Ankle sprains are common injuries that occur when ligaments are partially or completely torn. The ankle is a complex joint that involves numerous bony structures, muscles, and ligaments. Ligaments are connective tissue structures that connect different bones. They work to stabilize joints against the forces that occur during daily activities. However, when the ligament is stretched beyond its limit, an injury can occur.
Common Types of Ankle Ligament Sprains
There are many types of sprains that can cause ankle pain. The most commonly injured ligament in the ankle is the anterior talofibular ligaments or ATFL. The ATFL is located on the outside of the ankle. It is most commonly injured when the ankle is forced into motions called inversion and plantarflexion. When this happens the ankle rolls to the outside and twists to the inside. It is usually referred to as an inversion sprain and makes up 70-85% of all ankle sprains.
Inversion sprains commonly occur in sports such as basketball or tennis that involve a lot of jumping, running, side to side movements, and quick changes in direction.
Causes of Ankle Sprains
An ankle sprain that is caused by sudden and forceful outward twisting can cause a high ankle sprain injury. This is significantly less common than the previously discussed inversion sprain and is referred to as ‘high’ because they are located above the ankle joint.
These sprains can happen during contact activities like football, ice hockey, and lacrosse, as well as sports requiring quick changes in direction like volleyball or basketball. Less commonly, the can occur with falls onto the foot.
Grades of Ankle Sprains
Depending on the severity of the injury, an ankle sprain is classified into three (3) grades:
- A grade 1 sprain occurs when there is mild damage to a ligament. There will be mild pain and swelling but no major loss of ankle stability.
- A grade 2 sprain involves a partial tear of the ligament and when this occurs the ligament has been stretched to the point that the ankle loses stability. In this case, there will be moderate swelling and pain.
- A grade 3 sprain is a complete tear of the ligament and results in instability at the ankle joint. There will be a large amount of swelling, pain, loss of function and significant bruising.
Physical Therapy for Ankles Sprains
Physical therapy is effective in rehabilitating an ankle sprain through swelling management, stabilization and strengthening to promote tissue healing. The first issue that needs to be addressed in ankle sprains is swelling. As discussed in previous blogs, the swelling that occurs initially after injury is a normal part of healing but when swelling persists it is a problem. Physical therapy manages swelling through manual therapy techniques such as massage to reduce swelling, gentle mobility, and prescription of a specific home program of icing, elevation and rest to improve symptoms. As swelling resolves progressive strengthening to stabilize and promote healing of the injured structures is crucially important. If the ankle is allowed to heal without proper care, it will result in weakness, instability, and increase the likelihood of future injury.
It is also important to note that physical therapy can also help treat old ankle injuries. Many individuals struggle with repeated ankle sprains or indicate that they frequently roll the ankle during every day or sports-related activities. Physical therapy works to reduce any scar tissue that may be present and strengthen and stabilize the ankle.
Life’s Work Can Help!
Our goal at Life’s Work Physical Therapy is to help our clients stay active and prevent injury from keeping them from the functional, recreational and sport-related activities they love.