By Dr. Carol Frey
Quick quiz: In which youth sport do you expect to see the most ankle sprains. Ankle sprains are most common in basketball – with 45 percent. Soccer accounts for another 31 percent of ankle sprains, and volleyball 25 percent (www.nata.org).
An ankle sprain is a ligament injury. Ligaments attach bone to bone and provide stability to a joint. An injury to the ligament is called a sprain. There are three grades of injury to a ligament: grade I (mild), grade II (moderate) and grade III (severe).
The most commonly injured ligaments are the lateral collateral ligaments of the ankle (the ligaments on the outside of the ankle). These ligaments are called the anterior talofibular ligament (the most commonly torn), the caclaneofibular ligament and the posterior talofibular ligament. These ligaments can be injured when you “roll” over the outside of your ankle.
Other structures can be injured at the time of the original injury. Bones of the ankle or the foot may fracture, a tendon can be torn or strained, and the nerves can stretch. Remember that an ankle sprain is not always “just a sprain”. Several structures can be injured in one incident.
Usually, the athlete has a history of having his or her foot pointed down and inward at the time of the injury. Then they roll over the side of the foot or ankle. That‘s the mechanism at work in creating an ankle sprain.
If this injury happens, the athlete may hear a “pop” or not have the ability to walk on the limb. It is important to find out if there is a history of a prior sprain or if this athlete has a “trick ankle”. If there was a “pop” or he or she was not able to put weight on the ankle after the injury, chances are that the injury was a grade II or grade III. A doctor should evaluate this.
The goal of treatment is to prevent long-term problems, pain, or instability of the ankle. Rehabilitation is the key to avoiding future problems.
All ankle sprains are treated in three phases: In the first phase, the athlete will have the injury protected by tape or a brace along with RICE (rest, ice, compression and elevation). Stretching and strengthening of the tendons on the outside of the ankle and the Achilles tendon take place in the second phase. In the third phase of treatment, the athlete will try brisk walking or running and other maneuvers such as cutting or side-to-side slide. Finally, balance and coordination are sharped along with agility, endurance and sports specific drills.