An Ankle Sprain is a common sports injury whole over the world. An ankle sprain occurs when the strong ligaments that support the ankle stretch beyond their limits and complete or partially tear. An ankle sprain is one of the most common musculoskeletal injuries among the people of all ages and athletes. The most common type of ankle sprain is an inversion injury or lateral ankle sprain. The severity of an ankle sprain depends on whether the ligament is stretched partially torn or completely torn as well as on the number of ligament involved.
Grades of Ankle Sprain:
• Grade 1(Mild): The ligament is overstretched.
• Grade 11(Moderate): The ligament is overstretched or partially torn but without joint’s instability.
• Grade 111(Severe): The ligament is completely torn with instability of the joint.
Causes:
• Sports injuries.
• Wearing inappropriate shoes.
• Rapid shifting movement.
• Vigorous sports activity.
• Falling down.
• Walking or exercising on an uneven surface.
Symptoms:
• Pain.
• Swelling.
• Bruising.
• Difficulty walking.
• Stiffness of the joint.
• Soreness.
• Catching or popping sensation.
• Throbbing.
• Weakness.
• Skin discoloration.
Diagnosis:
i. Physical examination-
• Focal tenderness and swelling over involved in ligament.
• Anterior drawer test.
• Talar tilt test.
• Squeeze test.
ii. Radiographs: X-ray, MRI, Ultrasound.
Treatment:
The grade of sprains will dictate treatment.
Grade 1-Rest, Ice, compression, elevation, protection.
Grade 11- Ankle splint/brace.
Grade 111- Cast for several weeks.
i.Medication: Non steroid anti inflammatory drugs eg. Ibupronfen, naproxen.
ii. Physiotherapy:
• Strengthening exercise.
• Balancing exercise.
• Use of ankle brace for support.
• Use of crutches or other walking aids.
• Ultrasound therapy.
• Moist heat.
• Wax bath therapy.
• Range of motion exercise.
• Endurance and agility exercise.
• Mobilizing exercise.
• Flexibility exercise.
• Rehabilitation.
iii. Surgery: Arthroscopy, Reconstruction.
How can we prevent ankle sprain?
• Stretch regularly to keep your ankles flexible.
• Do ankle range of motion and strengthening exercises to keep your muscles strong.
• Warm up always before playing sports, exercise or doing any other kind of physical activity.
• Use of tape, lace up ankle brace.
• Wear shoes that feel comfortable. Tie any laces and close any Velcro or other steps to make the shoes as supportive as possible.
• Don’t wear shoes with high heels.
• Maintain a healthy body weight.
• Avoiding HARM (Heat, Alcohol, Running, and Message).
• Slow down or stop activities when you feel pain or fatigue.
• Pay careful attention when walking, running or working on an uneven surface.
Md. Ruhul Amin
BPT (DU)
Clinical Physiotherapist
Department of Physiotherapy
National Institute of Traumatology & Orthopedic Rehabilitation (NITOR), Sher-e-Bangla Nagar, Dhaka
