Sprained ankles can lead to ongoing gait instability, pain and loss of walking with confidence. The most common injury is for the foot to roll over to the outside; the lateral ankle inversion sprain. Annually, over 300, 000 serious ankle sprains report to UK A+E. Eversion sprains, whereby the foot rolls inwards in , is less common and,but more serious in presentation.
Generally, individuals rest and ice a sprained ankle, but can be aware they have incurred a serious injury. Ankles are complex anatomical structures. There are lots of little ligaments holding the whole structure together. These ligaments can stretch or rupture. The main lateral ligaments to get damaged are:
1, Anterior talofibular ligament (most common)
2, Calcaneofibular ligament
3, Posterior talofibular ligament
Unfortunately, another main ligament can get damaged on the medial inside ankle; the deltoid/ Spring Ligament. If untreated it can result in a flatfoot deformity, lateral hindfoot impingement and subtalar joint osteoarthritis. Often the Spring ligament is given less attention as the ankle sprain was towards the outside. It gets overseen, but plays a huge part in ankle stability. If you look at the diagrams is looks like a large fan.
Importance of RICE – Act quickly
A bad ankle sprain will result in considerable swelling with associated pain and bruising. If you suspect a break, go straight to hospital.
Treatment
- Rest. Avoid activities that cause pain, swelling or discomfort.
- Get hold of a walking stick, or zimmer.
- Ice. Use an ice pack or ice slush bath immediately for 15 to 20 minutes and repeat every two to three hours while you’re awake. …
- Compression. To help stop swelling, compress the ankle with an elastic bandage until the swelling stops. …
- Elevation.
- Patience. Do not return to normal activities until pain has subsided and all function has returned whilst weightbearing.
When should I seek Podiatry help?
Many ankle sprains can slowly resolve over time with no on going issues. There are then those that leave the ankle feeling weak with pain elicited in certain positions and on pressure. These are the cases that need urgent attention. If left alone arthritic changes can occur, loss of arch height, poor compensation and unstable ankle. Falling becomes a more frequent occurrence especially on an uneven surface. X-rays fail to show the problem.
Fix a sprained ankle. Get to an MSK Podiatrist. They can determine how unstable the ankle and subtalar joint complex is. Undertake stress tests and check weightbearing biomechanics dynamic and massive. Patients often try to compensate by favouring the opposite side, this can upset natural biomechanics causing knee and hip pain. Over time the arches can drop resulting in more tendon and ligament discomfort. Quality of life is being severely impacted.
The podiatrist can help to improve the biomechanics of the unstable foot and move the centre of gravity more towards the patient’s mid-line. Simple changes can be made to footwear or more specialist functional insoles issued. There is specific tapping techniques that can be applied along with exercises. In those more serious cases specialist foot and ankle braces can be made. The podiatrist can advise on balance and proprioceptive exercises. Get the big toe to work functionally better.
Often the big toe is not being used correctly. The patient literally has lost the ‘spring’ in their step. It is crucial to engage the hallux to help the patient toe-off and push forward with propulsion. Having no propulsive spring can lead to a patient stooping forward. Toes can start to claw. This could simply have started with an untreated ankle sprain? Patients are not aware they have any biomechanical issues related directly to a bad ankle sprain. It really is important to get checked out. Maybe a simple cut out to where the ball of sits can help improve stability, or a wedge placed down the outside(inside) the shoe.
Fix a sprained ankle with haste!
