Ankle injuries are quite common. While they can occur during contact sports, most people injure their ankles while walking or running on uneven or slippery ground. Some people injure their ankles while walking on even ground in impractical shoes. Most ankle injuries cause sprains, but they can also cause fractures and strains.
Understanding the Ankle Anatomy
The ankle is a very complex ball-and-socket type joint, technically called the talocalcaneonavicular joint. It transmits all of the body’s weight from the legs to the feet. It is a very flexible joint, able to move in all directions.
In the ankle, the two lower leg bones (the tibia and fibula) articulate with the talus bone, which connects to the heel bone (the calcaneus), which lies beneath the talus, and the navicular bone, which is part of the foot and is in front of the talus. Your ligaments hold the joint together.
Typical Ankle Injuries
During a typical ankle injury, the foot awkwardly rolls too far inwards (inversion) underneath the body. During this event, one or more of the three lateral ligaments on the outside of the ankle may be damaged (a sprain). The anterior talofibular ligament connects the talus to the fibula. It is the weakest of the three lateral ligaments and is the one most often injured. The other two lateral ligaments are called the posterior talofibular ligament and the calcaneofibular ligament.
During an ankle injury event, one or both of the peroneal tendons may also become injured (a strain). There are two peroneal tendons, one running from the little toe to the ankle and the other wrapping from the outside of the ankle underneath the foot to the inside of the arch.
You may also have broken bones during ankle injuries. The tibia, fibula, and/or talus bone can all suffer a fracture. Most commonly, one or more of the bone bumps involved in the articulation of these three bones is broken.
Treating an Injured Ankle
Symptoms of an injured ankle include:
- Restricted range of motion
- Instability of the ankle
If the symptoms become severe, seek medical care as soon as possible. This way, you can ascertain if a bone is broken or a ligament has been badly injured.
Ankle Injury Grades
Ankle injuries also have grades scaling from 1 to 3 depending on the severity.
- A Grade 1 injury can cause mild pain and swelling but you may still be able to bear weight without increased pain. In this case, the ankle shows no signs of instability.
- A Grade 2 injury causes moderate pain and swelling, and bearing weight is possible but extremely painful. Here, the ankle shows some signs of instability.
- A Grade 3, on the other hand, causes severe pain and swelling, and bearing weight is impossible. In this case, the ankle is very unstable. If your symptoms are this severe, you should seek medical help. You may have a torn ligament and/or a fractured bone.
For Grades 1 and 2, home care is usually sufficient. You have probably heard about RICE (rest, ice, compress, and elevate), but more recent research says you should not apply ice to sprains and strains because it delays healing. Instead, rest and elevate your sore ankle for 24 hours.
How to Prevent Reinjury After an Ankle Sprain
Protect the Ankle
After an ankle sprain, the injured ligaments will be weaker than normal, and they need to be protected while they heal. Wearing an ankle brace while walking and avoiding vigorous activity during the healing period is a good idea. You should also completely avoid impractical footwear, such as high heels, clogs, flip-flops, and loose-fitting sandals during the healing period. Healing should take:
- Grade 1 injury: 1 to 3 weeks.
- Grade 2 injury: 3 to 6 weeks.
- Grade 3 injury: several months.
Strengthen the Ankle
Exercises to keep the ankle and foot limber and strong should be performed regularly by everyone. These exercises are particularly important after an ankle injury. A simple ankle workout may consist of:
- Point and flex your toe.
- Place the heel of the foot on the floor and write the letters of the alphabet with your toes.
- Rotate your feet in full circles in both directions.
- Rise up and stand on your toes, then stand on your full foot, and repeat.
- Stand on a stair step with your heel hanging off the step. Lift up on your toes and then lower your weight into your heel repeatedly.
- Lift your toes off the ground and walk on your heels for a few steps. Then, walk on your toes for a few steps.
Consider Physical Therapy
In some cases, an ankle sprain can lead to chronic instability and repeated sprains. Injuries to the lateral ligaments (the ligaments on the outside of the ankle) rarely result in chronic instability, but syndesmotic sprains, which affect the ligaments holding the two leg bones together just above the ankle, are notorious for causing this problem. Syndesmotic sprains usually occur during a traumatic event while playing contact sports.
If you find yourself repeatedly spraining your ankle, you should consult a physical therapist for a proper diagnosis of the problem. Your physical therapist may recommend wearing a stiff ankle brace and will develop a personalized program of exercises to strengthen the ankle, improve your balance, and retrain your proprioception to avoid additional injury to your ankle.
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