‘Ankle Injuries – Inversion of the ankle ligament’ By Jade Blake, Physio4Life Senior Physiotherapist

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Are you one of these people that likes to stay fit and active, but struggle with weak ankles or you’re continually having to rest because of rolling over on them spraining the ligaments?

Damaging the ligaments on the outside of your ankle is an injury that has happened to a lot of us whether we enjoy sport or not. The injury is caused by a sudden inversion movement to the foot, putting strain on the outside ligaments. Depending on the severity of the movement will vary in the level of damaged cause to the ligaments.

There are 3 ligaments on the outside of the ankle as you can see pictured above and the most likely one to be injured is the one at the front you anterior talo-fibular ligament (ATFL), followed by your calcaneo-fibular ligament (CFL) and lastly the posterior talo-fibular ligament (PTFL). The reasoning behind this is the ankle tends to roll as the foot is landing and it will be slightly more in a plantarflexion position (more pointed).

Common ways to cause an inversion injury to your ankle:

– Foot slipping off a curb when not paying attention
– Landing on someone’s foot during sport e.g. Netball or football
– Running on uneven ground
– Sudden changes in direction either walking or running

How do I know if I have sprained the ligaments in my ankle?

– Sudden onset of pain in the outside part of your ankle with inversion movement
– Can sometimes feel or hear a ‘POP’ in the ankle
– Ankle will become swollen and bruised, the worse the swelling and bruising the worse the injury will tend to be
– Unable to weight bear on the ankle and bony tenderness, may indicate a fracture, so get this cleared before seeing a Physiotherapist (Ottawa rules). See image below.

After injury:
– RICE
– Book in to see Physiotherapist 3-5 days post injury
– Immediate work on ankle range of motion
– Rest from high weight bearing activities, a crutch may be needed initially
Severity of injury?

There are 3 grades when It comes to an ankle sprain:

– Grade 1: Tearing of a few ligament fibres
– Grade 2: 50% of ligament fibres torn
– Grade 3: Complete rupture or the ligament

Problems:

Because ligament sprains to the ankle are very common a lot of people just leave it to settle down with rest without seeing a health care professional. Yes the ankle will heal and recover itself, however the likelihood of reoccurrence of problems with the ankle and potential the lack of return to sport is high.

If the ankle is not addressed you will have:

– Lack or proprioception
– Build up of scar tissue
– Potentially long standing ankle instability depending on injury severity
– A long standing instability may need to be addressed with surgery
– Longer period of time before being able to return to running and sport

Ways to prevent occurrence or reoccurrence:

– Properly warm up before running taking part in sport
– Exercises:
 Single leg balance on a wobble cushion
 Single leg balance, rotating torso with hands together out infront of you
 Resistance band ankle strengthening
 Calf stretches
 Clams
 Single leg calf strengthening
 Single leg squats
 Bosu ball squats
 Wobble board exercises
– Physiotherapy treatment and full rehabilitation
– Correct footwear for weather and surface, whether it be walking along the pavement or playing hockey on AstroTurf

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