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Trips and Tricks

A mould of a foot's skeleton, showing tendons as well as bones

Sprained ankles are one of the most mishandled injuries out there. There is a perception that ankle sprains are a minor injury, and they are in the sense that most won’t be painful after a couple of weeks of rest.

What causes a sprained or twisted ankle?

There are a few different types of ankle sprain, but the one that most people are familiar with – and have likely experienced – is a foot roll, this is when the ankle rolls outwards so that the sole is facing the other foot.

This is usually caused by the foot treading on an uneven surface, landing from a jump, tripping over a curb when running or, landing on another player during sports.

The talofibular ligament (ATFL) and calcaneofibular ligament (CFL) are the most likely to be injured in a typical sprain, followed by the posterior talofibular ligament (PTFL), which is rarely damaged.

If a twist in the ankle goes beyond damaging the PTFL will usually also cause fractured or broken bones in the foot – which is an injury that people definitely don’t ignore.

Can’t I just wait for the pain to go away?

Ankle sprains are a common injury that many people don’t consider worth visiting a physiotherapist for.

However twisted ankles will often leave residual symptoms which can cause further complications down the line.

Even a slight change in the flexibility and strength of a ligament following an ankle sprain can result in slight changes in the movement and balance of your foot. This can cause compensatory movement patterns. These movement patterns often have a psychological component as well. Following an ankle sprain, you may be more fearful of putting your full weight on the affected ankle, changing the way that you walk and run.

Compensatory movement patterns can quite easily develop without you noticing. If they are not corrected they can lead to structural changes in your body which increase your risk of injury, as muscles, tendons and ligaments are being subjected to forces they are not adapted for.

This can also result from changes in proprioception, which is your brain’s awareness of how your joints are positioned. Proprioception is why you know where your hands and feet are even if you can’t see them.

A couple of weeks of not being able to move a painful, swollen ankle properly is enough time for changes in your proprioception to occur which may linger even after your ankle has recovered.

Because of the interrelation between the ankles, knees, and hips, a change in movement and function in the ankle can have long-reaching consequences all the way up your legs.

What does it mean if I keep spraining my ankle?

The laxity of ligaments on the outside of the ankle can increase following damage from an injury, making them less able to keep the foot in place.

If you assume an ankle sprain is a minor issue and continue as you were before without giving it the time and attention required to heal, you’ll be more vulnerable to suffering a sprain again.

Over time, laxity in the ankle ligaments can develop into chronic ankle instability, where the ankle rolls outwards even under a minor load. This often leads to a vicious cycle where ankle instability leads to repeated ankle sprains, which further reduce stability, leading to further sprains.

It’s important to intervene with physiotherapy as soon as possible if you are suffering from recurrent ankle sprains.

How can a physiotherapist treat my ankle sprain?

The sooner you see us, the better we will be able to manage your recovery from the acute phase all the way through to the return to sport/daily life phase! We also work with Hobsonville Podiatry so if we feel you may require some orthotic insoles to minimise your risk of re-injury we can refer you directly to them too!