Mechanism of injury
The injury occurs when the forefoot abruptly rotates primarily inward, causing the ankle and fibula ligaments to “stretch” beyond their capacity and/or tear. This can for example occur upon landing after a jump, where there is a sudden shift of the body’s center of gravity onto the landing leg. The ankle “turns” outward, while the foot turns inward, causing great stress and injury to the collateral ligaments. Ankle sprains are therefore quite common in sports that involve jumping, such as basketball, football, mountain running, etc., where athletes may land sharply or land on uneven ground.
Depending on the degree of stretching and/or tearing of the ligaments, ankle sprains are divided into 1st degree, where there is stretching but no tearing of the ligaments, 2nd degree, where there is a partial tear, and 3rd degree, where there is a total tear of the ligaments. When a ligament is stretched or torn, its stiffness and strength rarely return to their original state.
It is worth noting that in an ankle injury, with the mechanism described above, there are other structures that may be damaged, such as the articular cartilage and tendons. Also, in some cases there is an injury to the bones of the joints, resulting in some bone swelling or fracture in the area, which are difficult to detect from the beginning. Thus, the recovery of an injury may seem simple, but in reality it has a complex evolution.
Symptoms
Following the injury, patients report pain on the outer side of the ankle at rest and with movement, if possible. Edema (swelling) of varying degrees is observed, depending on the extent of the injury, and bruising is also likely to occur on the side of the ankle, due to bleeding under the skin.
Coping
The method of treating the injury depends on the degree of the sprain and the extent of the injury. In most cases, even in severe injuries, rehabilitation of the area can be achieved without surgery. An important role in the choice of treatment method, but also during it, is the patient’s ability to load the foot. Patients who cannot walk after injury will need to be immobilized for a longer period of time.
During the first hours and days after the injury, the goal of treatment is to reduce pain, limit swelling, and mobilize the joint as conditions allow. It is recommended to use ice every two or three hours for no longer than a quarter of an hour. The healing time for a sprain varies, from a few weeks in the mildest cases to several months in the most severe cases.
For the rehabilitation after the injury, as well as the gradual return of the patient to daily and sports activities, the role of physical therapy is essential. The goal is to restore mobility in the ankle area, strengthen the musculature, improve stability in the injured area, and prevent or improve instability.
