Acute Ankle Sprain

Acute ankle sprain is the most common athletic injury.
It constitutes 25% of all injuries in sportsmen.
Worldwide the risk of ankle sprains varies with the sports –

  • 21-53% : basketball,
  • 17-29% : soccer,
  • 25% : volleyball.

Ankle sprains account for 10% to 15% of all lost playing time.

ankle sprain reasons - sports injury_

ankle & foot sprain in sports injury_

Ligaments of the ankle joint

The relation of the tibia, fibula, and talus is maintained by an articular capsule and 3 groups of ligaments

The Medial, Lateral and Syndesmotic ligaments.

  • Medial Ligaments: The deltoid ligament is considered the strongest of the ankle ligaments.
  • Lateral Ligaments: The Anterior Talofibular , The Posterior Talofibular, and the Calcaneofibular Ligament make up the lateral collateral ligaments of the ankle.

The most common mechanism of injury is a combination of plantar flexion and inversion.

The Anterior Talofibular Ligament is the most easily injured followed by the Calcaneofibular ligament

The Posterior Talofibular Ligament is the strongest of the lateral complex and is rarely injured in an inversion sprain.

 

Ankle sprains may be more serious than they appear

Friday, Jun 07, 2013
Mind Your Body, The Straits Times,singapore

  • We did a study on 50 patients at the hospital who had sprained their ankle.
  • MRI scan done on each of them revealed that only 28 per cent, or about 15 patients, had a lateral ligament injury.
  • Rest of the patients had conditions that are not normally associated with ankle sprain, such as swollen bones, inner ligament injury and cartilage injuries.
    • Fracture of the proximal fibula (Maisonneuve fracture)
    • Avulsion fracture of the peroneus brevis tendon.
    • Osteochondral talar dome lesion.
    • Lisfranc fracture dislocation.
    • Bimalleolar/ trimalleolar ankle fractures.

 

When to go see a doctor?

  • Unable to bear weight
  • Significant swelling
  • Significant deformity
  • Getting worse or no improvement in 2-3 days

ankle-sprain-treatment-kolkata

P.R.I.C.E. Protocol

  • Prevention– Proper shoes and warm up exercises
  • Rest– limit weight bearing, crutches if necessary, an ankle brace helps control swelling and adds stability.
  • Ice– No ice directly on the skin, no ice more than 20 minutes at a time to avoid frost bite.
  • Compression– can be helpful in controlling swelling and is usually accomplished with an crepe bandage.
  • Elevate– above the waist or heart as needed.

 

Different treatment Strategies

  • Lace-up ankle support: reduce swelling
  • Semi-rigid ankle support: shorter time to return to work & sport,.
  • Tape treatment: in the acute setting
  • Elastic bandage: More Instability, Slower return to work and sports.
ankle-sprain-lace-up-support-kolkata
Elastic bandage for ankle sprain treatment kolkata

 

Graded exercise regimens

  • Reduce the risk of ankle sprain
  • Proprioceptive, stretching and strengthening

Wobble Board Exercises

  • Originally produced for skiers and surfers  to practice their skills in the off season and at night
  • Used to develop balance, motor coordination skills, weight distribution and core strength
  • To prevent sports injuries especially to the ankle and knee and for rehabilitation after injuries

wobble-board-excercises-for-ankle-sprain-treatment-kolkata