Ankles are a common site of injury in the lower limb, ankle sprain being the most common type of ankle injury. Plantar flexion and inversion (in simple terms the toes are pointed downward and inwards) is the most common way of experiencing ankle sprains.
There could be several factors leading to ankle sprains. They are caused primarily when an individual with poor joint position sense, balance and weak muscles walks on an uneven or crude surface and twists their ankle leading to a sprain. In a typical incident of ankle sprain the ligaments of the ankle get sprained (stretched) and in severe cases can lead to a complete tear of the ligament.
The most common outcome of the sprain could be pain and swelling for a mild or grade 1 sprain, no mechanical instability or loss of function is observed. At times individuals suffering from a mild sprain (grade 1) may not suffer from pain or associated issues. However, this is not the case for a grade 2 or moderate sprain. In a grade 2 sprain, the symptoms could be a bit severe where the pain levels might be slightly more in comparison to a grade 1 sprain. Considerable loss of function, swelling, and mechanical instability are observed in grade 2 ankle sprains. The clinical picture is a bit different and severe in a grade 3 sprain where the individual cannot bear weight on the affected limb and experiences severe loss of function. In addition to this, severe instability and swelling are noted in this stage. In events where an individual is unable to bear weight on the affected limb, it is advisable to secure and immobilize the joint. This protects the joint from further damage.
Once the swelling and pain begin subsiding it is recommended that a physiotherapist should be consulted for rehabilitation. Rehabilitation begins with an assessment of the joint to ascertain the condition of the injury, balance, muscle strength and control.
Treatment in the early stages focuses on pain reduction and improving the joint range of motion. In the later stages, the aim is to improve balance and joint position sense. Proper rehabilitation is critical in the later stages of ankle sprain to strengthen the muscles around the ankle and retrain the tissues within the ankle that affect balance. Failure to do so may result in repeated ankle sprains.
At ProPhysio we have observed a trend where patients diagnosed with a grade 1 or grade 2 sprain who fail to complete all the aspects of the rehabilitation often experience recurrent ankle sprains. Balance impairment is the main cause of repeated ankle sprains. This then leads to a shift of weight to the opposite side. We have also observed issues with the opposite knee, hip and back due to this chronic weight shift.
