The Common Ankle Sprain

The Common Ankle Sprain

What is it?

The common ankle sprain refers to injury to the lateral aspect of the ankle and more specifically, stretching and tearing of the ligaments at the lateral compartment between the fibula and the calcaneum & talus. The most frequently injured ligament is the anterior talofibular ligament (known as the ATFL for short) followed closely by the calcaneofibular ligament. Excessive lateral stress to the ankle can also lead to damage of the tendons including those of the peroneals and the extensors.

What causes it?

A sprain occurs when a joint is forced into a position that is out of its normal range of motion. For the common ankle sprain this typically involves the ankle being forced into an inversion +/- plantarflexion position, stressing the lateral ligaments.

Examples of situations that can lead to an ankle sprain are:

·       Losing your balance and stepping out heavily to the side, twisting the ankle

·       Heavy falls that lead to the ankle landing in an inverted position

·       Walking over long distances on uneven ground

Signs and Symptoms

The most obvious signs of damage to the ligaments are:

·       Pain – increasing with weight-bearing through the foot

·       Swelling – can onset immediately or take a few hours to come up

·       Bruising – in some cases, where the bleeding to the damaged tissue is excessive enough

Treatment

Acute management of an ankle sprain should follow the P.R.I.C.E guidelines consisting of:

Protection

Rest

Ice

Compression

Elevation

This should be followed for the first 72hours with particular attention being paid to Compression.

In most cases, sufferers of an ankle sprain will not visit their doctor or A&E department, gradually increasing the weight through the ankle as their pain allows. Those that do seek professional help for the injury will be assessed and if ruled out of having a fracture will be advised to do much the same – increase weight-bearing as pain allows.

If the ligament damage is too severe and pain continues to inhibit function then manual therapy in the form of Physiotherapy, Osteopathy or Chiropractic may be of assistance.

Once the client is able to weight-bear they should gradually increase the strengthening of the supporting muscle groups (peroneals, extensors & flexors) and increase their awareness of the ankle joint with progressively harder proprioception exercises.

Pilates & Ankle Sprains

It is more likely that as a Pilates teacher you will have a client attend a class having sustained a sprain than have a new client attend based on suffering an ankle sprain. Pilates is great for the ongoing treatment and strengthening of the ankle. Instructing the client particularly on ankle mobility exercises, progressively harder weight-bearing exercises (bilateral weight-bearing unilateral weight-bearing, eyes open, eyes closed, etc) and where possible, the use of studio equipment to further accelerate the process.

If at any time the ankle becomes swollen and painful as a response to the exercise, return to the acute management for 24 hours. If it remains painful and swollen after 24 hours then advise the client to return to their manual therapist for further assessment.

Always instruct the client to ‘listen’ to their ankle ... if it#s aching ... it’s probably done enough. Rest is just as important as strengthening in the rehab.