It’s time for another Austin-area sports medicine 101 class!
Today we’re discussing sprained ankles and other ankle pain.
Introduction and Injury Causes
Ankle sprains are one of the most common sports and active lifestyle injuries. Ankles injuries are normally the result of a missed step or step on uneven ground where the ankle rolls into, more commonly, inversion (rolling your foot inwards) and injuring the Anterior Talofibular ligament (ATFL) or Calcaneofibular ligament (CF) at the lateral ankle joint or eversion (rolling your foot outwards) and injuring the Deltoid ligament at the medial ankle joint. The force of the movement and the body weight distributed over the ankle can sprain the ligaments attaching the lower leg (Fibula or Tibia) to the Talus or heel bone (Calcaneus) and strain muscle tendons crossing the bones and joints.
Grades of Ankle Sprain
There are degrees of severity with ankle sprains ranging from Grade 1 being a mild sprain to Grade 3 being a complete rupture of the ligament(s).
- Grade 1 ligament sprains often involve mild tenderness, swelling and pain with minimal or no functional mobility loss (still able to walk without much pain).
- Grade 2 ankle sprains have more moderate pain and swelling, often involve bruising and skin discoloration from the injury, and have more pronounced loss of function with reduced ability to weight bear and mild to moderate ligamentous laxity.
- Grade 3 ankle sprains includes the rupture of one or more of the ligaments of the ankle and involve severe bruising and skin discoloration and also severe loss of function, instability and ligamentous laxity.
Initial Therapy & Other Info
Ankle sprains can also involve fractures to the distal ends of the Fibula and Tibia which may result in avulsion fractures (fractures with tendon attached) or fractures with bony fragments broken off of the Tibia or Fibula. Some sprains, which are higher up the ankle and into the lower leg, are referred to as ‘High Ankle Sprains’. These can involve the syndesmosis (the ligaments between the Tibia and Fibula) and result in pain, swelling and bruising higher up the lower leg than most typical ankle sprains.
Initial therapy includes following the RICE guidelines and may involve the use of crutches or a walking boot. If there is severe bruising and swelling an X-ray may be needed to determine if a fracture is present and a possible trip to the Emergency Room to make sure there is no issue with a blood vessel being blocked from the injury.