Ankle sprains occur once every 1000 hours of participation in sport. Across the wider population, approximately 1 million ankle sprains occur per year (UK). The most common ankle sprain, equating to almost 75%, is a lateral ankle sprain. The data suggests it's marginally more common in females than males and is more likely to occur in your teens. Ankle sprains are commonly miss-managed increasing the rate of re-injury or chronic issues.
Anatomy & Physiology
As detailed in the image below, the lateral ankle sprain occurs due to an inversion injury. This is where the ankle rolls laterally due to a loss of footing, heavy landing or direct impact. Most commonly, the Anterior Talofibular Ligament (ATFL) is the one that is damaged (73%). This damage causes inflammation leading to pain, swelling and a loss of function.
How do I know it isn't broken?
At PhysioForm, we always advise seeking a professional opinion. Whether that's your GP, A&E or here with us. However, if that's not possible, here are a few of the key assessment criteria we use to decide whether an ankle needs an X-ray or not.
(Image Courtesy of MDCalc)
Generally palpable tenderness in any of the areas A-D in combination with the inability to weight-bear for more than 4-5 steps, indicates the need for an X-ray. This doesn't necessarily mean it's broken, but if you have these symptoms it's definitely best to get it investigated. I must note here, that from experience, swelling can be miss-leading. I've assessed grossly swollen ankles with no break & mild swelling with a fractured fibula - everybody is different.
Why early rehabilitation is essential
Early rehabilitation with a physiotherapist, ensures that the ankle does not become chronically unstable. On most sports teams, there's a player with a glass ankle. They person who rolls their ankle 4-5 times per season. They have a condition called Chronic Ankle Instability (CAI). CAI can end careers and athletic pursuits. If you have an ankle sprain, no matter how minor, It's essential that you start the rehabilitation process early. Evidence suggests that early diagnosis, balance training and a phased return to sport are key to reducing the risk of CAI.