- Ankles are one of the most common sporting injuries.
- A sprain is defined as a tearing of the ligaments that connect bone to bone and help stabilise the joint.
- The degree of ligament damage depends on the amount of force generated by the injury and can vary from strain, partial tear or complete rupture of the ligament or avulsion of the bone the ligament attaches to.
- Sports requiring jumping, turning and twisting movements and explosive changes of direction are particularly vulnerable to ankle sprains.
- Following an ankle sprain, the ankle joint may become unstable and take a long time to recover
- The ankle joint is a hinge joint formed between the tibia and fibula and the talus and allows the foot to bend upwards and downwards.
- The subtalar joint is formed by two bones of the foot, the talus and calcaneus (heel bone) they allow the foot to rock side to side.
- The joint’s stability comes from the shape of the bones, the constraining ligaments (passive control) and the surrounding muscles and tendons (dynamic control)
- The outside of the ankle the joint is stabilised by three smaller ligaments; the anterior talofibular the calcaneofibular and the posterior talofibular ligaments. Sprains to any of these ligaments (inversion sprains, foot twists inward) account for more than 80% of all ankle sprains.
- The inside of the ankle the joint is stabilised by a thick, strong fibrous ligament called the deltoid ligament. Sprains to the deltoid ligament (eversion sprains, foot twists outward) account for less than 20% of all ankle sprains.
- Injury to any ligament results in local swelling bruising and pain the more severe the injury the greater the degree of these symptoms.
- Ligament sprains to the ankle joint may also involve the ligaments between the tibia and fibula bones. These injuries may involve a fracture, are often slower to recover, and may require surgery.
- There is always a possibility of bony injury or fracture, a good rule of thumb to assess for a fracture is severe point tenderness over the bones of your ankle/ lower leg and an inability to put weight through your foot.
RISK OF INJURY
Acute ankle sprains result from a force being applied to the ankle joint that cause an excessive range of movement at the joint.
- Undertaking training prior to competition to ensure readiness to play.
- Gradually increasing the intensity and duration of training.
- Undertaking flexibility, balance, stretching and strengthening exercises in weekly training programs.
- Including agility work in training programs so the ankle joint is capable of sustaining high acceleration forces and quick changes in direction.
- Allowing adequate recovery time between workouts or training sessions.
- Warming up to ensure surrounding muscles are ready to support the joint during activity.
- Wearing ankle taping or bracing especially for previously injured ankles.
- Wearing shoes appropriate to the sport that provide stability and support.
- Checking the training and playing area to ensure a flat and even surface.
- Drinking water before, during and after play.
- Avoiding activities that cause pain. If pain does occur, discontinuing the activity immediately and commencing RICER.