Skręcenie stawu skokowego – Patofizjologia i mechanizm

Skręcenie stawu skokowego
Patofizjologia i mechanizm

Skręcenie stawu skokowego jest jednym z najczęstszych urazów układu mięśniowo-szkieletowego, stanowiąc około 14% wszystkich urazów sportowych, z mechanizmem dominującym polegającym na wymuszonym zgięciu podeszwowym i inwersji stopy, co prowadzi do uszkodzenia bocznych więzadeł, głównie więzadła skokowo-strzałkowego przedniego (ATFL). Uszkodzenia te klasyfikuje się na trzy stopnie: I – mikrourazy bez niestabilności, II – częściowe naderwanie z umiarkowaną niestabilnością, oraz III – całkowite zerwanie więzadeł z wyraźną niestabilnością i obrzękiem. W 66% przypadków uszkodzeniu ulega izolowane ATFL, a w 20% ATFL i więzadło piętowo-strzałkowe (CFL), co wiąże się z cięższym przebiegiem i dłuższym powrotem do zdrowia. Proces gojenia przebiega w trzech fazach: zapalnej (do 72 godzin), naprawczej (3-14 dni) i przebudowy, trwającej ponad 6 tygodni, z ryzykiem przewlekłej niestabilności stawu (CAI) wynikającej z zaburzeń propriocepcji i osłabienia mięśniowego, co podkreśla konieczność odpowiedniej rehabilitacji ukierunkowanej na reedukację nerwowo-mięśniową.

Patogeneza skręcenia stawu skokowego

Skręcenie stawu skokowego (Skręcenie stawu skokowego) to jedna z najczęstszych kontuzji układu mięśniowo-szkieletowego, dotykająca około 25 000 osób dziennie i stanowiąca około 14% wszystkich urazów sportowych¹². Uraz ten powoduje uszkodzenie pasywnych struktur więzadłowych stawu skokowego, a jego mechanizm i nasilenie determinują rodzaj i stopień uszkodzenia³.

Mechanizm urazu

Najczęstszym mechanizmem urazu jest wymuszony zgięć podeszwowe stopy i inwersja (skręcenie stopy do wewnątrz), co prowadzi do uszkodzenia bocznych więzadeł stawu skokowego⁴⁵. Mechanizm ten występuje w około 85% wszystkich skręceń stawu skokowego⁶. Podczas inwersji stopy w pozycji zgięcia podeszwowego, siły działające na staw skokowy powodują nadmierne rozciągnięcie struktur więzadłowych poza ich normalny zakres elastyczności, co prowadzi do ich uszkodzenia⁷.

Anatomicznie, mechanizm urazu można opisać jako sytuację, w której stopa jest ustawiona nierównomiernie na podłożu, co powoduje przekroczenie normalnej siły nacisku. Prowadzi to do rozciągnięcia więzadeł poza ich normalny zakres w nieprawidłowej pozycji⁸. Jeśli siła działająca na staw jest wystarczająco duża, może dojść do całkowitego zerwania włókien elastycznych więzadeł⁹.

Uszkodzenia więzadeł bocznych

Podczas skręcenia stawu skokowego, uszkodzenia więzadeł występują w określonej sekwencji. Więzadło skokowo-strzałkowe przednie (ATFL – anterior talofibular ligament), uważane za najsłabsze ze wszystkich, jest uszkadzane jako pierwsze¹⁰. Stanowi ono główne ograniczenie rotacji wewnętrznej i przywiedzenia kości skokowej przy odciążonym stawie skokowym¹¹. ATFL jest najbardziej podatne na urazy i jego uszkodzenie często prowadzi do niestabilności przednio-tylnej¹².

Po ATFL, uszkodzeniu może ulec więzadło piętowo-strzałkowe (CFL – calcaneofibular ligament), a w najcięższych przypadkach także więzadło skokowo-strzałkowe tylne (PTFL – posterior talofibular ligament)¹³. CFL odpowiada za ograniczenie nadmiernej inwersji stawu skokowego i jest bardziej obciążone przy końcowych zakresach zgięcia grzbietowego¹⁴. PTFL jest najmniej często uszkadzanym więzadłem z kompleksu bocznego, ponieważ wymaga dużej siły do jego uszkodzenia oraz jest napięte tylko w ekstremalnym zgięciu grzbietowym¹⁵.

Badania wskazują, że izolowane uszkodzenie ATFL występuje w 66% przypadków skręceń stawu skokowego, podczas gdy ATFL i CFL są uszkadzane jednocześnie w około 20% przypadków¹⁶. Uszkodzenie CFL razem z ATFL jest związane z cięższym przebiegiem urazu i dłuższym czasem powrotu do zdrowia¹⁷.

Inne mechanizmy i typy skręceń

Oprócz klasycznego skręcenia bocznego, istnieją również inne typy skręceń stawu skokowego:

Skręcenie przyśrodkowe (medial ankle sprain) – spowodowane przez nadmierną ewersję (wywrócenie stopy na zewnątrz) i zgięcie grzbietowe stopy. Uszkodzeniu ulega silne więzadło deltoidalne znajdujące się po przyśrodkowej stronie stawu¹⁸¹⁹. Ten typ skręcenia występuje rzadziej ze względu na większą wytrzymałość więzadła deltoidalnego oraz anatomiczne połączenie między przyśrodkowym kostkowym a kością skokową²⁰.
Skręcenie wysokie (high ankle sprain) – dotyczy uszkodzenia więzadeł zespolenia piszczelowo-strzałkowego, które łączą dystalną część piszczeli i strzałki. Mechanizm urazu obejmuje nadmierne zgięcie grzbietowe i ewersję stopy z rotacją wewnętrzną piszczeli²¹. Podczas tego urazu kość skokowa zmusza strzałkę do oddzielenia się od piszczeli²². Ten typ skręcenia występuje rzadziej (około 10% wszystkich skręceń), ale jest bardziej upośledzający i wymaga innego leczenia niż typowe skręcenia²³.

Stopnie ciężkości skręcenia stawu skokowego

Skręcenia stawu skokowego klasyfikuje się według trzech stopni ciężkości, w zależności od zakresu uszkodzenia więzadeł i nasilenia objawów klinicznych²⁴:

Stopień I (lekkie skręcenie)

Charakteryzuje się niewielkim rozciągnięciem i drobnymi uszkodzeniami włókien (fibryli) więzadła²⁵. Jest to mikroskopowe uszkodzenie bez makroskopowego rozerwania²⁶. Więzadło nie jest wydłużone, więc nie stwierdza się niestabilności w badaniu klinicznym²⁷. Objawy obejmują łagodny obrzęk i tkliwość²⁸. Powrót do pełnej sprawności następuje zazwyczaj po 1-2 tygodniach²⁹.

Stopień II (umiarkowane skręcenie)

Obejmuje częściowe naderwanie więzadła³⁰. Badanie stawu skokowego wykazuje nieprawidłową ruchomość (wiotkość) stawu³¹. Więzadło jest częściowo zerwane, co powoduje rozciągnięcie, które może destabilizować staw, ale nadal wyczuwalny jest punkt końcowy podczas badania³². Występuje więcej bólu, obrzęku, tkliwości i/lub wybroczyn niż w przypadku skręcenia I stopnia³³. Powrót do zdrowia trwa zazwyczaj 2-6 tygodni³⁴.

Stopień III (ciężkie skręcenie)

Oznacza całkowite zerwanie więzadła³⁵. Jeśli badający ciągnie lub popycha staw skokowy w określonych ruchach, widoczna jest znaczna niestabilność³⁶. Skręcenia III stopnia charakteryzują się całkowitym przerwaniem więzadła z wyraźną niestabilnością i wiotkością³⁷. Niestabilność może być jednak maskowana przez obrzęk lub napięcie obronne mięśni³⁸. Całkowite zerwanie więzadeł stawu skokowego (stopień III) spowoduje niemal natychmiastowy i silny obrzęk oraz przebarwienia³⁹. Powrót do pełnej sprawności może trwać 6 tygodni lub dłużej⁴⁰.

Ciężkość skręcenia determinowana jest siłą urazu⁴¹. Im większa siła działająca na staw, tym poważniejsze uszkodzenie struktur więzadłowych. Nasilenie bólu zależy od stopnia rozciągnięcia i rozerwania więzadeł⁴².

Zmiany patofizjologiczne po skręceniu stawu skokowego

Hipermobilność stawu

Po uszkodzeniu stabilizatorów więzadłowych stawu skokowego dochodzi do zwiększenia ruchomości pomiędzy kośćmi kompleksu staw skokowy/stopa (hipermobilność)⁴³. Ta zwiększona ruchomość może być oceniana jakościowo i empirycznie za pomocą różnych technik klinicznych, takich jak testy ręcznego naprężenia, artrometria instrumentalna i zdjęcia rentgenowskie z obciążeniem⁴⁴.

Testy kliniczne stosowane do oceny uszkodzenia więzadeł obejmują test szuflady przedniej, który ocenia integralność więzadła skokowo-strzałkowego przedniego, oraz test naprężenia inwersyjnego, badający integralność więzadła piętowo-strzałkowego⁴⁵.

Proces gojenia więzadeł

Proces gojenia się więzadeł po skręceniu stawu skokowego przebiega w trzech fazach: zapalnej, naprawczej i przebudowy⁴⁶:

Faza zapalna – występuje w ciągu pierwszych 72 godzin, gdy miejsce urazu jest zalewane ważnymi substancjami wspierającymi gojenie⁴⁷.
Faza naprawcza – uszkodzone komórki są zastępowane przez zdrowe. Kolagen, białko odpowiedzialne za nadanie więzadłom ich wytrzymałości, zaczyna formować się w sposób nieuporządkowany. Ten proces zaczyna się po 3-5 dniach i trwa około dwóch tygodni. W tej fazie więzadło może wytrzymać tylko niewielkie siły. Zbyt wczesny powrót do aktywności może zakłócić proces gojenia i doprowadzić do wygojenia więzadła w pozycji wydłużonej, co jest czynnikiem ryzyka rozwoju przewlekłej niestabilności stawu skokowego⁴⁸.
Faza przebudowy – następuje reorganizacja włókien kolagenowych, co zwiększa wytrzymałość więzadła na obciążenia⁴⁹.

Obecna literatura sugeruje, że gojenie więzadeł trwa ponad sześć tygodni. Jednak badania wykazały również wiotkość stawu utrzymującą się nawet sześć miesięcy po urazie⁵⁰. Przewlekła wiotkość odnotowywana w literaturze może wynikać z niewłaściwej rehabilitacji, co podkreśla potrzebę dalszych badań nad rodzajem opieki i leczenia, które najlepiej wspierałyby gojenie tkanek i przywracały normalną funkcję stawu⁵¹.

Zmiany w propriocepcji

Propriocepcja to zdolność do określania pozycji stawów (czucie pozycji stawu) i ich ruchu (kinestezja) bez kontroli wzrokowej⁵². Po skręceniu stawu skokowego dochodzi do zaburzenia mechanizmów proprioceptywnych, co zwiększa ryzyko ponownego urazu⁵³.

Więzadła zawierają receptory czuciowe, w tym narządy ścięgniste Golgiego, które są bardzo wrażliwe zarówno na napięcie, jak i na ucisk⁵⁴. Uszkodzenie tych receptorów podczas skręcenia stawu skokowego prowadzi do zakłócenia informacji zwrotnej do mózgu, co zaburza kontrolę postawy i równowagi⁵⁵. Również tkanka bliznowata powstająca podczas gojenia nie jest wyposażona w receptory rozciągania, co dodatkowo upośledza propriocepcję⁵⁶.

Kluczowe dla przywrócenia tego mechanizmu sprzężenia zwrotnego nerwowo-mięśniowego jest współpraca z fizjoterapeutą w zakresie propriocepcji i reedukacji nerwowo-mięśniowej. Odbywa się to w próbie odzyskania niektórych mechanizmów sprzężenia zwrotnego somatosensorycznego, które zostały wcześniej uszkodzone⁵⁷.

Powikłania i następstwa skręcenia stawu skokowego

Przewlekła niestabilność stawu skokowego

Jednym z najpoważniejszych następstw skręcenia stawu skokowego jest rozwój przewlekłej niestabilności stawu skokowego (CAI – Chronic Ankle Instability). CAI występuje, gdy stabilność więzadłowa jest zaburzona, prowadząc do częstego uczucia „uciekania” stawu⁵⁸. Może rozwinąć się po poważnym skręceniu stawu skokowego lub nawracających skręceniach, szczególnie gdy zaangażowanych jest wiele więzadeł⁵⁹.

U osób z CAI występuje zmniejszona siła mięśni podudzia (ewertorów stopy i zginaczy podeszwowych), deficyty równowagi dynamicznej, zwiększony ból i zmieniona biomechanika stawu skokowego⁶⁰. Między 50% a 70% osób, które doznały bocznego skręcenia stawu skokowego, rozwinie przewlekłą niestabilność stawu, charakteryzującą się utrzymującym się bólem, niestabilnością, nawracającymi urazami i trwałą niepełnosprawnością funkcjonalną⁶¹.

Najlepszym sposobem zapobiegania CAI jest właściwa rehabilitacja po początkowym urazie⁶². Leczenie CAI obejmuje początkowo ortezowanie lub trening nerwowo-mięśniowy. Jednak jeśli objawy utrzymują się, można rozważyć leczenie chirurgiczne⁶³.

Uszkodzenia towarzyszące

Skręceniu stawu skokowego mogą towarzyszyć inne uszkodzenia, które komplikują proces leczenia i wpływają na rokowanie:

Uszkodzenia chrząstki stawowej – powtarzające się skręcenia stawu skokowego mogą wywierać nadmierny nacisk na staw, powodując obrażenia kompresyjne lub ścinające na powierzchni chrząstki, znane jako defekty kostno-chrzęstne⁶⁴. Jeśli nie są leczone, mogą ostatecznie utworzyć coś przypominającego krater w stawie skokowym⁶⁵. W około 8-10% pacjentów cierpiących na ciężkie skręcenie stawu skokowego wystąpią związane z tym urazy chrząstki w stawie skokowym, które mogą prowadzić do utrzymujących się objawów⁶⁶.
Złamania – podczas skręcenia stawu skokowego w inwersji złamania kości piszczelowej lub stopy występują w nawet 15% przypadków⁶⁷. Najczęstsze lokalizacje to boczny kostka strzałki, przyśrodkowy kostka piszczeli, V kość śródstopia i kość łódkowata.
Uszkodzenia ścięgien strzałkowych – ścięgna strzałkowe mogą ulec uszkodzeniu przy tym samym mechanizmie urazu, który powoduje skręcenie bocznych więzadeł stawu skokowego – uraz inwersyjny⁶⁸.
Urazy trakcyjne nerwów – mogą powodować zaburzenia czucia i funkcji nerwów w obszarze urazu⁶⁹.

Ryzyko nawrotów

Nadrzędnym czynnikiem predysponującym do skręcenia stawu skokowego jest historia wcześniejszego skręcenia stawu skokowego⁷⁰. Oznacza to, że po pierwszym urazie ryzyko ponownego skręcenia jest znacznie wyższe. W ciągu pierwszych 6 miesięcy po powrocie do sportu po skręceniu stawu skokowego istnieje około 50% szans na ponowny uraz⁷¹.

Badania wykazały, że wcześniejsze skręcenie stawu skokowego jest najczęstszym urazem prowadzącym do wtórnego skręcenia tego samego lub przeciwległego stawu skokowego, co może być wyjaśnione czynnikami nerwowo-mięśniowymi⁷². Bez odpowiedniej rehabilitacji, zaburzenia propriocepcji i osłabienie mięśni mogą prowadzić do błędnego koła nawracających urazów⁷³.

Zaburzenia przepływu krwi i powikłania zakrzepowe

Skręcenie stawu skokowego może prowadzić do zaburzeń przepływu krwi, co w rzadkich przypadkach zwiększa ryzyko powikłań zakrzepowych. Gdy dochodzi do skręcenia stawu skokowego, tkanki wokół stawu są uszkodzone, co prowadzi do stanu zapalnego i obrzęku. Ten stan zapalny może zwężać naczynia krwionośne, utrudniając normalny przepływ krwi⁷⁴.

Zmniejszony przepływ krwi w połączeniu z gromadzeniem się krwi wokół miejsca urazu tworzy idealne środowisko do tworzenia skrzepów⁷⁵. W rzadkich przypadkach może to prowadzić do zakrzepicy żył głębokich (DVT), która jest potencjalnie zagrażającym życiu stanem⁷⁶.

Rozwój zmian zwyrodnieniowych po skręceniu stawu skokowego

Powtarzające się skręcenia stawu skokowego, szczególnie gdy nie są odpowiednio leczone, mogą prowadzić do rozwoju zmian zwyrodnieniowych (artrozy) stawu skokowego. Jeśli skręcenie stawu skokowego spowodowało uszkodzenie chrząstki stawu, może to przyspieszyć proces degeneracyjny⁷⁷.

W przypadku całkowitego zerwania więzadeł bocznych, staw skokowy może stać się niestabilny po przejściu początkowej fazy urazu. Jeśli to nastąpi, istnieje możliwość, że uraz spowodował również uszkodzenie samej powierzchni stawu skokowego⁷⁸. Z czasem ta niestabilność może prowadzić do uszkodzenia kości i chrząstki, gładkiej wyściółki stawu⁷⁹.

Jeśli nawracające skręcenia stawu skokowego nie są leczone, prowadzi to do rozwoju artrozy stawu skokowego. Artroza stawu skokowego rozwija się zazwyczaj przez 20-30 lat⁸⁰. Obecne leczenie bolesnej artrozy stawu skokowego obejmuje albo artrodezy (usztywnienie) stawu skokowego, albo endoprotezoplastykę (wymianę) stawu skokowego. Dlatego znacznie lepiej jest zapobiegać rozwojowi artrozy stawu skokowego poprzez rekonstrukcję więzadeł bocznych stawu skokowego⁸¹.

Celem leczenia operacyjnego jest przywrócenie długości (tj. skrócenie) wydłużonych więzadeł skokowo-strzałkowego przedniego i piętowo-strzałkowego⁸².

Czynniki ryzyka skręcenia stawu skokowego

Istnieje kilka czynników predysponujących do skręcenia stawu skokowego, które można podzielić na wewnętrzne (cechy własne) i zewnętrzne (zewnętrzny czynnik przyczynowy)⁸³:

Czynniki wewnętrzne

Wcześniejsze skręcenie stawu skokowego – jak wspomniano wcześniej, jest to najważniejszy czynnik ryzyka ponownego urazu⁸⁴.
Zaburzenia propriocepcji – upośledzenie zdolności do wyczuwania pozycji i ruchu stawu zwiększa ryzyko urazu⁸⁵.
Siła mięśniowa – im silniejsza koncentryczna funkcja mięśni antagonizujących przesadny ruch inwersji i supinacji, tym mniejsze prawdopodobieństwo skręcenia stawu skokowego⁸⁶.
Ograniczona elastyczność stawu – badania sugerują, że ograniczona elastyczność stawu może przyczyniać się do skręceń stawu skokowego⁸⁷.

Czynniki zewnętrzne

Typ aktywności – skręcenia stawu skokowego są częstsze w sportach wymagających gwałtownych zmian kierunku, skoków i lądowań, takich jak koszykówka, siatkówka i piłka nożna⁸⁸.
Nawierzchnia – nierówne podłoże, dziury lub pęknięcia w nawierzchni zwiększają ryzyko skręcenia⁸⁹.
Obuwie – niewłaściwe obuwie sportowe może zwiększać ryzyko urazu. Buty wysokie są zalecane do zapobiegania urazom w koszykówce i futbolu⁹⁰.
Intensywność treningu – nagłe zwiększenie intensywności lub objętości treningu może zwiększać ryzyko urazu⁹¹.

Zrozumienie tych czynników ryzyka jest kluczowe dla opracowania odpowiednich programów edukacyjnych i prewencyjnych, zarówno w sporcie amatorskim, jak i profesjonalnym⁹².

Anatomia funkcjonalna więzadeł stawu skokowego

Stabilność stawu skokowego jest utrzymywana zarówno przez strukturę kostną, jak i kompleks więzadłowy⁹³. Więzadła stawu skokowego zapewniają stabilność mechaniczną, dostarczają informacji proprioceptywnych i kontrolują ruch stawu⁹⁴.

Kompleks boczny

Kompleks więzadeł bocznych składa się z trzech głównych więzadeł:

Więzadło skokowo-strzałkowe przednie (ATFL) – jest to główne ograniczenie rotacji wewnętrznej i przywiedzenia kości skokowej przy odciążonym stawie skokowym⁹⁵. ATFL jest wewnątrztorebkowe, ma najniższą odporność na uszkodzenie i jest najważniejszym więzadłem w stabilności skokowo-strzałkowej. Jest poddawane maksymalnemu napięciu, gdy staw skokowy jest w zgięciu podeszwowym⁹⁶.
Więzadło piętowo-strzałkowe (CFL) – jest zewnątrztorebkowe, grubsze i silniejsze niż ATFL, i jako następne ulega uszkodzeniu w urazie zgięcia podeszwowego/inwersji⁹⁷. Zarówno struktura kostna jamy stawu, jak i więzadło piętowo-strzałkowe ograniczają przywiedzenie kości skokowej przy obciążonym stawie skokowym⁹⁸.
Więzadło skokowo-strzałkowe tylne (PTFL) – jest najsilniejszym z trzech więzadeł i najmniej podatnym na uszkodzenie, ponieważ jest napięte tylko w ekstremalnych warunkach zgięcia grzbietowego⁹⁹.

Kompleks przyśrodkowy

Stabilność przyśrodkowa stawu skokowego jest zapewniana przez silne więzadło deltaoidalne, więzadło piszczelowo-strzałkowe przednie i kostną jamę stawową¹⁰⁰. Więzadło deltoidalne staje się napięte podczas ewersji stawu skokowego, przez co ulega uszkodzeniu, jeśli występują nadmierne siły ewersji i rotacji zewnętrznej (odwiedzenia) stopy w połączeniu z rotacją wewnętrzną podudzia¹⁰¹.

Więzadła zespolenia piszczelowo-strzałkowego

Zespolenie piszczelowo-strzałkowe obejmuje kilka struktur w dystalnej części stawu skokowego, w tym więzadło piszczelowo-strzałkowe przednie dolne (AITFL), więzadło piszczelowo-strzałkowe tylne dolne, więzadło międzykostne i więzadło poprzeczne piszczelowo-strzałkowe¹⁰². Razem więzadła te znacząco przyczyniają się do stabilności stawu skokowego i stabilizują dystalną architekturę piszczelowo-strzałkową, zapobiegając rozdzieleniu¹⁰³.

Gdy obciążona jest noga, piszczel i strzałka doświadczają silnych sił, które je rozdzielają. Więzadła zespolenia, czyli syndesmoza, służą jako amortyzujące kable, które zapobiegają zbyt dalekiemu rozdzieleniu tych dwóch kości¹⁰⁴.

Biomechanika urazu skręcenia stawu skokowego

Zrozumienie biomechaniki skręcenia stawu skokowego jest kluczowe dla badań nad zapobieganiem urazom¹⁰⁵. Biomechanika ta jest rzadko opisywana w literaturze, ponieważ jest praktycznie niemożliwe i nieetyczne przeprowadzenie systematycznych dynamicznych testów skręcenia stawu skokowego w laboratorium¹⁰⁶.

Mechanizm biomechaniczny

Istnieją dwie główne etiologie, które powodują uraz skręcenia stawu skokowego w inwersji¹⁰⁷:

Nieprawidłowa postawa podczas lądowania – z lekko odwróconym lub supinowanym stawem skokowym powoduje, że siła reakcji podłoża działająca na boczną krawędź stopy skierowana jest przyśrodkowo i nie przechodzi przez środek stawu skokowego, tworząc w ten sposób energiczny moment skręcający do wewnątrz, następnie nadmierną inwersję, a wreszcie wysokie napięcia więzadeł, które rozrywają więzadła boczne¹⁰⁸.
Reakcja mięśni strzałkowych, które funkcjonują, aby przeciwdziałać inwersji stawu skokowego, jest zbyt wolna (60-90 ms), aby nadążyć za nagłą wybuchową inwersją, która nastąpiła w ciągu 50 ms po uderzeniu stopy¹⁰⁹.

Fuller zasugerował, że większość urazów skręcenia stawu skokowego była spowodowana zwiększonym momentem supinacji w stawie podskokowym, który był często wynikiem pozycji i wielkości pionowo rzutowanej siły reakcji podłoża przy początkowym kontakcie stopy¹¹⁰.

Analiza kinematyczna

Badania nad rzeczywistymi incydentami urazów dostarczyły cennych danych na temat biomechaniki skręcenia stawu skokowego¹¹¹. Dane sugerują, że szczytowa inwersja osiąga 48 stopni, a taki zakres inwersji jest często uważany za normalny w literaturze¹¹².

Szczytowa prędkość inwersji osiąga 638 stopni/s, i jest to pierwsza wartość tego typu odnotowana w badaniach¹¹³. Dalsze analizy z wykorzystaniem profilu danych kinematycznych stawu skokowego do napędzania obliczeniowego modelu stopy i stawu skokowego w celu symulacji urazu wykazały, że moment inwersji wynosił 23 Nm, a moment rotacji wewnętrznej 11 Nm, co skutkowało 15-20% odkształceniem więzadła skokowo-strzałkowego przedniego¹¹⁴.

Inna analiza geometryczna wykazała, że skręcenie stawu skokowego w inwersji z mechanizmem rotacji wewnętrznej spowoduje uszkodzenie więzadła skokowo-strzałkowego przedniego¹¹⁵.

Znaczenie właściwego leczenia i rehabilitacji

Właściwe leczenie i rehabilitacja są kluczowe dla pełnego powrotu do zdrowia po skręceniu stawu skokowego i zapobiegania przewlekłym powikłaniom¹¹⁶.

Badania nad leczeniem ostrych skręceń stawu skokowego wykazały, że leczenie funkcjonalne jest lepsze niż unieruchomienie¹¹⁷. Przegląd Cochrane wykazał, że podpory sznurowane lub półsztywne są bardziej skuteczne w leczeniu urazu stawu skokowego niż taśma czy elastyczne bandaże¹¹⁸.

Badania wykazują, że wskaźnik skręceń stawu skokowego można zmniejszyć o 50-60%, jeśli interwencje ćwiczeniowe są wykonywane dwa do pięciu razy w tygodniu przez 10-30 minut na sesję¹¹⁹. Istnieją również dowody wskazujące, że sznurowane stabilizatory stawu skokowego mogą zmniejszyć pierwsze i nawracające skręcenia stawu skokowego o 40-50%¹²⁰.

Niestety, między 20% a 50% osób z pierwszym skręceniem stawu skokowego rozwinie długotrwałe problemy, a prawdopodobieństwo ponownego urazu tego samego stawu skokowego w ciągu następnych 12 miesięcy jest dwukrotnie większe¹²¹. Ponowne urazy mogą prowadzić do przewlekłego bólu, utrzymującego się obrzęku, niestabilności stawu skokowego i uczucia uciekania oraz zmniejszonej wydolności funkcjonalnej¹²².

Dlatego tak ważne jest, aby każde skręcenie stawu skokowego zostało ocenione, najlepiej wcześnie, przez odpowiednio wykwalifikowanego specjalistę, a najlepszym specjalistą jest fizjoterapeuta¹²³. Badania nad postępowaniem w przypadku urazów stawu skokowego pokazują, że im wcześniej uraz zostanie oceniony i wdrożony plan postępowania oparty na dowodach, tym lepsze wyniki¹²⁴.

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Materiały źródłowe

#1 Understanding acute ankle ligamentous sprain injury in sports | BMC Sports Science, Medicine and Rehabilitation | Full Text
https://bmcsportsscimedrehabil.biomedcentral.com/articles/10.1186/1758-2555-1-14
This paper summarizes the current understanding on acute ankle sprain injury, which is the most common acute sport trauma, accounting for about 14% of all sport-related injuries. Among, 80% are ligamentous sprains caused by explosive inversion or supination. The injury motion often happens at the subtalar joint and tears the anterior talofibular ligament (ATFL) which possesses the lowest ultimate load among the lateral ligaments at the ankle. […] The aetiology of most ankle sprain injuries is incorrect foot positioning at landing a medially-deviated vertical ground reaction force causes an explosive supination or inversion moment at the subtalar joint in a short time (about 50 ms). Another aetiology is the delayed reaction time of the peroneal muscles at the lateral aspect of the ankle (6090 ms).
#2 Ankle Sprain | UConn Musculoskeletal Institute
https://health.uconn.edu/msi/clinical-services/orthopaedic-surgery/foot-ankle-and-podiatry/ankle-sprain/
A sprained ankle is a very common injury. Approximately 25,000 people experience it each day. A sprained ankle can happen to athletes and non-athletes, children and adults. It can happen when you take part in sports and physical fitness activities. It can also happen when you simply step on an uneven surface, or step down at an angle. […] The ligaments of the ankle hold the ankle bones and joint in position. They protect the ankle joint from abnormal movements-especially twisting, turning, and rolling of the foot. […] A ligament is an elastic structure. Ligaments usually stretch within their limits, and then go back to their normal positions. When a ligament is forced to stretch beyond its normal range, a sprain occurs. A severe sprain causes actual tearing of the elastic fibers. […] Ankle sprains happen when the foot twists, rolls or turns beyond its normal motions. A great force is transmitted upon landing. You can sprain your ankle if the foot is planted unevenly on a surface, beyond the normal force of stepping. This causes the ligaments to stretch beyond their normal range in an abnormal position.
#3 Ankle sprain: pathophysiology, predisposing factors, and management strategies
https://pmc.ncbi.nlm.nih.gov/articles/PMC3781861/
LAS result in damage to the passive ligamentous structures of the ankle. Indeed, forceful ankle plantar flexion and inversion, the most common mechanism of injury, often leads to tearing of the lateral ligaments of the ankle. Specifically, the anterior talofibular ligament (ATFL), reported to be the weakest is first ligament injured. Rupture to the ATFL is followed by damage to the calcaneofibular ligament (CFL) and finally to the posterior talofibular ligament (PTFL). Isolated injury to the ATFL occurs in 66% of LAS while ATFL and CFL ruptures occur concurrently in another 20%. The PTFL is not commonly injured because of the large amount of force required to cause damage, as well as the amount of dorsiflexion needed to strain the ligament. The amount of dorsiflexion necessary to strain the PTFL places the ankle in a closed packed and thus more stable position which decreases the likelihood of injury to the ligament. In addition to the lateral ligamentous structures of the talocrural joint, the subtalar ligaments can also be injured.
#4 Ankle sprain: pathophysiology, predisposing factors, and management strategies
https://pmc.ncbi.nlm.nih.gov/articles/PMC3781861/
LAS result in damage to the passive ligamentous structures of the ankle. Indeed, forceful ankle plantar flexion and inversion, the most common mechanism of injury, often leads to tearing of the lateral ligaments of the ankle. Specifically, the anterior talofibular ligament (ATFL), reported to be the weakest is first ligament injured. Rupture to the ATFL is followed by damage to the calcaneofibular ligament (CFL) and finally to the posterior talofibular ligament (PTFL). Isolated injury to the ATFL occurs in 66% of LAS while ATFL and CFL ruptures occur concurrently in another 20%. The PTFL is not commonly injured because of the large amount of force required to cause damage, as well as the amount of dorsiflexion needed to strain the ligament. The amount of dorsiflexion necessary to strain the PTFL places the ankle in a closed packed and thus more stable position which decreases the likelihood of injury to the ligament. In addition to the lateral ligamentous structures of the talocrural joint, the subtalar ligaments can also be injured.
#5 Management of Ankle Sprains | AAFP
https://www.aafp.org/pubs/afp/issues/2001/0101/p93.html
The most common mechanism of injury in ankle sprains is a combination of plantar flexion and inversion. The lateral stabilizing ligaments, which include the anterior talofibular, calcaneofibular and posterior talofibular ligaments, are most often damaged. The anterior talofibular ligament is the most easily injured. Concomitant injury to this ligament and the calcaneofibular ligament can result in appreciable instability. […] Medial ankle stability is provided by the strong deltoid ligament, the anterior tibiofibular ligament and the bony mortise. Because of the bony articulation between the medial malleolus and the talus, medial ankle sprains are less common than lateral sprains. In medial ankle sprains, the mechanism of injury is excessive eversion and dorsiflexion. […] Injury to the tibiofibular syndesmosis ligaments, which bind together the distal ends of the tibia and fibula, is commonly referred to as a high ankle sprain. Although this injury accounts for only about 10 percent of ankle sprains, it represents a more disabling problem and requires different treatment than common ankle sprains. The mechanism of injury is excessive dorsiflexion and eversion of the ankle joint with internal rotation of the tibia. […] The anterior drawer test can be used to assess the integrity of the anterior talofibular ligament, and the inversion stress test can be used to assess the integrity of the calcaneofibular ligament.
#6 Sprained Ankle – OrthoInfo – AAOS
https://orthoinfo.aaos.org/en/diseases–conditions/sprained-ankle/
An ankle sprain occurs when the strong ligaments that support the ankle stretch beyond their limits and tear. The severity of a sprain can vary greatly depending on the number of ligaments involved and the extent to which the ligaments are torn. […] Around 90% of ankle sprains involve an inversion injury (the foot turns inward) to the anterior talofibular (ATFL) and calcaneofibular (CFL) ligaments the lateral ligaments on the outside of the ankle. […] The less common medial ankle sprain is caused by an eversion injury (the foot turns out) to the deltoid ligament on the inside of the ankle. […] If there is a complete tear of the ligaments, the ankle may become unstable after the initial injury phase passes. Over time, this instability can result in damage to the bones and cartilage, the smooth lining of the joint.
#7 Sprained Ankle
https://www.parklandhealth.org/sprained-ankle
A sprained ankle can happen when you take part in sports and physical fitness activities. […] A ligament is an elastic structure. Ligaments usually stretch within their limits, and then go back to their normal positions. When a ligament is forced to stretch beyond its normal range, a sprain occurs. A severe sprain causes actual tearing of the elastic fibers. […] Ankle sprains happen when the foot twists, rolls or turns beyond its normal motions. A great force is transmitted upon landing. You can sprain your ankle if the foot is planted unevenly on a surface, beyond the normal force of stepping. This causes the ligaments to stretch beyond their normal range in an abnormal position. […] If there is a severe in-turning or out-turning of the foot relative to the ankle, the forces cause the ligaments to stretch beyond their normal length. If the force is too strong, the ligaments can tear.
#8 Ankle Sprain | UConn Musculoskeletal Institute
https://health.uconn.edu/msi/clinical-services/orthopaedic-surgery/foot-ankle-and-podiatry/ankle-sprain/
A sprained ankle is a very common injury. Approximately 25,000 people experience it each day. A sprained ankle can happen to athletes and non-athletes, children and adults. It can happen when you take part in sports and physical fitness activities. It can also happen when you simply step on an uneven surface, or step down at an angle. […] The ligaments of the ankle hold the ankle bones and joint in position. They protect the ankle joint from abnormal movements-especially twisting, turning, and rolling of the foot. […] A ligament is an elastic structure. Ligaments usually stretch within their limits, and then go back to their normal positions. When a ligament is forced to stretch beyond its normal range, a sprain occurs. A severe sprain causes actual tearing of the elastic fibers. […] Ankle sprains happen when the foot twists, rolls or turns beyond its normal motions. A great force is transmitted upon landing. You can sprain your ankle if the foot is planted unevenly on a surface, beyond the normal force of stepping. This causes the ligaments to stretch beyond their normal range in an abnormal position.
#9 Sprained Ankle
https://www.parklandhealth.org/sprained-ankle
A sprained ankle can happen when you take part in sports and physical fitness activities. […] A ligament is an elastic structure. Ligaments usually stretch within their limits, and then go back to their normal positions. When a ligament is forced to stretch beyond its normal range, a sprain occurs. A severe sprain causes actual tearing of the elastic fibers. […] Ankle sprains happen when the foot twists, rolls or turns beyond its normal motions. A great force is transmitted upon landing. You can sprain your ankle if the foot is planted unevenly on a surface, beyond the normal force of stepping. This causes the ligaments to stretch beyond their normal range in an abnormal position. […] If there is a severe in-turning or out-turning of the foot relative to the ankle, the forces cause the ligaments to stretch beyond their normal length. If the force is too strong, the ligaments can tear.
#10 Ankle sprain: pathophysiology, predisposing factors, and management strategies
https://pmc.ncbi.nlm.nih.gov/articles/PMC3781861/
LAS result in damage to the passive ligamentous structures of the ankle. Indeed, forceful ankle plantar flexion and inversion, the most common mechanism of injury, often leads to tearing of the lateral ligaments of the ankle. Specifically, the anterior talofibular ligament (ATFL), reported to be the weakest is first ligament injured. Rupture to the ATFL is followed by damage to the calcaneofibular ligament (CFL) and finally to the posterior talofibular ligament (PTFL). Isolated injury to the ATFL occurs in 66% of LAS while ATFL and CFL ruptures occur concurrently in another 20%. The PTFL is not commonly injured because of the large amount of force required to cause damage, as well as the amount of dorsiflexion needed to strain the ligament. The amount of dorsiflexion necessary to strain the PTFL places the ankle in a closed packed and thus more stable position which decreases the likelihood of injury to the ligament. In addition to the lateral ligamentous structures of the talocrural joint, the subtalar ligaments can also be injured.
#11 :: JKOA :: The Journal of the Korean Orthopaedic Association
https://www.jkoa.org/DOIx.php?id=10.4055/jkoa.2014.49.1.1
Ankle sprain is one of the most common musculoskeletal injuries, nearly half of all ankle sprains occur during athletic activity. […] The stability of the ankle joint is maintained by both bony structure and ligamentous complex. The anterior talofibular ligament is the primary restraint of internal rotation and adduction of the talus with the ankle joint unloaded, while both bony mortise structure and calcaneofibular ligament restrict adduction of the talus with the ankle joint loaded. […] Plantar flexion and inversion is the most common mechanism of ankle sprains, which lead to injury of the anterior talofibular ligament followed by calcaneofibular ligament. Ligament injuries are classified according to three grades based on the extent of rupture and the severity of clinical features. Associated injuries with lateral ankle sprain include peroneus tendon rupture, osteochondral fracture, deltoid ligament injury, syndesmosis injury, and nerve traction injuries.
#12 Faster Sprained Ankle Treatment | Ankle Sprain Treatment Singapore
https://www.hellophysio.sg/condition/sprained-ankle-treatment/
The ATFL is the most prone to injury, and its damage often leads to anteroposterior instability, while CFL damage can cause instability during inversion movements. […] In exceptional circumstances, the anterior ligament may be torn, with associated capsular damage and rupture of the peroneal tendons. The deltoid ligament may be damaged by traumatic eversion. However, this type of sprain occurs only rarely. The possibility of associated injuries, such as distal or proximal fracture of the fibula and the talus, should be considered. […] Additionally, excessive upward bending of the foot may injure the syndesmotic ligaments. Beyond ligaments, this condition can also impact other anatomical structures, including bones, muscles, tendons, nerves and blood vessels. […] The clinical signs of a sprained ankle encompass difficulty walking or moving the joint, a sharp or tearing feeling, increased pain with movement, discolouration, and swift onset of bruising. The severity of the sprain dictates the intensity of these symptoms.
#13 Ankle sprain: pathophysiology, predisposing factors, and management strategies
https://pmc.ncbi.nlm.nih.gov/articles/PMC3781861/
LAS result in damage to the passive ligamentous structures of the ankle. Indeed, forceful ankle plantar flexion and inversion, the most common mechanism of injury, often leads to tearing of the lateral ligaments of the ankle. Specifically, the anterior talofibular ligament (ATFL), reported to be the weakest is first ligament injured. Rupture to the ATFL is followed by damage to the calcaneofibular ligament (CFL) and finally to the posterior talofibular ligament (PTFL). Isolated injury to the ATFL occurs in 66% of LAS while ATFL and CFL ruptures occur concurrently in another 20%. The PTFL is not commonly injured because of the large amount of force required to cause damage, as well as the amount of dorsiflexion needed to strain the ligament. The amount of dorsiflexion necessary to strain the PTFL places the ankle in a closed packed and thus more stable position which decreases the likelihood of injury to the ligament. In addition to the lateral ligamentous structures of the talocrural joint, the subtalar ligaments can also be injured.
#14 Different Types of Ankle Sprains and Implications for Recovery | POGO Physio Gold Coast
https://www.pogophysio.com.au/blog/different-types-of-ankle-sprains-and-implications-for-recovery/
The Anterior Talofibular Ligament (ATFL) is the first structure injured in the majority of ankle sprains. The ATFL resists pathological inversion and plantar flexion of the ankle joint and is the weakest of the lateral ligaments (2, 7). […] The addition of CFL injury alongside ATFL injury is common with more severe sprains and associated with longer recovery (9). The CFL resists excessive inversion of the ankle joint and is further stressed at the end ranges of dorsiflexion (2, 7). […] The medial deltoid ligament becomes taut in ankle eversion, thus becomes injured if excessive eversion forces and external rotation (abduction) of the foot coupled with internal rotation of the lower leg may result in a medial ankle sprain involving the deltoid ligament (13). […] Syndesmotic ankle sprains are generally caused by hyperpronation (external rotation, eversion, and abduction), hyperdorsiflexion or hyper plantar flexion, or another athlete falling onto the fixed ankle (13, 14, 17).
#15 Ankle Sprain | PM&R KnowledgeNow
https://now.aapmr.org/ankle-sprain/
As the ankle moves from dorsiflexion to plantar flexion, bony stability decreases and forces on the ankle ligaments increase. The ATFL generally consists of two bands that are separated by branches of the perforating peroneal artery. The ATFL is intracapsular, has the lowest failure resistance, and is the most important ligament in talofibular stability. It is under maximal stress with the ankle in plantarflexion. The CFL is extracapsular, thicker, and stronger than the ATFL, and the next to tear in a plantarflexion/inversion injury. The PTFL is the strongest of the three ligaments and least likely to fail because it is only taut in extremes of dorsiflexion. […] An injury to the distal tibiofibular syndesmosis is known as a high ankle sprain. The syndesmosis encompasses several structures in the distal ankle, including the anterior-inferior tibiofibular ligament (AITFL), posterior-inferior tibiofibular ligament, interosseous ligament, and the transverse tibiofibular ligament. Together, these ligaments significantly contribute to the stability of the ankle and stabilize the distal tibiofibular architecture and prevent separation. The most common mechanism of injury is a high energy forced external rotation with the foot in dorsiflexion. This injury may coexist with either medial or lateral ankle sprains, with medial ankle sprains being more common.
#16 Ankle sprain: pathophysiology, predisposing factors, and management strategies
https://pmc.ncbi.nlm.nih.gov/articles/PMC3781861/
LAS result in damage to the passive ligamentous structures of the ankle. Indeed, forceful ankle plantar flexion and inversion, the most common mechanism of injury, often leads to tearing of the lateral ligaments of the ankle. Specifically, the anterior talofibular ligament (ATFL), reported to be the weakest is first ligament injured. Rupture to the ATFL is followed by damage to the calcaneofibular ligament (CFL) and finally to the posterior talofibular ligament (PTFL). Isolated injury to the ATFL occurs in 66% of LAS while ATFL and CFL ruptures occur concurrently in another 20%. The PTFL is not commonly injured because of the large amount of force required to cause damage, as well as the amount of dorsiflexion needed to strain the ligament. The amount of dorsiflexion necessary to strain the PTFL places the ankle in a closed packed and thus more stable position which decreases the likelihood of injury to the ligament. In addition to the lateral ligamentous structures of the talocrural joint, the subtalar ligaments can also be injured.
#17 Different Types of Ankle Sprains and Implications for Recovery | POGO Physio Gold Coast
https://www.pogophysio.com.au/blog/different-types-of-ankle-sprains-and-implications-for-recovery/
The Anterior Talofibular Ligament (ATFL) is the first structure injured in the majority of ankle sprains. The ATFL resists pathological inversion and plantar flexion of the ankle joint and is the weakest of the lateral ligaments (2, 7). […] The addition of CFL injury alongside ATFL injury is common with more severe sprains and associated with longer recovery (9). The CFL resists excessive inversion of the ankle joint and is further stressed at the end ranges of dorsiflexion (2, 7). […] The medial deltoid ligament becomes taut in ankle eversion, thus becomes injured if excessive eversion forces and external rotation (abduction) of the foot coupled with internal rotation of the lower leg may result in a medial ankle sprain involving the deltoid ligament (13). […] Syndesmotic ankle sprains are generally caused by hyperpronation (external rotation, eversion, and abduction), hyperdorsiflexion or hyper plantar flexion, or another athlete falling onto the fixed ankle (13, 14, 17).
#18 Management of Ankle Sprains | AAFP
https://www.aafp.org/pubs/afp/issues/2001/0101/p93.html
The most common mechanism of injury in ankle sprains is a combination of plantar flexion and inversion. The lateral stabilizing ligaments, which include the anterior talofibular, calcaneofibular and posterior talofibular ligaments, are most often damaged. The anterior talofibular ligament is the most easily injured. Concomitant injury to this ligament and the calcaneofibular ligament can result in appreciable instability. […] Medial ankle stability is provided by the strong deltoid ligament, the anterior tibiofibular ligament and the bony mortise. Because of the bony articulation between the medial malleolus and the talus, medial ankle sprains are less common than lateral sprains. In medial ankle sprains, the mechanism of injury is excessive eversion and dorsiflexion. […] Injury to the tibiofibular syndesmosis ligaments, which bind together the distal ends of the tibia and fibula, is commonly referred to as a high ankle sprain. Although this injury accounts for only about 10 percent of ankle sprains, it represents a more disabling problem and requires different treatment than common ankle sprains. The mechanism of injury is excessive dorsiflexion and eversion of the ankle joint with internal rotation of the tibia. […] The anterior drawer test can be used to assess the integrity of the anterior talofibular ligament, and the inversion stress test can be used to assess the integrity of the calcaneofibular ligament.
#19 Ankle Sprains: Inversion vs. Eversion – JOI and JOI Rehab
https://www.joionline.net/library/ankle-sprains-inversion-vs-eversion/
This type of injury occurs when someones foot rolls outwards or away from the body. While this injury may not be as common as an inversion ankle sprain, these sprains are more severe. This is because the deltoid ligaments on the inside of ones ankle are stronger and thicker than their counterparts on the outside. Meaning that when these tear or stretch this can lead to increased instability of the ankle overall. […] In addition to different mechanisms of injury there are grades to ankle sprains. These grades help us clinicians understand how much damage has been done to the joint and surrounding structures. […] Therapy efforts for ankle sprains typically involve strengthening of the ankle overall with body weight or resistance bands. Balance must also be addressed to improve the stability of the ankle to help decrease instances of further sprains.
#20 Management of Ankle Sprains | AAFP
https://www.aafp.org/pubs/afp/issues/2001/0101/p93.html
The most common mechanism of injury in ankle sprains is a combination of plantar flexion and inversion. The lateral stabilizing ligaments, which include the anterior talofibular, calcaneofibular and posterior talofibular ligaments, are most often damaged. The anterior talofibular ligament is the most easily injured. Concomitant injury to this ligament and the calcaneofibular ligament can result in appreciable instability. […] Medial ankle stability is provided by the strong deltoid ligament, the anterior tibiofibular ligament and the bony mortise. Because of the bony articulation between the medial malleolus and the talus, medial ankle sprains are less common than lateral sprains. In medial ankle sprains, the mechanism of injury is excessive eversion and dorsiflexion. […] Injury to the tibiofibular syndesmosis ligaments, which bind together the distal ends of the tibia and fibula, is commonly referred to as a high ankle sprain. Although this injury accounts for only about 10 percent of ankle sprains, it represents a more disabling problem and requires different treatment than common ankle sprains. The mechanism of injury is excessive dorsiflexion and eversion of the ankle joint with internal rotation of the tibia. […] The anterior drawer test can be used to assess the integrity of the anterior talofibular ligament, and the inversion stress test can be used to assess the integrity of the calcaneofibular ligament.
#21 Management of Ankle Sprains | AAFP
https://www.aafp.org/pubs/afp/issues/2001/0101/p93.html
The most common mechanism of injury in ankle sprains is a combination of plantar flexion and inversion. The lateral stabilizing ligaments, which include the anterior talofibular, calcaneofibular and posterior talofibular ligaments, are most often damaged. The anterior talofibular ligament is the most easily injured. Concomitant injury to this ligament and the calcaneofibular ligament can result in appreciable instability. […] Medial ankle stability is provided by the strong deltoid ligament, the anterior tibiofibular ligament and the bony mortise. Because of the bony articulation between the medial malleolus and the talus, medial ankle sprains are less common than lateral sprains. In medial ankle sprains, the mechanism of injury is excessive eversion and dorsiflexion. […] Injury to the tibiofibular syndesmosis ligaments, which bind together the distal ends of the tibia and fibula, is commonly referred to as a high ankle sprain. Although this injury accounts for only about 10 percent of ankle sprains, it represents a more disabling problem and requires different treatment than common ankle sprains. The mechanism of injury is excessive dorsiflexion and eversion of the ankle joint with internal rotation of the tibia. […] The anterior drawer test can be used to assess the integrity of the anterior talofibular ligament, and the inversion stress test can be used to assess the integrity of the calcaneofibular ligament.
#22 High Ankle Sprain – E3 Rehab
https://e3rehab.com/highanklesprain/
The purpose of this blog is to discuss the anatomy, mechanism of injury, assessment, and management of high ankle sprains, also referred to as syndesmosis injuries. […] On the other hand, a high ankle sprain refers to an injury to the distal tibiofibular joint, which is the connection between the tibia and fibula. […] Unlike a lateral ankle sprain in which you twist or roll your ankle, a syndesmosis injury occurs when your foot is planted, your ankle is dorsiflexed, and your foot is rotating outward relative to your tibia. […] However, when a significant rotation component is added, which the joint isn’t structured for, the talus forces the fibula to peel away from the tibia. […] Due to the high-force mechanism of injury, it’s also possible for disruption of the deltoid ligament and fractures to occur.
#23 Syndesmotic ankle injury (high ankle sprain) – UpToDate
https://www.uptodate.com/contents/syndesmotic-ankle-injury-high-ankle-sprain
A syndesmotic ankle sprain is an injury to one or more of the ligaments comprising the distal tibiofibular syndesmosis; it is often referred to as a „high ankle sprain.” […] Compared with the more common lateral ankle sprain, the high ankle sprain causes pain more proximally, just above the ankle joint, and is associated more often with significant morbidity. […] Diagnosis can be difficult. […] Clinicians should consider the possibility of syndesmotic injury in athletes with pain or injury around the ankle or lower leg. […] Treatment too is different from typical ankle sprains, and surgery may be necessary, making recognition important for optimal recovery.
#24 :: JKOA :: The Journal of the Korean Orthopaedic Association
https://www.jkoa.org/DOIx.php?id=10.4055/jkoa.2014.49.1.1
Ankle sprain is one of the most common musculoskeletal injuries, nearly half of all ankle sprains occur during athletic activity. […] The stability of the ankle joint is maintained by both bony structure and ligamentous complex. The anterior talofibular ligament is the primary restraint of internal rotation and adduction of the talus with the ankle joint unloaded, while both bony mortise structure and calcaneofibular ligament restrict adduction of the talus with the ankle joint loaded. […] Plantar flexion and inversion is the most common mechanism of ankle sprains, which lead to injury of the anterior talofibular ligament followed by calcaneofibular ligament. Ligament injuries are classified according to three grades based on the extent of rupture and the severity of clinical features. Associated injuries with lateral ankle sprain include peroneus tendon rupture, osteochondral fracture, deltoid ligament injury, syndesmosis injury, and nerve traction injuries.
#25 Ankle Sprain | UConn Musculoskeletal Institute
https://health.uconn.edu/msi/clinical-services/orthopaedic-surgery/foot-ankle-and-podiatry/ankle-sprain/
If there is a severe in-turning or out-turning of the foot relative to the ankle, the forces cause the ligaments to stretch beyond their normal length. If the force is too strong, the ligaments can tear. You may lose your balance when your foot is placed unevenly on the ground. You may fall and be unable to stand on that foot. When excessive force is applied to the ankle’s soft tissue structures, you may even hear a „pop.” Pain and swelling result. […] The amount of force determines the grade of the sprain. A mild sprain is a Grade 1. A moderate sprain is a Grade 2. A severe strain is a Grade 3. […] Grade 1 Sprain: Slight stretching and some damage to the fibers (fibrils) of the ligament. […] Grade 2 Sprain: Partial tearing of the ligament. If the ankle joint is examined and moved in certain ways, abnormal looseness (laxity) of the ankle joint occurs.
#26 Acute Ankle Sprain – StatPearls – NCBI Bookshelf
https://www.ncbi.nlm.nih.gov/books/NBK459212/
Acute ankle sprains are commonly seen in both primary care practices and emergency departments and can result in significant short-term morbidity, recurrent injuries, and functional instability. […] Ankle sprains most commonly involve injury to the anterior talofibular ligament (ATFL) and/or the calcaneofibular ligament (CFL). Ankle sprains vary depending on the mechanism of injury (high- versus low-energy injuries), position of the foot, and rotational force on the joint and stabilizing ligamentous structures. Low grade injuries (grade I and II) result in stretching or microscopic tears of the stabilizing ligaments, while a high grade (grade III) ankle sprain compromises the syndesmotic structures. […] The most common ankle injury occurs with inversion of the ankle which stresses the lateral ligament complex. The three ligaments that compose the lateral complex are the anterior talofibular (ATFL), the calcaneofibular (CFL), and posterior talofibular (PTFL) and they tend to be injured in this order with the anterior talofibular ligament being injured most commonly. The ATFL is the weakest ligament of the lateral ligament complex, and approximately 70% of lateral ankle sprains involve only this ligament and a mechanicsm of plantar flexion and inversion. The CFL is injuries more commonly in dorsiflexion and inversion mechanisms. The posterior talofibular ligament is the least commonly injured of the lateral ligament complex.
#27 What Is An Ankle Sprain – OrthoPaedia
https://www.orthopaedia.com/what-is-an-ankle-sprain/
What is the definitional distinction between Grade I, II and III sprains? […] A „sprain” is an injury to a ligament (contrasted with „strain” which refers to injury to a muscle-tendon unit). […] Technically speaking, a sprain of a ligament is a tear. […] According to the Goldilocks rule, these injuries are classified into one of three categories: Grade 1 sprain: microscopic tearing only. The ligament is not elongated and thus no laxity is detected on exam. […] Grade 2 sprain: The ligament is partially torn, resulting in stretching that may destabilize the joint, but an end-point is reached (and may be perceived by the examiner). […] Grade 3 sprain: A complete tear of the ligament. Note that despite the full tearing, instability on exam may be masked by swelling or guarding. […] So now letâs talk about ankles. Two ligaments are the primary stabilizers of the lateral ankle: The anterior talofibular ligament (ATFL) is the most commonly injured ligament when an ankle is sprained.
#28 What Is An Ankle Sprain – OrthoPaedia
https://www.orthopaedia.com/what-is-an-ankle-sprain/
The characteristic findings of ankle sprains vary by grade, as follows: Grade 1 sprain: Mild swelling and tenderness. No objective joint instability because the ligament only has microscopic damage. […] Grade 2 sprain: More pain, swelling, tenderness, and/or ecchymosis than Grade 1. […] Grade 3 sprain: Significant laxity on examâif the patient is relaxed and not too edematous. That is, instability may be masked by swelling or guarding.
#29 I Think I Sprained My Ankle! What Do I Do Now? | Wentworth-Douglass Hospital
https://www.wdhospital.org/wdh/services-and-specialties/orthopedic-care/blog/i-think-i-sprained-my-ankle-what-do-i-do-now
Everyone has had an ankle sprain. In fact, approximately 30% of all sports injuries are ankle sprains and they have been described as one of the most common causes of a trip to the emergency room. Approximately 85% of ankle sprain occur when the foot and ankle turn inwards(inversion) towards the opposite foot. When an ankle is turned inwards, the ligaments are stretched. A signal is sent to the brain to reflexively contract the outside muscles (peroneals) to prevent further inversion. If the force is extremely sudden or violent, the forces may exceed the ability of the ligaments to hold the ankle bones in place or exceed the strength of the peroneals to prevent further inversion. This can result in an ankle sprain or fracture. Sprains involve injury to ligaments which are the structures that hold bones together. A Grade I sprain involves stretching of the fibers but no break. A Grade II sprain involves breaking of some fibers but the majority are intact. A Grade III sprain involves complete rupture of all the fibers. The low ankle sprain is by far the most common and is an injury to the lower three ligaments and is usually caused by inversion. The high ankle sprain is an injury that involves the ligament that connects the tibia to the fibula (syndesmotic ligament). In contradistinction to the low ankle sprain, a high ankle sprain usually results from eversion (foot rotates out and away from the body) which is opposite of the low ankle sprain inversion mechanism. The high ankle sprain is a more severe injury and takes about twice as long for clinical recovery. Mild to moderate pain likely indicates a Grade I or at most a Grade II ankle sprain. A complete rupture of the ankle ligaments (Grade III) will result in almost immediate and severe swelling and discoloration. Treatment of Grade I-III sprains of both high and low ankle sprains is usually conservative and successful. Rarely, a complete ankle Grade III rupture will result in recurrent ankle injury and potentially requires stabilization. This is only after failing conservative treatment which again is usually effective in even Grade III injuries. Most ankle sprains will respond to conservative treatment. This may require professional evaluation and formal physical therapy. That said, grades I-II will usually respond to a home program of PRICE followed by progressive weight bearing activities. A rough clinical guideline is that Grade I sprains may take 1-2 weeks, Grade II, 2-6 and Grades III can take 6 or more weeks and sometimes even lead to advanced intervention including surgery. In summary, ankle sprains are common. Deformity, bone (not soft tissue pain), and a complete inability to weight bear indicate need for professional evaluation to exclude a fracture, dislocation, and to develop a therapeutic plan. For minor sprains, the PRICE regimen coupled with pocketbook exercises can guide a safe and effective return to play or work. Any severe pain, or failure to progress indicates the need for professional evaluation to make sure the injury sustained is an ankle sprain and not something more severe that may require emergent care. To close, most ankle sprains will get better with PRICE, TIME, and rehabilitation (peroneal strengthening).
#30 Ankle Sprain | UConn Musculoskeletal Institute
https://health.uconn.edu/msi/clinical-services/orthopaedic-surgery/foot-ankle-and-podiatry/ankle-sprain/
If there is a severe in-turning or out-turning of the foot relative to the ankle, the forces cause the ligaments to stretch beyond their normal length. If the force is too strong, the ligaments can tear. You may lose your balance when your foot is placed unevenly on the ground. You may fall and be unable to stand on that foot. When excessive force is applied to the ankle’s soft tissue structures, you may even hear a „pop.” Pain and swelling result. […] The amount of force determines the grade of the sprain. A mild sprain is a Grade 1. A moderate sprain is a Grade 2. A severe strain is a Grade 3. […] Grade 1 Sprain: Slight stretching and some damage to the fibers (fibrils) of the ligament. […] Grade 2 Sprain: Partial tearing of the ligament. If the ankle joint is examined and moved in certain ways, abnormal looseness (laxity) of the ankle joint occurs.
#31 Ankle Sprain | UConn Musculoskeletal Institute
https://health.uconn.edu/msi/clinical-services/orthopaedic-surgery/foot-ankle-and-podiatry/ankle-sprain/
If there is a severe in-turning or out-turning of the foot relative to the ankle, the forces cause the ligaments to stretch beyond their normal length. If the force is too strong, the ligaments can tear. You may lose your balance when your foot is placed unevenly on the ground. You may fall and be unable to stand on that foot. When excessive force is applied to the ankle’s soft tissue structures, you may even hear a „pop.” Pain and swelling result. […] The amount of force determines the grade of the sprain. A mild sprain is a Grade 1. A moderate sprain is a Grade 2. A severe strain is a Grade 3. […] Grade 1 Sprain: Slight stretching and some damage to the fibers (fibrils) of the ligament. […] Grade 2 Sprain: Partial tearing of the ligament. If the ankle joint is examined and moved in certain ways, abnormal looseness (laxity) of the ankle joint occurs.
#32 What Is An Ankle Sprain – OrthoPaedia
https://www.orthopaedia.com/what-is-an-ankle-sprain/
What is the definitional distinction between Grade I, II and III sprains? […] A „sprain” is an injury to a ligament (contrasted with „strain” which refers to injury to a muscle-tendon unit). […] Technically speaking, a sprain of a ligament is a tear. […] According to the Goldilocks rule, these injuries are classified into one of three categories: Grade 1 sprain: microscopic tearing only. The ligament is not elongated and thus no laxity is detected on exam. […] Grade 2 sprain: The ligament is partially torn, resulting in stretching that may destabilize the joint, but an end-point is reached (and may be perceived by the examiner). […] Grade 3 sprain: A complete tear of the ligament. Note that despite the full tearing, instability on exam may be masked by swelling or guarding. […] So now letâs talk about ankles. Two ligaments are the primary stabilizers of the lateral ankle: The anterior talofibular ligament (ATFL) is the most commonly injured ligament when an ankle is sprained.
#33 What Is An Ankle Sprain – OrthoPaedia
https://www.orthopaedia.com/what-is-an-ankle-sprain/
The characteristic findings of ankle sprains vary by grade, as follows: Grade 1 sprain: Mild swelling and tenderness. No objective joint instability because the ligament only has microscopic damage. […] Grade 2 sprain: More pain, swelling, tenderness, and/or ecchymosis than Grade 1. […] Grade 3 sprain: Significant laxity on examâif the patient is relaxed and not too edematous. That is, instability may be masked by swelling or guarding.
#34 I Think I Sprained My Ankle! What Do I Do Now? | Wentworth-Douglass Hospital
https://www.wdhospital.org/wdh/services-and-specialties/orthopedic-care/blog/i-think-i-sprained-my-ankle-what-do-i-do-now
Everyone has had an ankle sprain. In fact, approximately 30% of all sports injuries are ankle sprains and they have been described as one of the most common causes of a trip to the emergency room. Approximately 85% of ankle sprain occur when the foot and ankle turn inwards(inversion) towards the opposite foot. When an ankle is turned inwards, the ligaments are stretched. A signal is sent to the brain to reflexively contract the outside muscles (peroneals) to prevent further inversion. If the force is extremely sudden or violent, the forces may exceed the ability of the ligaments to hold the ankle bones in place or exceed the strength of the peroneals to prevent further inversion. This can result in an ankle sprain or fracture. Sprains involve injury to ligaments which are the structures that hold bones together. A Grade I sprain involves stretching of the fibers but no break. A Grade II sprain involves breaking of some fibers but the majority are intact. A Grade III sprain involves complete rupture of all the fibers. The low ankle sprain is by far the most common and is an injury to the lower three ligaments and is usually caused by inversion. The high ankle sprain is an injury that involves the ligament that connects the tibia to the fibula (syndesmotic ligament). In contradistinction to the low ankle sprain, a high ankle sprain usually results from eversion (foot rotates out and away from the body) which is opposite of the low ankle sprain inversion mechanism. The high ankle sprain is a more severe injury and takes about twice as long for clinical recovery. Mild to moderate pain likely indicates a Grade I or at most a Grade II ankle sprain. A complete rupture of the ankle ligaments (Grade III) will result in almost immediate and severe swelling and discoloration. Treatment of Grade I-III sprains of both high and low ankle sprains is usually conservative and successful. Rarely, a complete ankle Grade III rupture will result in recurrent ankle injury and potentially requires stabilization. This is only after failing conservative treatment which again is usually effective in even Grade III injuries. Most ankle sprains will respond to conservative treatment. This may require professional evaluation and formal physical therapy. That said, grades I-II will usually respond to a home program of PRICE followed by progressive weight bearing activities. A rough clinical guideline is that Grade I sprains may take 1-2 weeks, Grade II, 2-6 and Grades III can take 6 or more weeks and sometimes even lead to advanced intervention including surgery. In summary, ankle sprains are common. Deformity, bone (not soft tissue pain), and a complete inability to weight bear indicate need for professional evaluation to exclude a fracture, dislocation, and to develop a therapeutic plan. For minor sprains, the PRICE regimen coupled with pocketbook exercises can guide a safe and effective return to play or work. Any severe pain, or failure to progress indicates the need for professional evaluation to make sure the injury sustained is an ankle sprain and not something more severe that may require emergent care. To close, most ankle sprains will get better with PRICE, TIME, and rehabilitation (peroneal strengthening).
#35 Ankle Sprain | UConn Musculoskeletal Institute
https://health.uconn.edu/msi/clinical-services/orthopaedic-surgery/foot-ankle-and-podiatry/ankle-sprain/
Grade 3 Sprain: Complete tear of the ligament. If the examiner pulls or pushes on the ankle joint in certain movements, gross instability occurs. […] The injured ligament may feel tender. If there is no broken bone, the doctor may be able to tell you the grade of your ankle sprain based upon the amount of swelling, pain and bruising. […] If there is a complete tear of the ligaments, the ankle may become unstable after the initial injury phase passes. If this occurs, it is possible that the injury may also have caused damage to the ankle joint surface itself. […] The amount of pain depends on the amount of stretching and tearing of the ligament. Instability occurs when there has been complete tearing of the ligament or a complete dislocation of the ankle joint. […] A Grade 3 sprain can be associated with permanent instability.
#36 Ankle Sprain | UConn Musculoskeletal Institute
https://health.uconn.edu/msi/clinical-services/orthopaedic-surgery/foot-ankle-and-podiatry/ankle-sprain/
Grade 3 Sprain: Complete tear of the ligament. If the examiner pulls or pushes on the ankle joint in certain movements, gross instability occurs. […] The injured ligament may feel tender. If there is no broken bone, the doctor may be able to tell you the grade of your ankle sprain based upon the amount of swelling, pain and bruising. […] If there is a complete tear of the ligaments, the ankle may become unstable after the initial injury phase passes. If this occurs, it is possible that the injury may also have caused damage to the ankle joint surface itself. […] The amount of pain depends on the amount of stretching and tearing of the ligament. Instability occurs when there has been complete tearing of the ligament or a complete dislocation of the ankle joint. […] A Grade 3 sprain can be associated with permanent instability.
#37 Ankle Sprain | PM&R KnowledgeNow
https://now.aapmr.org/ankle-sprain/
Ankle sprain is the stretching or tearing of ankle ligaments. In grade 1 (mild) sprains, a few fibers are torn but there is no laxity or residual instability. Grade 2 (moderate) sprains involve an incomplete tear of the ligament with mild laxity and instability. Grade 3 (severe) sprains are characterized by complete disruption of the ligament with gross instability and laxity. […] Lateral ligament sprains are most common (85% of sprains) and occur from subtalar supination/inversion, talocrural plantarflexion, and tibial external rotation. As the foot rotates, the anterior talofibular ligament (ATFL) is injured first, then the calcaneofibular ligament (CFL) and posterior talofibular ligaments (PTFL) tend to tear in that sequence, depending on severity of the injury. Eversion sprains are caused by extreme external foot rotation, injuring the deltoid ligament that helps to stabilize the medial ankle. High ankle sprains occur via more severe eversion injuries affecting the tibiofibular syndesmosis and/or the anterior tibiofibular ligament.
#38 What Is An Ankle Sprain – OrthoPaedia
https://www.orthopaedia.com/what-is-an-ankle-sprain/
The characteristic findings of ankle sprains vary by grade, as follows: Grade 1 sprain: Mild swelling and tenderness. No objective joint instability because the ligament only has microscopic damage. […] Grade 2 sprain: More pain, swelling, tenderness, and/or ecchymosis than Grade 1. […] Grade 3 sprain: Significant laxity on examâif the patient is relaxed and not too edematous. That is, instability may be masked by swelling or guarding.
#39 I Think I Sprained My Ankle! What Do I Do Now? | Wentworth-Douglass Hospital
https://www.wdhospital.org/wdh/services-and-specialties/orthopedic-care/blog/i-think-i-sprained-my-ankle-what-do-i-do-now
Everyone has had an ankle sprain. In fact, approximately 30% of all sports injuries are ankle sprains and they have been described as one of the most common causes of a trip to the emergency room. Approximately 85% of ankle sprain occur when the foot and ankle turn inwards(inversion) towards the opposite foot. When an ankle is turned inwards, the ligaments are stretched. A signal is sent to the brain to reflexively contract the outside muscles (peroneals) to prevent further inversion. If the force is extremely sudden or violent, the forces may exceed the ability of the ligaments to hold the ankle bones in place or exceed the strength of the peroneals to prevent further inversion. This can result in an ankle sprain or fracture. Sprains involve injury to ligaments which are the structures that hold bones together. A Grade I sprain involves stretching of the fibers but no break. A Grade II sprain involves breaking of some fibers but the majority are intact. A Grade III sprain involves complete rupture of all the fibers. The low ankle sprain is by far the most common and is an injury to the lower three ligaments and is usually caused by inversion. The high ankle sprain is an injury that involves the ligament that connects the tibia to the fibula (syndesmotic ligament). In contradistinction to the low ankle sprain, a high ankle sprain usually results from eversion (foot rotates out and away from the body) which is opposite of the low ankle sprain inversion mechanism. The high ankle sprain is a more severe injury and takes about twice as long for clinical recovery. Mild to moderate pain likely indicates a Grade I or at most a Grade II ankle sprain. A complete rupture of the ankle ligaments (Grade III) will result in almost immediate and severe swelling and discoloration. Treatment of Grade I-III sprains of both high and low ankle sprains is usually conservative and successful. Rarely, a complete ankle Grade III rupture will result in recurrent ankle injury and potentially requires stabilization. This is only after failing conservative treatment which again is usually effective in even Grade III injuries. Most ankle sprains will respond to conservative treatment. This may require professional evaluation and formal physical therapy. That said, grades I-II will usually respond to a home program of PRICE followed by progressive weight bearing activities. A rough clinical guideline is that Grade I sprains may take 1-2 weeks, Grade II, 2-6 and Grades III can take 6 or more weeks and sometimes even lead to advanced intervention including surgery. In summary, ankle sprains are common. Deformity, bone (not soft tissue pain), and a complete inability to weight bear indicate need for professional evaluation to exclude a fracture, dislocation, and to develop a therapeutic plan. For minor sprains, the PRICE regimen coupled with pocketbook exercises can guide a safe and effective return to play or work. Any severe pain, or failure to progress indicates the need for professional evaluation to make sure the injury sustained is an ankle sprain and not something more severe that may require emergent care. To close, most ankle sprains will get better with PRICE, TIME, and rehabilitation (peroneal strengthening).
#40 I Think I Sprained My Ankle! What Do I Do Now? | Wentworth-Douglass Hospital
https://www.wdhospital.org/wdh/services-and-specialties/orthopedic-care/blog/i-think-i-sprained-my-ankle-what-do-i-do-now
Everyone has had an ankle sprain. In fact, approximately 30% of all sports injuries are ankle sprains and they have been described as one of the most common causes of a trip to the emergency room. Approximately 85% of ankle sprain occur when the foot and ankle turn inwards(inversion) towards the opposite foot. When an ankle is turned inwards, the ligaments are stretched. A signal is sent to the brain to reflexively contract the outside muscles (peroneals) to prevent further inversion. If the force is extremely sudden or violent, the forces may exceed the ability of the ligaments to hold the ankle bones in place or exceed the strength of the peroneals to prevent further inversion. This can result in an ankle sprain or fracture. Sprains involve injury to ligaments which are the structures that hold bones together. A Grade I sprain involves stretching of the fibers but no break. A Grade II sprain involves breaking of some fibers but the majority are intact. A Grade III sprain involves complete rupture of all the fibers. The low ankle sprain is by far the most common and is an injury to the lower three ligaments and is usually caused by inversion. The high ankle sprain is an injury that involves the ligament that connects the tibia to the fibula (syndesmotic ligament). In contradistinction to the low ankle sprain, a high ankle sprain usually results from eversion (foot rotates out and away from the body) which is opposite of the low ankle sprain inversion mechanism. The high ankle sprain is a more severe injury and takes about twice as long for clinical recovery. Mild to moderate pain likely indicates a Grade I or at most a Grade II ankle sprain. A complete rupture of the ankle ligaments (Grade III) will result in almost immediate and severe swelling and discoloration. Treatment of Grade I-III sprains of both high and low ankle sprains is usually conservative and successful. Rarely, a complete ankle Grade III rupture will result in recurrent ankle injury and potentially requires stabilization. This is only after failing conservative treatment which again is usually effective in even Grade III injuries. Most ankle sprains will respond to conservative treatment. This may require professional evaluation and formal physical therapy. That said, grades I-II will usually respond to a home program of PRICE followed by progressive weight bearing activities. A rough clinical guideline is that Grade I sprains may take 1-2 weeks, Grade II, 2-6 and Grades III can take 6 or more weeks and sometimes even lead to advanced intervention including surgery. In summary, ankle sprains are common. Deformity, bone (not soft tissue pain), and a complete inability to weight bear indicate need for professional evaluation to exclude a fracture, dislocation, and to develop a therapeutic plan. For minor sprains, the PRICE regimen coupled with pocketbook exercises can guide a safe and effective return to play or work. Any severe pain, or failure to progress indicates the need for professional evaluation to make sure the injury sustained is an ankle sprain and not something more severe that may require emergent care. To close, most ankle sprains will get better with PRICE, TIME, and rehabilitation (peroneal strengthening).
#41 Ankle Sprain | UConn Musculoskeletal Institute
https://health.uconn.edu/msi/clinical-services/orthopaedic-surgery/foot-ankle-and-podiatry/ankle-sprain/
If there is a severe in-turning or out-turning of the foot relative to the ankle, the forces cause the ligaments to stretch beyond their normal length. If the force is too strong, the ligaments can tear. You may lose your balance when your foot is placed unevenly on the ground. You may fall and be unable to stand on that foot. When excessive force is applied to the ankle’s soft tissue structures, you may even hear a „pop.” Pain and swelling result. […] The amount of force determines the grade of the sprain. A mild sprain is a Grade 1. A moderate sprain is a Grade 2. A severe strain is a Grade 3. […] Grade 1 Sprain: Slight stretching and some damage to the fibers (fibrils) of the ligament. […] Grade 2 Sprain: Partial tearing of the ligament. If the ankle joint is examined and moved in certain ways, abnormal looseness (laxity) of the ankle joint occurs.
#42 Ankle Sprain | UConn Musculoskeletal Institute
https://health.uconn.edu/msi/clinical-services/orthopaedic-surgery/foot-ankle-and-podiatry/ankle-sprain/
Grade 3 Sprain: Complete tear of the ligament. If the examiner pulls or pushes on the ankle joint in certain movements, gross instability occurs. […] The injured ligament may feel tender. If there is no broken bone, the doctor may be able to tell you the grade of your ankle sprain based upon the amount of swelling, pain and bruising. […] If there is a complete tear of the ligaments, the ankle may become unstable after the initial injury phase passes. If this occurs, it is possible that the injury may also have caused damage to the ankle joint surface itself. […] The amount of pain depends on the amount of stretching and tearing of the ligament. Instability occurs when there has been complete tearing of the ligament or a complete dislocation of the ankle joint. […] A Grade 3 sprain can be associated with permanent instability.
#43 Ankle sprain: pathophysiology, predisposing factors, and management strategies
https://pmc.ncbi.nlm.nih.gov/articles/PMC3781861/
With damage to the ligamentous stabilizers of the ankle after a LAS, an associated increase in the motion available between the bones of the ankle/foot complex occurs (hypermobility). The resulting hypermobility can be assessed qualitatively and empirically using various clinical techniques such as manual stress tests, instrumented arthrometry and stress radiographs. In order to regain stability of the ankle joint, immediate care and rehabilitation should focus on enhancing ligament healing. Acutely, this occurs by protecting the joint (immobilization, crutch use) then slowly adding exercises that help the newly laid down collagen align with the forces of the ankle. The current literature suggests it takes over six weeks for ligament healing to occur. However, studies have also documented joint laxity six months after injury. The chronic laxity that has been reported in the literature may be due to inappropriate rehabilitation, which necessitates the need for further investigation into the type of care and treatment that will best facilitate tissue healing, and normal joint function.
#44 Ankle sprain: pathophysiology, predisposing factors, and management strategies
https://pmc.ncbi.nlm.nih.gov/articles/PMC3781861/
With damage to the ligamentous stabilizers of the ankle after a LAS, an associated increase in the motion available between the bones of the ankle/foot complex occurs (hypermobility). The resulting hypermobility can be assessed qualitatively and empirically using various clinical techniques such as manual stress tests, instrumented arthrometry and stress radiographs. In order to regain stability of the ankle joint, immediate care and rehabilitation should focus on enhancing ligament healing. Acutely, this occurs by protecting the joint (immobilization, crutch use) then slowly adding exercises that help the newly laid down collagen align with the forces of the ankle. The current literature suggests it takes over six weeks for ligament healing to occur. However, studies have also documented joint laxity six months after injury. The chronic laxity that has been reported in the literature may be due to inappropriate rehabilitation, which necessitates the need for further investigation into the type of care and treatment that will best facilitate tissue healing, and normal joint function.
#45 Management of Ankle Sprains | AAFP
https://www.aafp.org/pubs/afp/issues/2001/0101/p93.html
The most common mechanism of injury in ankle sprains is a combination of plantar flexion and inversion. The lateral stabilizing ligaments, which include the anterior talofibular, calcaneofibular and posterior talofibular ligaments, are most often damaged. The anterior talofibular ligament is the most easily injured. Concomitant injury to this ligament and the calcaneofibular ligament can result in appreciable instability. […] Medial ankle stability is provided by the strong deltoid ligament, the anterior tibiofibular ligament and the bony mortise. Because of the bony articulation between the medial malleolus and the talus, medial ankle sprains are less common than lateral sprains. In medial ankle sprains, the mechanism of injury is excessive eversion and dorsiflexion. […] Injury to the tibiofibular syndesmosis ligaments, which bind together the distal ends of the tibia and fibula, is commonly referred to as a high ankle sprain. Although this injury accounts for only about 10 percent of ankle sprains, it represents a more disabling problem and requires different treatment than common ankle sprains. The mechanism of injury is excessive dorsiflexion and eversion of the ankle joint with internal rotation of the tibia. […] The anterior drawer test can be used to assess the integrity of the anterior talofibular ligament, and the inversion stress test can be used to assess the integrity of the calcaneofibular ligament.
#46 The Complete Guide to an Ankle Sprain | Kinetic Labs
https://kineticlabs.ca/blog/complete-guide-to-ankle-sprain/
Grade III is a complete rupture of the ATFL, possible involvement of the CFL, and noticeable joint laxity. […] To answer this question, let’s discuss how ligaments heal. There are three phases that ligaments undergo to heal the inflammatory, reparative and remodeling phases. Inflammation occurs over the first 72 hours, whereby the injury site is flooded with important substances that promote healing. In the reparative phase, damaged cells are replaced by healthy cells. Collagen the protein responsible for giving ligaments their strength begins to form in a disorganized fashion. This process begins after 3 to 5 days and lasts for roughly two weeks. During this phase, the ligament can resist only small amounts of force. Returning to activities too soon can disrupt the healing process and lead to the ligament healing in an elongated position, which is a risk factor for developing chronic ankle instability.
#47 The Complete Guide to an Ankle Sprain | Kinetic Labs
https://kineticlabs.ca/blog/complete-guide-to-ankle-sprain/
Grade III is a complete rupture of the ATFL, possible involvement of the CFL, and noticeable joint laxity. […] To answer this question, let’s discuss how ligaments heal. There are three phases that ligaments undergo to heal the inflammatory, reparative and remodeling phases. Inflammation occurs over the first 72 hours, whereby the injury site is flooded with important substances that promote healing. In the reparative phase, damaged cells are replaced by healthy cells. Collagen the protein responsible for giving ligaments their strength begins to form in a disorganized fashion. This process begins after 3 to 5 days and lasts for roughly two weeks. During this phase, the ligament can resist only small amounts of force. Returning to activities too soon can disrupt the healing process and lead to the ligament healing in an elongated position, which is a risk factor for developing chronic ankle instability.
#48 The Complete Guide to an Ankle Sprain | Kinetic Labs
https://kineticlabs.ca/blog/complete-guide-to-ankle-sprain/
Grade III is a complete rupture of the ATFL, possible involvement of the CFL, and noticeable joint laxity. […] To answer this question, let’s discuss how ligaments heal. There are three phases that ligaments undergo to heal the inflammatory, reparative and remodeling phases. Inflammation occurs over the first 72 hours, whereby the injury site is flooded with important substances that promote healing. In the reparative phase, damaged cells are replaced by healthy cells. Collagen the protein responsible for giving ligaments their strength begins to form in a disorganized fashion. This process begins after 3 to 5 days and lasts for roughly two weeks. During this phase, the ligament can resist only small amounts of force. Returning to activities too soon can disrupt the healing process and lead to the ligament healing in an elongated position, which is a risk factor for developing chronic ankle instability.
#49 The Complete Guide to an Ankle Sprain | Kinetic Labs
https://kineticlabs.ca/blog/complete-guide-to-ankle-sprain/
Grade III is a complete rupture of the ATFL, possible involvement of the CFL, and noticeable joint laxity. […] To answer this question, let’s discuss how ligaments heal. There are three phases that ligaments undergo to heal the inflammatory, reparative and remodeling phases. Inflammation occurs over the first 72 hours, whereby the injury site is flooded with important substances that promote healing. In the reparative phase, damaged cells are replaced by healthy cells. Collagen the protein responsible for giving ligaments their strength begins to form in a disorganized fashion. This process begins after 3 to 5 days and lasts for roughly two weeks. During this phase, the ligament can resist only small amounts of force. Returning to activities too soon can disrupt the healing process and lead to the ligament healing in an elongated position, which is a risk factor for developing chronic ankle instability.
#50 Ankle sprain: pathophysiology, predisposing factors, and management strategies
https://pmc.ncbi.nlm.nih.gov/articles/PMC3781861/
With damage to the ligamentous stabilizers of the ankle after a LAS, an associated increase in the motion available between the bones of the ankle/foot complex occurs (hypermobility). The resulting hypermobility can be assessed qualitatively and empirically using various clinical techniques such as manual stress tests, instrumented arthrometry and stress radiographs. In order to regain stability of the ankle joint, immediate care and rehabilitation should focus on enhancing ligament healing. Acutely, this occurs by protecting the joint (immobilization, crutch use) then slowly adding exercises that help the newly laid down collagen align with the forces of the ankle. The current literature suggests it takes over six weeks for ligament healing to occur. However, studies have also documented joint laxity six months after injury. The chronic laxity that has been reported in the literature may be due to inappropriate rehabilitation, which necessitates the need for further investigation into the type of care and treatment that will best facilitate tissue healing, and normal joint function.
#51 Ankle sprain: pathophysiology, predisposing factors, and management strategies
https://pmc.ncbi.nlm.nih.gov/articles/PMC3781861/
With damage to the ligamentous stabilizers of the ankle after a LAS, an associated increase in the motion available between the bones of the ankle/foot complex occurs (hypermobility). The resulting hypermobility can be assessed qualitatively and empirically using various clinical techniques such as manual stress tests, instrumented arthrometry and stress radiographs. In order to regain stability of the ankle joint, immediate care and rehabilitation should focus on enhancing ligament healing. Acutely, this occurs by protecting the joint (immobilization, crutch use) then slowly adding exercises that help the newly laid down collagen align with the forces of the ankle. The current literature suggests it takes over six weeks for ligament healing to occur. However, studies have also documented joint laxity six months after injury. The chronic laxity that has been reported in the literature may be due to inappropriate rehabilitation, which necessitates the need for further investigation into the type of care and treatment that will best facilitate tissue healing, and normal joint function.
#52 Burlington Physiotherapy – Sprained Ankle
https://burlingtonsportstherapy.com/blog/ankle-sprains/
Ankle sprains account for 25-50% of all injuries in sports and 17% of soccer injuries. An inversion ankle sprain is the most common ankle sprain injury, accounting for 77%. It usually involves stepping on the lateral ridge of the foot and going over on the ankle, damaging the ligaments around the lateral malleolus. […] Proprioception is a term that is commonly associated with ankle sprain. In technical terms, it is the combination of joint position sense and kinesthesia. In more simple terms, its the mechanism that allows us to know and feel the position of our joints without looking at them. Unfortunately, when we injure a ligament and different joint structures (as with an ankle sprain) this mechanism is disrupted and we are more susceptible to injury. […] Proprioceptive training is commonly used in sport-specific conditioning and rehabilitation in an effort to optimize our proprioception and prevent injury. In other words, we re-teach our ankle how to function properly and avoid another sprain.
#53 How and Why Does Inversion Ankle Sprain Affect Athletes
https://certifiedfoot.com/inversion-ankle-sprains-athelete/
Not to mention that repeated inversion ankle sprain injuries can put undue pressure within the joint itself and cause a compression or shearing injury on the surface of the cartilage â this is known as an osteochondral defect. If this is left untreated, it can eventually form what resembles a crater within the ankle joint. […] However, bear in mind that in individuals with functional injury, these clinical maneuvers may not necessarily be abnormal. This is because they are sensory receptors specifically affiliated with tendons, known as Golgi tendon organs that are very sensitive to both tension and pressure. […] This explains why once a person has had one ankle sprain, and if they are not properly rehabilitated they are likely to undergo these injuries over and over again. […] Crucial to reestablishing this neuromuscular feedback mechanism, is working together with physical therapy for proprioception and neuromuscular reeducation. This is done in an attempt to help to regain some of the somatosensory feedback mechanisms that were previously injured.
#54 How and Why Does Inversion Ankle Sprain Affect Athletes
https://certifiedfoot.com/inversion-ankle-sprains-athelete/
Not to mention that repeated inversion ankle sprain injuries can put undue pressure within the joint itself and cause a compression or shearing injury on the surface of the cartilage â this is known as an osteochondral defect. If this is left untreated, it can eventually form what resembles a crater within the ankle joint. […] However, bear in mind that in individuals with functional injury, these clinical maneuvers may not necessarily be abnormal. This is because they are sensory receptors specifically affiliated with tendons, known as Golgi tendon organs that are very sensitive to both tension and pressure. […] This explains why once a person has had one ankle sprain, and if they are not properly rehabilitated they are likely to undergo these injuries over and over again. […] Crucial to reestablishing this neuromuscular feedback mechanism, is working together with physical therapy for proprioception and neuromuscular reeducation. This is done in an attempt to help to regain some of the somatosensory feedback mechanisms that were previously injured.
#55 The Complete Guide to an Ankle Sprain | Kinetic Labs
https://kineticlabs.ca/blog/complete-guide-to-ankle-sprain/
An ankle sprain is an injury to the ligaments connecting the lower leg bones to the foot. This happens when the foot is suddenly and forcibly inverted (foot turns in) or everted (foot turns out). An inversion ankle sprain is the most common mechanism of a sprained ankle and is one of the leading injuries in sport. […] These ligaments are important because they provide mechanical stability to the ankle joint. The ligaments also provide sensory feedback to the brain to help with your body’s proprioception the ability to determine where you are in your environment. When the ligament is damaged, sensory feedback also becomes impaired and without appropriate treatment, it can lead to a higher risk of recurrent ankle sprains. […] Ankle sprains can be separated into three categories based on the severity of damage to the ligaments Grade I, II, and III.
#56 Acute, Chronic and Recurrent Ankle Sprains | Kingsley Physio | More than your local Physio
https://kingsleyphysio.com/common-conditions/acute-chronic-recurrent-ankle-sprains/
Your physiotherapist will also tape the ankle following each treatment session. […] Once the initial pain and swelling has settled, you will be encouraged to graduate your return to activity. […] To reduce the risk of reoccurrence, all of these factors need to be addressed by your physiotherapist. […] The stability of the foot and ankle can only be altered by providing additional external support braces, taping etc. […] If the ankle remains loose (unstable) following an injury, your physiotherapist may discuss appropriate ankle braces or taping techniques that can provide additional support and considerable injury prophylaxis. […] Proprioception can be thought of as the ability to sense the position or movement of a joint. […] When ligaments or tendons are damaged they lose their ability to perceive stretch as effectively the resulting scar tissue is not equipped with these stretch receptors.
#57 How and Why Does Inversion Ankle Sprain Affect Athletes
https://certifiedfoot.com/inversion-ankle-sprains-athelete/
Not to mention that repeated inversion ankle sprain injuries can put undue pressure within the joint itself and cause a compression or shearing injury on the surface of the cartilage â this is known as an osteochondral defect. If this is left untreated, it can eventually form what resembles a crater within the ankle joint. […] However, bear in mind that in individuals with functional injury, these clinical maneuvers may not necessarily be abnormal. This is because they are sensory receptors specifically affiliated with tendons, known as Golgi tendon organs that are very sensitive to both tension and pressure. […] This explains why once a person has had one ankle sprain, and if they are not properly rehabilitated they are likely to undergo these injuries over and over again. […] Crucial to reestablishing this neuromuscular feedback mechanism, is working together with physical therapy for proprioception and neuromuscular reeducation. This is done in an attempt to help to regain some of the somatosensory feedback mechanisms that were previously injured.
#58 The Complete Guide to an Ankle Sprain | Kinetic Labs
https://kineticlabs.ca/blog/complete-guide-to-ankle-sprain/
One consequence of recurrent ankle injuries is a condition called chronic ankle instability (CAI). CAI occurs when ligament stability is altered, leading to frequent giving way sensations of the ankle. It can develop after a major ankle sprain or recurrent sprains, especially when multiple ligaments are involved. Individuals with CAI have reduced strength in their lower leg muscles (foot evertors and plantarflexors), dynamic balance deficits, increased pain and altered biomechanics of the ankle. […] The best way to prevent CAI is through proper rehabilitation after the initial injury.
#59 The Complete Guide to an Ankle Sprain | Kinetic Labs
https://kineticlabs.ca/blog/complete-guide-to-ankle-sprain/
One consequence of recurrent ankle injuries is a condition called chronic ankle instability (CAI). CAI occurs when ligament stability is altered, leading to frequent giving way sensations of the ankle. It can develop after a major ankle sprain or recurrent sprains, especially when multiple ligaments are involved. Individuals with CAI have reduced strength in their lower leg muscles (foot evertors and plantarflexors), dynamic balance deficits, increased pain and altered biomechanics of the ankle. […] The best way to prevent CAI is through proper rehabilitation after the initial injury.
#60 The Complete Guide to an Ankle Sprain | Kinetic Labs
https://kineticlabs.ca/blog/complete-guide-to-ankle-sprain/
One consequence of recurrent ankle injuries is a condition called chronic ankle instability (CAI). CAI occurs when ligament stability is altered, leading to frequent giving way sensations of the ankle. It can develop after a major ankle sprain or recurrent sprains, especially when multiple ligaments are involved. Individuals with CAI have reduced strength in their lower leg muscles (foot evertors and plantarflexors), dynamic balance deficits, increased pain and altered biomechanics of the ankle. […] The best way to prevent CAI is through proper rehabilitation after the initial injury.
#61 Ankle Injuries and Sprains (Assessment, Symptoms, and Treatment)
https://patient.info/doctor/ankle-injuries-pro
Ankle sprains and injuries are common in primary care, AE and sports medicine. Most are inversion and plantar flexion injuries that lead to damage to the lateral ligaments. […] Between 50% and 70% of people who sustain a lateral ankle sprain will develop chronic ankle instability, which is characterised by lingering pain, instability, injury recurrence, and persistent functional disability. […] Ankle sprains are classified from grade I to grade III depending on their severity: Grade I injuries – the ligament is stretched, with microscopic (but not macroscopic) tearing. Grade II injuries – the ligament is stretched with partial tearing. Grade III injuries – the ligament is completely ruptured. […] Syndesmotic (high ankle) sprain is caused by dorsiflexion and eversion of the ankle with internal rotation of the tibia – eg, during skiing or football. The syndesmotic ligaments are the combination of the interosseous ligament and lower tibiofibular ligaments which normally stabilise the mortise joint and fix the fibula in the fibular notch. […] Chronic ankle instability may follow an acute lateral ankle sprain. Initial treatment involves bracing or neuromuscular training. However, if symptoms persist, surgery may be considered.
#62 The Complete Guide to an Ankle Sprain | Kinetic Labs
https://kineticlabs.ca/blog/complete-guide-to-ankle-sprain/
One consequence of recurrent ankle injuries is a condition called chronic ankle instability (CAI). CAI occurs when ligament stability is altered, leading to frequent giving way sensations of the ankle. It can develop after a major ankle sprain or recurrent sprains, especially when multiple ligaments are involved. Individuals with CAI have reduced strength in their lower leg muscles (foot evertors and plantarflexors), dynamic balance deficits, increased pain and altered biomechanics of the ankle. […] The best way to prevent CAI is through proper rehabilitation after the initial injury.
#63 Ankle Injuries and Sprains (Assessment, Symptoms, and Treatment)
https://patient.info/doctor/ankle-injuries-pro
Ankle sprains and injuries are common in primary care, AE and sports medicine. Most are inversion and plantar flexion injuries that lead to damage to the lateral ligaments. […] Between 50% and 70% of people who sustain a lateral ankle sprain will develop chronic ankle instability, which is characterised by lingering pain, instability, injury recurrence, and persistent functional disability. […] Ankle sprains are classified from grade I to grade III depending on their severity: Grade I injuries – the ligament is stretched, with microscopic (but not macroscopic) tearing. Grade II injuries – the ligament is stretched with partial tearing. Grade III injuries – the ligament is completely ruptured. […] Syndesmotic (high ankle) sprain is caused by dorsiflexion and eversion of the ankle with internal rotation of the tibia – eg, during skiing or football. The syndesmotic ligaments are the combination of the interosseous ligament and lower tibiofibular ligaments which normally stabilise the mortise joint and fix the fibula in the fibular notch. […] Chronic ankle instability may follow an acute lateral ankle sprain. Initial treatment involves bracing or neuromuscular training. However, if symptoms persist, surgery may be considered.
#64 How and Why Does Inversion Ankle Sprain Affect Athletes
https://certifiedfoot.com/inversion-ankle-sprains-athelete/
Not to mention that repeated inversion ankle sprain injuries can put undue pressure within the joint itself and cause a compression or shearing injury on the surface of the cartilage â this is known as an osteochondral defect. If this is left untreated, it can eventually form what resembles a crater within the ankle joint. […] However, bear in mind that in individuals with functional injury, these clinical maneuvers may not necessarily be abnormal. This is because they are sensory receptors specifically affiliated with tendons, known as Golgi tendon organs that are very sensitive to both tension and pressure. […] This explains why once a person has had one ankle sprain, and if they are not properly rehabilitated they are likely to undergo these injuries over and over again. […] Crucial to reestablishing this neuromuscular feedback mechanism, is working together with physical therapy for proprioception and neuromuscular reeducation. This is done in an attempt to help to regain some of the somatosensory feedback mechanisms that were previously injured.
#65 How and Why Does Inversion Ankle Sprain Affect Athletes
https://certifiedfoot.com/inversion-ankle-sprains-athelete/
Not to mention that repeated inversion ankle sprain injuries can put undue pressure within the joint itself and cause a compression or shearing injury on the surface of the cartilage â this is known as an osteochondral defect. If this is left untreated, it can eventually form what resembles a crater within the ankle joint. […] However, bear in mind that in individuals with functional injury, these clinical maneuvers may not necessarily be abnormal. This is because they are sensory receptors specifically affiliated with tendons, known as Golgi tendon organs that are very sensitive to both tension and pressure. […] This explains why once a person has had one ankle sprain, and if they are not properly rehabilitated they are likely to undergo these injuries over and over again. […] Crucial to reestablishing this neuromuscular feedback mechanism, is working together with physical therapy for proprioception and neuromuscular reeducation. This is done in an attempt to help to regain some of the somatosensory feedback mechanisms that were previously injured.
#66 Ankle Sprain Treatment Hertfordshire | Ankle Injury | Ankle Surgeon Buckinghamshire
https://www.precisionfootandankle.co.uk/ankle-sprain-orthopaedic-foot-ankle-surgeon-high-wycombe-buckinghamshire.html
An ankle sprain is one of the most common injuries around the foot and ankle. Sprain refers to stretching of the ligaments that provide stability to the ankle. Different mechanisms of injury include an inversion injury when the ankle rolls inside, eversion injury when it rolls outside or a twisting injury as shown in the illustration below. […] Of these, lateral ligament sprains are by far the most common and typically involve injury to the Anterior talofibular ligament (ATFL) and Calcaneofibular ligament (CFL). Conversely, injury to the inner ankle ligament, called the Deltoid, is much less common. […] Furthermore, in approximately 8-10% of patients suffering a severe ankle sprain, there will be associated injuries to the cartilage within the ankle joint itself, that may lead to residual symptoms.
#67 Different Types of Ankle Sprains and Implications for Recovery | POGO Physio Gold Coast
https://www.pogophysio.com.au/blog/different-types-of-ankle-sprains-and-implications-for-recovery/
During an inversion ankle sprain, fracture of the shin or foot occurs in up to 15% of cases (28). The most common locations are the lateral malleolus of the fibula, medial malleolus of the tibia, the 5th metatarsal and the navicular. […] Ankle inversion is the most common mechanism implicated in midtarsal sprains accounting for approximately 73% (36). Ankle inversion causes distraction across the anterolateral ankle, stressing the lateral collateral ligaments, commonly causing rupture or avulsion of the ATFL and can also rupture the bifurcate ligament.
#68 When is an ankle sprain âNot Just An Ankle Sprainâ?
https://www.pdxfootandankle.com/blog/when-is-an-ankle-sprain-not-just-an-ankle-sprain-22405.html
Ankle sprains are remarkably common. In fact, one can argue that it may be the most common injury in the world. A sprain, by definition, is an injury to a ligament. And when one references an ankle sprain, it is usually the anterior talofibular ligament and/or the calcaneofibular ligament that is being referenced. Ankle sprains are graded to indicate either the severity of the tear or the number of ligaments involved. Therefore, if someone has persistent pain and/or difficulty weeks or months after an ankle sprain, especially if there was difficulty bearing weight for more than three weeks after the injury, the problem may not be just an ankle sprain. The peroneal tendons can be injured in the exact mechanism that sprains the lateral ankle ligaments; an inversion injury. The history is very similar, but patients report difficulty progressing, or a sense of weakness and difficulty on uneven ground. However, if therapy fails, or the tear is quite significant, symptoms may persist. Un-healed tears can result in persistent difficulty with activity requiring balance, quick adjustments, pivoting, rotation, and pain particularly going downstairs or downhill. An unrecognized Achilles Tendon Rupture severely impacts the function of the ankle. The Achilles Tendon is the major flexor of the ankle is responsible for picking the heel up off of the ground, and for power in push off when doing activities such as running or jumping. When unrecognized, and patients are not immobilized and walk, then the fracture may have a difficult time healing, or may not heal, and result in persistent pain with walking, far beyond the normal healing time of an ankle sprain.
#69 :: JKOA :: The Journal of the Korean Orthopaedic Association
https://www.jkoa.org/DOIx.php?id=10.4055/jkoa.2014.49.1.1
Ankle sprain is one of the most common musculoskeletal injuries, nearly half of all ankle sprains occur during athletic activity. […] The stability of the ankle joint is maintained by both bony structure and ligamentous complex. The anterior talofibular ligament is the primary restraint of internal rotation and adduction of the talus with the ankle joint unloaded, while both bony mortise structure and calcaneofibular ligament restrict adduction of the talus with the ankle joint loaded. […] Plantar flexion and inversion is the most common mechanism of ankle sprains, which lead to injury of the anterior talofibular ligament followed by calcaneofibular ligament. Ligament injuries are classified according to three grades based on the extent of rupture and the severity of clinical features. Associated injuries with lateral ankle sprain include peroneus tendon rupture, osteochondral fracture, deltoid ligament injury, syndesmosis injury, and nerve traction injuries.
#70 How and Why Does Inversion Ankle Sprain Affect Athletes
https://certifiedfoot.com/inversion-ankle-sprains-athelete/
The inversion ankle sprain is the single most common injury in all of the sports and athletic injuries universally. […] To further compound matters, the number one predisposing factor to suffer an ankle sprain is a history of a previous ankle sprain. This means that if you suffer one of these injuries you are exponentially more likely to get several others. However, what this also indicates is that if initial injuries are not rehabilitated and treated properly, you are more likely to have progressive deterioration and ankle instability to this very common and cumbersome injury. […] Appropriate treatment of an ankle sprain injury involves a detailed history and physical examination â this is essentially to determine if ligaments are sprained or torn. Spraining basically implies overstretching of a ligament tissue and tearing means complete rupture and a possible detachment altogether.
#71 Ankle sprain
https://fittoplay.org/body-parts/ankle/ankle-sprain/
A sprained ankle is one of the most common sports injuries. In certain sports, especially team sports such as football, basketball, volleyball, and handball, up to 50% of all acute injuries are ankle sprains. A sprained ankle will almost always occur on the outside of the foot. Ankle injuries occur most frequently when stopping, turning, jumping, or landing. The foot is then twisted inwards or outwards, which may lead to one or more of the ligaments in the ankle tearing either partially or entirely. Ligaments hold bones together and have a stabilising function. Recovery is usually very quick following a sprained ankle where the injury is on the outside of the foot. The ligaments tend to be completely healed after 6-12 weeks, but full function can be attained much earlier if proper treatment is applied during the acute phase. In the first 6 months of returning to sport following an ankle sprain, there is about a 50% chance of re-injury. Acute ankle injuries can usually be prevented.
#72 Intrinsic and Extrinsic Risk Factors for Lateral Ankle Sprain: A Literature Review
https://scholars.direct/Articles/sports-medicine/aspm-3-026.php?jid=sports-medicine
Recent studies reported previous ankle sprain as a risk factor for ipsilateral and contralateral future lateral ankle injury. Moreover, a systematic review identified and reviewed 26 articles, describing the relationship between injury and re-injury for the four most common lower extremity injury. Their results showed that previous ankle sprain is the most common injury resulting in a secondary sprain of the ipsilateral or contralateral ankle, which may be explained by neuromuscular factors. […] Proprioception is a complex process which is coordinated by afferent and efferent impulses, working as feedback loops. It implies a fine tune between nervous and musculoskeletal systems, allowing one to be aware of his own joint position (joint position sense) and joint movement (kinesthesia). This neuromuscular feedback mechanism might be interrupted with injury and abnormalities, but surgical intervention and rehabilitation might restore it.
#73 Sprained Ankle
https://www.parklandhealth.org/sprained-ankle
When excessive force is applied to the ankle’s soft tissue structures, you may even hear a „pop”. Pain and swelling result. The amount of force determines the grade of the sprain. […] Instability occurs when there has been complete tearing of the ligament or a complete dislocation of the ankle joint. […] If the sprain happens frequently and pain continues for more than four weeks to six weeks, you may have a chronic ankle sprain. […] Possible complications of ankle sprains and treatment include abnormal proprioception. There may be imbalance and muscle weakness that causes a re-injury. If this happens over and over again, a chronic situation may persist with instability, a sense of the ankle giving way (gross laxity) and chronic pain.
#74 Don’t Let Injuries Put You on Thin Ice: Managing Blood Clots with an Ankle Sprain – American Blood Clot Association
https://bloodclot.org/dont-let-injuries-put-you-on-thin-ice-managing-blood-clots-with-an-ankle-sprain-2/
Ankle sprains are among the most common injuries, but they can have serious complications if not treated properly. One of the most dangerous potential side effects of an ankle sprain is a blood clot. When a person suffers a sprain, the injury can cause swelling and restrict blood flow, creating an ideal environment for a clot to form. […] Blood clots, or thrombosis, occur when the bodyâs natural process of blood coagulation becomes disrupted. Normally, blood flow is smooth and unobstructed, but when a blood vessel is injured, the body responds by forming a clot to prevent excessive bleeding. However, in the case of an ankle sprain, the bodyâs response can become problematic. […] When you sprain your ankle, the tissues around the joint are damaged, leading to inflammation and swelling. This inflammation can constrict blood vessels, impeding the normal flow of blood. The reduced blood flow combined with the pooling of blood around the injury site creates an ideal environment for clot formation.
#75 Don’t Let Injuries Put You on Thin Ice: Managing Blood Clots with an Ankle Sprain – American Blood Clot Association
https://bloodclot.org/dont-let-injuries-put-you-on-thin-ice-managing-blood-clots-with-an-ankle-sprain-2/
Ankle sprains are among the most common injuries, but they can have serious complications if not treated properly. One of the most dangerous potential side effects of an ankle sprain is a blood clot. When a person suffers a sprain, the injury can cause swelling and restrict blood flow, creating an ideal environment for a clot to form. […] Blood clots, or thrombosis, occur when the bodyâs natural process of blood coagulation becomes disrupted. Normally, blood flow is smooth and unobstructed, but when a blood vessel is injured, the body responds by forming a clot to prevent excessive bleeding. However, in the case of an ankle sprain, the bodyâs response can become problematic. […] When you sprain your ankle, the tissues around the joint are damaged, leading to inflammation and swelling. This inflammation can constrict blood vessels, impeding the normal flow of blood. The reduced blood flow combined with the pooling of blood around the injury site creates an ideal environment for clot formation.
#76 Don’t Let Injuries Put You on Thin Ice: Managing Blood Clots with an Ankle Sprain – American Blood Clot Association
https://bloodclot.org/dont-let-injuries-put-you-on-thin-ice-managing-blood-clots-with-an-ankle-sprain-2/
A blood clot that forms as a result of an ankle sprain can be especially dangerous because it can travel to other parts of the body. This can lead to a potentially life-threatening condition called deep vein thrombosis (DVT), where the clot travels to the deep veins of the leg, causing blockages and potentially even pulmonary embolism. […] An ankle sprain occurs when the ligaments surrounding the ankle joint are stretched or torn, usually as a result of twisting or rolling the ankle. This can cause inflammation, swelling, and restricted blood flow to the injured area. Unfortunately, this is also the perfect environment for a blood clot to form. […] When blood flow is impeded, it can lead to the development of a blood clot. The clot can then travel through the bloodstream to other parts of the body, causing serious complications such as deep vein thrombosis (DVT) or pulmonary embolism. DVT occurs when the clot travels to the deep veins of the leg, causing blockages and potentially life-threatening consequences.
#77
https://www.footcaremd.org/conditions-treatments/ankle/high-ankle-sprain
The goals of treatment are to move the tibia and fibula to the correct positions with respect to each other and to heal in those positions. […] It can take up to 6-8 weeks to return to normal activity, but can sometimes take even longer. […] One good indication that you are ready to go back to sports is if you can hop on the foot 15 times. […] As mentioned above, the recovery for high ankle sprains can take considerably longer than typical ankle sprains. […] Outcomes generally are good if the injury is recognized and treated appropriately. […] It is more likely, however, to have some stiffness of the ankle after a high ankle sprain as compared to a standard ankle sprain. […] Arthritis also can develop from a very severe sprain if the cartilage of the ankle is damaged at the time of the original injury.
#78 Ankle Sprain | UConn Musculoskeletal Institute
https://health.uconn.edu/msi/clinical-services/orthopaedic-surgery/foot-ankle-and-podiatry/ankle-sprain/
Grade 3 Sprain: Complete tear of the ligament. If the examiner pulls or pushes on the ankle joint in certain movements, gross instability occurs. […] The injured ligament may feel tender. If there is no broken bone, the doctor may be able to tell you the grade of your ankle sprain based upon the amount of swelling, pain and bruising. […] If there is a complete tear of the ligaments, the ankle may become unstable after the initial injury phase passes. If this occurs, it is possible that the injury may also have caused damage to the ankle joint surface itself. […] The amount of pain depends on the amount of stretching and tearing of the ligament. Instability occurs when there has been complete tearing of the ligament or a complete dislocation of the ankle joint. […] A Grade 3 sprain can be associated with permanent instability.
#79 Sprained Ankle – OrthoInfo – AAOS
https://orthoinfo.aaos.org/en/diseases–conditions/sprained-ankle/
An ankle sprain occurs when the strong ligaments that support the ankle stretch beyond their limits and tear. The severity of a sprain can vary greatly depending on the number of ligaments involved and the extent to which the ligaments are torn. […] Around 90% of ankle sprains involve an inversion injury (the foot turns inward) to the anterior talofibular (ATFL) and calcaneofibular (CFL) ligaments the lateral ligaments on the outside of the ankle. […] The less common medial ankle sprain is caused by an eversion injury (the foot turns out) to the deltoid ligament on the inside of the ankle. […] If there is a complete tear of the ligaments, the ankle may become unstable after the initial injury phase passes. Over time, this instability can result in damage to the bones and cartilage, the smooth lining of the joint.
#80 Unstable Ankle Following an Ankle Sprain | Dr Peter Lam – Sydney Orthopaedic Foot and Ankle Surgeon
https://www.peterlam.com.au/conditions/unstable-ankle-following-an-ankle-sprain/
Chronic ankle symptoms following a sprain may be due to either or both of the following sources: (1) residual symptoms from ankle joint pathology – ankle instability, chondral or osteochondral (joint surface) injuries in the ankle, anterior ankle impingement, posterior ankle impingement; (2) injuries to structures around the ankle joint – peroneal tendon tear, peroneal tendon subluxation or dislocation, fracture of the anterior process of calcaneus, lateral process of talus fracture, fracture of the base of the 5th metatarsal. […] If recurrent ankle sprains are left untreated then this will lead to the development of ankle arthritis. The ankle arthritis usually develops over a 20 to 30 year period. […] The current treatment for painful ankle arthritis is either ankle fusion or ankle replacement. Thus it is much better to prevent the development of ankle arthritis with ankle lateral ligament reconstruction. […] The aim of the operation is to restore the length (i.e. shorten) of the elongated anterior talofibular and calcaneofibular ligaments.
#81 Unstable Ankle Following an Ankle Sprain | Dr Peter Lam – Sydney Orthopaedic Foot and Ankle Surgeon
https://www.peterlam.com.au/conditions/unstable-ankle-following-an-ankle-sprain/
Chronic ankle symptoms following a sprain may be due to either or both of the following sources: (1) residual symptoms from ankle joint pathology – ankle instability, chondral or osteochondral (joint surface) injuries in the ankle, anterior ankle impingement, posterior ankle impingement; (2) injuries to structures around the ankle joint – peroneal tendon tear, peroneal tendon subluxation or dislocation, fracture of the anterior process of calcaneus, lateral process of talus fracture, fracture of the base of the 5th metatarsal. […] If recurrent ankle sprains are left untreated then this will lead to the development of ankle arthritis. The ankle arthritis usually develops over a 20 to 30 year period. […] The current treatment for painful ankle arthritis is either ankle fusion or ankle replacement. Thus it is much better to prevent the development of ankle arthritis with ankle lateral ligament reconstruction. […] The aim of the operation is to restore the length (i.e. shorten) of the elongated anterior talofibular and calcaneofibular ligaments.
#82 Unstable Ankle Following an Ankle Sprain | Dr Peter Lam – Sydney Orthopaedic Foot and Ankle Surgeon
https://www.peterlam.com.au/conditions/unstable-ankle-following-an-ankle-sprain/
Chronic ankle symptoms following a sprain may be due to either or both of the following sources: (1) residual symptoms from ankle joint pathology – ankle instability, chondral or osteochondral (joint surface) injuries in the ankle, anterior ankle impingement, posterior ankle impingement; (2) injuries to structures around the ankle joint – peroneal tendon tear, peroneal tendon subluxation or dislocation, fracture of the anterior process of calcaneus, lateral process of talus fracture, fracture of the base of the 5th metatarsal. […] If recurrent ankle sprains are left untreated then this will lead to the development of ankle arthritis. The ankle arthritis usually develops over a 20 to 30 year period. […] The current treatment for painful ankle arthritis is either ankle fusion or ankle replacement. Thus it is much better to prevent the development of ankle arthritis with ankle lateral ligament reconstruction. […] The aim of the operation is to restore the length (i.e. shorten) of the elongated anterior talofibular and calcaneofibular ligaments.
#83 Intrinsic and Extrinsic Risk Factors for Lateral Ankle Sprain: A Literature Review
https://scholars.direct/Articles/sports-medicine/aspm-3-026.php?jid=sports-medicine
Most of the times, the treatment for a sprained ankle is conservative, rarely including surgery. Even though ankle sprains tend to be considered „easy to treat”, sometimes a bad outcome may be present. According to the severity of the tear, the patient might have different grades of short-and long-term disabilities. […] A thorough understanding of the risk factors behind ankle sprain is mandatory to create proper education and prevention programs, either in non-professional and professional sports activities. […] Williams proposed a classification for injuries’ mechanism, which we adapted, dividing risk factors into intrinsic (one’s characteristics) and extrinsic (external causative agent). […] The mechanism that usually leads to an ankle sprain is an exaggerated inversion and supination of the foot. Thus, it is logical to expect that the stronger the concentric function of the muscles that antagonize this exaggerated motion is, the less likely it will be to have an ankle sprain. Additionally, the stronger the eccentric contraction of supinators and invertors is, the fewer injuries will occur.
#84 How and Why Does Inversion Ankle Sprain Affect Athletes
https://certifiedfoot.com/inversion-ankle-sprains-athelete/
The inversion ankle sprain is the single most common injury in all of the sports and athletic injuries universally. […] To further compound matters, the number one predisposing factor to suffer an ankle sprain is a history of a previous ankle sprain. This means that if you suffer one of these injuries you are exponentially more likely to get several others. However, what this also indicates is that if initial injuries are not rehabilitated and treated properly, you are more likely to have progressive deterioration and ankle instability to this very common and cumbersome injury. […] Appropriate treatment of an ankle sprain injury involves a detailed history and physical examination â this is essentially to determine if ligaments are sprained or torn. Spraining basically implies overstretching of a ligament tissue and tearing means complete rupture and a possible detachment altogether.
#85 Intrinsic and Extrinsic Risk Factors for Lateral Ankle Sprain: A Literature Review
https://scholars.direct/Articles/sports-medicine/aspm-3-026.php?jid=sports-medicine
Recent studies reported previous ankle sprain as a risk factor for ipsilateral and contralateral future lateral ankle injury. Moreover, a systematic review identified and reviewed 26 articles, describing the relationship between injury and re-injury for the four most common lower extremity injury. Their results showed that previous ankle sprain is the most common injury resulting in a secondary sprain of the ipsilateral or contralateral ankle, which may be explained by neuromuscular factors. […] Proprioception is a complex process which is coordinated by afferent and efferent impulses, working as feedback loops. It implies a fine tune between nervous and musculoskeletal systems, allowing one to be aware of his own joint position (joint position sense) and joint movement (kinesthesia). This neuromuscular feedback mechanism might be interrupted with injury and abnormalities, but surgical intervention and rehabilitation might restore it.
#86 Intrinsic and Extrinsic Risk Factors for Lateral Ankle Sprain: A Literature Review
https://scholars.direct/Articles/sports-medicine/aspm-3-026.php?jid=sports-medicine
Most of the times, the treatment for a sprained ankle is conservative, rarely including surgery. Even though ankle sprains tend to be considered „easy to treat”, sometimes a bad outcome may be present. According to the severity of the tear, the patient might have different grades of short-and long-term disabilities. […] A thorough understanding of the risk factors behind ankle sprain is mandatory to create proper education and prevention programs, either in non-professional and professional sports activities. […] Williams proposed a classification for injuries’ mechanism, which we adapted, dividing risk factors into intrinsic (one’s characteristics) and extrinsic (external causative agent). […] The mechanism that usually leads to an ankle sprain is an exaggerated inversion and supination of the foot. Thus, it is logical to expect that the stronger the concentric function of the muscles that antagonize this exaggerated motion is, the less likely it will be to have an ankle sprain. Additionally, the stronger the eccentric contraction of supinators and invertors is, the fewer injuries will occur.
#87 Acute Ankle Sprain: An Update | AAFP
https://www.aafp.org/pubs/afp/issues/2006/1115/p1714.html
Acute ankle injury, a common musculoskeletal injury, can cause ankle sprains. Some evidence suggests that previous injuries or limited joint flexibility may contribute to ankle sprains. […] The typical ankle sprain is an inversion injury that occurs in the plantar-flexed position. Ankle sprains can be classified as grade I to III, depending on the severity of the injury. The most easily injured ligaments are the lateral stabilizing ligaments (i.e., anterior talofibular, calcaneofibular, and posterior talofibular). High ankle (syndesmotic) sprains are caused by dorsiflexion and eversion of the ankle with internal rotation of the tibia; this can injure posterior and anterior tibiofibular ligaments. […] The immediate goals of treating acute ankle sprain are to decrease pain and swelling and protect ankle ligaments from further injury. The PRICE (Protection, Rest, Ice, Compression, Elevation) treatment protocol for acute ankle injury is commonly used.
#88 Sprained ankle – Wikipedia
https://en.wikipedia.org/wiki/Sprained_ankle
A sprained ankle (twisted ankle, rolled ankle, turned ankle, etc.) is an injury where sprain occurs on one or more ligaments of the ankle. It is the most commonly occurring injury in sports, mainly in ball sports (basketball, volleyball, and football) as well as racquet sports (tennis, badminton and pickleball. […] Movements especially turning, and rolling of the foot are the primary cause of an ankle sprain. The risk of a sprain is greatest during activities that involve explosive side-to-side motion, such as tennis, skateboarding or basketball. Sprained ankles can also occur during normal daily activities such as stepping off a curb or slipping on ice. Returning to activity before the ligaments have fully healed may cause them to heal in a stretched position, resulting in less stability at the ankle joint. This can lead to a condition known as Chronic Ankle Instability (CAI), and an increased risk of ankle sprains.
#89 Ankle Sprains in the Runner – Conroe Foot Specialists
https://www.conroefootspecialists.com/document_disorders.cfm?id=276
Ankle sprains are one of the most common joint injuries runners experience. The injury can occur when one rolls over a rock, lands off a curb, or steps in a small hole or crack in the road. Usually the sprain is only mild, but on occasion it may seriously injure the ligaments or tendons surrounding the ankle joint. Management of this injury relies on early and accurate diagnosis, as well as an aggressive rehabilitation program directed toward reducing acute symptoms, maintaining ankle stability, and returning the runner to pre-injury functional level. […] Most ankle sprains involving the ligaments are weight bearing injuries. When a runner’s foot rolls outward (supinates) and the front of the foot points downwards as he or she lands on the ground, lateral ankle sprain can be a result. It is usually this situation that causes injury to the anterior talo-fibular ligament. However, when the foot rolls inwards (pronates) and the forefoot turns outward (abducts), the ankle is subject to an injury involving the deltoid ligament that supports the inside of the ankle. This can occur when another runner steps on the back of the ankle, as at the beginning of a race, or when a runner trips and falls on the runner in front of him.
#90 Intrinsic and Extrinsic Risk Factors for Lateral Ankle Sprain: A Literature Review
https://scholars.direct/Articles/sports-medicine/aspm-3-026.php?jid=sports-medicine
A systematic review from the late 90’s relating athlete’s shoe type and ankle sprain prevention reported numerous findings. High top shoes were recommended for injury prevention in basketball and football. However, lower incidences of sprained ankles were found in athletes wearing specially designed swivel shoes instead of the conventional cleats. […] Most professionals working with athletes would rather prevent an injury than treat one. However, solid scientific evidence is needed to build structured and efficient prevention programs.
#91 Intrinsic and Extrinsic Risk Factors for Lateral Ankle Sprain: A Literature Review
https://scholars.direct/Articles/sports-medicine/aspm-3-026.php?jid=sports-medicine
A systematic review from the late 90’s relating athlete’s shoe type and ankle sprain prevention reported numerous findings. High top shoes were recommended for injury prevention in basketball and football. However, lower incidences of sprained ankles were found in athletes wearing specially designed swivel shoes instead of the conventional cleats. […] Most professionals working with athletes would rather prevent an injury than treat one. However, solid scientific evidence is needed to build structured and efficient prevention programs.
#92 Intrinsic and Extrinsic Risk Factors for Lateral Ankle Sprain: A Literature Review
https://scholars.direct/Articles/sports-medicine/aspm-3-026.php?jid=sports-medicine
Most of the times, the treatment for a sprained ankle is conservative, rarely including surgery. Even though ankle sprains tend to be considered „easy to treat”, sometimes a bad outcome may be present. According to the severity of the tear, the patient might have different grades of short-and long-term disabilities. […] A thorough understanding of the risk factors behind ankle sprain is mandatory to create proper education and prevention programs, either in non-professional and professional sports activities. […] Williams proposed a classification for injuries’ mechanism, which we adapted, dividing risk factors into intrinsic (one’s characteristics) and extrinsic (external causative agent). […] The mechanism that usually leads to an ankle sprain is an exaggerated inversion and supination of the foot. Thus, it is logical to expect that the stronger the concentric function of the muscles that antagonize this exaggerated motion is, the less likely it will be to have an ankle sprain. Additionally, the stronger the eccentric contraction of supinators and invertors is, the fewer injuries will occur.
#93 :: JKOA :: The Journal of the Korean Orthopaedic Association
https://www.jkoa.org/DOIx.php?id=10.4055/jkoa.2014.49.1.1
Ankle sprain is one of the most common musculoskeletal injuries, nearly half of all ankle sprains occur during athletic activity. […] The stability of the ankle joint is maintained by both bony structure and ligamentous complex. The anterior talofibular ligament is the primary restraint of internal rotation and adduction of the talus with the ankle joint unloaded, while both bony mortise structure and calcaneofibular ligament restrict adduction of the talus with the ankle joint loaded. […] Plantar flexion and inversion is the most common mechanism of ankle sprains, which lead to injury of the anterior talofibular ligament followed by calcaneofibular ligament. Ligament injuries are classified according to three grades based on the extent of rupture and the severity of clinical features. Associated injuries with lateral ankle sprain include peroneus tendon rupture, osteochondral fracture, deltoid ligament injury, syndesmosis injury, and nerve traction injuries.
#94
https://step2.medbullets.com/orthopedics/120486/ankle-sprain
A 23-year-old man presents to the emergency department for ankle pain. He says that prior to symptom development, he was at soccer practice running exercise drills. He then rolled his ankle and subsequently developed severe pain. He says he was able to walk off the field with assistance, but walking exacerbated his pain. On physical exam, the ankle appears swollen. There is anterior displacement of the talus from the tibia. He has an antalgic gait and requires rest after walking 15 steps. He is advised to rest, ice, compress, and elevate the ankle for the next 2-3 days. […] Clinical definition: ankle ligament injury (e.g., stretching and partial or complete rupture) […] the ligaments of the ankle provide mechanical stability, proprioceptive information, and joint motion. […] lateral ankle sprain: inversion of a plantar-flexed foot injures the ankle’s lateral ligament complex.
#95 :: JKOA :: The Journal of the Korean Orthopaedic Association
https://www.jkoa.org/DOIx.php?id=10.4055/jkoa.2014.49.1.1
Ankle sprain is one of the most common musculoskeletal injuries, nearly half of all ankle sprains occur during athletic activity. […] The stability of the ankle joint is maintained by both bony structure and ligamentous complex. The anterior talofibular ligament is the primary restraint of internal rotation and adduction of the talus with the ankle joint unloaded, while both bony mortise structure and calcaneofibular ligament restrict adduction of the talus with the ankle joint loaded. […] Plantar flexion and inversion is the most common mechanism of ankle sprains, which lead to injury of the anterior talofibular ligament followed by calcaneofibular ligament. Ligament injuries are classified according to three grades based on the extent of rupture and the severity of clinical features. Associated injuries with lateral ankle sprain include peroneus tendon rupture, osteochondral fracture, deltoid ligament injury, syndesmosis injury, and nerve traction injuries.
#96 Ankle Sprain | PM&R KnowledgeNow
https://now.aapmr.org/ankle-sprain/
As the ankle moves from dorsiflexion to plantar flexion, bony stability decreases and forces on the ankle ligaments increase. The ATFL generally consists of two bands that are separated by branches of the perforating peroneal artery. The ATFL is intracapsular, has the lowest failure resistance, and is the most important ligament in talofibular stability. It is under maximal stress with the ankle in plantarflexion. The CFL is extracapsular, thicker, and stronger than the ATFL, and the next to tear in a plantarflexion/inversion injury. The PTFL is the strongest of the three ligaments and least likely to fail because it is only taut in extremes of dorsiflexion. […] An injury to the distal tibiofibular syndesmosis is known as a high ankle sprain. The syndesmosis encompasses several structures in the distal ankle, including the anterior-inferior tibiofibular ligament (AITFL), posterior-inferior tibiofibular ligament, interosseous ligament, and the transverse tibiofibular ligament. Together, these ligaments significantly contribute to the stability of the ankle and stabilize the distal tibiofibular architecture and prevent separation. The most common mechanism of injury is a high energy forced external rotation with the foot in dorsiflexion. This injury may coexist with either medial or lateral ankle sprains, with medial ankle sprains being more common.
#97 Ankle Sprain | PM&R KnowledgeNow
https://now.aapmr.org/ankle-sprain/
As the ankle moves from dorsiflexion to plantar flexion, bony stability decreases and forces on the ankle ligaments increase. The ATFL generally consists of two bands that are separated by branches of the perforating peroneal artery. The ATFL is intracapsular, has the lowest failure resistance, and is the most important ligament in talofibular stability. It is under maximal stress with the ankle in plantarflexion. The CFL is extracapsular, thicker, and stronger than the ATFL, and the next to tear in a plantarflexion/inversion injury. The PTFL is the strongest of the three ligaments and least likely to fail because it is only taut in extremes of dorsiflexion. […] An injury to the distal tibiofibular syndesmosis is known as a high ankle sprain. The syndesmosis encompasses several structures in the distal ankle, including the anterior-inferior tibiofibular ligament (AITFL), posterior-inferior tibiofibular ligament, interosseous ligament, and the transverse tibiofibular ligament. Together, these ligaments significantly contribute to the stability of the ankle and stabilize the distal tibiofibular architecture and prevent separation. The most common mechanism of injury is a high energy forced external rotation with the foot in dorsiflexion. This injury may coexist with either medial or lateral ankle sprains, with medial ankle sprains being more common.
#98 :: JKOA :: The Journal of the Korean Orthopaedic Association
https://www.jkoa.org/DOIx.php?id=10.4055/jkoa.2014.49.1.1
Ankle sprain is one of the most common musculoskeletal injuries, nearly half of all ankle sprains occur during athletic activity. […] The stability of the ankle joint is maintained by both bony structure and ligamentous complex. The anterior talofibular ligament is the primary restraint of internal rotation and adduction of the talus with the ankle joint unloaded, while both bony mortise structure and calcaneofibular ligament restrict adduction of the talus with the ankle joint loaded. […] Plantar flexion and inversion is the most common mechanism of ankle sprains, which lead to injury of the anterior talofibular ligament followed by calcaneofibular ligament. Ligament injuries are classified according to three grades based on the extent of rupture and the severity of clinical features. Associated injuries with lateral ankle sprain include peroneus tendon rupture, osteochondral fracture, deltoid ligament injury, syndesmosis injury, and nerve traction injuries.
#99 Ankle Sprain | PM&R KnowledgeNow
https://now.aapmr.org/ankle-sprain/
As the ankle moves from dorsiflexion to plantar flexion, bony stability decreases and forces on the ankle ligaments increase. The ATFL generally consists of two bands that are separated by branches of the perforating peroneal artery. The ATFL is intracapsular, has the lowest failure resistance, and is the most important ligament in talofibular stability. It is under maximal stress with the ankle in plantarflexion. The CFL is extracapsular, thicker, and stronger than the ATFL, and the next to tear in a plantarflexion/inversion injury. The PTFL is the strongest of the three ligaments and least likely to fail because it is only taut in extremes of dorsiflexion. […] An injury to the distal tibiofibular syndesmosis is known as a high ankle sprain. The syndesmosis encompasses several structures in the distal ankle, including the anterior-inferior tibiofibular ligament (AITFL), posterior-inferior tibiofibular ligament, interosseous ligament, and the transverse tibiofibular ligament. Together, these ligaments significantly contribute to the stability of the ankle and stabilize the distal tibiofibular architecture and prevent separation. The most common mechanism of injury is a high energy forced external rotation with the foot in dorsiflexion. This injury may coexist with either medial or lateral ankle sprains, with medial ankle sprains being more common.
#100 Management of Ankle Sprains | AAFP
https://www.aafp.org/pubs/afp/issues/2001/0101/p93.html
The most common mechanism of injury in ankle sprains is a combination of plantar flexion and inversion. The lateral stabilizing ligaments, which include the anterior talofibular, calcaneofibular and posterior talofibular ligaments, are most often damaged. The anterior talofibular ligament is the most easily injured. Concomitant injury to this ligament and the calcaneofibular ligament can result in appreciable instability. […] Medial ankle stability is provided by the strong deltoid ligament, the anterior tibiofibular ligament and the bony mortise. Because of the bony articulation between the medial malleolus and the talus, medial ankle sprains are less common than lateral sprains. In medial ankle sprains, the mechanism of injury is excessive eversion and dorsiflexion. […] Injury to the tibiofibular syndesmosis ligaments, which bind together the distal ends of the tibia and fibula, is commonly referred to as a high ankle sprain. Although this injury accounts for only about 10 percent of ankle sprains, it represents a more disabling problem and requires different treatment than common ankle sprains. The mechanism of injury is excessive dorsiflexion and eversion of the ankle joint with internal rotation of the tibia. […] The anterior drawer test can be used to assess the integrity of the anterior talofibular ligament, and the inversion stress test can be used to assess the integrity of the calcaneofibular ligament.
#101 Different Types of Ankle Sprains and Implications for Recovery | POGO Physio Gold Coast
https://www.pogophysio.com.au/blog/different-types-of-ankle-sprains-and-implications-for-recovery/
The Anterior Talofibular Ligament (ATFL) is the first structure injured in the majority of ankle sprains. The ATFL resists pathological inversion and plantar flexion of the ankle joint and is the weakest of the lateral ligaments (2, 7). […] The addition of CFL injury alongside ATFL injury is common with more severe sprains and associated with longer recovery (9). The CFL resists excessive inversion of the ankle joint and is further stressed at the end ranges of dorsiflexion (2, 7). […] The medial deltoid ligament becomes taut in ankle eversion, thus becomes injured if excessive eversion forces and external rotation (abduction) of the foot coupled with internal rotation of the lower leg may result in a medial ankle sprain involving the deltoid ligament (13). […] Syndesmotic ankle sprains are generally caused by hyperpronation (external rotation, eversion, and abduction), hyperdorsiflexion or hyper plantar flexion, or another athlete falling onto the fixed ankle (13, 14, 17).
#102 Ankle Sprain | PM&R KnowledgeNow
https://now.aapmr.org/ankle-sprain/
As the ankle moves from dorsiflexion to plantar flexion, bony stability decreases and forces on the ankle ligaments increase. The ATFL generally consists of two bands that are separated by branches of the perforating peroneal artery. The ATFL is intracapsular, has the lowest failure resistance, and is the most important ligament in talofibular stability. It is under maximal stress with the ankle in plantarflexion. The CFL is extracapsular, thicker, and stronger than the ATFL, and the next to tear in a plantarflexion/inversion injury. The PTFL is the strongest of the three ligaments and least likely to fail because it is only taut in extremes of dorsiflexion. […] An injury to the distal tibiofibular syndesmosis is known as a high ankle sprain. The syndesmosis encompasses several structures in the distal ankle, including the anterior-inferior tibiofibular ligament (AITFL), posterior-inferior tibiofibular ligament, interosseous ligament, and the transverse tibiofibular ligament. Together, these ligaments significantly contribute to the stability of the ankle and stabilize the distal tibiofibular architecture and prevent separation. The most common mechanism of injury is a high energy forced external rotation with the foot in dorsiflexion. This injury may coexist with either medial or lateral ankle sprains, with medial ankle sprains being more common.
#103 Ankle Sprain | PM&R KnowledgeNow
https://now.aapmr.org/ankle-sprain/
As the ankle moves from dorsiflexion to plantar flexion, bony stability decreases and forces on the ankle ligaments increase. The ATFL generally consists of two bands that are separated by branches of the perforating peroneal artery. The ATFL is intracapsular, has the lowest failure resistance, and is the most important ligament in talofibular stability. It is under maximal stress with the ankle in plantarflexion. The CFL is extracapsular, thicker, and stronger than the ATFL, and the next to tear in a plantarflexion/inversion injury. The PTFL is the strongest of the three ligaments and least likely to fail because it is only taut in extremes of dorsiflexion. […] An injury to the distal tibiofibular syndesmosis is known as a high ankle sprain. The syndesmosis encompasses several structures in the distal ankle, including the anterior-inferior tibiofibular ligament (AITFL), posterior-inferior tibiofibular ligament, interosseous ligament, and the transverse tibiofibular ligament. Together, these ligaments significantly contribute to the stability of the ankle and stabilize the distal tibiofibular architecture and prevent separation. The most common mechanism of injury is a high energy forced external rotation with the foot in dorsiflexion. This injury may coexist with either medial or lateral ankle sprains, with medial ankle sprains being more common.
#104 Low ankle sprains versus High ankle sprains | Orthopedic Center for Sports Medicine
https://nolasportsmedicine.com/low-ankle-sprains-versus-high-ankle-sprains/
In contrast to low ankle sprains, a high ankle sprain happens when there is shearing damage done to the syndesmotic ligaments, these are the ligaments that hold together the tibia and fibula above the talus. When bearing weight on the leg, the tibia and fibula experience strong forces that spread them apart. The syndesmotic ligaments, or syndesmosis, serve as shock absorbing cables that prevent these two bones from spreading too far apart. High ankle sprains commonly occur when the foot and ankle rotate together such as sudden twisting, turning, or cutting motion seen in high-impact sports like football, basketball, and soccer. […] Diagnosis of a high ankle sprain is also based on patient history, physicial exam, and imaging to rule out fractures or compartment syndrome. High ankle sprains may be frustrating for patients because clinically they do not look that bad, meaning that they do not cause as much swelling or bruising as seen with low ankle sprains. Because of this, patients can become unaware of the severity of their injury which can eventually affect the recovery and healing process.
#105 Understanding acute ankle ligamentous sprain injury in sports | BMC Sports Science, Medicine and Rehabilitation | Full Text
https://bmcsportsscimedrehabil.biomedcentral.com/articles/10.1186/1758-2555-1-14
Fuller suggested that most ankle sprain injuries were caused by an increased supination moment at subtalar joint, which was often a result of the position and the magnitude of the vertically projected ground reaction force at initial foot contact. […] Understanding the injury mechanism is very important for the research of injury prevention. In ankle supination sprain, there is ankle inversion plus an internal twisting of the foot, and plantarflexion with the subtalar joint adducting and inverting. […] The biomechanics of ankle supination sprain injury was seldom reported in the literature, as it is practically impossible and also unethical to conduct systematic dynamic ankle sprain test in the laboratory.
#106 Understanding acute ankle ligamentous sprain injury in sports | BMC Sports Science, Medicine and Rehabilitation | Full Text
https://bmcsportsscimedrehabil.biomedcentral.com/articles/10.1186/1758-2555-1-14
Fuller suggested that most ankle sprain injuries were caused by an increased supination moment at subtalar joint, which was often a result of the position and the magnitude of the vertically projected ground reaction force at initial foot contact. […] Understanding the injury mechanism is very important for the research of injury prevention. In ankle supination sprain, there is ankle inversion plus an internal twisting of the foot, and plantarflexion with the subtalar joint adducting and inverting. […] The biomechanics of ankle supination sprain injury was seldom reported in the literature, as it is practically impossible and also unethical to conduct systematic dynamic ankle sprain test in the laboratory.
#107 Ankle sprain research – Dr Daniel Fong Sport Injury Laboratory
https://danielfong.org/ankle-sprain-research/
Ankle ligamentous sprain is the most common sport-related injury. […] Since 2014, I have been working on a series of studies on the injury mechanism of ankle sprain, and an innovative design of a wearable anti-sprain system for preventing the injury. […] There are two major aetiologies which cause an ankle inversion sprain injury. Firstly, an incorrect landing posture with a slightly inverted or supinated ankle joint would cause a ground reaction force acting on the lateral foot edge to point medially and not pass through the ankle joint centre, thus creating a vigorous inward twisting torque, subsequent excessive inversion, and finally high ligament strains which tear the lateral ligaments. Secondly, the reaction of the peroneal muscles, which function to resist ankle inversion, is too slow (60-90ms) to catch up to accommodate the sudden explosive inversion which happened within 50ms after a foot strike.
#108 Ankle sprain research – Dr Daniel Fong Sport Injury Laboratory
https://danielfong.org/ankle-sprain-research/
Ankle ligamentous sprain is the most common sport-related injury. […] Since 2014, I have been working on a series of studies on the injury mechanism of ankle sprain, and an innovative design of a wearable anti-sprain system for preventing the injury. […] There are two major aetiologies which cause an ankle inversion sprain injury. Firstly, an incorrect landing posture with a slightly inverted or supinated ankle joint would cause a ground reaction force acting on the lateral foot edge to point medially and not pass through the ankle joint centre, thus creating a vigorous inward twisting torque, subsequent excessive inversion, and finally high ligament strains which tear the lateral ligaments. Secondly, the reaction of the peroneal muscles, which function to resist ankle inversion, is too slow (60-90ms) to catch up to accommodate the sudden explosive inversion which happened within 50ms after a foot strike.
#109 Ankle sprain research – Dr Daniel Fong Sport Injury Laboratory
https://danielfong.org/ankle-sprain-research/
Ankle ligamentous sprain is the most common sport-related injury. […] Since 2014, I have been working on a series of studies on the injury mechanism of ankle sprain, and an innovative design of a wearable anti-sprain system for preventing the injury. […] There are two major aetiologies which cause an ankle inversion sprain injury. Firstly, an incorrect landing posture with a slightly inverted or supinated ankle joint would cause a ground reaction force acting on the lateral foot edge to point medially and not pass through the ankle joint centre, thus creating a vigorous inward twisting torque, subsequent excessive inversion, and finally high ligament strains which tear the lateral ligaments. Secondly, the reaction of the peroneal muscles, which function to resist ankle inversion, is too slow (60-90ms) to catch up to accommodate the sudden explosive inversion which happened within 50ms after a foot strike.
#110 Understanding acute ankle ligamentous sprain injury in sports | BMC Sports Science, Medicine and Rehabilitation | Full Text
https://bmcsportsscimedrehabil.biomedcentral.com/articles/10.1186/1758-2555-1-14
Fuller suggested that most ankle sprain injuries were caused by an increased supination moment at subtalar joint, which was often a result of the position and the magnitude of the vertically projected ground reaction force at initial foot contact. […] Understanding the injury mechanism is very important for the research of injury prevention. In ankle supination sprain, there is ankle inversion plus an internal twisting of the foot, and plantarflexion with the subtalar joint adducting and inverting. […] The biomechanics of ankle supination sprain injury was seldom reported in the literature, as it is practically impossible and also unethical to conduct systematic dynamic ankle sprain test in the laboratory.
#111 Ankle sprain research – Dr Daniel Fong Sport Injury Laboratory
https://danielfong.org/ankle-sprain-research/
There are many ways to further study the injury mechanism, and the most direct one is to study the real injury incidents. […] The data suggested that the peak inversion has reached 48 degrees, and such a range of inversion is often regarded as normal from the literature. […] The peak inversion velocity reached 638 deg/s, and this was the first time such a value was reported. […] I further used the profile of ankle kinematics data to drive a computational foot and ankle model to simulate the injury, and the result suggested that an inversion moment of 23Nm and an internal rotation moment of 11Nm were presented, resulting in a 15-20% strain at the anterior talofibular ligament. […] Another geometric analysis showed that an inversion ankle sprain with an internal rotation mechanism would cause injury to the anterior talofibular ligament.
#112 Ankle sprain research – Dr Daniel Fong Sport Injury Laboratory
https://danielfong.org/ankle-sprain-research/
There are many ways to further study the injury mechanism, and the most direct one is to study the real injury incidents. […] The data suggested that the peak inversion has reached 48 degrees, and such a range of inversion is often regarded as normal from the literature. […] The peak inversion velocity reached 638 deg/s, and this was the first time such a value was reported. […] I further used the profile of ankle kinematics data to drive a computational foot and ankle model to simulate the injury, and the result suggested that an inversion moment of 23Nm and an internal rotation moment of 11Nm were presented, resulting in a 15-20% strain at the anterior talofibular ligament. […] Another geometric analysis showed that an inversion ankle sprain with an internal rotation mechanism would cause injury to the anterior talofibular ligament.
#113 Ankle sprain research – Dr Daniel Fong Sport Injury Laboratory
https://danielfong.org/ankle-sprain-research/
There are many ways to further study the injury mechanism, and the most direct one is to study the real injury incidents. […] The data suggested that the peak inversion has reached 48 degrees, and such a range of inversion is often regarded as normal from the literature. […] The peak inversion velocity reached 638 deg/s, and this was the first time such a value was reported. […] I further used the profile of ankle kinematics data to drive a computational foot and ankle model to simulate the injury, and the result suggested that an inversion moment of 23Nm and an internal rotation moment of 11Nm were presented, resulting in a 15-20% strain at the anterior talofibular ligament. […] Another geometric analysis showed that an inversion ankle sprain with an internal rotation mechanism would cause injury to the anterior talofibular ligament.
#114 Ankle sprain research – Dr Daniel Fong Sport Injury Laboratory
https://danielfong.org/ankle-sprain-research/
There are many ways to further study the injury mechanism, and the most direct one is to study the real injury incidents. […] The data suggested that the peak inversion has reached 48 degrees, and such a range of inversion is often regarded as normal from the literature. […] The peak inversion velocity reached 638 deg/s, and this was the first time such a value was reported. […] I further used the profile of ankle kinematics data to drive a computational foot and ankle model to simulate the injury, and the result suggested that an inversion moment of 23Nm and an internal rotation moment of 11Nm were presented, resulting in a 15-20% strain at the anterior talofibular ligament. […] Another geometric analysis showed that an inversion ankle sprain with an internal rotation mechanism would cause injury to the anterior talofibular ligament.
#115 Ankle sprain research – Dr Daniel Fong Sport Injury Laboratory
https://danielfong.org/ankle-sprain-research/
There are many ways to further study the injury mechanism, and the most direct one is to study the real injury incidents. […] The data suggested that the peak inversion has reached 48 degrees, and such a range of inversion is often regarded as normal from the literature. […] The peak inversion velocity reached 638 deg/s, and this was the first time such a value was reported. […] I further used the profile of ankle kinematics data to drive a computational foot and ankle model to simulate the injury, and the result suggested that an inversion moment of 23Nm and an internal rotation moment of 11Nm were presented, resulting in a 15-20% strain at the anterior talofibular ligament. […] Another geometric analysis showed that an inversion ankle sprain with an internal rotation mechanism would cause injury to the anterior talofibular ligament.
#116 Acute, Chronic and Recurrent Ankle Sprains | Kingsley Physio | More than your local Physio
https://kingsleyphysio.com/common-conditions/acute-chronic-recurrent-ankle-sprains/
An accurate diagnosis is essential in order to formulate an appropriate treatment plan. If rehabilitation is either misdirected or rushed because of a poor initial diagnosis, the long term complications and potential for recurrent injury is enormous. […] The role of physiotherapy in the treatment of a sprained ankle has come a long way from the passive interventions of a decade ago. […] Once a diagnosis has been made and the possibility of bony or neurovascular injuries has been excluded, your physiotherapist will commence progressive mobilising (loosening) of the soft tissues around the ankle. […] The aim in the early days of treatment is not only to minimise swelling around the injury (excessive swelling can obstruct adequate blood flow to the damaged tissues, delay healing and cause secondary tissue damage) but also to restore normal and pain free movement to the ankle.
#117 Acute Ankle Sprain: An Update | AAFP
https://www.aafp.org/pubs/afp/issues/2006/1115/p1714.html
Controlled trials of nonsteroidal anti-inflammatory drugs (NSAIDs; e.g., piroxicam [Feldene], celecoxib [Celebrex], naproxen [Naprosyn]) in patients with ankle sprain showed that, compared with placebo, NSAIDs were associated with improved pain control and function, decreased swelling, and more rapid return to activity. […] Although the overall quality of studies on functional treatment is somewhat limited, a systematic review of 21 trials (2,184 total participants) showed that functional treatment is superior to immobilization for treatment of ankle sprains. […] A Cochrane review showed that lace-up or semirigid supports are more effective for ankle injury than tape or elastic bandages. […] Surgery versus conservative treatment for acute lateral ankle ligament sprain is controversial. A Cochrane review comparing surgical repair with a variety of conservative treatments analyzed 17 trials (1,950 total participants). […] Therapeutic ultrasonography appears to have no value in the treatment of acute ankle sprain.
#118 Acute Ankle Sprain: An Update | AAFP
https://www.aafp.org/pubs/afp/issues/2006/1115/p1714.html
Controlled trials of nonsteroidal anti-inflammatory drugs (NSAIDs; e.g., piroxicam [Feldene], celecoxib [Celebrex], naproxen [Naprosyn]) in patients with ankle sprain showed that, compared with placebo, NSAIDs were associated with improved pain control and function, decreased swelling, and more rapid return to activity. […] Although the overall quality of studies on functional treatment is somewhat limited, a systematic review of 21 trials (2,184 total participants) showed that functional treatment is superior to immobilization for treatment of ankle sprains. […] A Cochrane review showed that lace-up or semirigid supports are more effective for ankle injury than tape or elastic bandages. […] Surgery versus conservative treatment for acute lateral ankle ligament sprain is controversial. A Cochrane review comparing surgical repair with a variety of conservative treatments analyzed 17 trials (1,950 total participants). […] Therapeutic ultrasonography appears to have no value in the treatment of acute ankle sprain.
#119
https://www.nfhs.org/articles/methods-for-preventing-ankle-sprains-in-high-school-athletes/
There is good evidence to show that lace-up ankle braces can reduce first-time and recurrent ankle sprains by 40 to 50 percent. […] Research shows that the rate of ankle sprains can be reduced by 50 to 60 percent if exercise interventions are performed two to five times per week for 10-30 minutes a session. […] The major advantage to an NMTP is its potential to prevent a variety of injuries including muscle strains, ankle sprains and ACL tears. […] Coaches need to be aware, however, that the number of ankle sprains can be reduced by using external support or exercise programs.
#120
https://www.nfhs.org/articles/methods-for-preventing-ankle-sprains-in-high-school-athletes/
There is good evidence to show that lace-up ankle braces can reduce first-time and recurrent ankle sprains by 40 to 50 percent. […] Research shows that the rate of ankle sprains can be reduced by 50 to 60 percent if exercise interventions are performed two to five times per week for 10-30 minutes a session. […] The major advantage to an NMTP is its potential to prevent a variety of injuries including muscle strains, ankle sprains and ACL tears. […] Coaches need to be aware, however, that the number of ankle sprains can be reduced by using external support or exercise programs.
#121
https://www.movementforlifephysio.com.au/ankle-sprains
The most common mechanism is an inversion injury, where the foot rolls inwards (or inverts) and the ligaments on the outside of the ankle are torn. […] Often considered a benign injury (that is, not complicated or serious), ankle injuries cause a significant amount of time lost from sports and work, have a relatively high complication rate and have the highest incidence of reinjury of all musculoskeletal injuries. […] Quite often there are multiple ligaments and tendons injured, some bone bruising, strained muscles, maybe even a fracture. […] 20% – 50% of people with a first time ankle sprain will develop long term problems, and you are twice as likely to reinjure the same ankle in the following 12 months! […] Repeat injuries can progress to chronic pain, persistent swelling, ankle instability and giving way, and reduced functional capacity.
#122
https://www.movementforlifephysio.com.au/ankle-sprains
The most common mechanism is an inversion injury, where the foot rolls inwards (or inverts) and the ligaments on the outside of the ankle are torn. […] Often considered a benign injury (that is, not complicated or serious), ankle injuries cause a significant amount of time lost from sports and work, have a relatively high complication rate and have the highest incidence of reinjury of all musculoskeletal injuries. […] Quite often there are multiple ligaments and tendons injured, some bone bruising, strained muscles, maybe even a fracture. […] 20% – 50% of people with a first time ankle sprain will develop long term problems, and you are twice as likely to reinjure the same ankle in the following 12 months! […] Repeat injuries can progress to chronic pain, persistent swelling, ankle instability and giving way, and reduced functional capacity.
#123
https://www.movementforlifephysio.com.au/ankle-sprains
The research into management of ankle injuries shows that the earlier an injury is assessment and an evidence-informed management plan implemented, the better the outcomes. […] Every sprained ankle needs to be assessed, preferably early, by a suitably qualified professional and the best professional is a physiotherapist. […] Because physio’s are highly skilled in assessing and diagnosing the structures damaged when an ankle is sprained.
#124
https://www.movementforlifephysio.com.au/ankle-sprains
The research into management of ankle injuries shows that the earlier an injury is assessment and an evidence-informed management plan implemented, the better the outcomes. […] Every sprained ankle needs to be assessed, preferably early, by a suitably qualified professional and the best professional is a physiotherapist. […] Because physio’s are highly skilled in assessing and diagnosing the structures damaged when an ankle is sprained.