Ankle sprains are one of the most commonly occurring injuries in athletics. They can side-line any athlete from competing and are difficult to prevent from coming back.
Mechanism of Injury
- Lateral ankle sprain: usually from inversion with plantarflexion (turning the toes in while pointing them down) leading to injury of the ligaments on the outside of the ankle.
- Medial ankle sprain: usually from eversion with dorsiflexion (turning the toes out while pointing them up) leading to injury of the ligaments on the medial side of the ankle. Because the ligament here (deltoid ligament) is very strong, this injury is rarer and can take up to twice as long to heal than lateral sprains. It is also often associated with fractures of the fibula or other bones in the ankle (medial malleolus, talar dome, articular surfaces).
- Syndesmotic sprain: Injury to the front and/or back lower ligaments of the ankle. This often occurs from hyperdorsiflexion (pointing the toes up too far) and eversion (pointing the toes out).
Signs and Symptoms
Lateral Ankle Sprain
- Potential significant swelling within 2 hours because of the rich blood supply.
- Tender to the touch over the outside ankle ligaments, bruising that drains into the foot.
- Different levels of instability (depending on grade of the sprain).
- Positive tests for ligament laxity of your outside ankle ligaments.
- X-ray shows no signs of fracture.
Medial Ankle Sprain.
- Tender to the touch over the inside ankle ligament.
- Bruising and swelling along the medial side of the ankle
- Positive test for ligament laxity of the inside ankle ligament.
- X-ray needed to rule out avulsion fracture (bone fragment pulled away from the bone) or fracture of the inside ankle bone, or top of the ankle.
Syndesmotic Sprain
- Positive tests for front/back ligament laxity and severe swelling (possibly fracture) in the lower leg
- Pain and swelling over the front/back ligaments and the lower leg space.
- Specific X-ray may show abnormal joint space in the lower leg.
- Recovery time is longer compared to other sprains.
- Need to rule out fracture and avulsion.
There are 3 degrees of ankle sprains which indicate the severity of the sprain:
1st degree: involves minimal swelling, point tenderness, no ligament laxity, no limp or difficulty hopping. An athlete typically recovers in 2-10 days.
2nd degree: has more swelling specific to the ankle, increased ligament laxity, a limp and athlete is unable to heel raise, hop, or run. Typical recovery time is 10-30 days.
3rd degree : includes a lot of swelling, tenderness on both the inside and outside of the ankle, even more ligament laxity, and the athlete cannot put any weight on the ankle. Recovery can be anywhere from 30-90 days or more.
Please visit us for consultation and treatment
Pusat Rawatan Tradisi Wong
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