October 7, 2020 Physical Therapy of Milwaukee

Lateral Ankle Sprain

Lateral ankle sprains are one of the most common sport-related injuries. Lateral ankle sprains typically occur due to forced plantarflexion/inversion movement. Individuals who suffer numerous repetitive ankle sprains have been reported to having functional and mechanical instability within the ankle joint and an increased likelihood of re-injury.

Anatomy:

Let’s dive into the anatomy of the “Ankle Complex”

The Talocrural Joint (commonly known as the ankle joint) is considered a hinge joint and is made up of 3 bones, the tibia, fibula, and talus. The movements your true ankle joint allow are plantarflexion (i.e. pressing down on a gas pedal) and dorsiflexion (i.e. bringing toes up towards ceiling) which occur in what we call the sagittal plane. In addition to the boney structures associated with the ankle joint, it receives ligamentous support from the joint capsule and several surrounding ligaments including the anterior talofibular ligament (ATFL), posterior talofibular ligament (PTFL), calcaneofibular ligament (CFL), and the deltoid ligament.

The Inferior Tibiofibular Joint is made up of the distal articulation of the tibia and fibula. This joint allows for a small amount of rotation. Injury to your inferior tibiofibular joint is commonly known as a “High Ankle Sprain”. This joint in particular is also stabilized by thick interosseous membrane and your anterior inferior tibiofibular ligament and posterior inferior tibiofibular ligament.

The Subtalar Joint is the articulation of talus and calcaneus which allows movements in the frontal plane such as inversion (bringing foot in towards body) and eversion (moving foot away from body). It plays an important role in shock absorption. This joint in particular has extensive ligamentous support.

Injury:

As previously stated, lateral ankle sprains are one of the most common sports-related injury and occur due to forced plantarflexion and inversion. The most commonly affected ligament is the ATFL. Common deficits with repetitive ankle sprains are instability within the joint, loss of ROM (range of motion), loss of muscle strength, and reduced proprioception (awareness of the position and movement of the body), which in turn could lead to impaired balance.

Grades of sprains:

Grade 1- mild, painful and minimal micro tearing of ligament fibers;

Grade 2- moderate, painful and significant tearing of ligament fibers;

Grade 3- severe, often not painful, complete rupture of ligament fibers.

 

Rehabilitation:

Don’t wait to get treated for ankle sprains until they become chronic. Taking action before is important to avoid compensations up your lower extremity kinetic chain (i.e. knee joint, hip joint, pelvis, etc.). The rehabilitation process necessary to recover from a lateral ankle sprain would consist of reducing pain and swelling, restoration of strength, proprioception, and range of motion.

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