Ankle Injuries

Ankle sprains are the most commonly diagnosed ankle problems with thousands occurring each day. Although the term 'sprained ankle' is sometimes thought to be synonymous with 'lateral ligament injury' (injury to the ligaments on the outside aspect of the ankle) and, thus, imply a rather benign injury this is not always the case. If the ankle is indeed a lateral ligament sprain, inadequate rehabilitation can lead to prolonged symptoms, decreased sporting performance and high risk of recurrence. The diagnosis of a 'sprained ankle' can also mask damage to other structures in addition to the ankle ligaments, such as subtle fractures around the ankle joint and dislocations of certain tendons around the joint. Such injuries are frequently not diagnosed and this causes ankle pain that persists much longer than would be expected with a straightforward ankle sprain.

The ankle contains three joints each of which allows movement in a certain direction. The ligaments of the ankle joint are known as the lateral ligament complex and the medial or deltoid ligament complex. The lateral ligament consists of 3 parts; the medial ligament is a strong fan-shaped ligament. Damage to the lateral ligament complex through inversion injuries is far more common than eversion injuries – injuries to the medial ligament complex. This is due to the relative instability of the lateral joint and weakness of the lateral ligaments compared with the medial ligament. Occasionally in severe injuries, both medial and lateral ligaments are damaged. The degree of swelling and bruising is usually, but not always, an indication of severity.

Common ankle injures seen by Stockport Physio are:

• Lateral & Medial Ligament Injuries
• Persistent Pain after Ankle Sprain
• Persistent Pain after Ankle Sprain
• Other Causes of Ankle Pain

Lateral Ligament Injuries

These occur in activities requiring rapid changes in direction especially if these take place on uneven surfaces (e.g. grass fields). They are also seen when a player, having jumped, lands on another competitor's feet. Complete tear of all three lateral ligaments results in dislocation of the ankle joint and is frequently associated with a fracture. Ankle sprain may be accompanied by an audible snap, crack or tear, which, although often of great concern to the person, has no particular diagnostic significance. The management of lateral ligament injuries, initially is to reduce pain and swelling through specific compression strapping by the therapist and regular icing. Then to restore range of motion as quickly as possible through ankle mobilisations, the prescription of specific exercises and stationary cycling and then to build muscle strength, balance and to look to prescribing a progressive sport-specific exercise programme using rocker boards, wobble cushions, hydraulic resistance exercises, trampets and specific gym equipment.

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