Ankle Injuries

Ankle sprainsAnkle sprains are a common injury in many sports, especially football, basketball and netball. The lateral ligaments of the ankle are most commonly sprained with an 'inversion' or 'rolling' injury while running, changing direction or landing.

• Being able to weight-bear immediately following the injury is a good sign of ligament sprain rather than fracture. However, with thorough assessment from a Sports Physio or Sports Physician an Xray may still be indicated to determine if any fracture has occurred.

• Immediate management with Rest, Ice, Compression and Elevation (R.I.C.E.) is essential in limiting inflammation and swelling and subsequently this speeds up the recovery process. Remember placing the foot in a bucket of cold water for 10 minutes is usually more effective than ice packs. Continue this hourly for 48 hours, maintaining a compression bandage in between cold water treatments.

• Factors that promote increased blood flow such as hot showers/spas, heat creams, massage, alcohol and excessive weight-bearing/dancing on tables should be avoided.

• Sports Physio assessment is recommended within the first 48 hours to determine the extent of ligament damage, loss of range of movement, proprioception (balance) and functional strength.

• The athlete may need crutches to walk during this stage. Early mobilisation is encouraged as the inflammation settles over the first 48 hours. Physio treatment includes mobilisation using manual techniques to restore joint range of motion, instruction in safe exercises to restore strength, proprioception and ankle joint control. Anti-inflammatory gels or tablets and electrotherapy modalities may also assist reducing inflammation and swelling.

• Most lateral ankle sprains progress well, however some remain painful and swollen for much longer than usual and may require further diagnostic assessment (eg: CT Scan or MRI) to determine the full extent of the injury and if any chondral (articular cartilage) damage has occurred. These so-called 'difficult ankles' may need extended rest from impact loading activities such as running and jumping.

• When return to sport is indicated by the Physio, the athlete should have full range of motion, normal proprioception and good lower leg control and eccentric muscle power. They should be able to run, change direction, jump and hop with no pain. Some ankles may need tape or a brace to provide protection from further injury. Discuss this option with your Sports Physio to see if your ankle requires this.

• Many professional athletes now tape or brace both ankles regardless of prior injury, to prevent lateral ankle sprains occurring! You may also want to do regular 'wobble-board' training as a preventative action.