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One of the most common injuries seen in footy and netball is the lateral ligament sprain of the ankle.
Ligaments are the tough, fibrous bands that join out bones and limit the amount of movement. A sprain, or tear, occurs when the foot rolls inwards excessively, over-stretching the ligament and adjacent blood vessels. It is common in activities requiring rapid changes of direction, jumping, playing on uneven surfaces, or when landing on the outside of the foot, or on an opponent’s foot. The result is pain, bleeding and swelling like an egg over the outside of the ankle.
The severity of ankle sprains is graded I to III. Grade I refers to a minor sprain that may not stop the player from continuing, but will pull up sore and swollen and usually require 1-2 weeks rest from sport. Grade II sprains involve more extensive tearing and stretching of the ligament complex and will take 4-6 weeks for healing and return to sport. Bruising is usually present, and walking is difficult for several days. Grade III sprains are rare and involve a complete disruption, or rupture of the ligaments. This may be accompanied by a small avulsion fracture of the tip of the fibula and will require some immobilisation, prolonged rehabilitation over several months, or a surgical reconstruction to regain a stable joint.
What should you do after a sprain?
As soon as possible, and for 72 hours after injury, use the R.I.C.E method:
- REST – Only move within your pain limit.
- ICE – 20 minutes every 2 hours, apply ice or frozen gel pack wrapped in a damp towel to control bleeding and pain, or better yet, utilise the new ProIce unit at Corio Bay Sports Medicine Centre
- COMPRESSION – Firmly bandage the foot, ankle and lower leg to control swelling.
- ELEVATION – As much as possible, elevate your ankle higher than heart level.
Furthermore you should avoid H.A.R.M in the first 48 hours:
HEAT, ALCOHOL, RUNNING, & MASSAGE, each of which will increase the amount of bleeding and swelling in the area and delay your recovery.
Physiotherapists are well placed to diagnose the extent of the injury, order x-rays where necessary, provide taping or bracing to protect the injured ankle, provide hands-on treatment to ease pain, reduce swelling, improve scar healing and increase range of ankle movement. Most importantly we help develop an exercise program to regain muscle strength and balance around the ankle in preparation for a return to sport, plus show you ways to maintain fitness while you are recovering.
Complications
Things don’t always go to plan. Sometimes we feel that we have managed a sprain correctly but for some reason there is persistent pain or swelling or weakness, or else we just keep rolling the ankle. In this situation there may be some overlooked cartilage or tendon damage, or scar tissue around the nerve over the lateral ankle, damage to the tibiofibular joint above the ankle, or simply inadequate recovery of strength and co-ordination. A physiotherapist can help you sort out these issues. You do not need a referral to see a physio.