cover the foot, ankle and lower calf and should be applied in double thickness.

3) Weight-bearing on the injured ankle should be kept to a minimum. Gentle active movements of the ankle in all directions will help to mobilise swelling and maintain range of movement.

These steps can be summarised as follows:-

Rest
Ice
Compression
Elevation

In addition to employing these techniques, it is important that you see your GP or physiotherapist as early as possible. This is so that a specific diagnosis can be made management arranged ensuring a return to full fitness.

If you have any further queries regarding ankle sprains, please contact one of the therapists at the Courtyard Clinic.