Ankle & Foot

Ankle sprains are the most common injury to the ankle joint. The ankle joint has several ligaments that add stability and prevent unwanted motion. The ankle joint is capable of moving in three planes; frontal, sagittal and transverse. Being able to move through three planes provides excellent mobility at the cost of decreased stability. When the ankle is pushed too far into any one direction a ligament can be strained or torn. The most common way to sprain or “Roll” your ankle is having it turn inward and damaging the outside of you ankle. The two most common ligaments that are damaged with this injury are the Anterior Talofibular Ligament (ATFL) and the Calcaneofibular Ligament (CFL). After “rolling” your ankle, swelling and bruising are common and indicate that a ligament and likely some blood vessels have been damaged. Icing your ankle and keeping it immobile until a physician or physical therapist can evaluate your ankle is advisable.

Damage to a ligament can be categorized into three grades or levels of severity.

Grade 1: Ligament is stretched or slightly torn. Tenderness, stiffness and swelling are mild. The ankle likely feels relatively stable and permits weight bearing with minimal pain.

Grade 2: Partial tearing of the ligament has happened and abnormal laxity of the ankle joint can be assessed felt by a practitioner when passively moved.

Grade 3: Complete tear of the ligament with gross instability noticed when the joint is passively moved by a practitioner.

A licensed physical therapist can assess what type of sprain occurred and if consultation to a physician is recommended. Appropriate splinting and bracing initially can help the ligament begin to scar and heal. Specific exercise can increase the strength of the supporting muscles around the ankle, which will help prevent additional sprains. In the event of a complete Grad 3 sprain or ligament rupture the patient may want to consider surgical options if the joint cannot be stabilized through physical therapy intervention alone.