While an ankle sprain is one of the most common injuries in sports and day to day life, most people still don’t understand exactly what they are. An ankle sprain can occur to either the inside (medial) or the outside (lateral) ligaments of the ankle. A ligament is a band of connective tissue in the body that connects two bones together. These structures are easy to tear and damage when a joint is forced into a position it is not normally in. Depending on the severity of the sprain, an ankle can take a few days up to 12 weeks to fully recover from the injury.
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A Sprained ankle is a common injury may occur when:
There are two groupings of ligaments in the ankle, one on either side of the joint. On the lateral side of the ankle, there are three ligaments that connect bone to bone, known as the lateral collateral ligaments of the ankle. The anterior talofibular ligament is the most commonly injured. It connects the front of the talus, which is a bone that sits directly on top of the calcaneus (heel bone) to the bottom of the fibula. The other two ligaments are the posterior talofibular ligament, which connects the back of the talus to the bottom of the fibula, and the calcaneo-fibular ligament, which connects the calcaneus to the fibula. On the medial side of the ankle, there is one ligament with three parts called the deltoid ligament, also referred to as the medial collateral ligament of the ankle. This ligament is not as often injured and connects the tibia to the calcaneus, talus, and navicular bones.
A low ankle sprain consists of any injury to these ligaments. Ankle sprains occur with a forceful inversion (lateral ankle sprain) or eversion (medial ankle sprain) to the ankle. When excess force is applied to the ligaments holding the bones in the ankle together, it causes them to tear either partially or fully. There are different ways lateral ankle sprains are graded depending on the number of ligaments involved. A grade one ankle sprain only involves the anterior talofibular ligament, a grade two sprain usually adds the calcaneo-fibular ligament in and a grade three sprain involves all three ligaments. A grade 2 ankle sprain recovery time can take 4-6 weeks to fully recover.
The RICE Method (Rest, Ice, Compression, Elevation) is recommend for home treatment for a low ankle sprain.
Physical therapy and rehabilitation for a low ankle sprain is normally a very straightforward and simple process. The specific protocol is determined by the grade of the sprain and the activity level of the patient prior to the injury, but follows the same basic model. It begins with focusing on decreasing swelling and improving range of motion back to a normal functional range. Once both of these goals have been met, the strengthening phase begins and though it starts off simply, with non-weight bearing therapeutic exercises, it progresses to weight bearing therapeutic exercises and then to jumping and running as tolerated or as needed by the specific patient. Improved stability and strengthening of the ankle are incredibly important in low ankle sprain rehabilitation as once an ankle sprain has occurred, without the proper strengthening, it is much more likely to happen again.
The majority of sprained ankles heal with no complications. The pain should decrease after 2-3 weeks. After the swelling goes down you can walk with out pain. You should ease back into exercises that will strengthen and build flexibility.
If you have sprained your ankle in the past, it is possible to do it again. The ligaments in the ankle contain nerve receptors that detect position and movement. Those receptors send a message to the brain to tell your muscle how to respond to keep you upright and balanced. When you sprain your ankle, some of those receptors, called proprioceptors, get damaged. When the ligament heals, the receptors may not. When you are on an uneven or unsure surface, the brain may not receive the correct information about the ankle position. This can lead to inadequate muscle response and another injury.
Physical therapy after an ankle sprain can help to refine other proprioceptors and decrease the risk of recurring ankle sprains.