Although ankle sprains are statistically the most common sporting injury especially in gymnastics, ankle injuries can differ considerably and each and every ankle sprain can damage different structures leading to different areas of pain, different time frames 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
- Grade 2 – moderate, usually presents with visible bruising from ligament bleeding
- Grade 3 – a complete tear/rupture of the ligament. Sometimes the ankle doesn’t even that hurt much, but the ligament ends have been separated causing ankle instability and “loose” ankles.
Common Types of Ankle Sprains
Lateral Ligament Sprain (LCL) – this is the most common type of ankle sprain, and can result in minimal pain, however sometimes the patient suffers recurrent episodes of ankle weakness and giving way due to ligament weakness
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 ligament between the fibula and tibia is stretched and torn.
This injury often causes great difficulty walking, and can be managed in a Cam-Walker Boot if deemed serious enough.
Internal bone brusing or sub-chondral fracture
Often ankle sprains 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 and even micro-scopic fractures that are often missed on plain Xray
Common Secondary problems of ankle sprains
Secondary problems 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 aggravated by kicking, jumping and “pointe” in dance
Management of Ankle sprains
As ankle sprains can vary so much in terms of structures damaged, secondary complications and time frames for recovery it is always best to get your ankle assessed by a PhysioHealth physiotherapist.
A rehabilitation plan can then be initiated focusing on restoring full ankle range of movement, a progression of strength and balance exercises and guidance on returning to gymnastics.
As gymnastics is such a high stress and dynamic sport, full recovery is crucial to help prevent further recurrence and lost time from training.
