Although ankle sprains are statistically the most common sporting injury, ankle injuries can differ considerably and  each and every ankle sprain can damage different structures leading to different areas of pain, different timeframes for length of recovery, and often poor long term outcome.

Ankle sprains and a ligament tear are really the same thing.

We typically grade ligament injuries in 3 grades:

  • Grade 1 – minor damage to the ligaments
  • Grade 2 – moderate damage, usually presents with visible bruising from ligament bleeding
  • Grade 3 – a complete tear/rupture of the ligament.
    • Sometimes the ankle doesn’t hurt very much due to pain receptor damage
    • The ligament ends have been separated causing ankle instability and “loose” ankles.

Common Types of Ankle Sprains

Lateral Ligament Sprains                                                                     

  • Most common type of ankle sprain

Can result in minimal pain, however sometimes the patient suffers recurrent episodes of ankle weakness and giving way due to ligament looseness.

Medial Ligament Sprain

  • This can occur due to twisting the ankle outwards into eversion.
  • The medial ligament sprain often takes longer to recover due to higher forces involved to injure it in the first place.
  • Usually medial ankle sprains have a lower chance of instability and re-injury.

High Ankle Sprain

  • This is a severe type of ankle sprain, and is caused when the strong syndesmosis fibres between the fibula and tibia are stretched and torn.
  • This injury often causes great difficulty walking, and can be managed in a Cam-Walker Boot if deemed serious enough.
  • Usually occurs when the ankle is forced upward (Dorsiflexion)

Internal bone brusing or sub-chondral fracture

Often ankle sprain can occur with ligament tearing, and as the ankle bones move, the bones within the ankle can compress or bash together.

  • This can cause a range of problems such as:
    • Chondral surface damage(cartilage damage)
    • Sub-chondral bruising
    • Micro-scopic fractures often missed on plain X-ray.

Common Secondary problems of ankle sprains

Secondary problems following ankle sprains frequently occur. Some can be minimised by proper initial management, however some are un-avoidable due to swelling or damage caused from the initial injury.

  • Common secondary problems can include:
    • Recurrent instability/giving way leading to loss
    • of confidence and re-injury
    • Chronic lateral pain from inflammation and scar tissue in the sinus tarsi
  • Posterior ankle pain due to impingement of soft tissues at the back of ankle, especially aggravted by kicking, jumping and “pointe” in dance

What can I do about it?

It is very important that you visit a health professional for management of your ankle injury. All too often, ankle injuries are poorly managed or not treated at all which leads to problems in the future.

If you roll your ankle, get help by visiting a Physioheatlh physiotherapist to ensure it is managed properly.