The ankle joint is a complex structure. The ankle complex is made up from 4 bones the tibia (large shin bone), fibula (smaller shin bone), talus and calcaneous (heel bone). The talus bone sits on top of the calcaneous and sits between the two shin bones. These joints are not very stable. The ligaments around the ankle joint are the structures which provide stability to the ankle complex.
An inversion ankle sprain is damage to the lateral (outside) ligaments of the ankle complex which are the anterior talo-fibular ligament and the calcaneo-fibular ligament. However, the ligaments are not the only structures damaged. The joint capsule can also be damaged causing bruising and swelling.
Ankle inversion injury is more common than an eversion injury. This is due to the ligaments on the outside of the ankle complex are not as strong as the deltoid ligament located on the inside of the ankle therefore making the outside of the ankle more susceptible to injury.
What is the cause of it?
The lateral ligament injuries occur in activities that involves jumping or activities that requires rapid changes in direction, particularly on uneven surfaces. This injury can also occur if a previous ankle injury was poorly rehabilitated.
How does it feel?
There will be a feeling of pain on the lateral (outside) aspect of the ankle. During the ankle sprain an audible snap, crack or tear may be heard. There would be difficulty putting weight on the injured ankle. The later symptoms may include swelling and bruising (haemorrhaging).
What should you do?
Initially the 1st 24 hours post injury requires RICE (Rest, Ice, Compression and Elevation) treatment. Rest requires you to stop your activity or sport, and limiting the amount of weight you put through your leg. Ice should be applied at the site of injury for 15–20 minutes every few hours. This will help limit the amount of haemorrhaging and swelling. Compression involves the application of a firm elastic bandage around your ankle. It should be firm but not to cause pain. Elevation involves lying with your ankle resting comfortably on a chair or pillows so that it is above the level of your heart. You should continue the RICE regime until you consult your osteopath, preferably within two days of the initial injury.
To help reduce the recovery time non weight bearing mobility exercise can be carried out within the pain free range of movement, such as moving the ankle in a circular motion clockwise and anti clockwise and moving the ankle up and down. These exercises will help reduce some stiffness and some swelling that would have occurred during this injury.
What shouldn't you do?
You should avoid activities which will increase blood flow cause further bleeding and swelling such as warm showers, heat pads, alcohol and excessive standing as these will prolong recovery time and increase the amount of pain felt. Wearing uncomfortable shoes can also prolong treatment as this will cause more stress to go through the ankle complex and into the injured ligaments.
Could there be any long term effects?
If not treated, this could lead to the formation of scar tissue causing instability within the ankle complex leading to recurrent inversion injuries. There may be pain/discomfort felt upon exercise or any activity that puts stress through the ankle complex. Scar tissue is difficult to break down.