Ankle Injuries

What causes Ankle Injuries?

The ankle joint is a synovial joint, which means it has a thick fibrous capsule surrounding the joint and an inner lining that contains fluid. The fluid helps to nourish and lubricate the joint whilst acting as a shock absorber. The bones of the ankle joint are the talus, the tibia and the fibula. Strong ligaments firmly anchor these bones in place to create a deep socket-like bracket. The ends of the bones are covered with shiny white hyaline cartilage which allows them to glide smoothly over each other.  The ankle mainly allows hinge like dorsi-flexion (pointing foot towards body), plantar flexion (pointing foot away from body) and inversion (turning your foot in). The tendons of several muscles cross the ankle, to provide it with control and support.

What are the types of Ankle Injuries? 

The ankle region is complex and packed densely with numerous supportive structures. Problems may include any of the following:

• Ligament tears and avulsions
• Tendon degeneration
• Tendon tears
• Arthritis
• Fracture, stress fracture and bony bruising
• Soft tissue impingement
• Growth plate overstress
• Muscle tears and contusions
• Nerve injuries

Because the ankle is a complex joint, several structures may become affected at the time of the injury. The most common ankle injury is a sprain to the lateral ligament complex.

What do you do if you have an Ankle Injury?

As with many acute (recent) soft tissue injuries, it’s advisable to follow the RICER principle: Rest Ice Compression Elevation Referral.

Resting will give the injured structure a chance to start healing. This means not participating in sports and activities until the pain is gone / under control. Inflammation is a part of the healing process and acts as a handbrake on your body to make you rest. However, too much inflammation can minimise joint movement and muscle activation.

Icing, compression and elevation allows the inflammation to settle as the by-products of the damaged tissue are reabsorbed by the body. These steps can also reduce the pain.

Referral means seeing the right professional after the injury for diagnosis and management. Your physiotherapist is the best person to see. 

Be wary of thinking “it’s just an ankle sprain”

Sprained ankles are one of the most common ankle injuries. A sprain is a tear within a ligament/s. There are different grades of sprains, depending on what percentage of ligament has been torn. Tearing the ligaments on the outer side of the ankle is far more common due to the positions of the bones around the ankle.

If an ankle is not as ‘stable’ after injury, with excessive ligamentous laxity, decreased muscular control (proprioception) and balance, then more demands and pressure may be placed upon the knee, hip and back, as these areas try to  compensate. This may then increase the risk of injury to these areas

What to expect from your treatment provider:

1.    A thorough assessment

2.    A diagnosis or alternative explanations if a specific diagnosis is unclear

3.    Advice on what to do and what to avoid

4.    An estimate on how long treatment will take and how much this will cost

5.    A discussion of your goals for this problem and whether they are realistic

6.    A program tailored to individual needs

7.    Referral to other treatment providers, who can assist in your management