The ligaments in our ankles play a critical role in our ability to walk, run, jump, and so much more. If these band-like structures become injured, without treatment, people can experience repeated sprains, (ankle) joint instability, plantar fasciitis, shin splints, and lasting ankle weakness. If you’re experiencing ankle pain or suffering from an ankle sprain, it’s very important to seek proper treatment rather than attempting to “tough it out.”

The Most Common Ankle Sprain

The most common type of ankle sprain is referred to as an inversion sprain. These sprains typically occur during sports activities (e.g., basketball, football) that require sudden stops and starts with frequent pivoting motions; although it is possible for someone to sprain their ankle from everyday activities as well.

The lateral ankle ligaments are located on each side (interior and exterior) of the ankle. The most common inversion sprain occurs when the interior part of the ankle turns inward even more, placing immense pressure on the outside edge of the exterior side of the foot. If a person experiences this type of lateral ankle injury, they will likely experience ankle swelling (possibly severe) along with foot pain. Between the swelling and the foot pain, walking can be very difficult, if not impossible.

Ankle Anatomy

The anterior talofibular ligament connects the front of the foot to the fibula bone coming from the leg. The posterior talofibular ligament is located in the rear and also connects the fibula bone to part of the ankle joint. The calcaneofibular ligament is another lateral ligament that forms an attachment between the fibula bone and the ankle portion of the foot. The most common of the three lateral ligaments to incur injury is the anterior talofibular ligament, although it is possible for the others to become injured as well.

Injury Assessment

When a patient first seeks a medical evaluation, it must be determined whether the individual is experiencing a “simple” ankle sprain or whether they have both a sprain and an ankle fracture (broken ankle bone). Special tests such as the anterior drawer test and talar tilt test can be conducted to determine the nature and areas of injury. Specifically, the Ottawa Ankle Rule test is often employed in order to determine if a patient is experiencing a sprain, or if they’ve actually broken (fractured) an ankle bone. During this test, four separate regions of the ankle and lower leg will be examined while the person attempts to put weight on the injured ankle. The inability to bear weight right after the injury and during an Ottawa Ankle Rule test points to the likelihood that the patient does have a fractured bone.

Physical Therapy Treatment for an Ankle Sprain

Once a patient receives a diagnosis for their ankle sprain, it’s fairly likely they’ll be prescribed a series of physical therapy treatments. Initially, a therapist may address any residual foot pain and/or ankle swelling. Next, the therapist will introduce some gentle stretching exercises that will increase a patient’s range of motion throughout the ankle/foot area and relax nearby muscles that have become overly tense in their attempt to protect the injured ankle.

Eventually, the therapist will introduce more exercises designed to strengthen all the major (and minor) muscle groups surrounding the ankle, foot, and leg. In order to accomplish this, they may employ exercises that work on single-leg stability, stable and unstable surface training, proprioception training, dynamic balance activities, as well as foot intrinsic exercises.

All of these exercises are designed to heal a lateral ankle injury by introducing challenging movements such as standing on one leg, balance exercises, strengthening the different parts of the foot attached to the injured ankle, strengthening the peroneal muscles (rear calf muscles) and the tibialis anterior (shin bone) muscles, and much more.

If you have more questions about ankle pain and how to find effective treatment, please contact Cawley Physical Therapy & Rehab at 570-208-2787.