Acute ankle sprains account for up to 10% of emergency department attendances and 25 % of musculoskeletal injuries with nearly 50% related to sport ^{1 2}. Most ankle joint sprains affect the outer aspect of the ankle and can range in severity.

There are many factors that can increase the chance of ankle ligament injury including strength, propriocepsis, range of motion and balance.¹ Ankle injuries are also commonly seen in those participating in basketball, soccer, running and ballet/dancing.^{2 4}

An ankle sprain can be a term used to describe a range of pathological events at the ankle including overstretching, partial tear or complete rupture. To effectively manage a ‘sprained ankle’ the podiatrist must ascertain the severity of damage to the ligaments, the number of ligaments damaged, the involvement/damage of adjacent structures and the stability of the joint. Through ‘classification’ of the injury, the podiatrist is able to determine the most effective treatment and rehabilitation plan.

Without adequate diagnosis and treatment an ankle injury can lead to osteoarthritis and ongoing pain. Of most risk, however, is that of reinjury. The most important risk factor for an ankle sprain is a previous ankle sprain². Over 33% of ankle injuries will go on to suffer subsequent ankle injuries developing into chronic ankle instability due to reduced proprioceptive function and reduced mechanical stability². Many of these can go on to require surgery. There is a significant decrease in recurrences when a supervised rehabilitation program has been undertaken^{1 2 4}. Ankle braces (external ankle support) have also be shown to play a significant role in reducing the risk of reinjury.^{3 4}

It is imperative that the injured ankle is diligently assessed, treated and rehabilitated to reduce the risk of reinjury and developing chronic ankle instability.

References:

1. Kerkhoffs, G., Van Den Bekerom, M., Elders, L., Can Beek, P., Hullegie, W., Bloemers G., DeHeus E., Logman, M., Rosenbrand, K., Kuipers, T., Hoogstraten, J., Dekker, R., TenDuis, H., VanDijk, N., Van Tuilder, M., Van Der Wees, P., De Bie, R., (2012), “Diagnosis, treatment and prevention of ankle sprains: an evidence based guideline”, British Journal of Sports Medicine, vol. 46, p. 854-860.
2. Van Den Bekerom, M., KErkhoffs, G., McCollum, G., Calder, J., Van Dijk, C., (2012), “Management of acute lateral ankle ligament injury in the athlete”, Knee Surgery, Sports and Traumatology and Arthroscopy, 1007/s00167-012-2252-7
3. Kaplan (2011), “Prevention of ankle sprains in sport: a systematic literature review”, British Journal of Sports Medicine, vol. 45, p. 355
4. Lamb, S., Marsh, J., Hutton, J., Cooke M., (2009), “Mechanical supports for acute, sever ankle sprain: a pragmatic, multicentre, randomised control trial”, Lancet, vol 373, p. 575-581.