Recurrent Ankle Sprains

An ankle sprain is a common injury that occurs when the ligaments around the ankle joint are stretched or torn when the ankle is twisted, turned in (inverted) or turned out (everted). Ligaments are tough bands of tissue that help connect bones together. The most commonly injured ligaments when you ‘roll’ your ankle are the three ligaments on the outside of the ankle. These are called;

  • anterior talofibular ligament (ATFL)
  • calcaneofibular ligament (CFL)
  • posterior talofibular ligament (PTFL)

Normally, the ATFL keeps the ankle from gliding forward & inward, & the CFL keeps the ankle from rolling inward on its side. When the ankle joint is forced into these positions these ligaments are overstretched & can tear. Initially the ankle joint will become swollen & may bruise. The ankle will be painful to move & depending on the severity of the injury, you may or may not be able to put weight through it. Certain areas, most commonly the outside of your ankle, may be tender to touch. The best results after an ankle sprain occur when treatment begins straight away. If the ankle ligaments do not heal adequately the ankle may become unstable, causing the ankle to give way & feel untrustworthy on uneven surfaces. This is because the ligaments become weaker after the injury (even when the pain goes away) & without proper rehabilitation re-straining the ankle is very likely. People who have had several mild ankle sprains or one severe sprain may develop irritation & thickening of the ligaments that were sprained causing them to get pinched near the edge of the ankle joint on certain movements. Studies show that the recurrence of ankle sprains can be as high as 80% & the incidence of developing a chronic ankle sprain between 20-40%. This is important because each sprain creates more scarring & increases the risk of more significant problems such as fractures (broken bones) & cartilage damage, so preventing recurrent sprains is essential. The 2 main reasons for these ongoing problems are;

  • persisting weakness in the peritoneal muscles which help stabilise the outer ankle
  • a loss of balance feedback (called proprioception) from your ankle to your brain.

Research shows that retraining these 2 components can dramatically reduce the risk of recurrent sprains. Your Physio can help you achieve this, as well as greatly speeding up your recovery from the original pain & inflammation. This lets you get back to your normal sports & activities a lot faster, & also reduces the risk of more inconvenience & damage through repeated injury.

Jon Perkins

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