What provides ankle stability?
Stability of your ankle is maintained by several structures, the shape of the bones, the tendons and muscles that pass across the ankle and the ligaments.
On the outside (lateral side) of your ankle the 2 most important ligaments are the anterior talofibular ligament and the calcaneofibular ligament.
What happens when I sprain my ankle?
The most common way an ankle sprain occurs is when the foot lands on an uneven surface and the foot rolls in – This is called inversion and is seen in the picture below.
The ligaments are stretched and depending on the severity of the sprain may be partially or completely torn. Small nerves in the ligaments that aid in balance may also be torn.
You may have pain on the inside (medial side) of the ankle due to bruising of the bone and ligament. As well as injury to the ligaments in some cases cartilage or tendons may also be damaged.
How should I treat my ankle sprain?
Initially treatment should consist of
Rest, Ice, Compression and Elevation.
Crutches or a boot may be required initially.
Once the pain has settled physiotherapy is the most important treatment to allow you to return to normal function.
80-90% of people who have an ankle sprain will return to normal function with no recurrent instability after a physiotherapy rehabilitation program.
Physiotherapy should include:
- Swelling management
- Range of movement exercises
- Muscle strengthening
- Balance retraining
A lace up ankle brace may be required to return to physical activities and sport.
A steroid injection may be necessary to allow you to complete your physiotherapy.
How quickly should I recover?
The majority of patients will feel significantly better by 6 weeks. By 3 months you will be back to most activities. A complete return to competitive sport may take 4-6 months.
Some patients who have ongoing pain, which may reflect an additional injury to other parts of the ankle will require further investigation.
What if I keep spraining my ankle?
If your ankle is unstable it may become inflamed and painful. If you have recurrent inversion sprains over a long period you may damage the cartilage of the ankle joint and may be at risk of developing spurs or arthritis.
Will I need surgery?
10-20% of patients who have an ankle sprain and undertake a diligent rehabilitation program will still have recurrent instability and sprains of their ankle. This may be a problem that limits daily activities, work or sporting pursuits.
In this situation surgery to reconstruct the lateral ligaments may be beneficial.
This information is an overview of the management of ankle instability and is not all inclusive.