Runners Pain Dictionary – Part 6
ANKLE SPRAIN – An ankle sprain happens when the ligaments of the ankle get stressed or torn as a result of the ankle rolling out (foot turning in/foot inversion) or less commonly, the ankle rolling in (foot turning out/foot eversion). The severity of the sprain depends on the number of ligaments affected. There are multiple ligaments in the ankle. The most commonly injured ligaments are the ones that run along the outside (lateral side) of the foot. (Reminder: ligaments are connective tissue connecting bones while Tendons attach muscles to bones)
Many of us have twisted our foot at some point or the other. But after some discomfort, settled down. When this twisting is accompanied by pain, swelling and bruising (internal bleeding under the skin) chances are ligaments have stretched or torn and an ankle sprain has occurred. Many activities can cause an ankle sprain. Many ankle sprains occur when there is rapid shifting of the foot with the foot planted (contacting ground) such as while tackling in football or soccer, jumping and sports. They also happen while stepping off curbs and while walking on unstable surfaces. Certain people seem more predisposed to ankle sprains such as those with feet displaying heel inversion (turning in) or hindfoot varus and those with previous history of similar injury that has left the ankle/foot unstable and muscles such as the peroneals (aka lateral ankle stabilizers) weak. The latter could largely be due to proper rehab protocol not being followed in restoring full mobility around the ankle and strengthening it with recommended stretches and exercises during healing process. Repeated ankle sprains can lead to chronic damage/instability within the ankle and may eventually invoke need for repair.
Depending upon the severity, one may feel tenderness and be able to walk with little pain or may not be able to put weight on the painful ankle at all. The more severe the sprain the more bruising, swelling and pain and the longer it takes to heal. Generally ankle sprains do not require any surgery and heal over a period of time proportional to strain intensity. Physical therapy has to be the mainstay in ensuring proper healing and restoration of functionality and strength of the ankle.This done, outcomes are positive with patients being able to resume their daily lives, activities and sports.
Following a sprain, the Rest, Ice, Compression and Elevation (R.I.C.E) protocol needs to be followed. A removable walking boot/support maybe needed for those unable to load the ankle and walk. As with injuries, short changing on rehab is recipe for chronic instability and predisposition to repeats.