Lateral ankle sprains or a “rolled ankle” are one of the most common injuries in footballers, with this outside of the ankle being involved in 75% of all ankle injuries.
The lateral ankle complex is made up of 3 ligaments - the ATFL, CFL and PTFL. The ATFL is the weakest of the three ligaments and is therefore the most commonly injured one.
Typical symptoms of a lateral ankle sprain include:
A rolling of the ankle when the injury happened - some people may hear a popping sound.
Pain when putting weight on the injured foot and pain on certain movements.
Restricted movement compared to the uninjured side.
Possible swelling and/or bruising around the outside of the ankle.
A feeling of not being stable on the injured ankle.
Why is it so important that we rehabilitate these injuries properly?
Up to 70% of all individuals who sustain a lateral ankle sprain develop some sort of ankle joint instability after the injury, and this can be short-term or long-term - those who play sports where running, cutting and jumping are characteristic are much more likely to see this. Football is a sport where all of these movements are vital, so it is so important that we manage and rehabilitate these injuries correctly.
Additionally, ankle sprains have one of the highest reinjury rates of all lower limb injuries, with up to a 2-fold increased risk of reinjury in the year after injury. Harry Kane is a perfect example of someone who suffers from recurrent ankle injuries!
What is the best rehabilitation process?
The ideal rehabilitation process depends on the extent of the damage sustained to the ligament and also which ligament has been injured. However, rehabilitation tends to follow the same process, just on a different time frame adapted to your injury:
The first thing is to reduce pain and swelling in the first 2-3 days after the injury happens. We can do this by applying ice, compression and elevation to the injured ankle.
It is also important that you start to move the ankle as soon as pain allows - this has been shown to have better outcomes than immobilising the ankle.
Next, we want to start to improve movement, strength and balance on the injured ankle, as well as the surrounding muscles and general lower body strength. Balance exercises are vital in successful return to football after this injury! This stage should continue until full range of motion, strength and balance are restored.
Once all of the above are back to or better than where they were pre-injury, this stage should aim to fully prepare you for a safe return to football - this is where we introduce lots more impact and rotation that mirror the demands of football whilst continuing to build strength in and around the injured ankle.
How do we prevent these injuries from happening again?
Injury prevention programmes for lateral ankle sprains have been shown to be very effective and should include:
Exercises that focus on stabilising the ankle joint - these will improve the ability of your muscles to work and stabilise the ankle joint rather than just relying on the ligaments themselves. Balance and postural control exercises are really good for this.
Exercises to improve knee-over-toe range of motion - the ankle needs to be stable and mobile to have the best chances of preventing such injuries. A combination of stretching and mobility exercises will help to achieve this.
Exercises to strengthen the whole lower limb and trunk, not just the ankle - this includes the hamstrings, quads, adductors and very importantly the glutes.
So, what can we do here at SV Sports Therapy to help with your lateral ankle sprain?
We can assess, treat, diagnose your injury, giving advice for each step of the process.
We can use a variety of treatment methods such as joint mobilisations and massage to help your injury along the way.
Create with a tailored exercise rehabilitation programme from the early stages, all the way up to getting you back on the pitch safely.
Create a tailored injury prevention programme to minimise the risk of re-injury - also an excellent option even if you haven’t got a lateral ankle sprain currently!