Just another one of them ankle sprains- she'll be right, wrong.

Did you know that the most common sport injury is a lateral ankle sprain, where your foot rolls inwards.

Are you aware that 40% of these ankle sprains end up becoming chronic ankle instability. This may feel like repeated feeling of the ankle giving way or actual sprains. Pain, weakness, loss of normal ankle movement and reduced function such as walking, jogging or hopping.

This ankle instability correlates with worse cartilage health. From this chronic instability group, 78% will develop osteoarthritis in the ankle.

So take a population sample of

• 10 people who sprain their ankles,

• 4 will develop chronic ankle instability (CAI).

• Of those with CAI, 3 will develop osteoarthritis in the ankle too.

  
  

  This arthritis doesn't start at 60+ years, it can begin as early as your 30s.

Let's not become a statistic.

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Couple run on uneven ground

Why do 4 out of 10 people develop Chronic Ankle Instability from an ankle sprain?

Everytime you twist your ankle, the ligaments which keep your bones together become overstretched. Ligaments are like ropes which once overstretched, rarely return to their original tensile strength. Now if you happen to twist your ankle again, those ligaments will be less able to resist that sprain event.

Apart from the ligaments, your muscles, bones and joints can also get injured. Muscles switch off or shrink, your foot's sense of control and balance become impaired. So the likelihood of reinjury increases with each incident.

Consequently you develop a chronic unstable ankle. If you were to run, perform jumping activities there would be added pressure to your knees and hips to compensate for the instability. Some people may end up not participating in their social or sporting activities. Leading to loss of muscular strength and deconditioning overall.

In our previous post we looked at the need to be specific with warm ups to prevent injuries like these.

Now, let's dive into how we treat this ankle sprain, to avoid CAI.

Objective assessment

1. We need to discern which structures are involved? ATFL ligament, subtalar joint injury, fibula fracture, 5th MT fracture...

2. What is the extent of the injury? Grade 1, 2, 3...

3. We gather a baseline measurement of your injury - walking ability, range of movement, balance, function...

4. We explore your work, social and environmental circumstance - do we need taping, braces, can we continue playing sport or walking?

5. Do we need to get imaging of the ankle? Is an xray, ultrasound, MRI required?

6. A management plan is mapped out - expected timeframe for recovery, treatment options available, ways to prevent future re-injury.

7. We review your case until you are back to your old self, and where possible better self.

The above clinical reasoning process is just a snapshot of what we do at Frontline Family Physio to make sure that you progress out of your injury.

Get your ankle sorted, address the limitations and you stand a good chance at preserving your functional capacity.

Feel better, move better and stay better when you look after your body. Even your ankle sprains.

Sean Hua

Director and Physiotherapist

Frontline Family Physio

Shop 6/2a Brown St Ashfield NSW 2131

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References:

1. Delahunt, E., & Remus, A. (2019). Risk Factors for Lateral Ankle Sprains and Chronic Ankle Instability. Journal of Athletic Training, 54(6), 611–616. https://doi.org/10.4085/1062-6050-44-18

2. Hertel, J., & Corbett, R. O. (2019). An Updated Model of Chronic Ankle Instability. Journal of Athletic Training, 54(6), 572–588.