Ankle injuries are a very common occurrence in sports and are frequently caused by “going over” your ankle – that is to say: excessively twisting it. This is common in sports with lots of changes of direction, such as football, basketball, and netball. As it is such a common injury, lots is known about it and there is a great deal of treatment available to help recover from an ankle injury.
The outside of the ankle joint is made up of 3 separate ligaments that resist ankle inversion – that is to say the ankle turning inward underneath you. Most people have experienced an ankle sprain in their life and are familiar with the typical signs – swelling, tenderness, and possibly bruising on the outside of the ankle joint. Depending on the extent of the injury, there may be instability of these ligaments, so balance and the ability to cut, pivot and twist on the ankle may be quite limited.
Ankle sprains typically heal well within 6-8 weeks, but extensive injuries that injure multiple ligaments may require greater than 3 months to fully rehabilitate. A significant loss of ankle strength and balance is common after an ankle sprain of any kind. A thorough rehabilitation program is highly recommended for anyone planning on returning to sport following an ankle injury.
After repeated injuries, the ankle can become chronically loose and therefore taping or bracing for training and games may be required. This can be highly effective for helping to manage a long-term ankle injury.
The inside of the ankle is supported by a strong, broad ligament, called the Deltoid ligament. A sprained medial ankle typically requires more force and a slightly awkward mechanism of injury, where the foot is forcefully everted – that is to say, tilted outwards. Typical signs include acute swelling and tenderness along the inside of the ankle joint, as well as a perception of instability – especially with side to side movement.
Depending on the severity of a Deltoid ligament sprain, athletes may continue to train and play while wearing tape, or may require short or long-term rehabilitation – as directed by your Physiotherapist’s findings.
A high ankle sprain is a more complicated ankle injury where the ligaments that hold the shin bones together are injured. This typically occurs when the ankle is bent and the leg or ankle is twisted while weight-bearing – such as when your foot gets caught during a tackle in rugby or other full-contact sports.
Pain is typically much higher up the outside of the ankle and this may extend further up the shin. Pain with weight-bearing is typically much worse with this injury and it is quite rare for players to continue playing.
Unfortunately, this type of injury typically requires a much longer period of rest and recovery – often 3-6 months for serious injuries. For complex high ankle sprains, an MRI may be required to rule out significant ligament injuries that may require an orthopaedic consultation.
Ankle fractures can occur during high force movements, such as a heavy landings or hard tackles, or due to a particularly heavy ankle sprain. Fractures of the ankle typically involve the end of the shin bones, the tibia and fibula, and depending on location, may require surgery.
Minor fractures, called avulsion fractures, occur when the ligament pulls off a small section of bone during an ankle sprain like those mentioned above. This is actually quite common and not of great concern for most athletes. Depending on the extent of the injury as seen on an X-ray, this may be managed with taping or booting, or simply non-weight bearing with crutches.
More serious fractures that are close to the ankle joint itself or other ligaments may be unstable or be misplaced enough to required surgery. Tell-tale signs of a serious ankle fracture would be significant swelling or bruising, a visual deformity, or the inability to take any weight through the leg. This requires a thorough assessment and typically requires a visit to A&E for an X-ray and orthopaedic consultation.
As with any injury, it can be challenging to find accurate and trustworthy information on the internet.
Despite the information we have supplied being helpful, in our experience it’s always worth your while to speak to a qualified physiotherapist, to get an accurate diagnosis and treatment plan that’s tailored specifically to you.
If you would like to speak to one of our team then call us on 01324 227 370 or you can book yourself in for a physiotherapy appointment with us here
Written by Jesse Coad, Senior Physiotherapist 🇦🇺