A sprained ankle is an acute injury with resultant damage to the ligaments of the ankle. The more serious the sprain, the greater the damage and the more tissue that may be involved. The range of damage can go from mild damage to the ligament up to including muscle, tendon and bone. A sprain results from a sudden movement that exceeds the range of motion of the ankle joint. If cared for improperly, the problem can become chronic. If treated quickly and properly, the ankle should heal well and allow a safe and early return to activity.

The ankle joint is formed by the tibia (shin bone), the fibula, the talus and the calcaneus. On the inside of the ankle, the joint is stabilised by a thick, strong fibrous ligament, the deltoid ligament. Sprains to this ligament (known as eversion sprains) account for less than 20% of ankle sprains. On the outside of the ankle, the joint is stabilised by 3 ligaments, the anterior talofibular (at the front), the calcaneofibular (at the side) and the posterior talofibular (at the back).

Sprains can be classified into degrees of injury, first degree being mild, second degree being moderate and the third degree being severe. Sprains to this side of the foot account for more than 80% of all ankle Sprains, as the range of movement for inversion (turning of the foot) is greater than for eversion. This is due to the anatomy of the foot, the laxer ligaments and the fibular extending farther than the tibia.

Sprains can be classified into degrees of injury, first degree being mild, second degree being moderate and third degree being severe.

1. Previous injury.
2. Compensation for other injury.
3. Inappropriate/worn out shoes.
4. Uneven surface.

1. Immediate - I.C.E.

ICE (crushed ice in a damp towel)
COMPRESSION (tensor bandage)
ELEVATION (using pillows, elevate above level of heart)

I.C.E. should be applied within minutes of the injury. The sooner it is applied, the less the secondary damage will be, meaning more effective rehabilitation and quicker recovery.

I.C.E. is left on for 20-30 minutes. The ice is removed and compression and elevation re-applied. Compression and elevation should be applied constantly for 1-3 days, depending on the severity. Ice is applied every 2 hours, for 20-30 minutes.

2. Anti-inflammatory medication may be prescribed.

3. Mobilisation is begun immediately. Movements Within a PAIN- FR =E range of motion can be performed. Early mobilisation can mean a quicker, safer recovery.

4. Crutches should be used if the person is unable to maintain a normal gait without pain and/or a limp. As much weight as is possible pain-free is taken by the foot going through normal movement. The rest is borne by the hands. As the injury heals, more weight can be progressively taken by the foot until the person eventually 'walks out of the crutches'.

5. Physiotherapy can assist in achieving a full and safe recovery. The main modality will be cryokinetics - a combination of ice and exercise. The physiotherapist may also use ultrasound, electrical muscle stimulation.

Mobilisation exercises are commenced immediately to prevent excessive scarring and assist in restructuring a strong ligament. Exercises may be uncomfortable but should not be painful.

One set of exercises leads to the next.
1. Range of motion exercises - circles, up and down, in and out, alphabet with big toes.

4. Jogging in a straight line, gradually progressing to 'S' jogging or large '8's, and eventually to cuts, zigzags, stop and starts. When the zigzags can be done pain free without support, athlete can return to sport and activity.

DISCLAIMER
The information in this brochure is of a general nature. Individual circumstances may require modification of general advice from an appropriate health professional eg Doctor