What Should I Do If I Rolled My Ankle

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Ankle injuries are one of the most common injuries that we see at Joeys during the Winter Season. One of the most frequent types of ankle injuries is a lateral ankle sprain. In this article, we'll delve into what a lateral ankle sprain is, its symptoms, causes, management strategies and prevention strategies.

What is a Lateral Ankle Sprain?

A lateral ankle sprain is an injury that occurs when the ligaments on the outside of the ankle are stretched or torn. This type of sprain is the most common, and is especially prevalent in sports that involve running, jumping, or sudden changes in direction.

Anatomy of the Ankle

To understand a lateral ankle sprain, it's helpful to know a bit about the ankle's anatomy. The ankle joint is made up of three bones: the tibia, fibula, and talus. These bones are held together by strong ligaments, which provide stability to the joint. The ligaments on the outside of the ankle, known as the lateral ligaments, include the anterior talofibular ligament (ATFL), the calcaneofibular ligament (CFL), and the posterior talofibular ligament (PTFL).

Severity of Lateral Ankle Sprains

Grade 1 (mild):

• Minor stretching or microscopic tears of the ligament fibres, with mild tenderness and swelling

Grade 2 (moderate):

• Partial tearing of the ligament, resulting in moderate pain, swelling, and bruising. There may be some instability in the joint

Grade 3 (severe):

• Complete tear of the ligament, causing severe pain, swelling, and bruising. Significant instability in the joint may be present, making it difficult to weight bear

Symptoms

• Pain on the outside of the ankle

• Pain that worsens when weight bearing on the affected foot or with movement of the ankle

• Swelling around the ankle joint, which appears rapidly after the injury occurs

• Bruising may develop around the ankle and foot

• Tenderness to the touch the ankle

• Sensation of weakness or instability in the ankle

• Limited range of motion of the ankle

Differentiating Between Mild, Moderate, and Severe Sprains

Grade 1 (mild):

• Mild tenderness and swelling

• Minimal bruising, if any

• Little or no instability in the joint

• Able to weight bear, though walking may be uncomfortable

Grade 2 (moderate):

• Moderate pain, swelling, and tenderness

• Noticeable bruising around the ankle and foot

• Some instability in the joint

• Difficulty weight bearing and walking without crutches

Grade 3 (severe):

• Complete tear of the ligament

• Severe pain and swelling

• Significant bruising

• Marked instability, making the ankle feel wobbly or give way

• Inability to weight bear on the foot without significant pain

Common Causes

SPORTS AND PHYSICAL ACTIVITIES:

• Running or walking on uneven terrain

• Jumping and landing activities

• Quick pivots and changing direction

• Contact sports or landing on another player's foot

IMPROPER FOOTWEAR:

• Wearing shoes without proper ankle support or with worn-out soles

• Not wearing metal studded boots on thick grass, wet surfaces or when playing rugby or soccer on a field with a cricket pitch

POOR PHYSICAL PREPARATION:

• Lack of strength, flexibility, and coordination

• Fatigued muscles provide less proactive and reactive support during physical activity

• Excessive training without adequate rest

• Inadequate warm-up

PREVIOUS ANKLE INJURIES:

• Previous ankle sprains increase may cause residual weakness or instability

Management Strategies

ASSESSMENT AND ACCURATE DIAGNOSIS:

• See your Sports Physio or Sports Doctor immediately for an assessment and accurate diagnosis. If you are injured while playing at Joeys on the weekend, we have Physios at all fields as well as a Sports Doctor.

 

PRICE (first 2-3 days):

1. Protect: Protect the injured ankle from further harm. Consider using crutches, a moon boot or a brace if advised.

2. Rest: Avoid prolonged weight bearing on the injured ankle.

3. Ice: Apply ice for 20 minutes every 2-3 hours during the first 48 hours.

4. Compression: Use an elastic bandage or tubigrib compression sleeve.

5. Elevation: Elevate the ankle above heart level whenever possible.

IMAGING:

• In some cases, X-rays may be needed to rule out a fracture to bones like the distal fibula.

• This is especially common in adolescents when the growth plates are still open.

• Isolated lateral ankle sprains can often be managed without MRI scans if they are properly assessed and accurately diagnosed.

PHYSIOTHERAPY REHABILITATION:

• Following a structured physiotherapy rehabilitation program to restore strength, mobility, and stability to the injured ankle. A sports physiotherapist will design a personalised rehabilitation program which considers your specific contributing factors and end goals.

• Follow @tbsphysio on Instagram to see our favourite exercises for ankle sprains.

BRACING / STRAPPING:

• Wearing ankle braces or straps during sport can provide additional support and stability, reducing the risk of re-injury. It is important to use bracing or strapping in conjunction with a good quality rehabilitation or prehabilitation program to avoid the muscles becoming reliant on the tape.

SURGERY:

• In severe cases where there is significant ligament damage or chronic instability, surgery may be necessary to repair or reconstruct the injured ligaments. Post-surgery rehabilitation is essential to ensure a full recovery and return to normal activities.

Prevention Strategies

PREHAB:

• Incorporate preventative ("prehab") proprioceptive and strengthening exercises into your gym program. Also, add prehab exercises into your warm-up before field or court training.

• Follow @tbsphysio on Instagram to see our top exercises for preventing ankle sprains.

RUNNING TECHNIQUE:

• Focusing on proper change of direction and landing mechanics can help minimise the strain on the ankles during activities that involve sudden movements, such as cutting or pivoting in sports like rugby, basketball or soccer.

SCREENING:

• Speak with your Physio about identifying any underlying risk factors including any anatomical variants you may have that predispose you to ankle sprains.

• This may include clinical tests, strength tests and performance testing and analysis with our VALD ForceDecks.

• The Drop Jump Test can be used to evaluate the reactive strength of the lower limb. Improving your reactive strength can help to reduce the risk of non-contact ankle sprains. These tests can be performed with force plates like our VALD ForceDecks.

APPROPRIATE FOOTWEAR:

• Wearing appropriate footwear with good ankle support can help prevent ankle sprains.

• Make sure you wear metal studs in wet weather, thick grass or when playing rugby or soccer on fields where there is a cricket pitch in the middle.

BRACING / STRAPPING:

• Wearing ankle braces or strapping during sport if you have a history of ankle sprains.

• As explained earlier, ensure this is only done in conjunction with a good quality rehabilitation or prehabilitation program.

Lateral ankle sprains are extremely common injuries which can be frustrating due to their recurrent nature. If you do sprain your ankle, make sure you get assessed by your sports physiotherapist immediately for the best outcome. How you manage ankle sprains in the first three days can have a big impact on how long it takes to return to sport.

Follow us on Instagram @tbsphysio to see our top exercises to help you stay on the field this season.