From the Guidelines
The most common sports injury to the ankle is a lateral ankle sprain (LAS), which occurs in approximately 40% of all traumatic ankle injuries during sports. According to the study by Vuurberg et al. 1, LAS is a frequently incurred musculoskeletal injury with a high prevalence among the general population and individuals who participate in sports. The study reports an incidence of 7 LAS per 1000 exposures for indoor sports.
Key Points to Consider
- Ankle sprains occur when ligaments stretch or tear, typically when the foot rolls inward (inversion sprain), affecting the lateral ligaments.
- Treatment follows the RICE protocol: Rest the ankle, apply Ice for 15-20 minutes every 2-3 hours for the first 48-72 hours, use Compression with an elastic bandage, and Elevate the ankle above heart level.
- Over-the-counter pain relievers like ibuprofen (400-600mg every 6-8 hours) or acetaminophen (500-1000mg every 6 hours) can help manage pain and inflammation.
- Most mild to moderate sprains heal within 2-6 weeks with proper care.
- For severe sprains, a walking boot or physical therapy may be necessary.
Prevention Strategies
- Proper footwear
- Gradual training progression
- Strengthening exercises like calf raises and ankle circles
- Balance training
It is essential to seek medical attention if you experience severe pain, inability to bear weight, visible deformity, or symptoms that don't improve within a few days, as reported in the study by Vuurberg et al. 1. Additionally, the study highlights that only approximately 50% of individuals who incur a LAS seek medical attention, which can lead to chronic ankle instability (CAI) if left untreated.
From the Research
Ankle Injuries in Sports
- Ankle sprains are a common injury in athletic populations, with a high rate of recurrence and significant resources spent on treatment, rehabilitation, and prevention 2.
- Acute ankle sprain is the most common lower limb injury in athletes, accounting for 16%-40% of all sports-related injuries, and is especially common in sports such as basketball, American football, and soccer 3.
Causes and Diagnosis
- The majority of ankle sprains affect the lateral ligaments, particularly the anterior talofibular ligament 3.
- A detailed history and proper physical examination are diagnostic cornerstones, with imaging not indicated for the majority of ankle sprain cases 3.
Treatment and Rehabilitation
- Several interventions have been recommended in the management of acute ankle sprains, including rest, ice, compression, and elevation, analgesic and anti-inflammatory medications, bracing and immobilization, early weight-bearing and walking aids, foot orthoses, manual therapy, exercise therapy, electrophysical modalities, and surgery (only in selected refractory cases) 3.
- Exercise and bracing have been recommended with a higher level of evidence and should be incorporated in the rehabilitation process, with a comprehensive and progressive exercise program including range of motion, stretching, strengthening, neuromuscular, proprioceptive, and sport-specific exercises 3.
- A clinical practice guideline on ankle sprain provides recommendations for preventing primary and recurrent injury, as well as interventions for patients with an acute or postacute lateral ankle sprain, and for patients with chronic ankle instability (CAI) 4.