Here at Melbourne Sports Physio, we see a lot of people with ankle sprains or “rolled ankles”, who have often suffered with recurrent injuries over many years, having to take weeks or months off from their sport or exercise every year.
Often, people assume that it will just get better on it’s own, only to return to exercise and have the same injury happen again! This blog post answers a few of the most common questions we are asked about ankle sprains
WHAT ARE THE COMMON TYPES OF ROLLED ANKLES?
The most common type of “rolled ankle”, or ankle sprain, involves the ankle turning outwards whilst the sole of the foot turns inwards, which puts stress on, and stretches, the ligaments on the outside of the ankle.
The ligaments are bands of fibrous tissue that connect bones to bones. This causes an over-stretch or possible tearing of the ligaments, which can cause a lot of pain, and even make walking difficult.
These ligaments are known as the lateral ligaments, of which there are three. This might happen playing sports that involve a lot of change of direction, a poor landing from a jump, or even just a mis-step off the curb!
It is also possible to roll your ankle the opposite direction as well, involving the ankle turning inwards as the food turns outwards. There are four ligaments on the inside of the ankle that are primarily responsible for stability to prevent the ankle rolling inwards. Collectively, these four ligaments are known as the Deltoid ligament.
The Deltoid ligament is thicker, stronger, and covers more area than the lateral ligaments, meaning that an injury to the inside ligaments is less common as they are better designed to hold up against a force opposing them.
If I have only injured my lateral ankle ligaments, why is there swelling and bruising on the inside?
We often see patients who are very concerned as they start to develop bruising and swelling in areas of the foot and ankle that they have been told they did not injure. Sometimes this develops days or even weeks after the initial injury.
It is very common to see the entire foot and ankle region look swollen and bruised after a significant sprain. When we injure our ligaments (or other body tissues!) this causes an inflammatory response, which is important as it is the bodies way of starting the healing process and rebuilding the tissues. This response can be fairly confronting as it often means a lot of bruising, pain and swelling, particularly in the ankle.
Due to the position of our ankle (being at the bottom of our leg!) gravity tends to track the swelling towards this area, including the foot, and can also mean that it is more difficult to reduce or fluctuates up and down more than swelling in other parts of your body. The ankle has different compartments and “joint capsules” which can also be disrupted or injured with an ankle sprain and may cause bruising and swelling in other parts of the foot.
Why Does It Keep Happening?
The biggest risk factor spraining your ankle is having had a previous sprain! When a ligament is overstretched or torn, it doesn’t always regain it’s previous stability and elasticity on it’s own. Within our ligaments and muscles are proprioceptive fibres, which feed back to your brain about where your limb is positioned in space.
If necessary, your brain would then initiate a reaction to correct this position if it was “extreme” or likely to cause injury. For example, you may have had an incident where you were walking on a gravel or uneven path and unexpectedly stepped onto a loose rock which puts you off balance, but have managed to correct yourself so that you don’t fall- this is an example of proprioception at work!
When you roll your ankle, these fibres are damaged, and unless we provide them with the right type of exercise and stimulus, they won’t always recover back to what they were! This is why an early diagnosis and correct rehab and preventative exercises are so important to help you prevent it happening again.
Other risk factors might include;
Playing or exercise surface (loose or uneven surfaces, slippery playing surface etc)
Height and weight; increased body weight will mean your ligaments and muscles are trying to correct for an increased amount of weight if put off balance)
Posture, including foot and hip. If your hip muscles aren’t working well to control your whole limb, your ankle stabilisers are going to have to work over time!)
Type and intensity of activity or sport; Contact sports and those that involve more change or direction and impact are more likely to result in a sprain than running in a straight line.
Muscle fatigue; our muscles are our “active stabilisers” of our joints, where our ligaments and joint capsule are “passive stabilisers” ie- we don’t have active control over them/can’t consciously contract them like we can a muscle. So, if your muscles are fatigued and aren’t contributing as well as they could to joint control, this might leave your ligaments a little overwhelmed and more vulnerable to injury.
How Long Will It Heal so I Can Get Back to Sport?
This depends on the severity of the sprain, as well as what the individual is wanting to get back to. Very mild sprains might be feeling better within a week or two, whilst the most severe type can take months. Sitting around resting for weeks on end is not the answer!
Having your ankle assessed by your Physiotherapist early on and making sure you’re doing the right type of rehabilitation exercise is crucial to giving you the best chance of a quicker recovery!
How can we help you?
At Melbourne Sports Physiotherapy our goal is to get you moving pain free as soon as possible.
But, we also want you to actually move better and live a healthier, more active and fulfilling life!
If your sports, fitness training or work has been wearing your body down, book in with one of our expert massage therapists so we can help you reduce your pain or stiffness.
If you are showing some signs of this condition or simply want help prevent this from happening in the future then book in with one of our highly experienced Remedial Massage Therapists today!
You can make an appointment by calling 03 9498 0205 or booking online.