Ankle Sprains

With a recent increase in ankle injury cases, I've decided to write a post about some of the key things about the injury. The ankle is probably by far the most commonly injured structure in any dynamic sport that requires jumping, cutting, and running, like: basketball, soccer, and volleyball, and it is also one of the most ignored injury in sports. The reason for the neglect is because the injury usually resolves by itself with rest. However, like all other injuries, without proper treatment and rehab, the chances of injuring the structure again is quite high.

By far one of the most commonly injured structure in the ankle is the ATFL (Anterior talo-fibular ligament) See image on top. The mechanism in which the injury occurs quite often involves landing of the foot on an unstable surface, such as another player's foot.

This action causes the foot to be in pronation (rotated inwards) on a planterflexed foot upon an externally rotated tibia (shin bone), which is a very unstable position for the ankle (see above). While in this position the ATFL becomes the lateral collateral ligament of the lateral ankle, and hence has the highest rate of injury amongst the 2 other lateral ligaments (calcaneofibular ligament, and posterior talofibular ligament). The injury can be graded into Grade I, II, or III. The classification can be defined as follows:

Grade I: no microscopic tear, with minor swelling and tenderness along the lateral ankle and no loss in ligament elasticity.

Grade II: partial tearing of the ligament is expected with moderate swelling, tenderness along the lateral ankle and pain. There is moderate loss in functionality, meaning gait and daily activities will be affected.

Grade III: major or a full tear of the ligament is expected with severe swelling and pain, there is full loss of function and range leaving the ankle completely unstable.

Unlike other joints, we as bipedal beings rely a lot on these ankle joints to support our daily living. After an injury to the ankle joint, whether benign or severe, it alters the way we move our body and how we propel ourselves during gait. Our brain and consequently, our body, is designed to adapt to the imposed demands of life, and the stronger the will, the more chances for the body to start compensating with other structures. Getting the right treatment and education about ankle injuries is imminent when it happens. Too many people and athletes ignore the seemingly small injury, and pay for the consequences few years or sometimes few months down the road. I cannot stress enough how important it is to treat an ankle injury right and go through all the rehab protocols when it happens. The more diligent one is able to follow the ankle rehab protocol, the lower the chances of reinjurying the same ankle again, and the faster the client will be able to get back into activities without complications.

Other than a Grade I ankle sprain, Grade II, and Grade III sprains affects functional ranges of the ankle. Here are the steps to guide you to regaining proper ankle biomechanics and neuromuscular control.

1. Recover range of motion: any range of moti