ANKLE INJURIES

Introduction, Common causes of injury, Treatment

Introduction

Ligaments are the body tissue used to hold our bones together. Ligament injuries around the ankle are among the most common sporting injuries, especially in those sports involving twisting and jumping.
Every sprain causes damage to the stabilising tissues of the joint with bleeding, swelling and tenderness. The damage to the ligament can be partial or total. Sometimes a small portion of bone is torn away at the point of ligamentous attachment, whilst the ligament itself remains intact.

Common problem and causes

Inversion injuries, where the foot is forcefully rolled inwards at the ankle, are by far the most common ankle injuries.
In about 70% of ankle joint injuries the anterior talofibular ligament is injured. In 20% of cases the calcaneofibular ligament is also involved. The mechanism of injury is usually a rolling over of the outside of the foot. The inside (deltoid) ligaments can also be damaged, however this is much less common.

Injury occurs when the ligaments are forcefully stretched past their normal length such that they are sprained or ruptured. Swelling and bruising normally accompanies ankle injuries and the extent is often a good indicator of severity.

Initial treatment

"DON'T WAIT TO GET BETTER"

It is very important to limit the bleeding and swelling as much as possible as the accumulation of blood slows down the healing process dramatically. The athlete should be taken immediately from the playing field and the RICER regimen performed. This aims to minimize bleeding and promote healing.

Other causes of ankle pain
1. Fractured (broken) ankle
2. Muscle tendon dislocation
3. Ankle joint dislocation

Type of help

The treatment of an ankle joint sprain depends entirely on the severity of the injury and the structures injured. Such injuries must be immediately treated with Rest, Ice, Compression and Elevation. Physiotherapy and medications will prevent further swelling and assist in the removal of excess swelling, thus speeding recovery. The healing of an ankle joint ligament can take 2-8 weeks and problems can remain for up to 8-10 months after the incident. Treatment is directed towards regaining full painfree movement of the ankle, full strength of the surrounding musculature and full proprioception (position sense) of the joint. An untreated ligament injury can lead to permanent instability with recurrent sprains. If necessary a ligament can be sutured together or reconstructed by surgery.