Ankle Sprain

Introduction

Ankle sprain is a common injury that occurs when the ligaments in the ankle are stretched or torn. Symptoms of an ankle sprain include:

• Pain and tenderness: There is pain and tenderness in the ankle area, particularly around the affected ligaments.
• Swelling: Swelling is a common symptom of an ankle sprain. The affected area may be swollen and may feel warm to the touch.
• Bruising: Bruising can occur around the ankle area as a result of a sprain.
• Limited range of motion: You may find it difficult to move your ankle or put weight on it.
• Instability: Your ankle may feel unstable, and you may feel like it may give out from under you.

Stiffness: Stiffness can also be a symptom of an ankle sprain.

Ankle sprains can be classified into three grades based on the severity of the injury

Grade 1: A mild sprain that involves stretching of the ligaments without any tearing. Symptoms may include mild pain, swelling, and stiffness.

Grade 2: A moderate sprain that involves partial tearing of the ligaments. Symptoms may include moderate pain, swelling, bruising, and difficulty walking.

Grade 3: A severe sprain that involves a complete tear of the ligaments. Symptoms may include severe pain, significant swelling and bruising, and inability to put weight on the affected foot.

Ankle sprains are typically caused by a twisting or rolling motion of the ankle, often when the foot is planted on an uneven surface or during activities that involve sudden changes in direction or jumping.

Biomechanics of ankle sprain:-

Ankle sprains occur when the ankle joint is forced beyond its normal range of motion, causing the ligaments that hold the bones together to stretch or tear. The biomechanics of an ankle sprain involve a combination of factors, including the position of the foot, the direction and magnitude of the external force, and the strength and flexibility of the ankle joint and its supporting structures.

When the foot is planted on an uneven surface or during activities that involve sudden changes in direction, the ankle joint may twist or roll inward or outward, depending on the direction of the external force. This motion can cause the ligaments on the inside or outside of the ankle to stretch or tear.

The ligaments that are commonly injured in an ankle sprain include the anterior talofibular ligament (ATFL), the calcaneofibular ligament (CFL), and the posterior talofibular ligament (PTFL). The ATFL is the most commonly injured ligament in ankle sprains, as it is the weakest and most vulnerable to injury.

Factors that can increase the risk of ankle sprains include previous ankle injuries, poor ankle joint stability, decreased range of motion, weak ankle muscles, and wearing inappropriate footwear.

PT Assessment of Ankle Sprain:-

Ankle sprains are a common injury that often require physiotherapy assessment and treatment. The assessment of ankle sprains usually involves a thorough examination of the affected ankle, including the following components:

History taking: The physiotherapist will ask questions about the injury, including how it occurred, the nature and severity of the pain, and any previous injuries or medical conditions that may affect the ankle.

Observation: The physiotherapist will visually inspect the ankle for swelling, bruising, deformity, or other signs of injury.

Range of motion (ROM) testing: The physiotherapist will assess the ankle’s ability to move in different directions, such as dorsiflexion, plantarflexion, inversion, and eversion.

Strength testing: The physiotherapist will test the strength of the muscles around the ankle, including the gastrocnemius, soleus, tibialis anterior, and peroneals.

Stability testing: The physiotherapist will test the stability of the ankle joint by performing stress tests, such as the anterior drawer test, talar tilt test, and inversion stress test.

Functional assessment: The physiotherapist will assess the patient’s ability to perform activities of daily living, such as walking, standing, and going up and down stairs.

Special tests: The physiotherapist may perform special tests to rule out other conditions that may mimic an ankle sprain, such as fractures, ligament tears, or nerve injuries.

Based on the assessment findings, the physiotherapist will develop a treatment plan tailored to the patient’s individual needs, which may include exercises, manual therapy, modalities, and education about self-management strategies. The goal of physiotherapy treatment is to reduce pain, improve function, and prevent future injuries.

Physiotherapy management of Ankle sprain:-

Once an ankle sprain has been assessed by a physiotherapist, an advanced physiotherapy management plan can be developed to help the patient recover and return to their pre-injury level of function. Here are some strategies that may be included in an advanced physiotherapy management plan for an ankle sprain:

Manual therapy: Manual therapy techniques such as soft tissue massage, joint mobilization, and manipulation can help improve joint range of motion, reduce pain and stiffness, and enhance tissue healing.

• Modalities: Modalities such as ice, heat, ultrasound, and electrical stimulation can be used to help reduce pain and swelling and promote tissue healing.
• Functional rehabilitation: Functional rehabilitation exercises can help the patient regain their ability to perform activities of daily living and return to their pre-injury level of function. The physiotherapist may recommend exercises such as balance training, proprioceptive training, and sport-specific drills.
•  Bracing and taping: Bracing and taping can provide support and stability to the ankle joint and help prevent re-injury. The physiotherapist may recommend ankle braces, compression stockings, or kinesiology tape.

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Comprehensive Guide to Ankle Sprains | Causes of ankle sprains | Functional rehabilitation for ankle sprains | Physiotherapy assessment of ankle sprains | Commonly injured ankle ligaments | Commonly injured ankle ligaments | ATFL | Biomechanics of ankle sprains explained